A Quick Guide to Editing The Central Maine Medical Center Medical Records
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Steps in Editing Central Maine Medical Center Medical Records on Windows
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PDF Editor FAQ
What is your review of NIT, Durgapur?
National Institute Of Technology, Durgapur has been ranked 8th by NIRF (2019) among NITs, the same ranking agency that ranks IIIT Hyderabad at 39th postion overall and VIT much higher. So there's certainly ambiguity here.Talking about the Teaching, that's good with some professors out of the class being Google AI scholars and some of them really pathetic with no teaching skills. Well certainly there are ample opportunities if you are sincere here and work hard. Many students each year from here go to CERN, Switzerland for internships, participate in ACM-ICPC. Well this year, 25 teams in first year alone participated in the online contests. Many International conferences take place here round the year ranging from Environment issues to Artificial intelligence as expected from a ‘Institute of National Importance'.The Infrastructure here is more than good and sufficient for a good college life. Newly constructed Halls for boys are at par with high standards. The campus has undergone rapid infrastructure upgradation. Coming to Sports Facilities, we have 2 Basketball courts, Badminton court, Tennis court, Football ground etc. to cater the needs of our students. You can see it yourself in the pictures. We also organise South-East Asia's 2nd largest fest - AAROHAN and tech-fests. The campus is always buzzing with life. We also have significant population of International students here from other countries and a International Airport is available in proximity for ease of commute. A fully-equipped medical center runs 24x7, upcoming shopping complex will also add up to the amenities.Coming to the placements, the CSE department here records highest Stats with more than 90% placements with companies like Microsoft, Amazon, Goldman Sachs, etc visiting here. Highest package last year(2018) was 39 lpa bagged by 11 students. There also have been International placements in the past - Google US had offered 95lpa to a student for International position in Mountain View, California. We are not even talking off-campus here, then the list would stretch to Tower Research Capital and Facebook. If you can show your skills in CP and projects, companies hire you easily.Overall the campus provides you ample opportunities to grow, cherish your hobbies ranging from coding clubs like Recursion, GLUG (open- source) to SPIC Macay and Robotics. Obviously, the campus and NIT won't spoon feed you. Rather it presents itself as an opportunity to which you will have to exploit yourself.There are two sides of each coin, so is with this one and other NITs and even IITs. It's completely upon you how you use the opportunity.Main EntranceNew Academic BlockLecture HallsView From My HostelMain AuditoriumGirls Hostel 😜Guest Lecture HallBird Eye ViewBoys Hostel (Hall 14)Night LifeAuditoriumDepartment of Chemistry and BiotechnologyMain Academic BlockCentral Library (Air-conditioned)NESCAFE Coffee ShopAAROHANThank you for sticking through the post…..!!!Well that's my campus. Hope you like it.
What would happen if they privatized the VA?
There are so many roads to go down in answering this question, none of them satisfactory. But, let’s follow two or three to see if something of value can be found. There is a qualifier here, and that is we have to understand the “they” in your question. “They” is not the White House. “They” is Congress, the ultimate board of directors for all things federal. The White House may lobby aggressively for privatization (though the Trump White House is backing off on that pledge), but in the end, dumping a Cabinet department—one of the very largest, with 150+ hospitals, hundreds of clinics, mobile clinics, VetCenters, and specialty care centers vital to the treatment and rehabilitation of wounded warriors—would come with massive congressional input and pushback, given that every state, and probably every voting district in the U.S. is linked in some way to veterans.Former Congressman John Linder (R-GA), a Vietnam-era veteran writing for The Hill this past January, made an oft-repeated, and undeniably passionate, personal, and compelling case for privatizing VA: “The VA should first commit to shortening the long lines waiting for the determination of eligibility for VA medical care. The government’s role in veterans’ care should then be focused entirely on matters that are the result of war. Traumatic brain injury, amputations, post-traumatic stress and the rehabilitation from those injuries are unique and special, and we should dedicate the entire medical resources of our government toward improving the lives of the wounded and their families.“Medicare needs reform as to reimbursement formulas and regulatory burdens,” Linder continued, “but it is the most patient-centric of all of our government healthcare programs. VA eligible vets should be enrolled in Medicare and allowed to make their own healthcare decisions. If that is privatizing VA healthcare, this old vet is for it.”Linder’s argument has a populist foundation—and, frankly, a pretty reasonable one if you’re the veteran or veteran family member in this situation—and that is there are many aging veterans (WW II are dying at the rate of 400 per day), and Cold War and Vietnam vets who aren’t far behind them who don’t enjoy urban or even suburban access to a VA hospital or clinic. There are many younger veterans suffering from traumatic brain injuries (TBI) or amputations or who are para- or quadriplegics for whom local access to VA specialized care is simply not an option—they have to look locally for care.Privatizing advocates in Congress, with Senator Bernie Sanders leading the way, pushed through legislation in 2014 allowing veterans to seek care from a private medical facility using the Choice Card, with reimbursement from the government if the nearest VA hospital is more than 40 miles away or the wait time for a closer VA hospital is over 30 days. In 2015, Senator John McCain (R-AZ) called for a permanent Choice Card that would have opened health care access anywhere, anytime, to all veterans. While that legislation languished, Donald Trump was elected and, just a few days ago, the President signed a bill to extend the current Choice program, closing financially-burdensome loopholes for veterans, but not fully implementing the McCain vision for private-care-for-all-vets.But VA isn’t just medical facilities: VA is benefits—the Veterans Benefits Administration, VBA—covering home loans, student loans, employment and training, insurance programs; While not statutorily a part of VA, the U.S. Court of Appeals for Veterans Claims in inextricably linked to veterans’ claims processes. VA is also cemeteries—unlike Arlington National Cemetery, which is operated by the Department of the Army and the Military District of Washington, VA’s vast inventory of final resting places for the nation’s veterans come under the services and supervision of the National Cemetery Administration (NCA). The Department of Veterans Affairs also shares special interests like veterans homelessness programs with other Cabinet Departments. There is also an Office of Tribal Government Relations within VA.Do the privatization advocates want benefits and cemeteries in their operations portfolios? Maybe benefits…but cemeteries, not likely; homelessness programs? Probably pass on that, too. So, if the question is appended to include “…privatized the VA healthcare system,” there is some room for a more detailed reply.Does the Congress have the will to support dismantling a 100-year-old system, multi-pronged system, employing nearly 300,000 people (voters), on a multi-billion dollar budget that benefits Congressional districts from Florida to Hawaii, and from Maine to California? Doing away with something as sacred as VA, even though it has significant flaws in its health care and benefits services, is asking a lot of a Congress that is reluctant to do much of anything of merit in the past two or three decades.Partial-privatization advocates like Linder suggest VA retain its core medical competencies—trauma care, prosthetics, and rehabilitation, for example—and open up the private care market to the balance of the nation’s 22 million veterans. But polls and research don’t bear out the need for such cherry-picking care. Veterans on the whole are not dissatisfied with their VA care and many veterans recognize that the stories of wait lists so long that veterans die before they are seen don’t represent the average veteran’s experience.But more than that is the problem of what I call “Records re-absorption” once a move to privatize VA got underway. It’s one thing for a major health care consortium (and it would have to be a consortium—no one healthcare organization has the total scope of abilities and resources to take over VA) to build a non-federal management structure to operate the medical side of VA.The nation’s largest healthcare corporations are familiar enough with the brick and mortar and management of hospitals to figure out how to operate the medical structures—the basics—currently operated by the federal government. What I don’t believe they have any proven track record on is transitioning a two-headed (VA and DoD) federally-created health care records over to a private heath care records’ management system which has to incorporate a veteran’s military medical records history as well.Even VA and the the Department of Defense haven’t arrived at an efficient record’s transfer system that allows for the seamless shifting of active-duty medical records to VA’s medical records databases. If you need evidence of that, just look at this partial list of speakers at the most recent (April 20–21, 2017) Military Electronic Health Care Conference in Washington, D. C.I. Achieving an Interoperable Electronic Health Record – Government & Military Needs, Programs and Opportunities“Not Everything is Computable: Archiving and Sharing the DoD Health Record”■ COL JOHN S. SCOTT, USAInformatics Policy Director, Health Affairs, Department of Defense, Office of the Assistant Secretary of Defense, Health Affairs, Uniformed Services University of the Health Sciences“MHS GENESIS: Driving Successful Business Transformation”■ DR. PAUL CORDTS, M.D.Director, Functional Champion, Military Health System, Defense Health Agency“Achieving Interoperability Among DoD, VA and Private Sector Partners”■ MR. LANCE SCOTTDefense Medical Information Exchange (DMIX)“Advancements in Health Data Interoperability and the Impact on the Veterans Benefits Management System”■ MR. THOMAS MURPHYPrincipal Deputy Under Secretary for Benefits, Department of Veterans Affairs Benefits Administration (VBA) and■ MR. BRAD HOUSTONDirector, Office of Business and Process Integration (VBA)“Interoperability 2020- Why Data Exchange is Not Enough”■ MR. KEN RUBINDirector of Standards and Interoperability, Veterans Affairs Health AdministrationI know some of these speakers, and they’ve been doing hard work in the vineyards of progress toward a seamless VA-DOD health records interoperability for years! In the 1980s, when I was on the staff of the House Veterans Affairs Committee, an Army general, a well-respected military physician, came to us with his idea for a medical identification card that would hold all a soldier’s (I’m using “soldier” to cover, generically and in a gender-neutral way, all branches of the military, rather than adding sailor, airman, marine, coastguardsman every time) active duty medical history. The card would stay with the soldier when he or she left the military and was eligible for VA care. The information on the card would then be “read” by the VA system, and all the appropriate boxes in the veteran’s VA medical history would be properly filled in with the previous active-duty history.A wonderful idea, and although it was about two decades ahead of its time in terms of chip storage and read/write capabilities, it should have been embraced and worked on. But neither our committee or the folks in the Pentagon could get enough energy behind the concept to really put the proper work into it. Despite come-to-God meetings in the Oval Office where more than one president has commanded the Secretaries of Defense and Veterans Affairs to get their act together and work together to come up with a joint-records-sharing plan, the real work has eluded both departments.The irony is that VA has a perfectly fine electronic records management system, one that is doctor-nurse-patient friendly, and completely transportable. During Hurricane Katrina, veterans who were evacuated from the New Orleans VA care area, had their health care records in place no matter where they went in escaping the storm’s path. That was 12 years ago. Even medical imaging records—X-Rays, CT scans, MRI’s—can be passed along to another VA Medical Center as needed.Look at the world of the private physician working through a private healthcare system. In all likelihood, they have a proprietary health records system that utilizes lap-tops, desktops, and a linked central server. My primary care physician and his practice are set up that way. If they are affiliated with a local hospital (and most are) or hospital system, they may have additional access protocols shared between their practice’s office and the hospital inpatient system’s. But that is not always the case.A doctor I spoke with in reference to this Quora answer, discussed the challenge of working with veterans’ health records.“I always look at hardcopies, paper printouts, of any records that they have brought with them,” he said, referring to new patients coming from the military. “If they have imaging,” he continued, “I look at the disks as well. There is absolutely no crossover between the military medical record system and ours. (my italics) Patients are often under the illusion that our system can directly access medical record systems at other practitioners offices, or even the hospital as well, but our systems have no such access.”With respect to the specialized coding system used by physicians—referred to as CPT and ICD 10—the physician I spoke with said, “As far as what coding system the military may use for their diagnoses and procedures, I would imagine that they use the same CPT terminology for procedures and ICD 10 as we do. But anything that came from anywhere else, military or otherwise, would have to be entered manually.” (my italics)Which should make anyone who supports privatizing VA healthcare think long and hard about re-absorbing veterans medical records into a privatized system when even VA and DoD haven’t been able to work out the transfer kinks. A lot of progress has been made, don’t get me wrong, but countless taxpayer dollars have been expended in the quest for records “jointness” and still more will be spent before anything approaching full transferability is achieved. Just because Amazon can deliver products to your doorstep by drone in under 30 minutes does not mean a similarly aggressive and consumer-savvy healthcare network will be able to deliver better healthcare to a veteran in anywhere near such a timely manner. The veteran healthcare learning curve will be exceedingly steep, and, I think, prohibitively expensive.A privatized VA healthcare system would, in my opinion, be a crippled and vision challenged beast from the very start. The private companies running it would not see anywhere near the profits they seek (or suggest to their stockholders); the veterans using it would, in all likelihood, have more, not fewer, time, records, and care obstacles placed in their way; veterans’ service organizations—like the VFW, the American Legion, the Disabled American Veterans and many other similarly chartered advocacy organizations—would lose much of their grip on VA; Congress would have to cede some authority (which it hates to do), and therefore would find new ways to meddle in the process; and non-veteran healthcare consumers would see their doctors’ offices filling up with veterans who, in all probability, would have “move-to-the-front-of-the-line privileges” as part of the privatization mandate, and that would never end well for either side.
Hospitals functioned without difficulty before computers, so why can’t hospitals now create a way to function offline for an extended period of time when their computer system becomes the victim of a cyberattack for ransom?
Hospitals have relied on computers ever since the mid-1960’s. It was not uncommon to see large IBM, Honeywell, etc., main frames in their cafeteria-size, air conditioned clean rooms. Since hospitals are complex operational entities, the role of computers was primarily for accounting and administrative. Not too much later, systems were designed, programmed and developed to run the physical plant.Technologically-advanced clinical departments also had their own internal computer systems. Typically, they were acquired from research funding and, sometimes, endowments and gifts. For the most part, departments such as Radiology, Cardiology, Clinical Laboratory, etc., have operated their computers independently while uploading copies of medical records to the medical center computers.It was with the promulgation of HIPAA and HITECH Act that essentially created a hospital’s Information Technology department. The centralization of a patient electronic medical records or hospital records system became mandatory. These involve large, complex computer operations and networking.To ease the expense of creating EMR or EHR, medical facilities were compelled to centralize all of their computer operations. This is a venture, costing in excess of $100 million in new servers and computer rooms that also included installing miles of Ethernet wiring to all hospital areas, standardizing local computers and workstations, equipment purchases and evolution of safe usage rules. Hence, centralization of all computing functions became de rigeur and a major problem for centralized IT systems is security and system failures.There is no return to independent computer operations under current rules. But the problems of security breakdown and system failures can be mitigated. It will cost more money but large medical centers have made the investment. And the answer was to utilize multiple, redundant systems within several clouds either internally or jointly. The capability of switching systems in real-time is best in maintaining functionality.If the concern of this question involves patient care that heavily relies on the hospital computer network, rest assured that those services that require it are protected. Their computer networks run off their own servers. Digital radiology procedures, cardiology monitoring, automated laboratory tests, etc., continue without being disturbed.
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