Category: Tech

Beyond the Worldwide Webb

Happy New Year, and wowee! Looking good, so far, getting the JWST deployed.

“Repent, Google!” Said the TikTok Man

Oh, the effort and difficulty it took getting Google to even list this site again, let alone accept a sitemap to index its contents:

Once again I lay blame on Bluehost for changes it made, causing all of the problems I have struggled to resolve. There are numerous quirks — especially with pre-fix posts — but most of the serious issues seem to have been cracked, and only because I switched from feeling annoyed to remembering why I started Prattling Before the Pratfall. It was originally intended purely as a learning curve challenge, with no expectation of continuing for more than 15 years. But now that I’m retired from a high tech career, a technical challenge is perhaps a good thing.

I’d better acknowledge the late Harlan Ellison for this post’s title, with the names of the world’s two busiest web sites. Harlan always — and I mean always — wanted to receive his due credit:

From HIS to EHR to EMR

It’s been more than ten years since the HITECH program within the American Recovery and Reinvestment Act began offering incentive payments to hospitals and doctors to encourage the use of electronic medical records. Medical providers that were already using electronic systems also received these payments when switching vendors.

The end result was that President Obama distorted the well-established and competitive medical information software market. This paved the way for a single privately-held company — Epic Systems — to become dominant in the market, despite its products being, by far, the most expensive.

Marketplace covers the recent acquisition of Cerner by database giant Oracle, but with no mention of Epic. Cerner has the government contracts for hospitals within the Department of Defense and, separately, the Veteran’s Administration.

The fact is, medical records within Epic’s huge installed base can be shared seamlessly between providers, if they so choose. I have seen this for myself, and appreciate the convenience. With Epic on track to eventually manage 75% of all non-military medical records in the United States, the government might want to consider an antitrust case against the company it helped to promote.

Ultimately, the solution is to force a standard format for medical records that can be shared between medical providers using different software systems. How likely is it the government will pursue that route to level the playing field, rather than a direct antitrust case? I see neither happening anytime soon.