DailyDDoSe ©️March 29, 2018
I was admitted and discharged five times since I first woke up paralyzed early January trying to get a neurological consult.
Was told in no uncertain terms, there neurosurgeon and have been told "there's no neurologist or [137/81] neurosurgeon in this hospital. Then I'm told I have to see one outpatient and they discharge me to home without a wheelchair, walker, transportation, a diagnosis or any kind of treatment plan and tell me if I don't leave I'm responsible for the entire bill.
When I explain to them that I can't walk they offer no suggestions and tell me to take a taxi and go to another hospital because I'm too young for inpatient rehab and that my insurance won't pay for transportation because "you have bad insurance."
They TELL me they requested a walker or services or a medical surgical transfer but that it has been denied and that I have no rights to appeal.
WUT?
I've worked in many capacities as a private and government contractor and have been studying, auditing, advising, writing and advocating for myself and others and have served twice as an expert witness on health care appeals.
I'm not going to post my curriculum vitae here and I shouldn't have to but I've NEVER heard such a ridiculous line of bullshit in my life and I'm too furious and weak to fight the system right now.
But you don't have to be a fùcking scientist to google my name and figure out that I might not be the best person to fuck with for too long while on steroids before I take this whole god damn hospital, insurance company (and YES, the corrupt piece of shit Governor too) down with me.
This isn't just a lawsuit waiting to happen, it's a god damned revolution.
I've done it before and I'll do again. I'm not in this alone, and neither are the millions of Americans who are forced into medical bankruptcy, permanent disability or unable to navigate or access appropriate, affordable, accessible, medically necessary lifesaving medical care in the richest country on earth.
Call congress, call me, call your reps!! Now is not the time to sit back and be complacent.
I'm going to need some time to heal. This experience has broken me in ways I did not see coming but I promise you, I will not stop fighting and I beg you to keep doing the same.
Thank you for all of the love, support, patience and kindness. Having kind, caring people reach out to me across the world has made all the difference. More than you could possibly know.
I refuse to sit back and watch all the work I've done and the work of so many others go unnoticed.
Peter Morley
Natalie Weaver
Alyssa Milano
Scott Dworkin
Craig Anne Heflinger
Virginia Betts
Lori Smith
Tony Garr
Emmanuel Morel
Telene Thomas
Kirsten Olson
Laz
Joker
Roanna Carleton
Wayne Oldfield
Creeples
To name just a few...
To be continued!
The Next Revolution in Healthcare
By Dan Riskin, MD
Every 50 years, there is a revolution in healthcare based on the trends of the era. In the 1870s, healthcare was revolutionized by the germ theory of disease and promotion of public health efforts. In the 1920s, the discovery of penicillin propelled forward the use of medication as treatment for disease. In the 1970s, use of the randomized controlled trial (RCT) ushered in an era of evidence-based medicine. As we approach the 2020's, the trend toward big data, tools and systemization of care will revolutionize the way hospitals and physicians work and, most importantly, the way patients are treated.
Dan Riskin lecturing at FutureMed at Singularity University in 2011.
Big data refers to a set of information and data so large and complex that it becomes difficult to process using conventional database management tools. At issue is how to access, distribute and utilize this vast amount of "unstructured" data. For patients, clinicians and hospitals that have massive amounts of clinical content in electronic health records (EHRs) that remains unused, the implications can be rising mortality rates and out-of-control medical costs.
Let's consider the current vanguard of data-driven healthcare in hospitals. At the best institutions, doctors and nurses are going room to room each day to mark down which patients meet which quality metrics and whether they're addressed. The result is a manually-entered, cumbersome flow chart that can, at best, address a handful of the hundreds of known quality measures and use limited data to address these. With a condition like deep-vein thrombosis for example, hospital staff relies on manual calculations to assess the risk of a patient. The problem is, if not treated properly, mortality rates rise. The real tragedy is that the information needed to properly assess the patient's risk and determine treatment is available in the clinician's notes, but without the proper tools the knowledge remains unavailable and hence, unused.
Today, the most formidable tools to effectively manage unstructured data include natural language processing, ontologies and data mining, which together support the effective use of unstructured data. Systemization of healthcare has been slowly implemented over decades, but has rapidly accelerated with EHR adoption and government mandates. Ultimately, the proper systems put into place allow the knowledge learned from big data to be distributed and used.
So, if data flow tools to manipulate data exist, and systems to implement process improvements are possible, how do these trends underlie a change in the field of healthcare? Data-driven healthcare has become increasingly well-defined and understood over recent years. It is the concept that large record sets can assure that best treatment algorithms are applied and that treatment algorithms are customized for individual patients. It means that although modern medicine treats the 83 year-old diabetic patient with hypertension similarly to the 45 year-old athlete with hypertension, based on them being grouped together in the same clinical trial, in the future, care will be personalized based on what worked best for millions of similar patients previously. This level of customized care offers the promise of better and more applicable care.
Financial outcomes are expected to improve as well. According to a 2011 report from McKinsey Global Institute, if health care in the US used big data creatively and effectively to drive efficiency and quality, the potential value from data in this sector could be more than $300 billion in value every year. Two-thirds of this figure would influence national health care expenditures, representing an 8 percent cost reduction.1
This is the future of healthcare: big data, robust tools and clear processes for intervention. It represents an opportunity for innovators and those that care about healthcare. It represents the potential for better outcomes and lower mortality rates for patients. Brace for a revolution in healthcare where we all have the opportunity to help and everyone has a stake.
[1] McKinsey and Company, McKinsey Global Institute, "Big Data: The next frontier for innovation, competition and productivity," May, 2011.
Dan Riskin, MD, is a FutureMed faculty member at Singularity University. Dr. Riskin is the CEO of Health Fidelity, provider of a commercial-grade, cloud-based natural language processing (NLP) service, and is also a Consulting Assistant Professor of Surgery at Stanford University.
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