Aug 22, 2008

Paper And Productivity

I reviewed an emergency room report recently. The patient was seen due to hyperglycemia. She is a diabetic and her blood sugar had gotten too high. This is a routine sort of emergency room visit. The report on the ER visit ran to 36 pages. Ten years ago, maybe even five years ago, the report would have been about three to five pages. I strongly doubt that her treatment was any different than it would have been five or ten years ago, but the hospital generated a lot more paper. This is routine in most medical settings today. Medical care generates far much more paper than it used to.

It takes more time these days to review an average Social Security disability claimant's file than it used to, because the average claimant's file is thicker than it used to be. This has an effect upon productivity. People in the field may not talk about this or even notice it because it has happened slowly over the years, but it is important.

I mention this because it is a reality that seems not to penetrate to the higher reaches of the Social Security Administration. Above a certain level one never reviews an actual claim file.

4 comments:

Anonymous said...

The electronic review system also does not identify duplicates which makes the review process even more lengthy. Of course the high school graduates who run this place would never know that because they don't talk to the attorneys who sit in cubicles actually doing this work. My last day working at this confederacy of dunces will be my best day.

Anonymous said...

Here are two other aspects of the same general phenomenon:

1. Some primary care practices are using software to generate treatment notes. This software carries over a lot of information from prior visits. It also includes the questions for which the old style treatment notes only gave the answers. So where before you might find three visits documented on one page of treatment notes, now it's more than three pages to document the one visit.

2. DVA facilities seem to be all hooked into some sort of central archive. So when the advocate asks for records from multiple DVA facilities gets multiple snapshots of the same records. These print out without internal page breaks. They're crammed full of empty stuff, like wellness questionnaires and screening criteria. One or two hundred pages of records for the type of patient the DVA tends to treat. Multiple these by the number of facilities the advocate contacts. And because all these multi-hundred page exhibits print out differently from page to page, it's extremely difficult to mark out duplicates.

Add in this major beef about electronic files: it's not nearly as easy to flip back for a second look at something inside e-View as it is for a paper file.

JOA

Anonymous said...

First of all we are converting paper to electronic and pretending that this is the only way to read electronic files. And will be the only way

That's fictitious

The electronic folder was not built to read paper

This is a transitional stage

Tt was built to be able to read electronic information.

Scanning and related technolgies were only supposed to be the norm though 09

After 09 it was supposed to go from text to data

Wen people stop living in 1987 and stop comparing the electronic processes to 1987 and start realizing that the electronic processes were bulit to deal with data transmission norms of 2017, then you will catch up

As long as you keep filtering data transmission through eyes that have only imagined paper data capture of the 80s, you won't go forward.

But that's ok you don't really want to

There were a lot of people who opposed movable type and thought illuminated manuscripts were the only way to go.

Celibate or celebrate?

Make yourself ready for the change, and you will be ready to make more money

Stay behind and those who have set up their practices to deal with new era data transmissions will get all the business.

Please enjoy your paper to electronic comparisons and fee petitions until then.

Bulk providers who can cope with bulk data will probably overtake the market if not in short term then certainly in long term.

In the long term, tho, quipped that famous economist, we are all dead.

Anonymous said...

But Congress will not appropriate enough money to hire the staff to keep SSA from collapsing--why would they spend the money needed for the conversion from text to data? If, in fact the intent it for SSA to collapse, then there is the incentive to not invest the money--SSA will drown in scanned medical records with no one to process them.