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May 5, 2015

MEGAHIT Working Well -- But How Much Does It Matter?

     From a report by Social Security's Office of Inspector General (OIG):
Despite challenges, SSA [Social Security Administration] continued expanding health IT [Information Technology] and partnered with 38 health care organizations, exchanged electronic records in 30 States and the District of Columbia, and identified ways of enhancing health IT case processing and data analytics. In addition, the DDSs [Disability Determination Services] reported they were generally satisfied with MEGAHIT (Medical Evidence Gathering and Analysis Through Health IT); however, some suggested enhancements to the system. Some DDSs also reported MEGAHIT issues that the Agency did not know about, despite SSA previously soliciting DDS user feedback. 
Finally, our review of 275 sample cases found (a) that MEGAHIT received electronic health records 19 days faster than traditional records and (b) SSA made disability decisions, on average, 21 days faster, in the 5 cases where only health IT records were requested. 
Recommendations 
  1. Continue to solicit, on a regular basis, DDS user feedback in MEGAHIT enhancements. 
  2. Enhance procedures to maintain and update MEGAHIT partner data, such as addresses. 
  3. Enhance methods to improve the use of information received via Health IT. 
  4. Increase health IT partners — taking advantage of nation-wide Federal efforts led by Health and Human Services’ Office of the National Coordinator for Health Information Technology. SSA agreed with the recommendations.
     Before anyone gets too excited about this, it's something that works best only when dealing with huge medical providers. In fact, that's the only way it works now since huge medical providers are the only ones using MEGAHIT. However, the vast majority of disability claimants receive at least part of their evaluation and treatment from smaller medical providers. Getting those records is mostly a matter of sending a written request through the mail and receiving a written response through the mail. That's not changing any time soon. MEGAHIT won't make those cases move any faster.

8 comments:

  1. A sample size of 5 cases? Out of how many total? I wonder how much money was wasted on this? Perhaps they could save money be googling statistical significance or confidence interval. I think I found the real waste and fraud. It is the parasites who study this stuff.

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  2. While I recognize the need for improving the system, for the 26 years in which I've practiced SSA dib law, I've often wondered how much less the backlogs would be if SSA put people to work processing cases instead of spending time dreaming up magical schemes. Remember such wasted efforts as Hearings Process Initiative (HPI)?

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  3. The problem with Megahit is that it sends in mega files that are not properly separated and in some cases, not in proper order.Who really gives a good look to a 400 page exhibit.

    As one poster alluded to above, the Agency spends way too much money paying contractors to come up with magical plans that don't work. Hire the correct number of people needed; hire some enlightened management who can actually motivate their employees, instead of browbeat them; and stop focusing on numbers, focus on good results and the numbers will follow. I have never seen such stupidity in all my life such as that which has gripped the Agency at this point.

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  4. Too many "wise" business minds have fallen into the same ridiculous belief system that tech (bros) can save our world from all its ills. If you just pay enough (young white bro) coders a ton of money, they can create an app that will fix whatever your problem is.

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  5. HPI might have worked if given a proper trial. All that happened was that they promoted a bunch of clerks to paralegals and then said it was a failure. the idea was that a new case would be assigned to an attorney advisor for development and conferencing with the Rep to see if some of the nuances could be ironed out. The case would be heard if need be and the attorney advisor already familiar with the case would write the decision. It was never given a chance to succeed. Perhaps the ALJ's were worried they would lose their golden egg if the AA's began reaching settlements with the Reps..

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  6. Agree with some of the tone of the comments above.

    Grossly disproportionate resources spent on a small number of cases in the name of expediting.

    What isn't reported is the volume of pages that are electronically dumped into the folders taking more time to read and analyze.

    Also most examiners send out a regular request for records anyway - so the medical sources love it because they get paid twice - once from the state and once from the SSA MEGAHIT office.

    The results - like QDD, CAL and other stuff like this are grossly exaggerated - and take away resources from doing the regular work timely.

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  7. I am pretty satisfied with Megahit. I do not think the 1000 pages is a problem. It often expedites the cases of people who actually have something pretty seriously wrong with them. One of Megahit sources is an HMO that before they had electronic files we would have to write to each office the person was seen at. Another is the group of doctors associated with a major university teaching hospital. Again each one would otherwise have to be written separately. The hospital itself is not a Megahit source and it is a major problem if we still need their records.

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  8. 7:46 5/6 You must work at the DDS. I say this because at DDS you really don't have to cite to any reference. When that 1,000 page file gets to ODAR and becomes an Exhibit without being broken down, it causes a night mare. We don't have the resources to break it down, it is too time consuming. We have to cite at least to an exhibit and the Agency will be pushing for more x/page # references. Good luck with a 1,000 page document. It may not be a problem from your vantage point, but it is a looming disaster from where I sit.

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