Post notes several barriers to successful implementation of an EMR system for US.
Although the federal government set a goal five years ago of creating an electronic health record for every American by 2014, the effort has lagged for several reasons. Roadblocks include concerns over lack of universal protocols for collecting data as well as rules that establish how, with whom and under what circumstances the data can be shared. Many health-care providers — physician practices, testing facilities, hospitals and clinics — fear liability if private information gets into the wrong hands. Embedded in all these issues is the cost, an estimated $150 billion, which has proven to be a significant barrier to that 2014 target.
So, who is responsible for defining the standards? Who will define liabilities? How many stakeholders are there to be included to construct a realistic evaluation model?
Can colleges be both efficient and serve as the incubator for future discoveries and future leaders?
… public colleges, which serve two-thirds of all four-year college students, are also increasingly expensive and inaccessible, he said. Tuitions there have increased at the same rate as that of the private institutions—about 3 percent above inflation—and promise to increase even more as declining revenue forces states to lessen their support.
Given those pressures, Mr. Ehrenberg said, “it is questionable whether we will be able to increase the fraction of our population that receives college degrees and to reduce the inequality of college-completion rates.” Chronicle Feb 16, 2009
How does one measure effiency in college programs?
Is the “business model” the correct one to evaluate the success/failure of higher education policy?
College ought not to be merely a place where someone learns “skills” and racks up credentials, but rather an environment and an experience in which students learn, in addition to history and literature and mathematics, also how to begin to navigate the adult civilized world in an adult, civilized, and responsible manner. Their naïve assumptions about life and nature should be tempered by the rigors of discourse, debate, and discussion. Higher education should be training for life as it is — not as it is imagined by the child’s mind.
When colleges adhere to the “business model” they create dangerous expectations for their students and do no service to the larger community.
How do you evaluate a program whose goal is to “train for life as it is?” Can you make an evaluation in a short time frame when the goals of a program are “life long”?
Downey’s editorial cites research in NC showing that the most effective expenditure of public funds in relation to achievement is that spent in the classroom.
In their High School Resource Allocation Study, Henry and Charles Thompson of East Carolina University found that money spent in the regular classroom produced far greater achievement than money spent on after-school programs, summer school or Saturday classes.
In fact, spending on supplemental programs outside the classroom —- including guidance counseling and psychological services —- was linked to lower student test scores
Can you construct an evaluation model that would systematically record classrrom expenditures school-by-school (which would then aggregate to district, system, state) to validate this finding?
Despite efforts to secure the federal territory in cyber space, the FAA finds its admin server hacked — and employee records were compromised:
While the FAA was hit this time, it certainly is not alone. Uncle Sam’s main jobs database, USAJobs, which is run by Monster.com, was hacked last month.
The security of government computers has been deemed a “high-risk” area, by the Government Accountability Office. “Most agencies continue to experience significant deficiencies that jeopardize the confidentiality, integrity, and availability of their systems and information,” the GAO said last month. “For example, agencies did not consistently implement effective controls to prevent, limit, and detect unauthorized access or manage the configuration of network devices to prevent unauthorized access and ensure system integrity.”
BBC reports one manager in Britain very upset over the cost to his organization:
Andrew Way, chief executive of London’s Royal Free Hospital, said technical problems had cost the trust £10m and meant fewer patients could be seen.
The Department of Health said lessons had been learnt from the trial.
The England scheme, part of a £12bn IT upgrade, aims to put 50 million patient records on a secure database by 2014.
Implementation costs are important to consider when designing and evaluating policies.