Craig Timberg, Drew Harwell and Alauna Safarpour:
A major source of skepticism about the infection-tracing apps is distrust of Google, Apple and tech companies generally, with a majority expressing doubts about whether they would protect the privacy of health data. A 57 percent majority of smartphone users report having a “great deal” or a “good amount” of trust in public health agencies, and 56 percent trust universities. That compares with 47 percent who trust health insurance companies and 43 percent who trust tech companies like Google and Apple.
“I don’t feel like they have a good track record of taking care of people’s privacy and data. And I don’t want to give them more if I don’t trust them,” said Brent Weight, 43, a Republican-leaning independent voter who runs a small trucking company in Rigby, Idaho. “Seems like every other day you’re hearing of a data breach in a big company, and they’re losing credit card information and everything else. For them to just tell us it’s going to be safe and anonymized, I’m not going to take them at face value.”
Among Americans overall, 41 percent say they both have a smartphone and are willing to use an infection-tracking app, the poll finds. Oxford University researchers have suggested that 60 percent of a country’s population would need to use a coronavirus-tracking app like this to stop the viral spread. Reduced adoption could limit its effectiveness in slowing new infections and deaths.
Saul J Weiner, Shiyuan Wang, Brendan Kelly, Gunjan Sharma, Alan Schwartz:
Accurate documentation in the medical record is essential for quality care; extensive documentation is required for reimbursement. At times, these 2 imperatives conflict. We explored the concordance of information documented in the medical record with a gold standard measure.
We compared 105 encounter notes to audio recordings covertly collected by unannounced standardized patients from 36 physicians, to identify discrepancies and estimate the reimbursement implications of billing the visit based on the note vs the care actually delivered.
There were 636 documentation errors, including 181 charted findings that did not take place, and 455 findings that were not charted. Ninety percent of notes contained at least 1 error. In 21 instances, the note justified a higher billing level than the gold standard audio recording, and in 4, it underrepresented the level of service (P = .005), resulting in 40 level 4 notes instead of the 23 justified based on the audio, a 74% inflated misrepresentation.
$37,920,077,070 in Taxpayer Electronic Medical Record Subsidies: 2009 – January 2018
A few photos from the first (outdoor) 2020 Dane County Farmer’s Market, organized for our “safer at home” and “social distancing” era. Oh, at the Coliseum rather than Capitol Square…
Dane County Farmer’s Market.
One obstacle might be the boredom threshold. If you are used to a high-octane life on the Grand Prix circuit, a three-hour meeting with healthcare regulators might leave you wanting to bite your arm off. Once, by accident, I ended up as part of a project-management workgroup seeking regulatory approval for a drug: after the 18th Gantt chart, I experienced one of those moments where boredom becomes physically painful.
But the other issue at stake is the difference between deterministic and probabilistic improvement. If you engage engineers, you don’t know what you are going to get. You may be unlucky and get nothing. Or their solution may be so outlandish that it is hard to compare with other competing solutions. On average, though, what you get will be more valuable than the gains produced by some tedious restructuring enshrined in a fat PowerPoint deck.
But in business, let alone in government, it is only in crises that people find a budget for probabilistic interventions of this kind (in peacetime, nobody would have given Barnes Wallis the time of day). The reason is that both bureaucrats and businesspeople are heavily attracted to the illusion of certainty. Standard cost-cutting ‘efficiencies’ can usually be ‘proven’ to work in advance; more interesting lines of enquiry come with career-threatening unknowability.
One problem with this pretence of certainty is that cost-savings are more easily quantified than potential gains — so business and government are increasingly geared towards providing people with more, poorer things at an ever-lower price. Yet much evidence suggests that people like fewer, better things at a slightly higher price.
Indeed one reason why the world is in a mess is because, for a long time, the ratio between ‘explore’ and ‘exploit’ has been badly out of whack. Entities like procurement have been allowed to claim full credit for money–grabbing cost-savings without commensurate responsibility for delayed or hidden costs. The shadow of this is everywhere, from Grenfell Tower to PPE shortages.