* Chris. He has reviewed the data analysis methodology for the Sphygmochron but isn't ready to present his understanding of it yet. For his application, he selected Java, and the Netbeans, and for libraries, will pick between Colt and Jama, and others for charting. Candidates include JFree Chart. He is setting his objective for December. Will spend time on design patterns, but architectural and lowerr level design. His minimal objective is to take a data set, perform a calculation and produce a chart, within an architectural pattern. For example, for matrixes, UL Decomposition, QR Decomposition, Gaussian Elimination. Tom suggested that we need to select test cases and each of these algorithms have known problem areas and test cases to use.
* Larry: Spent several days wearing Germaine's ABPM, and so
frustrating experience and the device was so irritating that he
decided to stop wearing. He had to constantly readjust and take
another reading. Bob said you should trust the reading because
he had several episodes where his blood pressure dropped and heart
rate dropped, should have seen a difference and didn't. The device
would often not take a reading, and he had to take it off and
put it on again to get a reading. Occasionally, the cuff would
cut off the flow of blood because the cloth slipped, clumped,
and fully inflated. It has other annoying things. If you are riding
in a car, it can't distinguish between the car vibrations from
your pulse and it will keep inflating the cuff. Also, rock music
will have the same effect. So, there is a significant opportunity
for an "unobtrusive" ABPM. He saw a daily rhythm, a
change off 30 points from day to night. Rock concerts make a significant
difference. He started a webpage for the Sphygmochron on the
Phoenix website. He created project on SourceForge using "subversion"
for multiple version tracking.
* Mary Jo: bought a copy of Mathlab and the statpack for it. Phoenix
will reimburse. Alex has been playing with it, the waveform
seem very good, experimented with them, set upper and lower thresholds
and found now difficulty in correlating it with systolic or diastolic
blood pressure. We need a system in the lab that isn't being changed.
The Sensor team is working on BP measurement: Brad, Carl, Steven James, Mary Jo, Alex.
* Tom: has been working on test driven development with Larry.
Chris asked how does he set up a test case, wants a data set
for his a Sphygmochron program.
Gerry Werth : Clinical Information Systems
Minitopic - Pay for Documentation
Helping Clinicians Play the "Game"
* Consultation Services
* Third Party Payer
* Documentation Standards
* Reimbursement
Consultation Services
* Consulting the following business model
* You are a consultant
You provide Evaluation Services and Recommendations.
* Your clients usually are not directly evaluating the Quality
of your work.
* They externally observe
* "Quality" of your work depends on whether - and how
well - your clients follow your recommendations.
Third Party Payer
* Extend the previous business model.
* Your clients are third payors for "insurance" in case
they need your services.
* The Insurer is the "Payor" for your services.
* The Payor has incentive to reduce its expenditures.
* The Payor "negotiates" volume discounts from your
fee schedule.
* The Payor inserts "Standards" for you to document
your services for reimbursement.
Document Standards
* The Payor has incentive to reduce fraudulent claims.
* The Payor also has incentive to reduce legitimate claims - by
raising documentation requirements.
* Because expertise is expensive, surrogate measures are used.
* You are scored on the number of "bullet points" for
major areas …
- ... of your background analysis. [History/Review of Systems]
- ... of your current assessment [Physical Exam]
* You are scored on "Difficulty" of your Decision-Making.
[Plan]
Reimbursement
* How would you feel about being paid this way?
This page is maintained by Ellis S Nolley. It was last updated on 11 January 2007.
The author(s) provide this information as a public service, and agree to place any novel and useful inventions disclosed herein into the public domain. They are not aware that this material infringes on the patent, copyright, trademark or trade secret rights of others. However, there is a possibility that such infringement may exist without their knowledge. The user assumes all responsibility for determining if this information infringes on the intellectual property rights of others before applying it to products or services.
Copyright (C) 2007 Ellis S. Nolley. Copying and distribution of this page is permitted in any medium, provided this notice is preserved.
Back to the Meeting Archive Page