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Author: TriSec    Date: 03/05/2013 11:22:30

Good Morning.

Today is our 4,167th day in Afghanistan.

We'll start this morning as we always do; with the latest casualty report from our ongoing war, courtesy of Antiwar.com:

US Military Deaths - Afghanistan: 2,178
Other Military Deaths - Afghanistan: 1,080

We find this morning's cost of war passing through:

$ 1, 429, 628, 675, 000. 00



Diving right in, let's veer into healthcare for just a moment. Most of us have doctors, and some of us even visit them. Next time you're in the office, take a look around. There's probably a wall or even an entire room full of manila folders. These are your medical records.

I work in the Electronic Data Interchange segment of healthcare. It's revolutionized claim filing. In the old days, you had to mail things in. They'd languish for days before being manually entered in the system, then probably wait another month before chewing through adjudication and paying or denying. Nowadays, a lot of providers push a couple of buttons at the end of the day. Their claims compile and transmit overnight, and we process them the next day. Fallon is on a two-week adjudication cycle, so doctors get paid about two weeks after submitting their claims.

Medical Records are where claims were perhaps 10 years ago. The industry is just getting off the ground, and there is a standard called "HL3" that allows doctors and specialists to share information with just a couple of clicks. It's supposed to streamline record-keeping, increase accuracy, and more importantly, streamline the process and make it more efficient for patient care. It's been embraced by most segments of the industry and is rapidly expanding....except within the Veteran's Administration.

This has been an ongoing embarassment for a number of years, and considering the amount of waste that's been uncovered, it's going to go on for years more before it ever gets resolved. Of course, with the budget cuts happening, it may NEVER get resolved, and of course it's always the veterans that suffer.


WASHINGTON — The departments of Defense and Veterans Affairs have wasted about $1 billion in a failed effort to streamline medical record-keeping, the chairman of the House Veterans’ Affairs Committee said in a hearing Wednesday.

“I’m concerned we’re taking a step back toward a model that has been tried and failed,” said committee Chairman Rep. Jeff Miller, R-Fla., at a hearing to examine the project.

Defense and VA officials said this month they had abandoned an ambitious plan to integrate medical records for both active-duty service members and veterans into a single electronic system to make the records more accessible for patients and doctors.

After cost estimates doubled and technology problems persisted, they decided on a less expensive plan to keep their current systems while making them “interoperable.”

The project, which started in 2004, was meant to streamline health care for active-duty troops and veterans as they transition to civilian life. Officials hoped a centralized system would prevent delays in care caused by problems in sharing health records between separate systems. The plan was set to start in 2017 for a total cost of $4 billion, according to Pentagon estimates from last year.

Committee members criticized the departments for giving up on a program that has already cost about $1 billion.

“It’s inexcusable,” said Rep. Jeff Denham, R-Calif. “In the private sector this would be done by now — it would have to be.”

A “patchwork of initiatives” tried over the past 15 years has left veterans shortchanged by an outdated system, said Valerie Melvin, director of information management and technology resources issues at the Government Accountability Office, Congress’ investigative arm. Melvin authored a report released Wednesday that questions the departments’ ability to share health records with existing systems.

“This is the result of poor oversight and inadequate accountability,” Melvin testified. “The program has not been positioned to fulfill key management responsibilities. More is needed.”

None of the testimony or reports “makes me think we won’t be sitting here in another 10 years asking the same questions and having the same problems,” said Rep. Phil Roe, R-Tenn.


Whether or not the next story is tied to medical records is a matter of conjecture. But the fact remains that the current generation of soldiers has the highest suicide rate among active-duty personnel in all of American history. It's not truly known why military suicides have increased, but there is always the possibility of lack of resources, mis-identification of potential suicides, and of course the difficulty of sharing information and receiving appropriate treatment. It all makes for interesting reading, but doesn't alter the fact that about 18 veterans are going to kill themselves today.


The armed forces mourned a grim toll in 2012 when more troops took their own lives than died in combat, but a precarious question remains: Why is the rate spiking when military life has long been a suicidal deterrent?

Among the services, the Army lost the most active-duty members last year to suicide: 182. Inside that branch, as two wars raged then waned, the annual suicide pace climbed. During 2001, nine out of every 100,000 active-duty soldiers killed themselves, while, during 2011, the suicide rate was nearly 23 per 100,000, according to the American Foundation for Suicide Prevention.

Compare that sobering trend to conflicts and peacetimes past. During the final three years of World War II, the Army’s annual suicide rate didn’t budge above 10 soldiers per 100,000, and during the Korean War in the early 1950s, that annual pace remained at about 11 soldiers per 100,000, according to a study published in 1985 by the Walter Reed Army Institute of Research.

Between 1975 and 1986, the Army’s annual suicide rate averaged 13 deaths per 100,000 soldiers, falling to as low as 10 in the early ‘80s, according to series of papers published in the journal Military Medicine. The Army’s suicide rate in 2001 was less than half that for all American males (18.2 per 100,000). Since then, the pace of self harm among active Army troops has more than doubled — and that trend is not ebbing: In January, the Army classified another 33 deaths as "potential suicides" among active-duty, National Guard and Army Reserve soldiers, according to the Department of Defense.

“A once-protective environment has moved to be something very different,” said David Rudd, co-founder and scientific director of the National Center for Veteran Studies based at the University of Utah.

“We need to look at the big picture to really understand what's going on today, but we all too often lose historical perspective,” said Rudd, who testified before Congress on the issue last month. The Army’s suicide pace between 1975 and 1985 should be viewed as the branch’s “baseline” rate, he added.


Finally this morning....What's it like to come home? A larger number of troops are starting to return from the combat zone. Some return to civilian life without a hitch, while others have tremendous problems making the transition. But it's just as hard on the families of returning soldiers as the soldiers themselves. And of course this ties back to everything else posted today...without an adequate support network, and accurate records of care, the transition is that much harder.


Two and a half months wasn't a lot of time, but it felt like forever.

Not long after U.S. Marine Corps Cpl. Gaby Caban was deployed to Kandahar, Afghanistan, in July 2011, she was homesick for her husband, Jose, and family. But she especially missed her 1-year-old daughter, Jayda.

“It was hard leaving her,especially since she was so little,” said Caban, 23.

Between12-hour night shifts spent working on C-130 planes, Caban took every opportunity to connect with family back home. “I would Skype with them, I would e-mail every single day, and I would call almost every day,” she said, but it didn't feel like enough.

“It really wasn't the same,” Caban said.

Then more than two months into her deployment, after a work-related accident that required partial amputation of fingers on her right hand, she was sent home. And although her reunion with her daughter and husband was joyful, her transition from active duty to civilian life was difficult for Caban and her family, and it's still an ongoing process.

“I had no idea how it was going to be,” she said. “Of course you think it's going to be different. I think as a person, they prepare you, but as a parent, I don't think they prepare you. I don't think you really can prepare for that.”

Caban isn't alone. For many other returning service members, reintegrating into daily routines and re-establishing relationships with families, spouses and children isn't always quick and easy.

It can be especially tough for returning military moms who are eager to get back into mom mode and the way things were, said Nadean Sitter, women veterans program manager for the Erie Veterans Affairs Medical Center.

“They come home, and they want it to be just like it was when they left,” Sitter said.“They want to take over their role.”

But family dynamics change when the other parent takes over for an extended period of time.

“They've developed their own norms, their own rules,” she said. “The kids, no matter what age they were, are older, and they're used to the new rules and the way things are.”

Or it can be the exact opposite. A returning mom might be expected to slip back into normal life, but she isn't ready to take on the stress.

“She's coming home, and he's like ..., 'I'm going to go back to my other life that I had before,'” Sitter said.“All o fa sudden, there's maybe a lot of pressure on this person to do things they might not be ready to do.”

Some situations are made even more complicated by issues like post-traumatic stress disorder or guilt for coming home when other comrades can't. It's also unknown how the lifted ban on women in combat, announced by the Pentagon on Jan. 23, will affect future military women.

“Some spouses don't understand that their wives really miss their unit, they miss the people they were with, they miss the camaraderie,” Sitter said.“So then there's conflict that can happen there.

“There are so many pieces. The most important things families can do is give it time.”


And I imagine we'll see more stories like all 3 of these as we go further into the process of getting the hell out of Afghanistan. It is a non-sequitir, but think about this for a minute. When we got into Afghanistan, Javi was just two months old. He turns twelve this summer.
 

67 comments (Latest Comment: 03/06/2013 01:22:14 by TriSec)
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Comment by wickedpam on 03/05/2013 13:56:33
Morning

Comment by Mondobubba on 03/05/2013 13:59:16
Buring Controversy in Massachusetts! "Roadrunner" vs "Dream On" for state rock song.


In this corner:



"Roadrunner" from the classic "Modern Lovers" album (Mondo's has this on both vinyl and CD)

In this corner:



(Mondo doesn't own any Aerosmith, but can't escape this song)




Comment by velveeta jones on 03/05/2013 14:14:07
Morning!

It occurs to me after reading your story that Vets returning home and trying to get back into normal routine also sounds like alcoholics who have damaged their families and are trying to "get back to normal" after getting sober. Just an observation.

Comment by Mondobubba on 03/05/2013 14:21:13
Tri, none of my various doctors I've seen in the past 60 days use paper records. They are all electronic. When I see my PCP, she comes in with her laptop and writes all over her notes directly into my file that way. Baptist South, the hospital I was in does all record keeping electronically and has since it opened about eight years ago.

Comment by Raine on 03/05/2013 14:31:49
Morning!

Comment by TriSec on 03/05/2013 14:32:56
I have a mixed bag up here.

My therapists are still on paper records, but they're a small shop.

The hospital (Mount Auburn) has a pretty slick recordkeeping system, and I even have a password and user name so I can log in and peruse my own files. Everything in the hospital is clickety-click. My oncologist already sent all the records off to the gastro....and they should pop up on his calendar a day or two before my visit later this month. (If he hasn't reviewed them already.)



Comment by Scoopster on 03/05/2013 14:34:16
Mornin' all..

Of those two I can't go with Aerosmith (I have a personal prejudice against them) and I've honestly never heard the Modern Lovers before.

I guess my pick would have to be something from the Dropkick Murphys, Bosstones or Boston. I suppose the ol' classic Dirty Water by the Standells has to be in the mix too.

Comment by BobR on 03/05/2013 14:36:16
Quote by TriSec:
I have a mixed bag up here.

My therapists are still on paper records, but they're a small shop.

The hospital (Mount Auburn) has a pretty slick recordkeeping system, and I even have a password and user name so I can log in and peruse my own files. Everything in the hospital is clickety-click. My oncologist already sent all the records off to the gastro....and they should pop up on his calendar a day or two before my visit later this month. (If he hasn't reviewed them already.)

I used to work for a software company that made that type of software. It's good to see that it's gaining traction.

Comment by velveeta jones on 03/05/2013 14:44:49

Small Gov't GOP-baggers hard at work! This will cost millions, if not billions, of our tax dollars.

Comment by wickedpam on 03/05/2013 14:45:57
We have Kaiser, they rarely do anything with paper. Which I have to say I'm fining rather nice - any department I go to they have all the info right there and I don't have to keep explaining stuff over and over.

Comment by TriSec on 03/05/2013 14:50:27
THis whole Mass Song thing is gaining worldwide traction - it was one of the feature stories on the BBC Commuter podcast yesterday.

I'd go with Aerosmith. Never cared for the Roadrunner song.

Dirty Water, or any band with "Boston" in it is too Boston-Centric, as the legislator from Duxbury pointed out on the podcast yesterday. He did offer up a compromise....Roadrunner for state song, Aerosmith for state band.



Comment by wickedpam on 03/05/2013 14:57:29
SNOWQUESTRATION is coming!!!!!

Comment by Raine on 03/05/2013 15:02:23
I went down a serious rabbit hole this morning... Montgomery ward Kit homes.

For those that weren't aware the hosue I owned in Germantown was a Ward home. and for years I had wondered what particular style it was. I found it today! Mine was the *Miami*

Comment by Raine on 03/05/2013 15:02:57
Comment by BobR on 03/05/2013 15:02:58
Quote by wickedpam:
SNOWQUESTRATION is coming!!!!!



Comment by Raine on 03/05/2013 15:03:53
I think we should drug test CEO's that get welfare.


Comment by TriSec on 03/05/2013 15:04:32
So, this whole bit from TRMS about the republican "straw poll" here in this state, at the Danversport Yach Club...

Uhh, it's the "working man's" marina on the North Shore. My brother's wedding reception was there, and I know people that have boats there. Not a "yacht" among them, really. (Those would be in Marblehead.)

The Marina itself is actually rather working class. And they have a nice restaraunt that's open to the public.



Comment by wickedpam on 03/05/2013 15:07:15
Quote by Raine:
I went down a serious rabbit hole this morning... Montgomery ward Kit homes.

For those that weren't aware the hosue I owned in Germantown was a Ward home. and for years I had wondered what particular style it was. I found it today! Mine was the *Miami*



totally cute house!!

Comment by Mondobubba on 03/05/2013 15:19:26



Yeah lets do something on the Federal level that has already been found to be a violation of the 4th Amendment on the state level.

Comment by Raine on 03/05/2013 15:24:11
Quote by wickedpam:
SNOWQUESTRATION is coming!!!!!
How much are they saying in Manassass?

WE are supposed to get 6 inches of the heavy wet gloop.

Comment by TriSec on 03/05/2013 15:27:11
Quote by Raine:
How much are they saying in Manassass?

WE are supposed to get 6 inches of the heavy wet gloop.


Depends where you are. Have I ever mentioned the moderating effect the ocean has on winter storms?

Coast, not much, Cape, rain only, interior (Worcester county) maybe some plowable stuff.


Comment by TriSec on 03/05/2013 15:29:03
Quote by wickedpam:



totally cute house!!


And wouldn't it be nice to have a "starter home" available again, instead of these ludicrous $900,000 McMansions that nobody can afford.

(I can drive through my area now, especially with snow still on the ground, and point out all the unplowed, unshoveled, unsold, and vacant monstrosities.)


Comment by wickedpam on 03/05/2013 15:39:37
Quote by Raine:
Quote by wickedpam:
SNOWQUESTRATION is coming!!!!!
How much are they saying in Manassass?

WE are supposed to get 6 inches of the heavy wet gloop.


about a foot. but I still have to come into work. Got a room for tomorrow night at the Holiday Inn Express in Springfield. I'm just hoping someone will come to their senses and close the office before we have to get on the road. There's no way our drivers are going to be able to drive in this.


Comment by Scoopster on 03/05/2013 15:44:44
Here's your state anthem right here Mondo!



Comment by Scoopster on 03/05/2013 16:11:05
Oh goodness..

OMG my workload will triple if this happens.

Comment by Will in Chicago on 03/05/2013 16:40:11
Quote by Raine:
I think we should drug test CEO's that get welfare.



Raine, that is about as likely to pass with the GOP as Rush Limbaugh taking a vow to act as humbly and politely as the Dalai Lama.

As for myself, I spent yesterday watching my great nephews who had a day off of school. Their Mom was busy, so I watched them and cleaned.

On the job front, I am checking out East. Let's see what is out there. (I will play the YouTube videos a bit later.)

Comment by Will in Chicago on 03/05/2013 16:43:39
Quote by TriSec:
Quote by Raine:
How much are they saying in Manassass?

WE are supposed to get 6 inches of the heavy wet gloop.


Depends where you are. Have I ever mentioned the moderating effect the ocean has on winter storms?

Coast, not much, Cape, rain only, interior (Worcester county) maybe some plowable stuff.



We are expecting 6 to 10 inches plus in NW Indiana..

Comment by Mondobubba on 03/05/2013 16:48:21
Quote by Raine:
I went down a serious rabbit hole this morning... Montgomery ward Kit homes.

For those that weren't aware the hosue I owned in Germantown was a Ward home. and for years I had wondered what particular style it was. I found it today! Mine was the *Miami*



I am totally envious. It is my dream to own/live in either a Sears or Wards house.

Comment by Raine on 03/05/2013 17:16:17
Quote by Mondobubba:
Quote by Raine:
I went down a serious rabbit hole this morning... Montgomery ward Kit homes.

For those that weren't aware the hosue I owned in Germantown was a Ward home. and for years I had wondered what particular style it was. I found it today! Mine was the *Miami*



I am totally envious. It is my dream to own/live in either a Sears or Wards house.
Mondo, you should totally bookmark that blog. I was very surprised at how many kit homes are out there and how many people don't even know they own one.

My house in NY had markings on each piece of wood, it was always a very cool thing to me. When we were looking at houses a couple years ago, unbeknownst to me at the time, many of those homes we loved were probably kit homes.








Comment by Raine on 03/05/2013 17:18:59
Quote by Scoopster:
Oh goodness..

OMG my workload will triple if this happens.
There is actually talk about the Olympics being brought to DC.

Bob and I mixed about this. I think it would be great, he wonders if the area could handle it.

I'll ya what, I'd love it more than anything else if it came to you area, it would give you a LOAD of work security!


Comment by Raine on 03/05/2013 17:28:07
Quote by TriSec:
Quote by wickedpam:



totally cute house!!


And wouldn't it be nice to have a "starter home" available again, instead of these ludicrous $900,000 McMansions that nobody can afford.

(I can drive through my area now, especially with snow still on the ground, and point out all the unplowed, unshoveled, unsold, and vacant monstrosities.)
Interesting thing about these homes, -- many came with a mortgage from the company that sold the house. You were given a certain amount of time to put them up or you would lose the mortgage from sears, or Ward. They promoted people to buy these houses as a way to save money on rent. It was cheaper to by a kit house and build it than to pay rent -- including the mortgage.

I find them fascinating. It's amazing to me that Gus Cross, the man who built the house I grew up in and later owned paid about $2500 dollars. That was in 1921. In 1978 my dad bought it for about 60 grand. It doubled in price by 2005-6. Since then it has doubled in price again. (no -- I don't regret selling my half to my co-owner at the time)

That says something, no? This was the country. I lived 20 minutes from the train station (amtrak, no commuter rail) and another 20 from the thruway. an hour from Albany and 1.5 hours from NYC.



Comment by Raine on 03/05/2013 17:44:41
Queue the tinfoil....

DRONES Ehrmhrghrwd

It is, however, a very strange story.

Comment by trojanrabbit on 03/05/2013 17:47:14
Quote by TriSec:
THis whole Mass Song thing is gaining worldwide traction - it was one of the feature stories on the BBC Commuter podcast yesterday.

I'd go with Aerosmith. Never cared for the Roadrunner song.

Dirty Water, or any band with "Boston" in it is too Boston-Centric, as the legislator from Duxbury pointed out on the podcast yesterday. He did offer up a compromise....Roadrunner for state song, Aerosmith for state band.


shrug....



Comment by Raine on 03/05/2013 17:47:47
Quote by TriSec:
Quote by Raine:
How much are they saying in Manassass?

WE are supposed to get 6 inches of the heavy wet gloop.


Depends where you are. Have I ever mentioned the moderating effect the ocean has on winter storms?

Coast, not much, Cape, rain only, interior (Worcester county) maybe some plowable stuff.
yup.

Lake Effect Snow can be like that too. Dad lives 500 feet from a cliff on lake ontario.

Often he'll only get an inch or so -- 500-1000 feet down the road, inland, they would have a foot.

Comment by trojanrabbit on 03/05/2013 17:55:35
Quote by Raine:
Quote by Scoopster:
Oh goodness..

OMG my workload will triple if this happens.
There is actually talk about the Olympics being brought to DC.

Bob and I mixed about this. I think it would be great, he wonders if the area could handle it.

I'll ya what, I'd love it more than anything else if it came to you area, it would give you a LOAD of work security!


4 words

No....chance.....in......Hell

This place pissed and moaned and whined and cried for decades to get the Fleet.....er....TDBankorwhatevertheycallthemselves Garden. Had to be threatened to lose the Patriots before anything happened in FoxboroUGH. And we'll probably never see another baseball park unless Fenway collapses.

FWIW, I'd wonder how much longer Menino is going to be Mayor.


Comment by Scoopster on 03/05/2013 17:58:55
Quote by trojanrabbit:
Quote by Raine:
Quote by Scoopster:
Oh goodness..

OMG my workload will triple if this happens.
There is actually talk about the Olympics being brought to DC.

Bob and I mixed about this. I think it would be great, he wonders if the area could handle it.

I'll ya what, I'd love it more than anything else if it came to you area, it would give you a LOAD of work security!


4 words

No....chance.....in......Hell

This place pissed and moaned and whined and cried for decades to get the Fleet.....er....TDBankorwhatevertheycallthemselves Garden. Had to be threatened to lose the Patriots before anything happened in FoxboroUGH. And we'll probably never see another baseball park unless Fenway collapses.

FWIW, I'd wonder how much longer Menino is going to be Mayor.

To be fair, I think Fenway isn't gonna ever be replaced. And I don't think most folks in Boston, Mass, or New England for that matter would want it to be replaced.

Comment by Scoopster on 03/05/2013 18:00:41
We're on a serious southern New England kick today heh..

When the hell did The Rock WCCC go semi-hard?!

Comment by TriSec on 03/05/2013 18:19:06
Fenway had the Renaissance.

It's not about the Red Sox, it's about "The Experience".

At least until the current ownership got distracted by FC Liverpool.

* spits *



Comment by livingonli on 03/05/2013 18:52:02
I think I need a vacation since I am feeling worn out.

Comment by Raine on 03/05/2013 18:57:31
So get this Shite... Watching MSNBC -- Andrea Mitchell was interviewing Elijah Cummings about the CR that the GOP put forward.


Boner put forth a continuing resolution to prevent a Government shutdown -- It basically continues the funding for defense and keeps everything on the domestic sight the same as the sequester.

POS.

Comment by Mondobubba on 03/05/2013 18:58:55
Quote by TriSec:
Fenway had the Renaissance.

It's not about the Red Sox, it's about "The Experience".

At least until the current ownership got distracted by FC Liverpool.

* spits *



Hey, Tri you want some English cheddar with that cheap domestic whine?


Comment by Raine on 03/05/2013 19:02:40
Is anyone an official member of DU here?

Comment by Raine on 03/05/2013 19:04:42
this is an interesting twist.

George Zimmerman's attorneys stunned court observers Tuesday when they waived their client's right to a "Stand Your Ground" hearing slated for April that might have led to a dismissal of the charges in the shooting death of unarmed teenager Trayvon Martin a year ago.

However, the defense lawyers didn't say whether they would waive the immunity hearing outright. They left open the possibility for that hearing to be rolled into Zimmerman's second degree murder trial. Zimmerman, a former neighborhood watch captain in his Florida subdivision, shot and killed the teen, who was visiting a house in the area.

The move allows the defense more time to prepare for the trial this summer, but also raises the stakes.




Comment by Will in Chicago on 03/05/2013 19:05:04
Quote by Raine:
Is anyone an official member of DU here?



Raine, I do have an account at DU. I seldom post there as the board's message posting features are a bit out of date.


Comment by Mondobubba on 03/05/2013 19:17:01
Me: Great! now I want you to do a left mouse click anywhere on your website as appears in the web builder.
Her: Where?
Me (through gritted teeth): Anywhere.You.See.Text.On.Your.Website.
Her:I don't see anything.
Me:Any.where.you see.text.

I am reminded of Richard Heller's best seller, "Catch-22"




Comment by TriSec on 03/05/2013 19:20:05
Quote by Mondobubba:


Hey, Tri you want some English cheddar with that cheap domestic whine?


I'd prefer Stilton, if you don't mind.



Comment by Mondobubba on 03/05/2013 19:21:25
Quote by TriSec:
Quote by Mondobubba:


Hey, Tri you want some English cheddar with that cheap domestic whine?


I'd prefer Stilton, if you don't mind.




OK, Mister I'm Missing the Point. Key word there was English.

Comment by Mondobubba on 03/05/2013 19:32:35
You know Tri, you would make a great Liverpool supporter. Your years of being a Red Sox fan have prepared you for the bitterness and cynicism being fan of the Reds requires.

Comment by Mondobubba on 03/05/2013 20:02:03
Hey Tri, did you know the New York Times is a partner in FSG? How come you don't gripe about Roush Fenway Racing distracting from the Sox? Or Fenway Sports Management? Or NESN? Hmmmmm?