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The PDF Prescription for Health Care Cost Control | Talking PDF

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The PDF Prescription for Health Care Cost Control

Pos ted on A ugus t 5, 2009 by Duff Johns on in Privacy, T alking PDF

Hea lt h ca r e cost s in t h e US h a v e sig n ifica n t ly ou t pa ced in fla t ion for sev er a l deca des. A lon g side t h e qu est ion of u n iv er sa l cov er a g e, t h e h ea lt h ca r e r efor m deba t e in W a sh in g t on , DC, t h er efor e, r ig h t ly cen t er s on con t r ollin g cost s. Policy -m a k er s h a v e r ecog n ized t h a t cu r r en t lon g -t er m t r en ds a r e u n su st a in a ble w h a t t o do a bou t it is t h e su bject du jour. T o g et m y blood dr a w n t h e ot h er da y , I w a t ch ed en t r ies m a de in t h r ee differ en t sy st em s. A t lea st fou r dist in ct pieces of pa per w er e g en er a t ed t o celebr a t e m y h ospit a l v isit . Na t u r a lly , Im n ot in clu din g t h e billin g a n d in su r a n ce pa per w or k , w h ich I h a v en t y et r eceiv ed. Com pu t er s w er e m u ch in ev iden ce, bu t t h ey a ppea r ed t o ser v e la r g ely a s a n in t er fa ce t o w ell-w or n la ser pr in t er s. In st ea d of sim ply en t er in g a bloodw or k or der in t o t h e sy st em , pa per h a d t o be pr in t ed for m e t o h a n d-deliv er t o t h e la b. T h e fr esh ly -pr in t ed for m r equ ir ed a st a m p befor e it w a s g ood . Oh , a n d t h e for m w a s on ly g ood t h e da y it w a s pr in t ed. If I cou ldn t w a it 4 5 m in u t es t o g et blood dr a w n , Id h a v e t o r epea t t h e w h ole pr ocess. T h ese a r e r ou t in e, m a n y -t im es-a -da y oper a t ion s w it h in a la r g e h ospit a l of g ood r epu t a t ion . St a n da r diza t ion , st r ea m lin in g a n d r a t ion a liza t ion of su ch ov er h ea d sh ou ld h a v e h a ppen ed lon g , lon g a g o. W h a t cen t u r y a r e w e liv in g in ? Lea v in g a side t h e polit ica l qu est ion s of h ow ca r e is fin a n ced or deliv er ed, ev er y on e a g r ees t h a t con t r ollin g a dm in ist r a t iv e cost s is essen t ia l t o br in g in g h ea lt h ca r e ex pen dit u r es in -lin e. Im n o doct or , bu t I k n ow a t h in g or t w o a bou t docu m en t s, a n d I h a v e a pr escr ipt ion for t h e h ea lt h ca r e in du st r y : PDF.

An Operational Perspective
Fr om t h e in for m a t ion a n d a dm in ist r a t iv e poin t s of v iew , h ea lt h ca r e is a sw a m p of files, docu m en t s, for m s, da t a ba ses, im a g es, m u lt im edia y ou n a m e it . Secu r it y a n d pr iv a cy con cer n s a r e ser iou s, per sist in g a n d ev er m or e con sequ en t ia l. Hu n dr eds of v en dor s t ou t pr opr iet a r y or ot h er w ise m u t u a lly in com pa t ible sy st em s, w h ile ev er y v en dor a n d in su r a n ce com pa n y h a s it s ow n for m s a n d pr ocedu r es. T oda y , t h e m a n y a n d v a r ied g a ps bet w een t h ese disjoin t ed pr ocesses a r e br idg ed w it h n ew pa per w or k for doct or s, h ospit a ls a n d pa t ien t s, r et u r n in g u s fu ll cir cle t o fa x m a ch in es, FedEx a n d oldfa sh ion ed pen a n d pa per . It s n ot so m u ch t h a t a n y on e or t w o or t h r ee of t h ese sy st em s is t er r ible. Ev en a pu r ely pa per -ba sed sy st em cou ld be r ea son a bly efficien t a n d effect iv e IF it w a s h ig h ly st r u ct u r ed, con sist en t a n d sy st em a t ica lly im plem en t ed. W e don t h a v e t o st ick w it h pa per a n d it s lim it a t ion s, bu t w e DO h a v e t o dea l w it h t h e g r in din g g ea r s bet w een t h e v a r iou s sy st em s in u se. W e ca n bem oa n t h e fa ct t h a t t h e big g est sin g le a dm in ist r a t iv e pr oblem is st a n da r diza t ion , or w e ca n do som et h in g a bou t it . T h a t s w h er e PDF com es in .
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The PDF Prescription for Health Care Cost Control | Talking PDF

Setting the Terms for Change

On e ca n t h in k in t er m s of t w o fu n da m en t a l v en u es for t ech n olog y con t r ibu t ion s t o ben din g t h e cu r v e slow in g or r ev er sin g t h e t r en d t ow a r ds h ig h er cost s: Br i dgi n g t ech n olog ies t h a t ca n con t r ibu t e t ow a r ds in t eg r a t ion of t oda y s r ea l-w or ld sy st em s. Ex a m ples in clu de fa x m a ch in es, docu m en t ba r -codes a n d OMR (Opt ica l Ma r k Recog n it ion ) sy st em s t o r ea d fill in t h e ov a l for m s. En d-St a t e t ech n olog ies t h a t con t r ibu t e t o (m or e or less) idea lized h ea lt h ca r e a dm in ist r a t iv e oper a t ion s. Ex a m ples in clu de r ela t ion a l da t a ba ses, en cr y pt ion , dig it a l sig n a t u r es a n d st a n da r diza t ion im plem en t ed a t a h ig h lev el. Per h a ps u n iqu ely , PDF offer s bot h br idg in g a n d en d-st a t e t ech n olog ies a ll in on e. W h a t a r e t h e st a n dou t qu a lit ies of PDF w it h r espect t o t h ese t w o v en u es in h ea lt h ca r e t ech n olog y n eeds?

PDF seamlessly integrates content from both paper or electronic sources

A ccom m oda t in g t h e m essy r ea lit y of t oda y s h a n d-filled for m s a n d pr in t ed r ecor ds is essen t ia l for a n y on e size fit s a ll elect r on ic docu m en t t ech n olog y . Ha ppily , PDF pa g es pr odu ced fr om W or d or Ex cel coex ist on equ a l t er m s w it h pa g es pr odu ced fr om sca n n er s or fa x m a ch in es, a n d bot h en joy t h e sa m e por t a bilit y , v iew in g opt ion s, lin k in g , t h u m bn a ils, secu r it y , dig it a l sig n a t u r es a n d ot h er fea t u r es of PDF. Ev en 3 D m odels m a y n ow be r epr esen t ed in PDF! En d-St a t e: In t eg r a t ion of m u lt iple sou r ces a n d sou r ce for m a t s in t o a v er ifia ble docu m en t a r y r ecor d is a k ey cr it er ia for en d-st a t e solu t ion s. Br i dgi n g: T h e ca pa cit y t o in t eg r a t e sca n n ed or fa x ed (or im a g ed, or plot t ed, or w h a t ev er ) con t en t t og et h er w it h ot h er PDFs g en er a t ed dir ect ly fr om a u t h or in g a pplica t ion s m a y be lev er a g ed t o in cr ea se efficien cy in a lm ost a n y sy st em t h a t u t ilizes (or m er ely a ccept s) PDF files.

T he PDF format encompasses documents in all their variety

In h ea lt h ca r e, docu m en t is a br oa d con cept cov er in g m a n y dist in ct sor t s of it em s; r epor t s, a r t icles, st a t em en t s, ch a r t s, da t a ba se r ecor ds, for m s (bla n k ) a n d for m s (filled), a r ch iv es, pr escr ipt ion s, in v oices, la bels y ou g et t h e idea . PDF ca n a n d does ser v e a s t h e elect r on ic v er sion of ea ch t y pe of h ea lt h ca r e-r ela t ed docu m en t in m a n y set t in g s. So fa r , h ow ev er , t h e m a n y a dv a n ced ca pa bilit ies of PDF, su ch a s m a r k u p, in t er a ct iv it y , scr ipt ed for m s, secu r it y , dig it a l sig n a t u r es a n d clien t -ser v er in t eg r a t ion , r em a in w oefu lly u n der -u t ilized. Bey on d t h e in n a t e ca pa bilit ies of t h e for m a t , PDF files m a y in clu de X ML v ia t h e X MP (eX t en sible Met a da t a Pla t for m ), a k ey m ech a n ism t o a ssu r e in t er oper a bilit y bet w een div er se sy st em s. PDF ca n ev en con t a in ot h er files: X ML, im a g es, Fla sh a n im a t ion s, m ov ies, da t a ba ses, specia lized m edica l da t a a n y t h in g . En d-St a t e: PDF pr ov ides a on e size fit s a ll solu t ion for ev er y t y pe of fin a l-for m docu m en t , a n d ca n per for m in dy n a m ic docu m en t r oles a s w ell. Br i dgi n g: A s or g a n iza t ion s lea r n t o in t eg r a t e elect r on ic docu m en t s in t o t h eir sy st em s, PDF ca n m eet t h eir n eeds a t ea ch st ep of docu m en t in t er a ct ion , fr om filla ble for m s t o pa t ien t files, fr om im a g e m a r k u p t o secu r e dist r ibu t ion .

PDF is just Portable

T h e cen t r a l v a lu e of PDF is so obv iou s, it s oft en u n der st a t ed. PDF pr ov ides a con sist en t , r elia ble r epr esen t a t ion of a n y docu m en t , on a lm ost a n y oper a t in g sy st em , a n d t h e Rea der soft w a r e is fr ee. A dobe Sy st em s in v en t ed t h e PDF for m a t in t h e ea r ly 1 9 9 0 s a n d r em a in s t h e pr eem in en t desk t op PDF
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The PDF Prescription for Health Care Cost Control | Talking PDF

soft w a r e v en dor . In 2 0 0 8 , PDF w en t pu blic a s ISO 3 2 0 0 0 . T h e for m a t is n ow a n in t er n a t ion a l st a n da r d m a n a g ed by in du st r y v olu n t eer s, of w h ich A dobe is bu t on e. T h e fr ee A dobe Rea der , t h e r a pidly ex pa n din g ecosy st em of in depen den t PDF dev eloper s, a n d t h e body of in t er n a t ion a l st a n da r ds g ov er n in g t h e t ech n olog y a ll con t r ibu t e in cem en t in g PDF a s t h e Por t a ble Docu m en t For m a t of ch oice in t o t h e for eseea ble fu t u r e.

What Can Government Do?

Hea lt h ca r e a dm in ist r a t ion g en er a t es m a n y m et r ics. Gov er n m en t sh ou ld r ew a r d a n d en cou r a g e m ea su r a ble pr og r ess in r edu cin g a dm in ist r a t iv e cost s w h ile im pr ov in g ser v ice. Dr iv e t h e a dopt ion of elect r on ic docu m en t a n d dig it a l sig n a t u r e t ech n olog y n a t ion w ide a n d in t er n a t ion a lly . Ma n y cou n t r ies a n d st a t es st ill don t a ccept dig it a l sig n a t u r es, a n d m a n y or g a n iza t ion s in st a t es t h a t do st ill w on t t a k e t h em . T o en su r e h ig h qu a lit y r esu lt s a n d t o set a lev el pla y in g field for soft w a r e dev eloper s, g ov er n m en t s sh ou ld su ppor t t h e dev elopm en t a n d a dopt ion of t ech n olog y solu t ion s m eet in g in du st r y st a n da r ds, pa r t icu la r ly ISO 3 2 0 0 0 (PDF), ISO 1 9 0 0 5 (PDF/A ) a n d t h e for t h com in g ISO/A W I 1 4 2 8 9 (PDF/UA ).

Conclusion
PDF t ech n olog y is a lr ea dy pa r t of h ea lt h ca r e a dm in ist r a t ion a t m a n y lev els, bu t oft en on a n ad hoc ba sis, a n d a lm ost a lw a y s w it h ou t t a k in g fu ll a dv a n t a g e of t h e for m a t . A s su ch , t h e pot en t ia l for PDF t ech n olog y t o r edu ce cost s a n d im pr ov e per for m a n ce in h ea lt h ca r e in for m a t ion m a n a g em en t h a s ba r ely been t a pped. Ma n y of t h e docu m en t h a n dlin g r equ ir em en t s in h ea lt h ca r e a r e be ser v ed by t h e qu a lit ies t h a t m a de PDF t h e w or lds de facto elect r on ic docu m en t t ech n olog y . It r em a in s for policy m a k er s a n d v en dor s t o fa sh ion a w or k in g con sen su s on m ov in g for w a r d. PDF, a n d h ow t o lev er a g e PDF t o bet t er ser v e h ea lt h ca r e a dm in ist r a t iv e n eeds, sh ou ld be a t t h e cor e of t h e t ech n olog y discu ssion . By Duff Johns on PDF Ben efit s, PDF For m s

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