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#hierarchical

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#Epic #Systems epitomizes everything perverse about the commercialized mess that American medicine has become.

“Epic’s clients are not doctors.
They are the CEOs and CFOs who write the checks to Epic,” says Dr. Bill Stead, who created pioneering #electronic #health #record systems at Duke and then at Vanderbilt University Medical Center,
both eventually supplanted by Epic.

Epic became the dominant vendor of databases because it was better than anyone else at combining regulatory compliance with 🔸maximizing hospital income.
Epic enables the hospital to maximize the use of codes that determine the payment.
“Before Epic, nobody was able to systematize upcoding,” says an executive of one hospital system.
🔥Epic’s software can enable doctors and hospitals to overcharge patients, insurers, and Medicare and Medicaid.

There are about 10,000 possible billing codes that indicate conditions and complications.
These #Hierarchical #Condition #Category (HCC) codes allow increased payments based on risk.
For instance, diabetes with no complications, HCC code 19, pays a capitation rate of $894.40 -- while diabetes combined with kidney failure can use 2 HCC codes, 18 and 136,
which increases the capitation rate to $1,273.60.
Doctors have the ability to also use codes for past patient conditions that have nothing to do with current presenting symptoms.

Assigning codes to each patient health malady is more of an art or artifice than a science, where doctors’ judgment calls can bleed into Medicare fraud.

Payments are based partly on time spent with a patient, on a scale from 1 to 5.
One doctor told me that her supervisor, who gets reports from Epic on her billing practices, regularly contacts her and says things like “That appointment was a 2. Don’t you think it might be a 3?”

Epic’s software can thus enable doctors and hospitals to overcharge patients, insurers, and government agencies such as Medicare and Medicaid.
Before a doctor can complete the record of a patient visit, they must respond to every question and check every required box.
🆘 Hospitals have financial incentives to make patients look sicker so that they can maximize revenue, and Epic’s software facilitates this.

prospect.org/health/2024-10-01

The American Prospect · An Epic DystopiaHow a near-monopoly gained control of most of the nation’s electronic medical records, to the detriment of medical practice and doctor morale
Replied in thread

@postmodern
I'm really only familiar with having #mixins provide #compartmentef or #hierarchical #functionality, not actual #interfaces with Things.

Which is why I prefer #𝚔𝚒𝚗𝚍_𝚘𝚏? over #𝚒𝚜_𝚊? since a descendant of #String might be more than a string, although still having String's semantics.

E.g., in my game framework, a pouch, a desk, a location, and a room all mix in my Container module. Room is a kind of Location, but both have Container semantics.

Continued thread

From #routing to #hierarchical multi-label classification and user #preference learning, SPLs outperform other baselines that relax constraints or use problem-specific architectures.

Even when they predict the wrong labels, they still form a valid configuration!

Join Kareem Ahmed, Stefano Teso, Kai-wei Chang, @guy
and me at
#NeurIPS2022 to talk about #SPLs and how to have #neural #nets to behave in the way we #expect them to do!

📜openreview.net/forum?id=o-mxIW
🖥️github.com/KareemYousrii/SPL

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