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Part 1 or 4

As a Medicare/Medicaid-qualified physician who lived and worked in AS for over 14 years (and ran the Dept. of Pediatrics at the LBJTMC for about half of that time), I am greatly troubled by the ongoing inability of the leaders in the Territory to properly obtain and manage adequate healthcare funding for its residents.

 While my last day of work at the hospital was in very late 2015, and I moved back to the mainland in early 2016, it appears as though very little since then has changed in this regard. And from what I can see here in these pages, sadly nothing has changed for the better.

 As an example, we used to have tremendous problems documenting our services provided for our patients… Not so much medically I mean (the doctors, nurses, pharmacists, therapists, and ancillary service providers generally kept detailed notes on all of these encounters), but professionally.

 What I mean by that is, ASG along with the ASMCA (LBJ) were failing to treat the delivery of medical care like the business that it really is! And when we talk about business of course, we simply must talk about money. There is just no other way to continue providing services if the flow of money is not very carefully considered, and then meticulously monitored and maintained at all times.

Personally I believe that the financial support of any healthcare system has to be considered right up there amongst our very highest priorities, that is to say, probably right behind “stopping the bleeding” of the patient in front of you at the moment! 

It truly is just that important, and absolutely essential to everyone's survival in this vital endeavor.

 Now, up until about 2003 or so LBJ had largely a paper-based medical records keeping and billing system (we were certainly not alone in this, as many other States and Territories also still kept records in that same, old-fashioned way), but the U.S. Government was making a big nationwide push to use Electronic Medical Records.

Thankfully LBJ was eventually able to obtain a "freeware" version of the system used throughout our country by the Veterans Administration (called C.P.R.S.).

 This was supposed to not only increase LBJ’s efficiency and accuracy (as well as to improve communication with off-island providers and organizations) in medical matters, but it was also supposed to help improve their reimbursements for provider services rendered.  To help sustain and improve the business of medicine... But did it?

In my next piece, I will attempt to outline what developed with LBJ’s electronic medical records system, and how I believe it reflects a much larger and deeper problem within the governance of ASG.