Health Care Providers Take Advantage of Government Incentives for Meaningful Use of EHRs

There have been many advances in Health Information Technology (HIT) however; many medical institutions and health care providers have been reluctant to move forward in utilizing them. Many providers have chosen to remain paper-based – which can cause a wide range of errors and inefficiencies.In 2009 the federal government decided to promote HIT with the passage of the HITECH Act within the American Recovery and Reinvestment Act. This act makes incentive funds available to health care providers who begin to utilize a certified electronic health record (EHR), as long as they use it to achieve specific goals, showing meaningful use.Meaningful Use basically means that health care providers have to show significant measurable use of the EHR technology. Just a couple of the ways meaningful use can be shown is through e-prescribing and electronic exchange of health information to improve quality of care. The incentives for meaningful use of a certified EHR are put in place with the desired result of coordinated high quality care for patients.The Department for Health and Human Services recently announced that, through a survey completed by the Office of the National Coordinator for Health Information Technology (ONC), approximately 81 percent of hospitals plan to implement meaningful use of a certified EHR in order to take advantage of the government offered incentive payments. Of those providers they estimate that 65% will enroll during the 1st stage of the incentive program which takes place in 2011-2012. In addition to hospitals, it is estimated that 41 percent of office-based physicians plan to take advantage of the incentive payments and implement meaningful use of a certified EHR as well.The implementation of certified EHR’s should bring more organization and effectiveness to the way health care is provided today. In the end health care should become more efficient with a better service being for patients.

Self Storage Loans and the Small Business Administration

Self storage loans are now being offered through the Small Business Administration and its affiliated lenders. Funding for these small business loan opportunities also increases the ability to refinance in the present-or as time progresses. Prospective borrowers looking to assume the responsibilities of building from scratch, upgrading, and/or remodeling can now take advantage of what the SBA has to offer.Recent developments in a steadily growing market have provided incentives for lenders and loan-seekers alike to capitalize on lower commercial loan rates, as well as many other amenities entailed in these premium packages. Self storage loans, when implemented through these channels, may very well become the investment opportunity of a lifetime.Small business financing of this nature can easily turn into greener pastures. A number of contributing factors have led to the storage industry’s uprising; the most obvious reason is that many Americans have adopted somewhat of a pack-rat mentality and they need extra space to store their wares. The most recent subprime snafu has also led to an increase in downsizing and diminishing additional space, which in turn can benefit those who are seeking self storage loans.While all of this may sound like a walk in the park, the borrowing process does require applicants to possess certain qualifications for each respective loan. Even though more and more lenders are referring to this enterprise as a preferred property milieu, preparing a solid loan request portfolio can make a big difference in getting approved.Having clout and credit is a big plus; commercial loan rates will likely hinge upon overall credit scores. Most lenders will combine that number with each prospective borrower’s business track record, recent personal bank statements and tax returns to determine whether or not any of these SBA affiliated self storage loans are within reach.The SBA urges future borrowers to have all of their ducks in a row to attain expedient approval. Using a business loan calculator will also help to put things into perspective regarding commercial interest rates, monthly payments and additional fees, if any.Current business owners looking to build an additional storage facility will need to provide the same credentials, including a property overview, proposed location, expected occupancy, documented managerial experience in the related field, and a few other details that can be explained in full by a reputable mortgage broker who specializes in self storage loans.Once approved, the benefits of small business financing for first-timers can be invested in a few different areas, including a strategically placed advertising campaign. Marketing the business effectively will likely lead to max occupancy, while simultaneously building a solid foundation in a relatively short period of time.Becoming an established business owner can lead to a variety of other investment opportunities where the commercial loan rates are even more favorable. Truth be told, this particular undertaking is a win/win scenario; the ability to generate revenue via self storage loans provides in part the type of national economic strength needed at the present time, especially in a globalized market setting.Supply side economics is virtually keeping pace with the demand when it comes to independently owned storage facilities; in fact, the larger chains occupy less than 20 percent of the market share. In this case, a business loan calculator can be temporarily replaced by a standard model.The SBA and its affiliates are working feverishly to provide small business financing for those who’d prefer to stay in the black for years to come. Self storage loans are now available in most every state.

History of The Karate Belt Ranking System

There are many myths in the martial arts, but the two I hear the most, which are recited in nearly every martial arts school I know, are (1) that the martial arts originated in the Shaolin Monastery in China and (2) how the belt ranking system originated. I have talked in other articles about how historians have shown that the martial arts did not originate in the Shaolin Monastery so here I will talk about where the belt ranking system originally came from.The most common version of the myth I hear is that originally the martial arts only used one belt and it was white (sometimes they say it was a white piece of rope). As the student practiced over the years their belt became darker and darker due to absorbing sweat, blood, and dirt. The myth goes that if you saw someone with a belt that had become black you knew they were an expert. This, while perhaps romantic, is totally false.There are actually three different components that make up our modern ranking structure and we need to look at each of them to fully understand our history. The three components of our ranking structure are the use of colored belts, the ranking structure that the belts symbolize, and the concept of the “degreed black belt”. Each of these has a separate history that is connected to the others.The use of colored belts comes from Japan and it was originally a way to organize competitors for tournaments. The Japanese take competitions very seriously and there is no shortage of things to compete in, such as swimming, flower arranging, diving, running, painting, sculpting, dancing, singing, serving tea, etc. In organized tournaments there were two different levels of competition: beginner and skilled. Either you were a skilled competitor with a local, regional, or national ranking or you were a beginner trying to become skilled.If you were going to hold a swimming contest, for example, perhaps hundreds of competitors would show up dressed in their traditional kimonos and you would need a quick way to tell which division each person was competing in. The answer the organizers came up with was that someone competing in the skilled division was to wear a black obi (a thick traditional fabric belt worn around the kimono) and a beginner was to wear a white obi. This manner of marking competitors gained popularity and more and more organizations decided to adopt it but they didn’t always use obi, sometimes they wore headbands or ribbons tied around their arms. It is from this practice that we get the wearing of the white belt for the beginner and the black belt for the skilled practitioner.The actual ranking system itself also comes from Japan and it is called the “Dan System” (pronounced “Don” and meaning “level.”) For some competitions having people separated into beginner and skilled divisions was enough but for more complex and popular games they needed a way to rank people within those divisions, and the most complex and most popular of all was the game of “Go”.Go is an oriental version of chess and taken very seriously in Japan, China, and other countries throughout the world. Sometime around 1680 a go competitor named Honinbo Dosaku, who is considered perhaps the greatest and most influential player in history, introduced the “dan system”. Under this system each player was ranked at a certain level based on their experience, record, and handicap. Skilled players were given a rank of “1″ through “9″, with the rank of “1″ representing that the person was ranked at the first level which was called “Shodan”, meaning literally “lowest level” and the rank of “9″ representing the person was ranked at the highest level, called “Meijin” meaning “brilliant man.” Honinbo Dosaku based this ranking system on the ranking system already used in China for go competitions called the “9 Pin Zhi”.If you were not considered a skilled player you were put into a group called “Kyu.” Originally there were no rankings inside Kyu, everyone was lumped together and the goal was to get good enough to progress out to the level of Shodan. What got you out of the Kyu division was purely skill and there was no time restraints making you wait a certain period of time. In the same way when the martial arts started using belts the Kyu ranks were very informal and if you could demonstrate enough skill to get your black belt in a short period of time they gave it to you. Later on Go organizations started adding ranks within the Kyu division and today there are 30 ranks in the Kyu system. A student today in Go starts out with a rank of 30 Kyu, the lowest rank possible, and works up to the rank of 1st Kyu, which is the highest rank in the kyu system and then goes on to the Dan Ranks; in modern go, kyu means “pupil” and dan means “skilled player”.When the martial arts started out they did not have a ranking system at all and you were either a student, a senior student with limited authority during class, or a teacher. As time passed and more formal schools emerged your teacher might issue you a certificate called a “Menkyo Kaiden” which translates to “certificate of total transmission.” This meant that you had learned the total art from that teacher and were qualified to teach it. The issuing of these certificates were fairly rare because it could take numerous years of hard work to earn one, like today people moved around so they sometimes had to learn from numerous instructors, and some instructors just didn’t give them out.The way the belt system came to the martial arts was by a Japanese man named Kano Jigoro (1860-1938). Growing up Kano Jigoro was a particularly small child from a wealthy family and had a problem with being bullied. To remedy this he began studying Jujitsu which is a martial art consisting of joint breaking techniques and throws. In 1868 Japan went through a change of government in the “Meniji Restoration” and the country became more and more westernized. Soon the violent practice of Jujitsu fell out of social favor and a lot of instructors quit teaching.In 1882 he founded a new art called “Judo”, meaning “the way of gentleness”. In the new modern westernized Japan Jujitsu and its violent techniques were considered unfashionable and not necessary so many practitioners tried to distance themselves from it by learning it in secret. Judo was to be a gentler martial art that was based on the teachings of Jujitsu but was also a sport that anyone could learn and compete in. It was to be a gentle modern sport for the new modern Japan.Judo thrived and soon Judo competitions happened with the same frequency as swimming or dancing competitions. Being a competitive activity with no real ranking system, Kano Jigoro adopted the wearing of belts that had already been in use for hundreds of years. There were no martial arts uniforms back then so they practiced in kimonos and beginning and intermediate competitors wore white obi over their kimonos and advanced competitors wore black obi over their kimonos. This was the extent of the ranking system in Judo at this time; either you were a white belt or a black belt and technically the founder of Judo was the same rank as his other black belts.Since Judo was a sport it didn’t take long for Kano to start adopting Dan ranks as some form of the system was used by most athletic associations. He started by adding 5 levels, 1st Dan through 5th Dan, with himself holding the highest rank. At this time there were still no ranks within the Kyu system and only the two belt colors were used. Later, Kano’s school won a competition against a leading Jujitsu school leading to Judo being more popular and more Jujtsu systems adopting the Dan system. When Karate was brought to Japan from Okinawa by Gichen Funokoshi there we no belts or dan ranks used in Karate but Funokoshi adopted them in an effort to make Karate more accepted by the Japanese.In 1895 the Japanese Emperor Meiji decided that throughout the county’s fast paced westernization it need to protect and embrace its warrior heritage so he created an organization called the “Dai Nippon Butoku Kai”, meaning the “Greater Japan Martial Virtue Society”, which operated as part of the Ministry of Education. The Dai Nippon Butoku Kai was the official government organization that had the authority to organize the martial arts and standardize and regulate their ranking systems. By this time most martial arts in Japan had adopted a ranking system and the ones that hadn’t would soon be forced to.In 1899 the Dai Nippon Butoku Kai published the official rules for Judo competitions. They also standardized levels to the Kyu and Dan grades. Under their system a student starts out as a white belt without any rank whatsoever, and then tests for 10th Kyu and works up to 1st Kyu. Once a student had demonstrated competency in the basics of the art he is considered to be a serious student and is awarded is 1st Dan and the rank of “Shodan”, or “lowest level”. While some people in America consider a Black Belt to be an expert, in Japan the first three dan ranks are considered student rankings.Traditionally, Shodan means you have learned and are competent in the basics of your art, you are ready to learn some advanced teachings, and the student is often allowed to teach lower belts; Nidan (the second Dan Level) means they are more polished in their basics, they are ready to learn more advanced teachings, and they are often allowed to teach the upper Kyu ranks; Sandan (the third Dan Level) is the final student ranking and means they have fully competent in the basics, are competent in a good deal of the advanced training they have received, and are allowed to teach students on their own, normally up to one rank below themselves. It is at the rank of Sandan that the “Yudansha” (holder of a Black Belt) is permitted to be called Sensei (teacher, or “one who is further down the path of learning than I”). By the time someone reaches 4th or 5th Dan they know and are competent in the entire system.While in America most people are eligible to become a “master” at 4th Dan, in Japan 4th and 5th Dan are considered to be “experts”. 6th Dan and above are considered “master level rankings” and are honorary rankings given more for time spent in the art and total lifelong contributions to the art rather than physical skill (although in some traditional systems you can be considered a “master level practitioner” at 5th Dan). The highest ranking in Japanese martial arts is 10th Dan and is generally reserved for the founders or leaders of the style.While in America some 1st Dan are considered experts and even open their own schools or start their own clubs, in Japan if you start your own school you are expected to be a 6th Dan or higher. The Japanese consider 6th Dan to be the rank of “head teacher.”After WWII American soldiers stationed in Japan studied Karate, Jujitsu, and Judo and when they returned they introduced the arts to the general public. It is from these returning soldiers that most martial art knowledge came to America, but with it comes a problem. Most soldiers did not spend more than a few years studying while in Japan and they were not qualified to teach let alone own their own schools. In addition there is a long tradition in the martial arts of deliberately withholding the real teachings from untrusted students. While in Japan there were teachers who offered to teach Americans, most teachers wanted nothing to do with us; after all we did just defeat them in war and were now occupying their country. There are many accounts of American soldiers harassing teachers, threatening them with violence or arrest, or even vandalizing their school if they refused to teach them. As a result most ended up giving in, but in the tradition of masters in both China and Japan, it is widely believed they taught them the movements but left out real applications. In this way they could pacify the Americans but keep the fighting secrets only for the Japanese.A result of these perhaps unqualified soldiers returning to open schools and introduce the martial arts to mainstream American were sometimes low quality teachings and lots and lots of misconceptions. One big misconception was that 1st Dan was an expert rank. People saw that only the teachers wore black belts so they assumed everyone with a black belt was an expert. As time went on masters from other countries have come to America and tried to correct that, and other misconceptions, but most have found that it was easier to “go with it” because it was those misguided people who paid their bills.The Belt System in Korea and ChinaIn 1904 Japan gained control over Korea and sought to turn it into an expansion of Japan. In order to make the country as Japanese as possible they outlawed native martial arts while encouraging the practice of Japanese martial arts like Jujitsu, Judo, and Karate. Not all native Korean martial arts survived this occupation but after it ended the Korean martial arts emerged as versions of Karate, using the same uniforms and ranking systems.A main difference in the ranking structures of Japan and Korea is most Korean arts only have 9 Dan ranks to the 10 used by the Japanese. The reason for this is that to Koreans 9 is a special number because it is the highest single digit multiple of 3 which they consider to be a sacred number.The Chinese martial arts had no formal ranking system but schools in America started to use the Japanese ranking system and giving out belts in the 1960′s because students had come to expect it. Currently most Chinese martial arts taught in the US have some type of belt system, although most use lightweight sashes instead of thick belts as a way to separate themselves from Japanese and Korean systems.Traditionally in China martial artists did wear sashes around their waist. These sashes served three purposes, (1) to squeeze the abdomen and support the lower back and stomach, (2) to show their school as different schools in the same town often wore different colors, and (3) to identify the person wearing them. If you saw someone’s sash knotted on the left side you knew they were a male, if you saw the knot of the right side you knew they were female, and if you saw they were wearing the knot in the middle then you knew that they were an instructor.An interesting note is that companies making martial art uniforms did not come about until the early 1900′s and most people in the US had to buy Judo uniforms from Japan until the 1970′s when they became widely available. Before this people either didn’t use uniforms or belts or they made them themselves. Until belts became widely accessible a teacher normally gave his student a white belt when they started training and the student had to die the belt different colors when they were promoted. This may be an origin of the myth that a black belt is black because it has gotten darker over the years.Origin of the “Degreed Black Belt”One thing most people don’t know is that before 1964 there was no such thing as a “degree” of black belt. The black belt was used to symbolize that a person had status under the Dan System, but each rank had a specific name:”Shodan” is the first level in the Dan System and means “lowest level”.
“Nidan” is the second level in the Dan System and means “second level”.
“Sandan” is the third level in the Dan System and means “third level”.
“Yodan” is the fourth level in the Dan System and means “fourth level”.
“Godan” is the fifth level in the Dan System and means “fifth level”.The above five ranks were symbolized by the wearing of a Black Belt. To attain these ranks the student would often have to go through a formal examination or compete for them in a competition. However, exceptions were made for weaker practitioners or practitioners of special status.”Rokudan” is the sixth level in the Dan System and means “sixth level”.
“Shichidan” is the seventh level in the Dan System and means “seventh level”.
“Hachidan” is the eighth level in the Dan System and means “eighth level”.The above three ranks were symbolized by the wearing of either a Black Belt or a belt of red and white sections. Traditionally formal examinations were only required up through Yondan or Godan (Fourth or Fifth Dan), and all rankings over 5th Dan were usually awarded without a formal examination and given for time in grade and total service to the perspective art. Service to the art was considered practicing, teaching, judging testing’s and tournaments, doing work for the schools, writing papers or books about martial arts, or being a spokesperson for the art to the general public.”Kudan” is the ninth level in the Dan System and means “ninth level”.
“Judan” is the tenth level in the Dan System and means “tenth level”.The above two ranks were symbolized by the wearing of either a Black Belt or a Red Belt. It should also be noted that because the ranks in the Dan System is what was important some martial arts did not use belts at all. In systems like Iaido (art of drawing the sword), Kendo (art of fencing with the sword), and Jodo (art of fighting with a short stick) they did not use any outward representation of rank at all.If you were promoted to the fourth level under the Dan System, for example, you were given the title of “Yodan” and that is what your certificate would say. The concept of “degrees of black belt” came from Grandmaster Ed Parker, a man who is known as the “Father of American Karate.”Grandmaster Ed Parker (March 19, 1931 – December 15, 1990) was the person to really make martial art mainstream in America. He taught Elvis Presley, many other celebrities, appeared on TV and in movies, and was the first person to have a large chain of schools in America. He was a considered by many to be a larger than life figure and a tireless self-promoter.Grandmaster Parker, who was born in Hawaii, began training in Kenpo in the 1940′s under the legendary Professor William Chow. He was promoted to Shodan in 1953 and soon after moved to the mainland and opened his first school. His main school was in Pasadena and called the “Pasadena Kenpo Karate Studio”. In 1957 three brothers named Jim, Al, and Will Tracy started taking classes there and in 1959 the school was turned over to them to run and they did until 1962 when they opened their own school.This was the first time someone had tried making martial arts a large scale commercial venture in America and while Grandmaster Parker knew martial arts he was still learning about running a successful business. The Tracy brothers became important to Grandmaster Parker because they put a selling system in place that made the schools more profitable than ever, and they organized the teaching methods and standardized what was being taught throughout all the schools. They made Kenpo more organized, more accessible to students, and more profitable and Grandmaster Parker was usually quick to adopt most of what they did as the “official way.” However, there were several areas on contention between Grandmaster Parker and the Tracys.Grandmaster Parker created his own organization called the “Kenpo Karate Association of America” (KKAA) and it was through this organization that he gave out rank. However in 1964 one of Grandmaster Parker’s students opened a school in Ireland so he turned the KKAA over to the Tracy brothers and he started the “International Kenpo Karate Association” (IKKA). Under the IKKA Grandmaster Parker had different requirements for promotion than he had in the KKAA and when asked the Tracy brothers agreed to join the IKKA on the condition that they and their students would be held to the old, and they felt more fair, standards of the KKAA.A big area of contention, and there many, between Grandmaster Parker and the Tracy brothers was giving out rank. Grandmaster Parker felt that he had the right to give out rank freely to whomever he wanted often without examinations or putting together a panel of other black belts. Grandmaster Parker would try to bribe students from other schools with a promotion to Shodan if they joined his organization and there were stories of him just giving brown belts their Shodan just because he liked them, because they did a favor for him, or just because he felt he didn’t have enough black belts.The Tracy brothers didn’t approve of this manner of giving out rank and it became the biggest area of contention between the two organizations. As the organizations grew this became more and more of an issue and Grandmaster Parker knew he had to do something so he solved this the issue in a way that would have made a Judo expert proud… he sidestepped the entire issue and just stopped using the Dan System!In order to get around the established ranking standards he started putting “1st Degree Black Belt” on the certificates instead of Shodan. This created a lot of controversy at first because there was no such thing as a “Black Belt rank”, it was the Dan rank that was important and the belt merely symbolized that the individual has some type of Dan ranking. “Black Belt rank” was just something he made up and it had no real meaning; it was a way for him to circumvent the Dan system with something similar enough where the uninitiated Americans ready to join the “karate craze” wouldn’t know the difference.Due to Grandmaster Ed Parker popular status most of what he did was blindly accepted by Americans who didn’t know any different. Today in America most rank certificates say “1st Degree Black Belt” instead of 1st Dan or Shodan, and it is my experience that most martial artists don’t understand what a Dan Rank is or what Shodan means.Honorary TitlesThe last thing we’ll cover here is the honorary titles given out in the martial arts, there are two non-traditional titles and four traditional titles commonly used in the martial arts. We will cover the nontraditional titles first.Non-traditional titles: Master and GrandmasterThe ranking of “master” again comes from the game of Go. At the start of the 17th century the Japanese Emperor instituted four Go schools in Japan where people devoted themselves full time to the practice of the game. Higher ranking players, often at the 5th Dan level and above, were considered to be “Master Players” due to the sheer devotion and skill needed to attain those rankings and play at those levels.When the martial arts fully adopted the Dan System under the Dai Nippon Butoku Kai between 1895 and 1899 they also adopted the concept of “Master Players” as well as various samurai titles not used in Go. While the Japanese martial arts didn’t have the actual title of “master” they did have several titles that expressed the same concept.The title of “master” didn’t really come into common usage until after WWII when American soldiers learned martial arts under Japanese instructors. The literal title of “master” most likely came about from the English translations of the various titles their instructors had. When the soldiers returned home and opened their own schools they talked about the “masters” in Japan and when the Japanese, Chinese, and Koreans came to America to teach they ran with it. After all, “master” is a fairly simple title that is easy to understand whereas traditional titles like “Hanshi” have a deeper meaning that is harder to translate.Today the title of “master” is used by most martial arts and granted to those as early as 4th Dan in some styles and as late as 9th or 10th Dan in some styles. The title of “Grandmaster” is a modern creation and is usually given as a title above master and designates the highest ranking in a given style. The origin of the title of grandmaster could come from a translation of the title “Hanshi”, which is talked about below.People ask me what the title “master” means and it really depends on deep you want to go with your explanation, but in my opinion the easiest definition for our culture is this:A teacher is someone who is capable of teaching students.
A master is someone who is capable of teaching teachers.
A Grandmaster is someone who is capable of teaching masters.Many systems have gotten away from using the title of “master” in favor of the term “master instructor” which is simply someone with a higher level of expertise than a regular instructor.Traditional Titles: Sensei, Sifu, Renshi, Shihan, Kyoshi, and Hanshi”Sensei” is a traditional Japanese title meaning “teacher” and it used not only in the marital arts but in the regular school system as well.”Sifu” is a Chinese name meaning “teacher” it is used in the regular school system as well.Renshi, Shihan, Kyoshi, and Hanshi are tradition titles that date from the time of the samurai. These titles are Japanese honorifics and are honorary titles that may have different meanings within different organizations, and are totally separate of rank. For example, one person may be a 5th Dan Renshi, and another person may be a 6th Dan with no honorific title. These titles speak more to a person’s character that their martial ability. These ranks are solely used in arts with a Japanese heritage are not found in any Chinese or Korean styles.”Renshi” means “expert trainer”. This title is usually given to a person who ranks 4th or 5th Dan.”Shihan” and “Kyoshi” both mean “master teacher” or “teacher of teachers.” These titles are normally given to people who rank 6th through 8th Dan.”Hanshi” is the highest title awarded in marital arts and can also be translated as “teacher or teachers” and some translate it as “grandmaster”. The translation to “grandmaster” is more of a translation of the concept of the title and not a literal translation.