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Big Tech Is Going After Health Care

nytimes.com

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Re: Big Tech Is Going After Health Care

#31

Post by eat_veggies »

snomad wrote: post #17
adventured wrote: post #12

Earlier quoted context omitted.

The way you fix the existing system, is by not trying to change it. You replace it instead. You build new, lighter, more nimble approaches to old problems, rather than trying to convince existing power structures to change. That's where any gains will come from by big tech entering the fray, if there end up being any. Trying to change something like the hyper regulated, hyper stagnant, special-interest dominated US h…

As the MOOCs found out, you can't just "replace" certain societal services - especially those beset with volumes of regulation and numerous groups of powerful stakeholders happy to reach out to politicians and the public (AARP, Insurance, numerous govt entities, drs groups, nurses groups). 2/3 of healthcare is paper pushing, the easiest thing the tech community can automate is boring old CRUD paper pushing. I hope on…

There'd need to be a lot of work making sure that it's safe in that:

a) Losing it should not expose your entire medical history to whoever picks it up

b) Losing it should not mean losing your data forever. Giving the consumer the responsibility for backups is not a solution either, since those can be lost or stolen as well.

c) It has to be tied to the person's identity, so you can't borrow/steal your friend's to get meds

d) Can't be tampered with or forged to fake conditions or clear conditions

e) Records who edits it, when, and a diff of changes.

f) Records who reads it, and when

g) Resistant to physical damage or water. I should be able to go swimming with this device or have it go through the wash without worrying about its safety.

These are all pretty hard problems on their own, and together, you'd have to design pretty much the world's safest storage device. If it existed, I'd put my SSH keys on it too!

Re: Big Tech Is Going After Health Care

#32

Post by WhitneyLand »

killjoywashere wrote: post #16
hacker_9 wrote: post #11

Earlier quoted context omitted.

The monitoring devices are the real problem, not the people. Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. A lot more specialist equipment is going to be needed to come to a final conclusion (Questioning from experts, MRIs, XRays, even Microsurgery with cameras). What consumers can curr…

Your comment is a great example of the disconnect between people in this space and people not in this space. Do you actually think anyone in this space would believe that weight spikes are tied to CHF in all cases? You don't diagnose CHF by weight. It's something you trend in known patients. Comments like this are one reason why doctors give zero shits about the potential of computing. Explaining even the basics of a…

Why on earth do you think you can generalize your anecdotal experience to conclude tech people are any more arrogant than doctors or staff in whatever field?

We can agree there is a massive disconnect, but there is plenty of arrogance to go around and I’ve seen it on both sides in these situations. Moreover, whoever’s arrogance it is, is only one part of the problem, and I think not the largest one.

Just the legal and regulatory hurdles alone pour molasses all over what would normally be a fast moving startup effort. Worse, some products or services have to worry about the reasons the bureaucracy exists in the first place: What level of risk mitigation is sufficient to keep from killing people? Here’s a hint, it’s a level that doesn’t speed up your time to market.

There can also be a lot of time wasted by people who may be very talelented within their specialties, but require lots of hand holding to ramp up on the medical issues, technologies, product design and user experience (which still always exist), and business strategies depending on their background. Ideally you have at least one person with great expertise in one, and training and/or a knack for the others, who can see the big picture, and everyone else must make honest assesments of where they can really add the most value.

We always talk around here about how ideas are cheap and the team and execution are what matter. Based on some time I’ve spent with doctors and entrepreneurs in these scenarios, my impression is that maxim is even more apt in this space.

Re: Big Tech Is Going After Health Care

#33

Post by killjoywashere »

hacker_9 wrote: post #29
killjoywashere wrote: post #16

Earlier quoted context omitted.

Your comment is a great example of the disconnect between people in this space and people not in this space. Do you actually think anyone in this space would believe that weight spikes are tied to CHF in all cases? You don't diagnose CHF by weight. It's something you trend in known patients. Comments like this are one reason why doctors give zero shits about the potential of computing. Explaining even the basics of a…

What an ironic comment - I tell a software developer that medical science isn't as easy as measuring weight changes, supporting the point that doctors need to do a lot more than that to come to a diagnosis, and then a doctor (I assume) tells me to STFU because.. oh, of what I originally said in the first place. What was your point here? I hope you don't make these kind of mistakes with actual patients.

This is what I was responding to:

> Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body.

Considering you were knowingly addressing someone who worked in the space and blew right past something you obviously knew within seconds (not all weight spikes equate to CHF), thinking there was even a remote possiblity they hadn't thought of that, despite having a physician on staff to discuss with.

Your response here (as quoted) is exactly why doctors throw their hands in the air and wait for someone else to come along. You actually thought you had an insight and despite remonstration, you persist in thinking you outwitted everyone on this thread. That's the point.

You're lack of humility coupled with your snowflake sensitivity is why we don't want to work with a lot of computer people. The sad fact that a lot of doctors also equate computer science with IT is another problem.

Re: Big Tech Is Going After Health Care

#34

Post by Clubber »

newman8r wrote: post #13
dawhizkid wrote: post #10

As someone who most recently worked in product at a healthcare startup I found the most difficult thing about innovation in the space is the cost of compliance/regulation. When you work in an industry that is so highly regulated, and assuming you are working at a company that follows the rule of law, how do you actually "disrupt" a set of problems in this industry when there is so little wiggle room for doing things…

I'm pretty sure email can be HIPAA compliant as long as you implement the system using the established guidelines.

Re email: Because you don't know if the destination server is encrypted (you send emails from your server and it finds the destination), any email must be intercepted at your server and a hyperlink to a secure site inserted in place of the email body. The email becomes just a notification via SMTP. The recipient then goes to the site and logs in to view the email. The PHI is what you care about (and it's, very, very strict). No PHI in the subject either.

I suspect the reason faxes are compliant is a few:

1. Grandfathered in. 2. The number of unauthorized people that can see them is very limited (to whomever has access to the fax machine). 3. Modern fax machines print face down. 4. Data is in hard copy format which is more difficult to copy.

As an aside, modern fax machines are probably less secure than the old ones. Fax machines using digi-boards and databases and whatnot. The vast majority of US healthcare use faxes though.

Re: Big Tech Is Going After Health Care

#35

Post by killjoywashere »

WhitneyLand wrote: post #32
killjoywashere wrote: post #16

Earlier quoted context omitted.

Your comment is a great example of the disconnect between people in this space and people not in this space. Do you actually think anyone in this space would believe that weight spikes are tied to CHF in all cases? You don't diagnose CHF by weight. It's something you trend in known patients. Comments like this are one reason why doctors give zero shits about the potential of computing. Explaining even the basics of a…

Why on earth do you think you can generalize your anecdotal experience to conclude tech people are any more arrogant than doctors or staff in whatever field? We can agree there is a massive disconnect, but there is plenty of arrogance to go around and I’ve seen it on both sides in these situations. Moreover, whoever’s arrogance it is, is only one part of the problem, and I think not the largest one. Just the legal an…

I have been working with some extremely smart, hard working computer scientists on a real, hard problem in this space, a problem I've been working on for 6 years. Easily 20 years of work left. I have a great deal of respect for what you are capable of.

The white hot fury was directed at the sophmoric response of hacker_9 which I then used as an exemplar of a few trends in behavior I have watched for over a decade.

Re: Big Tech Is Going After Health Care

#37

Post by Clubber »

659087 wrote: post #27

I don't want "big tech" anywhere near my doctor's office or anything else having to do with my health.

Too late. HIS is Health Information Systems and have been around for decades.

Also, thanks to the patriot act, doctors and hospitals share your health information to the federal authorities without a warrant. So there's that.

https://cdt.org/insight/law-enforcement-national-security-ac...

Re: Big Tech Is Going After Health Care

#38

Post by frahs »

hacker_9 wrote: post #11
blhack wrote: post #7

Good. I spent a few years working in a medical IoT startup, and the current state of the "mainstream" medical monitoring technology is not inspiring. During a brainstorming meeting, I asked one of our cofounders, a physician, to tell me about some of the problems he had seen in health. Don't try and solve it, just lets talk about problems. He said that by far one of the most common causes for re-hospitalization is co…

The monitoring devices are the real problem, not the people. Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. A lot more specialist equipment is going to be needed to come to a final conclusion (Questioning from experts, MRIs, XRays, even Microsurgery with cameras). What consumers can curr…

This isn't about diagnosis, it's about monitoring already at-risk patients. He clearly stated nurses take this sort of measurement manually for at-risk patients, it's a simple solution to automate an existing workflow that involves an unnecessary amount of manual labor.

Re: Big Tech Is Going After Health Care

#39

Post by frahs »

killjoywashere wrote: post #16
hacker_9 wrote: post #11

Earlier quoted context omitted.

The monitoring devices are the real problem, not the people. Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. A lot more specialist equipment is going to be needed to come to a final conclusion (Questioning from experts, MRIs, XRays, even Microsurgery with cameras). What consumers can curr…

Your comment is a great example of the disconnect between people in this space and people not in this space. Do you actually think anyone in this space would believe that weight spikes are tied to CHF in all cases? You don't diagnose CHF by weight. It's something you trend in known patients. Comments like this are one reason why doctors give zero shits about the potential of computing. Explaining even the basics of a…

I agree that his comment was not in good taste, but I think he must have simply misread or skimmed the parent comment, or misunderstood.

Your comment is a great example of unnecessary escalation. He made a mistake, no need to pin all this angst about the disconnect between doctors and engineers on one mistaken comment on the internet. While I think the parent commenter should apologize, I think ideally you should too, this is blowing things out of proportions and that's not the kind of dialogue I like to see on HN, or anywhere on the internet.

Re: Big Tech Is Going After Health Care

#40

Post by hacker_9 »

killjoywashere wrote: post #33
hacker_9 wrote: post #29

Earlier quoted context omitted.

What an ironic comment - I tell a software developer that medical science isn't as easy as measuring weight changes, supporting the point that doctors need to do a lot more than that to come to a diagnosis, and then a doctor (I assume) tells me to STFU because.. oh, of what I originally said in the first place. What was your point here? I hope you don't make these kind of mistakes with actual patients.

This is what I was responding to: > Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. Considering you were knowingly addressing someone who worked in the space and blew right past something you obviously knew within seconds (not all weight spikes equate to CHF), thinking there was even a re…

You would think OP would know that, but the original comment basically tells us all to measure our weight simply to check for CHF. If it were that simple we'd all do it I presume, but of course weight change can be a range of things. Many of which are not problematic. Hence why I pointed out that better measurement devices are needed. I've also got a feeling that it may just be you in particular that 'IT' don't like dealing with.
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