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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

#101

Post by aviv »

dawhizkid wrote: post #95
aviv wrote: post #74

Earlier quoted context omitted.

Insane how we both get downvoted isn't it? Oh well. Another decade or two before people wake up. Agree with you, so much of our economy and social structure is built on the fact that people get sick - and either stay sick or get medicated for the foreseeable future. Sad. All we can do is mention it, even though we get shut down quickly be it online or IRL. Mandatory anecdote: I cured severe arthritis in the knee 6 ye…

Step one is getting to consensus on sugar = toxic, then refined carbs = bad, then getting people to stop believing we were evolved to eat consistently throughout the day everyday It’s amazing that “you are what you eat” has become so controversial

The old "a calorie is a calorie" that Reddit/HN geeks like to point out wearing their science hat. LOL. Oh man... Sometimes I think we've gone too far. My kids have a hard time finding classmates to play tag with because most of them are overweight and prefer to sit in the shade and eat their Costco bought school lunch. It's really sad what's happening.

Re: Big Tech Is Going After Health Care

#102

Post by u801e »

Clubber wrote: post #85
u801e wrote: post #75

Earlier quoted context omitted.

> 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 Couldn't this be solved by just encrypting the email itself? Even the headers could be encrypted along with the body. On the subject of fax machines, would they still…

>Couldn't this be solved by just encrypting the email itself? Even the headers could be encrypted along with the body. Yes, but that's typically more cumbersome as you have to trade keys with everybody that needs an email. I wrote an emailer for a medium sized company and it sent about 500K emails and 500K faxes a month. That's a lot of key management. You could use symmetric encryption, but then you give out the sha…

> but that's typically more cumbersome as you have to trade keys with everybody that needs an email.

What would be needed is a public key infrastructure. If organizations like the state board of medicine could serve as a certificate authority for physicians licensed in that state (or maybe the DEA since they issue id numbers to physicians that are needed for controlled substance prescriptions), then the key management would not be as much of an issue. In other words, it shouldn't be handled by individual organizations; it should be handled by the authorities who are responsible for licensing doctors, nurses, pharmacists, hospitals, etc.

> On top of all that, each client will have to be taught how to decrypt (and encrypt) emails

This is certainly something that can be automated and shouldn't have to be a manual process. A plug-in for a program like Outlook should work in the vast majority of cases. That is, if the email is sent to the wrong address, then the recipient would only see encrypted text, but it would automatically be decrypted for the correct recipient.

Re: Big Tech Is Going After Health Care

#103

Post by slsii »

joshgel wrote: post #89
obastani wrote: post #73

Earlier quoted context omitted.

Couldn't this finding be explained by the fact that the hospitals with lower readmissions tend to be poorer (since poorer patients are less likely to be able to afford care)? I only took a quick look, but I didn't see how the paper accounts for this and other possible causality issues. On the other hand, it's certainly plausible to me that lower readmissions can cause higher mortality.

Sure. Or those hospitals gamed the system and didn't admit patients who should have been admitted. Or plenty of other explanations... We call readmissions rate a Surrogate Marker. Something that isn't a hard outcome that we care about (that much), but rather an indicator of quality. We need surrogates to assess quality because hard outcomes are rarer. But this paper makes us think that maybe we need better markers.

Do you have recommendations for any books or other resources that cover topics on healthcare quality measures? This is the first time I’ve heard of surrogate markers. I’ve been searching around for more info on the concept you’ve described but didn’t have a term for it.

Re: Big Tech Is Going After Health Care

#104

Post by aviv »

grzm wrote: post #94
aviv wrote: post #86

Earlier quoted context omitted.

Sure, most physicians nowadays will mention to the patient that diet and exercise are beneficial, but at the same time will outright dismiss the critical role that diet specifically plays in curing the disease. Yes, the alternative is a 10 to 30 day water fast for both of those. I know several people that successfully cured both. Especially Crohn's, the amount of misinformation given by physicians is stunning and bor…

I think there's a lot to be said for sleep, diet, and exercise for combating many what are often termed lifestyle illnesses. That said, I think there's a lot of use for tech (which is really just applied science) in monitoring, diagnosing, and researching illnesses and treatments, as well. And not all maladies can be treated by sleep, diet, and exercise alone. I can easily imagine anecdotal evidence like that you men…

The way I comment here is not really how I relay this information to people IRL, especially because I'm very aware and sensitive to their health situation at the time. Here I know I'm going to get downvoted instantly, so I don't bother as much. Mostly threads like this frustrate me, because I know so many people can be helped but online communities shut down these types of discussions and people barely scroll all the way to the bottom to read the truth.

So anyway, I hear your feedback and agree with it. Offline I'm much more patient and I do make it a point to take my time and only slowly break the news to them that traditional medicine has been lying to them for so many years, coupled with real evidence and pointers as to the direction they should be looking at in evaluating what I just shared with them.

Re: Big Tech Is Going After Health Care

#105

Post by mulmen »

junkscience2017 wrote: post #52
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…

so ELI5 why we shouldn't just get rid of HIPAA? from the way people talk, all HIPAA does is guarantee that things will always be awful(?) how does HIPAA help if it just keeps us in the past?

For the same reason you won't call Uber to take you to the hospital if you cut off your arm.

Re: Big Tech Is Going After Health Care

#106

Post by mxwll »

nikanj wrote: post #59
mxwll wrote: post #41

There are some major hurdles for these SV companies to overcome if they want any level of success in this arena. EPIC and Cerner together hold over 50% market share of EHR systems in American hospitals. Their interoperability and patient facing applications are a joke. EPIC actively makes it difficult for third parties to build on top of their system. Sure, these SV companies have figured out how to build great tech…

EPIC and Cerner are doing their best to, simultaneously: 1) Appear to be open, ready for innovation and playing fair (so hospitals don't replace them) 2) Maintain their position as gatekeepers, and use that position to extract as much revenue as possible. New startup wants to deploy tech at your hospital? Hospital probably will end up paying more to Cerner for the integration, than the new tech.

You hit the nail on the head.

Building anything on top of EPIC is unbelievably painful. You either pay EPIC engineers to access their "Dark API's" or pay $$ for their certifications.

Very few of these big medical device start-ups are actually integrating with patient records at a significant scale. Every instance of EPIC or Cerner is different and there is a lot of manual work needed to get up and running with live data in the patient record.

Re: Big Tech Is Going After Health Care

#107

Post by aviv »

joshgel wrote: post #83
opportune wrote: post #80

Earlier quoted context omitted.

Well as a physician, you can't really force your patient to exercise and eat better. The best you can do is prescribe a medication to treat the symptoms, tell your patient to exercise and eat better, and send them off. Do you have an alternative to prescribing medication for type 2 diabetes and Crohn's? Do you think doctors should simply withhold care since it's their patients' faults that they have those conditions?

Agree. My dad, also a physician, blames himself for being overweight. But if "everyone" is overweight, can it really be their fault? Surely "the system" has as much or more blame to share.

Your dad, Big Food, Big Pharma, MSM, his parents. The blame is in that order.

Re: Big Tech Is Going After Health Care

#108

Post by grzm »

aviv wrote: post #104
grzm wrote: post #94

Earlier quoted context omitted.

I think there's a lot to be said for sleep, diet, and exercise for combating many what are often termed lifestyle illnesses. That said, I think there's a lot of use for tech (which is really just applied science) in monitoring, diagnosing, and researching illnesses and treatments, as well. And not all maladies can be treated by sleep, diet, and exercise alone. I can easily imagine anecdotal evidence like that you men…

The way I comment here is not really how I relay this information to people IRL, especially because I'm very aware and sensitive to their health situation at the time. Here I know I'm going to get downvoted instantly, so I don't bother as much. Mostly threads like this frustrate me, because I know so many people can be helped but online communities shut down these types of discussions and people barely scroll all the…

> "The way I comment here is not really how I relay this information to people IRL"

> "Offline I'm much more patient"

I encourage you to behave more like you do in real life here on HN. Much of what has unfortunately become accepted as discourse on many forums does serious damage to actual meaningful discussion. If that's not what you're interested in, please just refrain from commenting. Many on HN, for all it's faults, are trying for something better than average, even if we don't always succeed. People are still people, regardless of where you're encountering them.

Re: Big Tech Is Going After Health Care

#109

Post by aviv »

grzm wrote: post #108
aviv wrote: post #104

Earlier quoted context omitted.

The way I comment here is not really how I relay this information to people IRL, especially because I'm very aware and sensitive to their health situation at the time. Here I know I'm going to get downvoted instantly, so I don't bother as much. Mostly threads like this frustrate me, because I know so many people can be helped but online communities shut down these types of discussions and people barely scroll all the…

> "The way I comment here is not really how I relay this information to people IRL" > "Offline I'm much more patient" I encourage you to behave more like you do in real life here on HN. Much of what has unfortunately become accepted as discourse on many forums does serious damage to actual meaningful discussion. If that's not what you're interested in, please just refrain from commenting. Many on HN, for all it's fau…

Well, IRL people would give some verbal feedback before they dismiss my suggestion. In HN, they just downvote and walk away.

And I have, so far I answered every comment, including the physician who wanted links to "proof", whatever that may be. After all, who really benefits from finding proof that water fast cures illnesses that otherwise require a lifelong regimen of medication and doctor visits?

Re: Big Tech Is Going After Health Care

#110

Post by opportune »

aviv wrote: post #104
grzm wrote: post #94

Earlier quoted context omitted.

I think there's a lot to be said for sleep, diet, and exercise for combating many what are often termed lifestyle illnesses. That said, I think there's a lot of use for tech (which is really just applied science) in monitoring, diagnosing, and researching illnesses and treatments, as well. And not all maladies can be treated by sleep, diet, and exercise alone. I can easily imagine anecdotal evidence like that you men…

The way I comment here is not really how I relay this information to people IRL, especially because I'm very aware and sensitive to their health situation at the time. Here I know I'm going to get downvoted instantly, so I don't bother as much. Mostly threads like this frustrate me, because I know so many people can be helped but online communities shut down these types of discussions and people barely scroll all the…

I've worked in healthcare tech before and one thing we didn't need was more people claiming you could solve every problem with some random FOTM untested medical method that doesn't hold up to scientific scrutiny. No need to make yourself out to be some sort of scientific martyr. If you can't do people here the justice of backing up your comments, don't comment and then complain about getting down voted
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