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Doctors ask engineers to spend more time in the hospital before building apps

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Re: Doctors ask engineers to spend more time in the hospital before building apps

#131

Post by gaius »

ken wrote: post #58
mothsonasloth wrote: post #11

From software development classes in School to University, we were told the most powerful method of requirements gathering was observation. Yet in my whole professional life I've never had a chance to do it despite putting the idea forward. One of my old colleagues who managed to observe a client was met with hostility and questions from the people he was observing. Other times clients want to dictate and have no dia…

When I was developing internal software at a big company, I went to observe some actual users at the company. (I thought what we were building didn't make sense, so I wanted to see if they actually used it that way.) I got a tongue lashing from management for that one! "You're a developer. You're not supposed to talk to users." The entire project, of course, was eventually cancelled.

The entire project, of course, was eventually cancelled

Been there, done that. Once spent months working on a project but when I finally got to talk to the users they told me it didn’t do what they wanted and even if it did they wouldn’t change their working practices (union rules maybe?)

At the end of the year the manager who had assigned me this project dinged me on my appraisal for not having delivered it.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#132

Post by markdown »

solatic wrote: post #115
SolarNet wrote: post #93

Earlier quoted context omitted.

Sure, but adequate and auditable documentation need not involve the patient nor money. Just a "here is the medical care we dispersed, on this date, to this person, it took these resources, these people administered the care." No following up every record for payments, no arguing with insurance companies over the price. And also, what abuse? If medical care is free and drugs are cheap, the only real abuse is drug abus…

> Sure, but adequate and auditable documentation need not involve the patient nor money. Just a "here is the medical care we dispersed, on this date, to this person, it took these resources, these people administered the care." No following up every record for payments, no arguing with insurance companies over the price. This is naive. The source of income (whether it's insurance companies, the government, patients)…

You know there are a hundred countries where this is a solved problem, right?

> The simplest way to commit fraud is to charge the insurance company (in a privatized system) or the government (in a public system) for large amounts of care for fake patients in fake cases

Insurance fraud is a problem for the insurance company. They deal with that already so it's not relevant here. And a govt hospital can be audited just like any other govt entity.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#134

Post by therealidiot »

KineticLensman wrote: post #129
gaius wrote: post #125

Earlier quoted context omitted.

The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! In the UK A&E is flooded with people with minor ailments that could have been treated at home with a first aid kit, or people who are just drunk. The system is definitely taken for granted. People even call ambulances for a ride to an appointment, not even an emergency. Source: once spent…

Also UK. Some 'abuse' of A&E happens because people cannot alway get access to a local surgery as opposed to driving to a nearby hospital, especially at weekends.

This.

I had half of my face stop working and had recently moved (and not yet registered with a new GP.)

I went to my previous GP and they turned me away (no longer in the catchment area) so I eventually ended up in A&E.

It doesn't help that the local ones near me at the time seem to live in the past... No call queuing or online scheduling, have to call within a 1 hour slot for appointments (so that's an hour of busy tones, oh well let's try again tomorrow)

Re: Doctors ask engineers to spend more time in the hospital before building apps

#135

Post by Scoundreller »

bdamm wrote: post #80
ams6110 wrote: post #75

Earlier quoted context omitted.

Somebody will be paying, and will want adequate and auditable documentation about what they are paying for. The potential for fraud is too great. Medicare and states all have to watch for fraud in their claim payments.

Right, but it’s probably done by auditing resources to treatment records. The actual patient needn’t be involved. And in countries like Canada you may end up with multiple operating agencies that are competing for efficiency, such as Coastal Health vs Providence, even though ultimately it’s the government footing the bill.

Providence is under Vancouver Coastal health. The authorities aren’t competing with each other (well, not really) as they have their own geographic catchments.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#136

Post by sjwright »

gaius wrote: post #125
sjwright wrote: post #123

Earlier quoted context omitted.

Also Australian. The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! Many ailments get more expensive to treat the longer they are left untreated. Once you come to terms with the fact it's permanently cheap/free, the psychological incentive to be wasteful ("use it or lose it") disappears completely. By comparison the American capitalist he…

The concept of abuse seems hilarious. What abuse? That people might visit their local doctor more frequently? That's a good thing! In the UK A&E is flooded with people with minor ailments that could have been treated at home with a first aid kit, or people who are just drunk. The system is definitely taken for granted. People even call ambulances for a ride to an appointment, not even an emergency. Source: once spent…

Sounds like NHS could open more local surgeries and save a lot of money. Or at the very least, add a wing to every A&E to allow stupid stuff to be handled by nurses and trainees.

In Australia, ambulance rides are not free unless you have a membership plan or private insurance.

It is absurd that the UK could not at minimum issue fines against abuse of ambulances. (Not to mention abuse of 999 calls!) The fact that this was an issue for more than five minutes is absurd and cannot be used as an indictment against public systems.

And even if the ambulance issue was unsolvable (ha!) it would still represent a fraction of a percentage of the waste occurring in the American system.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#137

Post by ivan_gammel »

gforge wrote: post #130

I am an orthopedic surgeon during the day and at night I write code. I just don't believe that spending a few hours watching surgery actually helps. You need to really work with the software, a solve daily problems and be aware of what problems are trivial software fixes. For instance, when I sign lab results I get to see the references for twenty year old subjects. It would be much more helpful to see the patients l…

All that you mention points to lack of proper UX design process as part of SDLC. Observation is part this process, it is important and better not to be skipped, because it can provide very useful insights, but it’s just a single stage of research - there are more techniques and methods to solve problems that you mention.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#138

Post by Scoundreller »

megablast wrote: post #77
oomkiller wrote: post #27

Unfortunately the problem is much greater than engineers not understanding doctors and other clinical staff, in my experience. For startups that want to sell to health systems and similar-sized/larger entities (really this is the minimum size that can work for most startups, practice sales usually have more friction than value), you unfortunately have to focus on the buyer, which is very rarely someone who is "in the…

We solved it by having a doctor on our team. In fact, not sure how you could solve any healthcare issues without it.

It also helps to have them as a conduit for your communications to other doctors. It’s sad that you have to pay someone a lot to (partly) forward your emails, but it works.

If responding to internal emails had a billing code, I think they would fight over who gets to respond.

Re: Doctors ask engineers to spend more time in the hospital before building apps

#140

Post by Scoundreller »

chapium wrote: post #32
oomkiller wrote: post #27

Unfortunately the problem is much greater than engineers not understanding doctors and other clinical staff, in my experience. For startups that want to sell to health systems and similar-sized/larger entities (really this is the minimum size that can work for most startups, practice sales usually have more friction than value), you unfortunately have to focus on the buyer, which is very rarely someone who is "in the…

Cerner and Epic are billing driven because that is priority 1 for hospitals.

Not a surprise. Overbilling Medicare is a huge Nono.

Having a nice audit trail of who gave that Tylenol and when makes life a lot easier.

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