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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

#151
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…

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…

he fact that this was an issue for more than five minutes is absurd and cannot be used as an indictment against public systems.

We also have issues with prescription abuse, such as people getting prescriptions filled who no longer need them, and don't take them anyway. The NHS tried to fix this by printing the real cost of the drug on the label, so people would be aware of the waste. But they had to stop because it was making people who genuinely needed the drugs feel guilty about how much it was costing. No easy answers to this, but something will need to happen because as I say, it is simply taken for granted by so many people.

Unfortunately, the NHS is something of a "sacred cow", any criticism no matter how evidence based of it is seen as a heinous blasphemy. Which means its problems are always brushed under the carpet and will never be fixed. "The envy of the world", we're told, but I doubt the French or the Germans or the Canadians or the Japanese or any number of other nations are envious of it!

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

#152

Earlier quoted context omitted.

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…

Why does the NHS have catchment areas? Surely you should be allowed to visit any GP anywhere. People do travel after all.

Surely you should be allowed to visit any GP anywhere

A GP practice is a private business, usually all the GPs are partners just as lawyers or accountants would be, and the staff such as receptionists are not NHS employees, they work for the practice. If they can't bill the NHS for their services because you're not on their books, they aren't interested. It is surprising perhaps, but many people in the UK are unaware of this, they think the GPs surgery is directly a branch of the main NHS, and get angry about "privatisation" without realising that GPs have always been private.

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

#153

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…

I'm sure I'm being naieve, but could we just get rid of billing altogether if we nationalize the health care system? I have to recount an anecdote. My mom was hiking in a foreign country, and got injured. She hobbled to the next town, and found a clinic. They treated her and were ready to let her go. She said: Q: Okay, how do I pay? A: You don't pay for health care. Q: I'm American. I'm not part of your health care s…

which country?

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

#154
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.

Epic and Cerner have been around since before UX and SDLC were common parlance, so their software and processes are likely locked into what we consider bad practices today.

Healthcare software exists in a weird trap where it can't move too quickly because hospitals are resistant to change, but it's software, and the software world normally moves quickly (including things around software like UX and SDLC concepts and ideas).

Simultaneously, hospitals can be slow getting off of deprecated platforms because of dysfunctional IT leadership, bad budgeting, and staff that can't or don't want to learn new software.

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

#155
post #150

Earlier quoted context omitted.

From my Spanish Perspective. What fraud? Going to the doctor is literally useless unless you're ill. They will literally send you away home if they find you to be fine. The doctors and nurses and personnel and what have you will also get mad at you for wasting their time unjustifiably (and I've done this myself and oh boy they left an impression on me). If you mean Government fraud, from the ones planning the system…

You're right that "patient"-doctor fraud is unlikely, but receiving unnecessary medication (addictive/fun/valuable drugs) or medical people overcharging or charging for unperformed or unnecessary procedures is a possibility for fraud.

But the personnel are salaried, not paid per procedure.

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

#156
post #78
post #76

My neighbor’s son is a doctor who needed some software written. He learned to write the software and now runs a software business (in addition to being a doctor). I guess it was easier than trying to bring developers in. Ive seen the same thing with a pilot who learned programming to write an incident management system for airlines. Only once the software was successful did he seek advice from ‘professionals’. Learni…

>> Learning to code is not the deepest skill around. Neither is learning to fly a plane. What's prized is the ability to do it in such a way as to not crash. The same applies to software engineering.

Healthcare has lots of low-hanging fruit that's solved by simple CRUD apps, and those can be reasonably maintainable (and secure) if you build it using easy frameworks and well-known patterns that are commonly found in tutorials lying about the internet.

It'll be so simple that it's equally maintainable.

The real issue is adoption, but that's expedited if you're a doctor who's also a software developer and makes it easier to sell.

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

#157
post #65

More time? I wish I was given _any_ time with my users so I could actually understand what features would make their lives easier. I actually did get to spend about two hours with some actual users of my software a month ago and I noticed that they were scrolling up and down a lot. I asked if it would make their workflow quicker if I made the save button float in the lower-right corner of the browser (I.e. position:…

The problem is that it may take 2 seconds of CSS, but it is a software change that then requires the product to be revalidated, along with the matching paperwork (functional design doc, software design, technical design, customer support documentation and training material) and validation evidence to be submitted to your official document control system. And this process can take days, weeks, or months, depending on…

Doesn't apply if you're doing software the right way: just yourself, for small clients.

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

#158
post #117

Earlier quoted context omitted.

Sorry, how is this relevant to what the OP comment posted? I don't follow...

We already have a healthcare system within the US where billing seems to mostly not happen. So, presumably, it isn't completely alien and foreign and something America would need to steal from elsewhere.

That’s decidedly not my experience. I’ve certainly been presented with bills for every single thing I’ve done at a hospital, including visits that I was assured I would not be billed for. I’ve even spent months trying to work out arrangements with hospitals and insurance only to have my bills sent to collections. The thousands of people who file bankruptcy each year for medical bills would likely wonder what you mean, too.

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

#160
post #150

Earlier quoted context omitted.

You're right that "patient"-doctor fraud is unlikely, but receiving unnecessary medication (addictive/fun/valuable drugs) or medical people overcharging or charging for unperformed or unnecessary procedures is a possibility for fraud.

But the personnel are salaried, not paid per procedure.

Most hospitals have on-call work, overtime, outsourced work, consumables that can be billed for etc. Pay cheques vary a huge amount depending on work done, and as a radiographer in a regional hospital my yearly wage was more than half made up by penal rates and overtime.
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