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Ask HN: What is the most impactful thing you've built?

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Re: Ask HN: What is the most impactful thing you've built?

#661

I've developed an application that presents information about a patient's circulatory system to anaesthetists during surgery to give them clearer information about the patients heart and vasculature so that they can make finer grained, individualised treatment decisions. There's currently only a small group of users, as we haven't been able to afford to go through clinical trials yet, but the evidence is mounting tha…

Would love to hear more. Discussed this sort of possibility with an anesthetist friend at length and heard all about the importance of intuition. And limitation/absurdities of existing technologies (“humans aren’t a solid ball of fat and flesh!”). Clinical trials sound incredibly difficult to achieve - such a slow industry!

Hello Scyzork. thanks for asking, I'm still working out how to tell this story succinctly.

Here's today's effort:

Historically clinicians have had to work with blood pressure and heart rate as the key observable values they had to estimate oxygen perfusion to the tissues.

Newer technologies allow you to also measure the volume of blood ejected from the heart with each beat. With this additional information, you can infer how the work of the heart, and how the constriction of the vasculature around the volume of the blood in the circulatory system are each contributing to maintaining blood pressure. Clinicians understand that this is how blood pressure works, but our users are telling us that once they see the information plotted on a 2d field in our software, that something clicks that hadn't clicked before, and they are able to maintain patient's blood pressure more precisely within the 'normal' zone unique to that patient, and they are telling us they won't do major surgery without our software now. Interestingly we also been told that it's shifted some clinician's 'intuition', that they are administering less fluid and giving more vasopressors than before, or as it was said to me "less fill 'em, more squeeze 'em". Anecdotally they believe their patients are recovering faster, and that they can now operate on people they would previously categorized as too high risk. This is what they're telling us, it'll take some serious work to be able to confirm or reject this as objective fact.

My observation of the operating theatre is - I expected it to be like mission control, but it's more like a busy cafe where two people just rang in sick and someone wanted a soy latte but they think this might be almond milk. The people in the theatre are smart, but they are very busy. Other people have tried to do what we are doing and not gained enough traction, I think it's because their interface was too complex for that environment, they were displaying too much, they hadn't distilled it down to the physiologically relevant actionable information. I think our software's working because because the physiological model underlying the displays is right, but also because we've stuck to a philosophy that it has to be simpler to use than a coffee machine, so that people have the headspace to be able to use it when they are busy and under pressure.

Re: Ask HN: What is the most impactful thing you've built?

#662
As part of my data consulting, I struggled with identity resolution and started working on scalable no code identity resolution - https://github.com/zinggAI/zingg/ . It has pushed my limits as a software engineer and product builder, and I had to do a lot of learning to build it. Its cool to see people use Zingg in their workflows and save months of working on custom solutions. Big highlight has been North Carolina Open Campaign Data https://crossroads-cx.medium.com/building-open-access-to-nc-...

Re: Ask HN: What is the most impactful thing you've built?

#664
post #609

Earlier quoted context omitted.

If I can ask do you mean like a customized distribution with what I assume to be a heavily patched kernel? Or is it just the kernel with a totally new/different userland from a normal “Linux” box?

Totally custom userland, though does reuse common open source components

What was the reasoning for it though? Just seems a huge time sink for questionable gain.

Re: Ask HN: What is the most impactful thing you've built?

#665

Earlier quoted context omitted.

Nice! Thanks for working on it, the "command prompt" is absolutely miserable. I read all the blog posts explaining Windows and its different terminal/shell layers before the new one was added. I hope it ships with Windows by default one day.

Your wish has been granted: https://devblogs.microsoft.com/commandline/windows-terminal-...

Ah cool! I guess I'll take advantage of that in a couple of years when we're all forced from 10 to the broken UI hell that is 11.

Re: Ask HN: What is the most impactful thing you've built?

#667

I designed and implemented a betting system using those Chinese POS you normally use for credit cards, made a deal with Telco for data packages for more than 10k paid users consuming under 5MB a month for 40 daily transactions. We end up serving millions of users a month and the system became part of Dominican culture Made some good money from it, was 21 at the time

No post body was provided.

Re: Ask HN: What is the most impactful thing you've built?

#668
I built a behavioural experimentation engine back in 2013ish using then new HTML5 + certain new JavaScript APIs with surprisingly robust, accurate and precise timing back when Flash presence was still relatively strong.

We proved that certain subliminal effects for which tight control of presentation times (Unfortunately the method the engine was embedded in was built on a closed platform... and died shortly after the first major re-design of that platform. At least its legacy lives on.

Re: Ask HN: What is the most impactful thing you've built?

#669
I had a niche in voter registration, and wrote frontend code and server processes that helped tens of millions of people register to vote in the US.

Worked on tools for Rock the Vote, vote.org, HelloVote (the first sms voter reg chatbot), and VoteAmerica. It’s a surprisingly tricky problem on the backend, with state specific rules and lots of smaller jurisdictions (most election officials are at the county level). Developed methods to extract a user signature from a photo and include in the generated pdf, so people wouldn’t have to print, sign, and mail the document, and we could do everything digitally.

In 2014 went to Libya to help there after the revolution (but before the civil war), and worked on a team that was helping build tools for that new democracy. They haven’t had another national election since, which goes to show that sometimes politics are more complicated than technology…

Re: Ask HN: What is the most impactful thing you've built?

#670
I developed an asset management service that accelerated the deployment of mobile educational games for children autism. It was my first internship as a bachelor CS student, and I have never implemented a backend service before. It was amazing to see the increasing number of positive feedback we got from parents about how our app helped with their children's education.
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