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Why I quit medicine

gautams.posterous.com

1–10 of 119 posts

Re: Why I quit medicine

#2
Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval process submission. It is so not a market that's friendly to startups.

Re: Why I quit medicine

#3
Paper isn't secure, but probably more 'secure' than data on a phone, cause there's far less risk of the paper getting duplicated silently than data being pulled from a smartphone (silent sending of address/contacts, etc).

Seriously? A shared Word document? With no audit trail of who wrote what? And that is an improvement over the state of the art? It sounds like Wordpress has far more robust data management (and probably security) than what he just described.

As a doctor who can code, I'm sure the OP will be in a great position to make real change. He knows the regulatory stuff to get past, what rules can be bent, who the movers/shakers are to get stuff moved. Likely just bringing some very basic CMS/ERP functionality to medical records management in a hospital would be huge.

Re: Why I quit medicine

#4
I see why it's important to have secure patient records. It would be devastating to have your personal medical information up on pastebin.

But you know what's worse? Dying because the doctor misses a vital piece of information which can't be found in disorganized paper notes, or a bureaucratically designed medical information system (which set the hospital back roughly the cost of a new life-saving machine).

Re: Why I quit medicine

#5
These guys need to buy this revolutionary product called a notebook. And no, I don't mean a laptop computer, but a "traditional" notebook. And probably a bunch of pens. A notebook is harder to lose than a scrap of paper and you can hand it over to the next doctor so he can read your note and add his own. Sounds interesting, doesn't it?

Re: Why I quit medicine

#6
I quit medicine too, but not because of the lack of adequate computer interface :)

The whole taking notes, jotting down patient information. It seems antiquated, but it's really a hard problem to "fix" - if it really needs fixing. These are not medical records he's talking about, but personal notes on each patient and todos you carry around with you during your shift.

Paper/pen in taking these notes is faster than computer/tablet input. I've tried it. In several different forms. There's a lot of shorthand doctors develop that help out. Arrows, diagrams, etc...

Still seems a small part of the bigger picture, which is electronic medical record keeping.

Regardless, good luck with your venture!

Re: Why I quit medicine

#9
post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

It happens far too often. Right now I'm looking at a government RFP (request for propsals) that fits what I'm doing very well. But everyone I speak to tells me that it's an entirely doomed process, and that the government will never choose a tiny tech startup over a large corporation. I'm pretty sure they're right.

Re: Why I quit medicine

#10
post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

I did some very basic research for an essay on "Healthcare in the Cloud", and yes, the regulatory side sounded very painful.

Among the relevant regulations, the big ones are HIPAA and HITECH:

http://en.wikipedia.org/wiki/Health_Insurance_Portability_an...

http://www.hhs.gov/ocr/privacy/hipaa/administrative/enforcem...

A big point that I remember was that a HIPAA breach was up to 1.5 million dollars in fines.

"A maximum penalty amount of $1.5 million for all violations of an identical provision"

This is one of the markets where BigCos can and should make a difference (and loads of cash in the process, but well, that's what regulations get).

On the flip side, HITECH introduced up to 20 billion dollars in incentives for adopting Electronic Health Records (EHRs), so maybe the millions in compliance are worth it for some startup :)

I got some interesting data from here ("Opportunities and Challenges of Cloud Computing to Improve Health Care Services"):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222190/

and some information by CompTIA’s Third Annual Healthcare IT Insights and Opportunities study.

http://www.comptia.org/news/11-11-16/Healthcare_Practices_Em...

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