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Why I quit medicine

gautams.posterous.com

21–30 of 119 posts

Re: Why I quit medicine

#21

Is that really why you quit, or an engaging PR backstory? As an entrepeneur, you'll have to deal with clogged sinks, office rentals, legal filings, and lots of other hassles similar to carrying around a piece of paper.

He didn't quit because paper is a hassle, but because he saw a significant problem in medicine that he could better solve as an entrepreneur.

Re: Why I quit medicine

#22
post #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).

I understand what you are saying but there are a significant number of people who are in no danger of dying who need medical care that needs to be confidential or their remaining life could be trashed.

So it's not always a choice between privacy and death. In fact I'd hazard a guess that this is the case the majority of the time.

Re: Why I quit medicine

#23
post #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.

The trick is to get an intro to a big boy and be a sub on their contract. It takes some social proof (wins on other RFPs) and you really have to know people. It's an entirely different way of selling.

Government contracting really is a different world.

Re: Why I quit medicine

#24

Is that really why you quit, or an engaging PR backstory? As an entrepeneur, you'll have to deal with clogged sinks, office rentals, legal filings, and lots of other hassles similar to carrying around a piece of paper.

Perhaps you should reread the OP. He's not saying that he personally is above petty hassles, he thinks it's a problem worth solving.

I bet he also believes he can make some money too, but I don't fault him for omitting that. Surely that goes without saying.

Re: Why I quit medicine

#25
I don't know, most hospitals around here use something like SAP IS-H/IS-H MED for patient and resource management. There are yearly "eHealth summits" and similar conferences. Their IT guys are organized in user groups and societies where they share their knowledge. Is it an "enterprisey" environment? You bet it is, mainly because of the regulations. However, the hospitals definitely do not live in the stone age.

Re: Why I quit medicine

#26
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…

Yes, and hospitals have arcane policies / IT departments, my dad is a doctor and the hospital he works at still has Internet Explorer 6 installed on all computers there and they refuse to upgrade it for fear it might break compatibility with some ancient software program they use they access through it. He wants me to create some little software program to see if he can get them to use it when the main system goes down but it has to work in IE6 so its kind of a nightmare and I've been dragging my feet on it because of this... its things like this that make dealing with healthcare such a pain in the ass.

Thinking about this more, its actually a bit scary if I do create something and he is able to get them to use it as I could be opening myself up to a lot of liability. I figure, as a doctor, he should be aware of all this but not 100% sure how up on this he actually is, maybe I should get him to sign something having him take full ownership and responsibility of the software

Re: Why I quit medicine

#27
Medical notes need to have some obvious design features common to many other computer software.

- locking: only one person able to change the record - auditing: keeping records of who read what, when, and where they did it - signing: any additions are cryptographically signed and timestamped - sharing: many clinicians need to be able to access the data across a wide range of hospital networks.

The UK NHS spent £11bn on a system which was late or didn't appear.

(http://www.bbc.co.uk/news/uk-15014288)

About 10,000 people in England die each year because a clinician makes a mistake with the meds. While that risk is very low (because there are a huge number of patients taking a huge number of meds) it'd be nice if something simple could be done to reduce that number.

Re: Why I quit medicine

#28
post #13

Good on you, man. I'm in medical school currently and the emphasis on locking down patient data is one of the most frustrating things to see. I'm convinced that it's a policy that everyone knows has little benefit and yet pushes for ethical brownie points. What's to be gained from freeing up the data far, far exceeds what could potentially be lost. Even freeing up anonymized patient data seems to be met with oppositi…

Ben Goldacre has a good blog post about "When Ethics Committees Kill"

(http://www.badscience.net/2011/03/when-ethics-committees-kil...)

Re: Why I quit medicine

#29
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 maxim…

Wonder if smartphones open up some new doors here? Assuming doctor and patient both have a smartphone medical notes for a patient are shared but only available for doctors within the physical vicinity of the patient i.e. the patient's phone acts as the gateway to that data.

Re: Why I quit medicine

#30
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…

While Obama and Congress are talking about how to make regulation more business friendly, why don't they focus on day-1 problems like this, instead of IPO problems? I've never heard of a good company unable to IPO just due to paperwork/regulation, but I've heard of many company not be able to get anywhere due to silly regulatory cruft. See the TacoCopter yesterday... FAA would never let it happen. Or your medical data startup. You can fix the problem- if they will let you.
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