This is one of the reason some things should never be left to the market or be driven by profit. Healthcare is a clear example of that.
Health-records software pushed opioids to doctors in secret deal with drugmaker
111–120 of 269 posts
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#112Earlier quoted context omitted.
Also, I've never heard a good thing about Epic...
It's made in Visual Basic, and it literally cannot interact with its own versions. Hospitals have different versions of the same system in the same building and cant exchange information. All EMR's suck though. (note: I made one)
I’ve always heard it was programmed in MUMPS
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#113They put pop-up stealth advertisements, targeted at your doctor, into your electronic medical record, so that he or she would get you addicted to painkillers. Software developers did this. For drug money. That's just terrible, isn't it? They shouldn't have done that. But even if the developers had ethical concerns, they had no recourse but to quit, and be replaced by someone else--who might get six months of work in…
>But even if the developers had ethical concerns, they had no recourse but to quit, and be replaced by someone else
I'm not saying that everyone who touched the software should be indicted, but there were options beyond quitting. They could've told the customers, the news outlets, or the government.
Of course, when you're surrounded by people doing the same thing and nobody else is speaking up, it's not unreasonable to think you're the only one who sees it as shady.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#114Earlier quoted context omitted.
To be fair to the developers and designers: how exactly would they know that the inclusion of "opioid prescription" as an item in that list would help fuel a an opioid epidemic? Hindsight is 20/20, but would you expect them at the time to think, "If we include this as an option in this list, it will contribute to a nationwide epidemic of opioid abuse and countless deaths"? Honestly, I think it's a stretch, especially…
I’ve never been a big fan of the “I don’t know what my software does—I just move JSON around” excuse. As professionals, we need to be aware of the intended use of the things we make, and that includes weighing the ethical implications. We also need a professional ethical vow with teeth like the Hippocratic Oath that allows tech professionals to push back against demands to write unethical software, but that’s a topic…
I don't disagree. But my point was that it's not always clear what the implications are. Sometimes it's more obvious, sometime it's not. We also don't know what the "intended" use of this feature that was presented to the people who made it was. They could very well have been deceived as to it's true nature.
This could very easily have been presented and sold to a team in a way that does not make it immediately seem like something evil.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#115the market will always gravitate towards products that scale, that's all drugs are. when you become more efficient it is intangible easily replicable things.
I think a quadrant based graph makes this more apparent and can influence public policy
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#116Earlier quoted context omitted.
This qualifies for /r/assholedesign
More than that. This is unethical design. It's a design that probably killed people.
I think it's safe to remove probably.
This went down a chain of people. CEO. VP. PM. Tech Lead. Developer.
All of them made a choice to kill people for profit.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#117Earlier quoted context omitted.
So the BAs and managers know too, and a typical assumption is that they know before they ever talk to a developer. They have every opportunity to reject it themselves on ethical grounds before they ever talk to a developer. And yet, they still bring this known-ethically-bad feature to the developer and ask them to implement it! If devs are talking and developing customer needs directly (a legitimate thing), then that…
> Devs should not be the ethical enforcement. Yes, they should. If nobody else does, they're the last in line and they should remain ethical. "Nobody else stopped the feature" is NOT AN EXCUSE.
No, people above devs should be ethical enforcement, before devs
Devs can be, if they have to be, but they shouldn't
If it reaches the dev, there should be greater consequences for not catching it earlier.
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#118Earlier quoted context omitted.
According to the "statement of facts" the US Attorney's office released, this action resulted in "tens of thousands" of additional prescriptions of highly addictive extended release opioids. Without a doubt this resulted in lives and families destroyed. I'm not sure the fine is "small" though (not that any fine could be sufficient), Practice Fusion was acquired last year for "only" $100M.
Civil suits are a possibility. Someone bought a whole lot of liability.
Class action lawsuits are a money making machine for lawyers but it seems this is the use case they were designed for
Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#119In retrospect doesn't seem like a very big surprise that they would resort to something like this as Practice Fusion was initially launched as free for a long time, and costed only $99 per month later. One should be increasingly wary of using free software for crucial applications and sensitive data. Being HIPAA compliant isn't enough. There's a regulatory body called POC3 ( https://www.poc3.org ) for communication d…
I think you mean free as in free beer and software as in software services. IMO the medical industry could use more free as in freedom software, and that may be an alternative way to prevent things like this.
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Re: Health-records software pushed opioids to doctors in secret deal with drugmaker
#120They put pop-up stealth advertisements, targeted at your doctor, into your electronic medical record, so that he or she would get you addicted to painkillers. Software developers did this. For drug money. That's just terrible, isn't it? They shouldn't have done that. But even if the developers had ethical concerns, they had no recourse but to quit, and be replaced by someone else--who might get six months of work in…
> I would do that job. I would take that money. I don't get a stupidly-inflated Valley salary with bonus RSUs, and I have bills to pay. I don't have a union that can protect me from nonsense. I know it's wrong. I would do it anyway, because I have been screwed by every company I have ever worked for, such that I learned that my ethics don't matter. Money matters.
You've identified a perverse incentive that requires punitive counter-incentive in response. Someone in your position will think twice about doing that job if by doing so, their freedom and ability to take care of their kids is put in jeopardy.
Of course, there needs to be punitive incentives at the top so that such that low-level employees are not pushed to act in ways that lead to results such as these.