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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

#201

Post by elliekelly »

chii wrote: post #97
SolarNet wrote: post #93

Earlier quoted context omitted.

Sure, but adequate and auditable documentation need not involve the patient nor money. Just a "here is the medical care we dispersed, on this date, to this person, it took these resources, these people administered the care." No following up every record for payments, no arguing with insurance companies over the price. And also, what abuse? If medical care is free and drugs are cheap, the only real abuse is drug abus…

> And also, what abuse? a clinic could mis-report (over-report?) how many patients they treated, and/or the procedure. They can then claim back more money than they actually spent, netting easy profit.

This happened to me. When I first moved to Boston I went to a new dentist who kept remarking how great my dental insurance coverage was. It turned out I had a cavity which was fully covered by my insurance so I went to his office, got the novocaine shot and spent an hour with the guy supposedly drilling in my mouth. I saw the dentist for about a year and had three cavities. The only three I'd ever had in my life.

A year or so later I switched to a dentist who was closer to my office. I told him I had had three cavities but they weren't showing up on the x-rays he took. We did two or three sets of x-rays before we figured out they were never going to show up because he had just been billing my great insurance for work he didn't actually do.

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

#202

Post by LeonB »

maxlybbert wrote: post #95
LeonB wrote: 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…

Coding isn’t hard. Writing maintainable code is. And most people learn that only after they have to modify a large system they wrote themselves.

In each of these cases the successful professional was able to pay people to maintain and improve the software after they’d proven the code enough to make it pay for itself many times over. That’s a real mark of “maintainable” and is outside the thinking of most programmers.

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

#203

Post by LeonB »

shagie wrote: post #164
LeonB wrote: 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…

One of the things that worries me about the not quite professional developing software of this nature is does it actually follow the regulations and restrictions that medical software needs to follow. HIPAA is not an easy thing to navigate and has deep implications on how data itself is stored.

The doctor has a much more nuanced view of that concern. And doctors tend to protect themselves and each other very well.

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

#204

Post by LeonB »

LeonB wrote: post #203
shagie wrote: post #164

Earlier quoted context omitted.

One of the things that worries me about the not quite professional developing software of this nature is does it actually follow the regulations and restrictions that medical software needs to follow. HIPAA is not an easy thing to navigate and has deep implications on how data itself is stored.

The doctor has a much more nuanced view of that concern. And doctors tend to protect themselves and each other very well.

In Taleb terms the doctor has “skin in the game” which acts as an excellent way to ensure quality.

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

#205

Post by sli »

oomkiller wrote: post #27

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…

> For startups that want to sell to health systems and similar-sized/larger entities (...), you unfortunately have to focus on the buyer, which is very rarely someone who is "in the trenches."

This is my current experience. The person bankrolling the project delivers lists of requirements, and nearly half of them end up being removed later when someone "in the trenches" either says they don't need/want it or it's too confusing of a feature.

Another part of the problem? "Confusing features" for doctors includes some very standard app features, like back buttons and refresh buttons. This honestly frightens me. We had to remove the back button -- which was requested by the buyer -- because it became a patient safety issue.

At least we don't have to target IE9.

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

#206

Post by craftinator »

DoreenMichele wrote: post #189
cjsawyer wrote: post #187

Earlier quoted context omitted.

Ha! Try that scenario again with cheap or no insurance. That’s the reality for many

I'm well aware that's the reality for many. My awareness of that is the reason I commented on the fact that the US already has one very well-developed and well-established medical system that works much like socialized medicine: The military medical system. We don't need to look to other countries at all to try to figure out how that's done. It's done right here on American soil every single day for military members,…

The military healthcare system proscribed Naproxen for my broken wrist. Not a win.

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

#207

Post by craftinator »

DoreenMichele wrote: post #173
philtar wrote: post #167

Earlier quoted context omitted.

I find your anecdote a little difficult to balance with the stories of all the vets who need medical treatment but can't get it.

I'm not up on what you are referencing. I can tell you active duty is different from what retirees deal with. Also "vets" doesn't necessarily mean they are retirees. If they didn't serve long enough to qualify for retirement, it's possible to be a veteran without still being part of the military benefits system. You actually have insurance in the military. When my husband was on recruiting duty, we did not live near…

I'm pretty damn upper class culturally. I'm just broke.

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

#208

Post by sonnyblarney »

analog31 wrote: post #71
oomkiller wrote: post #27

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…

This is very misleading.

In single payer systems, doctors and hospitals bill someone for their service, it's just that the 'insurance company' is the government.

Someone 'out of system' cannot provide the health/ID necessary, ergo, no way for them to bill. But otherwise they do bill.

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

#209

Post by kiriakasis »

mac01021 wrote: post #194
kiriakasis wrote: post #190

Earlier quoted context omitted.

Generally because stating it as "being forced to pay" often comes with a hint of it being wrong. So the question could have been: do you think we should have free/socialized streets/hospitals? If not how do you think they are different?

I'm not the GP and think we probably should have more socialized hospitals. But suggesting people who oppose publicly funded freeways should boycott publicly funded freeways is silly. Imagine an office Christmas party where everyone is told to chip in for refreshments and then the refreshments will be whatever the boss ends up buying with that money. I may not like that arrangement, and may prefer to keep my money an…

Right, indeed I think that in this situation eating the salad does not prevent you from criticizing the party.

But this is the point, you were "forced" to pay for something and you would be okay with not getting it. If only the people who paid for the Christmas party were invited that would be okay.

Do you think this reasoning should also apply to streets and hospitals?

(I am specifically referring to using the word "forced" and the moral implication of using it)

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

#210

Post by tivert »

danieltillett wrote: post #116
tivert wrote: post #90

Earlier quoted context omitted.

> I have often wondered if it would be better to just hire professional data entry people to follow the doctor around and enter all the information into the system. Those data people are called "medical scribes," my doctor has started using one. Seems like they're mostly pre-med college students looking to get exposure to healthcare environments. https://en.wikipedia.org/wiki/Medical_scribe

Sounds ideal - they can even remind the doctors to wash their hands before touching the patient.

> Sounds ideal - they can even remind the doctors to wash their hands before touching the patient.

I don't think doctors (or anyone else for that matter) is going to tolerate being followed around by an assistant who's going to nag them about how to do their job.

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