It sounds like between the trouble keeping doctors, the politics, and the IT director, your stress levels would probably be lower as an air traffic controller. I'm guessing the IT director is also responsible for managing peoples logins and privileges, so she's unlikely to fix them. C*Os probably won't care until you mention HIPAA, but it's not a HIPAA violation unless you mention that passwords are being shared, which implies you know who is sharing them.
Either way, that all blows chunks. I wish you and your dad the best of luck.
Vitals can be substantially easier with an EMR since the computers can talk directly to the monitoring equipment - you click a button, and you're done. I've seen nurses break down in tears when this wasn't working; taking vitals three minutes sucks if you have to key them in manually or do it on paper.
Most nurses also like the electronic MAR, since it can automagically calculate dosages and rates for continuous medications, automagically retrieve the right medication from the Pyxis, and automagically get approval from pharmacy. Most don't like the extra keyboarding involved, but being able to see normal ranges and highs and lows is nifty, as is being able to hide irrelevant documentation, or pull in required documentation. Typically physicians are the most dead set against EMRs because CPOE involves more work for them that they used to palm off to nurses. It's certainly not to make life easier for the insurance companies - hospitals couldn't care less, and insurance companies can drag out making payments for every paper claim that they "lose" or find to be "illegible" or otherwise not filled out to spec.
Bad setup or bad software can make EMRs suck as much as any IT project, but they're more or less inevitable. Federal "meaningful use" requirements mean that hospitals and practices will eventually get penalized on their Medicare and Medicaid reimbursements if they don't jump on board, which adds up quick.
The logging helps mitigate the privacy concerns of a doctor being able to see some/most/all of the hospital, but you're right that it wouldn't stop someone off the street from logging in and opening a record.
But, the whole situation you describe is relaly, really depressing. Usually, hospitals are pretty on-the-ball when it comes to security, or at least moreso than individual clinics are. It's particularly surprising that they're overlooking the password sharing - most CIOs/CMIOs will shriek and faint if you jump out from behind a corner screaming "HIPAA HIPAA HIPAA!"
It sounds like your hospital has really, really dysfunctional IT, but EMRs are possible to do right. And are you sure it was sabotage? There's a lot that blows up when an EMR is first installed.
Most doctors don't have access to all patients, and most systems will log every record you view anyway. It's kind of disturbing that the doctors let you shoulder surf, though.
What you want is a PACS. These are generally expensive. I can't recommend any specific vendors, but you want to be very careful with HIPAA. They're also FDA regulated, so you also want to be careful about hacking anything together that could be functionally confused with a PACS.
That said, I'd be really surprised if a radiology clinic didn't already have one (that "telerad" you alluded to?). I'd call up the vendor and ask what they can do; any modern system will speak DICOM, and a lot (if not most) of them can grab images from outside the facility.
Your idea isn't going to work, and it's not because of ColdWetDog's "lack of imagination.
Requiring everyone to own a smartphone or PDA just to have a medical record is impractical, at best.
You currently can't "forget" your medical record. This isn't an improvement, or even necessary.
You've made your entire medical record essentially patient reported. Your insurance company isn't going to write you a check just on your word, and that's now all you have.
If Medicare, or the Joint Commission, or AIUM, or whoever wants to audit the hospital, they now require the cooperation of every patient that hospital has seen. Hospitals see a lot of patients. Audits span years. You've just made oversight impossible.
The only copy of your medical record getting run over by a bus
is a lot different than having to get something faxed.
Current medical records depend on very little infrastructure. Some are still entirely on paper. You want to five nines the cell network, nationwide.
This doesn't help people "manage their information", because currently, they don't. As people increase their "management" of their medical record, the information it contains because impossible to act on, either for medical or legal reasons.
Individual control of a medical record is a nice idea, but it entirely defeats the purpose of having one.
I stopped for gas in Chicago not too long ago, and it confuzzled me when the pump asked for my ZIP code. I figured it was a weak attempt to make sure it was me using my credit card, but I almost pried the card scanner off trying to see if it was real or not.
you know what? every single movie, book, or play ever made can be described as derivative of something that came before, even going back to... the ancient greeks
So quit posting. If all of humanity after Socrates couldn't come up with something original, you sure as hell can't.
Maximum PC did an article on this thing. They managed to print a whistle (with the captive pea inside). One Cathal Garvey, a geneticist, is using it to stave off having to buy a few million worth of lab equipment; see the dremel-powered centrifuge or the microlathe.
So, it's not perfect or self-replicating, but you can do some cool stuff with it. Non-geneticists might appreciate being able to machine replacements for all the brittle plastic shit that can break, or just get their own Master Chief statue.
It's worth noting that while Nike supports stronger anti-counterfeiting laws (natch), they wrote Senator Wyden asking him not to break the internet. From the letter:
"The Internet is too important to our economy and to advancing American values to be inappropriately regulated and censored under the guise of protecting IP"
I wrote that small businesses get squashed by regulation, but big businesses can avoid it. Why would you conclude, in an article about Facebook and Goldman Sachs avoiding regulation, that I thought both of them were "small"?
Going public means having to comply with Sarbanes-Oxley. Compliance is an entire industry unto itself, so the law of unintended consequences happens:
Small companies can't afford to go public... so they don't. The IPO market is strangled, and Thee Little Guy is no longer regulated because he no longer exists.
Large companies can comply... if they want to. SarbOx is expensive enough that a scheme like this is actually profitable in comparison. The Big Guy is no longer regulated, because he has an army of lawyers to smuggle his shares out of the country in their rectums.
Without SarbOx, something this complicated and dangerously-close-to-illegal would just be stupid, and Facebook would be publicly traded, with all the oversight that entailed. But, maybe all that extra regulation everyone's dodging already prevented a second Enron~
If you are unwilling to assume responsibility for a device intended solely to kill human beings, you shouldn't have one.
Damn right. Guns' intended purpose, and therefore only purpose, is violence and murder. Just like torrent clients can only be used for piracy, jailbreaking can only be used for hacking, laser pointers can only be used for blinding people, and cough syrup can only be used for making crystal meth.
In fact, I shot three blind, meth-addled hipster pirates just on my morning commute yesterday.
Taken literally, "I could care less" does mean you at least care a little bit right now. See this continuum of caring I found.
Although "I couldn't care less" is the original form, "I could care less" is classic American sarcasm - a positive phrase meant negatively. I wouldn't consider it any more "wrong" than phrases like "Lucky you!" (said to someone suffering misfortune), or "Tell me about it!" (said when you've heard it all before and really don't want to be told all about it.)
During college, I briefly had a Facebook account to collaborate with classmates who were awful at checking e-mail. I thought exactly as you did and made myself one of the 30-odd Rurouni Kenshins already facespacing under an assumed alias.
Scary thing is, it doesn't even matter. From the classmates I added, Facespace knew I was a college student, where I went to school, that I lived on campus, and had a good fix on my age.
Even more was possible when Beacon was active. Did you buy anything online after logging into Facebook? Stream any TV? They know your gender and age. If you bought textbooks, they know your field of study.
Even for a/.er my paranoia:something-to-hide ratio is unhealthily high. But, it's not paranoia if they really are out to get you(r marketing demographics).
The "giant pool of money" theory is probably the best I've heard for explaining the current housing crisis.
When large financial institutions and countries sit on trillions of dollars (or the appropriate local currency), fractions of a percent of a percent of interest start to add up. So you invest, but in something safe like US treasury bills - you can't exactly bet your country's treasury on GM. Then interest rates plummeted, and people (and countries) started looking for better investments.
Well, real estate is always a safe investment, right? Housing prices always go up. So, a smart financier bundled a few thousand mortgages together, and started selling shares of that bundle to interested parties. Buying shares of mortgages was a hit. So much so, in fact, that there was greater demand for mortgages than there were actual mortgages.
So, there was an interesting business opportunity - issue as many mortgages as possible, because fucktons of people wanted to buy them. Doesn't matter if the person you issue the mortgage to has no money, because the whole mess will be off your hands before you worry about collecting a single payment. Then, suddenly, none of the people who received the no income, no job or assets (NINJA) mortgages could make payments, and the rest of the dominoes fell like a house of cards. Checkmate.
Although NPR phrased it a lot more eloquently. And they were probably sober at the time, too.
there isn't really much beyond that I would actually want, given that I was doing something I actually enjoyed
And there's the rub - most of us don't get paid for our hobbies. If someone pays you for doing what you love, you're either incredibly blessed or incredibly dull.
Put another way, "good" pay is necessary but not sufficient for job satisfaction. And if you can retire in your forties, you can work if you want as opposed to being compelled by necessity.
"I can even see color with it"...is this supposed to be odd or something?
Yes, because only the cones in the center of your eye are capable of perceiving color (the rods on the outside perceive only black and white.) Your brain senses everything in the periphery of your vision in black and white, but "fills in" best-guess colors from what your cones perceive directly in front of you.
I remember that from a psychology lecture only because a fellow classmate, like the parent poster, couldn't believe the color in his peripheral vision was an illusion. So, the professor drew an "X" in the middle of the chalkboard and asked him to stare at it without looking away. He then held up a colored note card directly in front of the "X" and asked him to name the color. (Of course, he named it correctly.)
The professor held up another note card, a bit further away from the X, and asked him to say what color that card was. And then he held up the next card, a bit further away from the X than the last one. And he kept holding the cards further and further towards the edge of his field of vision.
After about the fifth card, the kid was convinced that any card the professor held up was either a shade of gray, or the same color as the chalkboard. Once the note cards were in his peripheral vision, he couldn't tell what color they were, and couldn't tell that he couldn't tell what color they were. Great professor.
You want to watch a "real" programmer wet his pants in fear you hand him a huge 14 page VB mess written by a half a dozen guys over the years...
Do you want to see real bedwetting? If you're most anywhere in America, your healthcare depends on a few gigabytes of VB6. That it works speaks to the value of good development practices.
I miss two things about disc-and-box games: Being able to resell them, and the box. I do prefer my first-sale doctrines un-eroded, and I'm sitting in front of a bookshelf of old MicroProse games.
Steam is very palatable DRM because Valve is working on adding features to their platform - your save games follow your Steam account, you can install a game infinity times on infinity computers, you can still patch your games after the developer's site goes down, and Steam games don't make you hunt for a Ventrilo server.
Steam games permit 3rd party DRM, but games with extra DRM are labeled as such in the store and most publishers remove their DRM for the Steam version. Besides being unobtrusive and having a bunch of nifty features, Steam games typically feature less DRM.
It's really a matter of how badly you think Gabe Newell wants to delete your games. Given what he's done to other publishers, and done for indie gaming, I'm willing to give him the benefit of the doubt. As an unapologetic "Steam cultist", I'd say it is good DRM.
The Social Security Administration is not "cheap", and it's not a "mutual fund." Even if you consider it an "investment", it's flirting with bankruptcy. If it's still around 50 years from now, by design only the impoverished will collect more than what they put into it.
Prior to an awful lot of politically-motivated feature creep, it was simply "old age insurance" designed to keep fully half of our nation's elderly from starving to death.
Slashdot Mirror
It sounds like between the trouble keeping doctors, the politics, and the IT director, your stress levels would probably be lower as an air traffic controller. I'm guessing the IT director is also responsible for managing peoples logins and privileges, so she's unlikely to fix them. C*Os probably won't care until you mention HIPAA, but it's not a HIPAA violation unless you mention that passwords are being shared, which implies you know who is sharing them.
Either way, that all blows chunks. I wish you and your dad the best of luck.
Vitals can be substantially easier with an EMR since the computers can talk directly to the monitoring equipment - you click a button, and you're done. I've seen nurses break down in tears when this wasn't working; taking vitals three minutes sucks if you have to key them in manually or do it on paper.
Most nurses also like the electronic MAR, since it can automagically calculate dosages and rates for continuous medications, automagically retrieve the right medication from the Pyxis, and automagically get approval from pharmacy. Most don't like the extra keyboarding involved, but being able to see normal ranges and highs and lows is nifty, as is being able to hide irrelevant documentation, or pull in required documentation. Typically physicians are the most dead set against EMRs because CPOE involves more work for them that they used to palm off to nurses. It's certainly not to make life easier for the insurance companies - hospitals couldn't care less, and insurance companies can drag out making payments for every paper claim that they "lose" or find to be "illegible" or otherwise not filled out to spec.
Bad setup or bad software can make EMRs suck as much as any IT project, but they're more or less inevitable. Federal "meaningful use" requirements mean that hospitals and practices will eventually get penalized on their Medicare and Medicaid reimbursements if they don't jump on board, which adds up quick.
The logging helps mitigate the privacy concerns of a doctor being able to see some/most/all of the hospital, but you're right that it wouldn't stop someone off the street from logging in and opening a record.
But, the whole situation you describe is relaly, really depressing. Usually, hospitals are pretty on-the-ball when it comes to security, or at least moreso than individual clinics are. It's particularly surprising that they're overlooking the password sharing - most CIOs/CMIOs will shriek and faint if you jump out from behind a corner screaming "HIPAA HIPAA HIPAA!"
It sounds like your hospital has really, really dysfunctional IT, but EMRs are possible to do right. And are you sure it was sabotage? There's a lot that blows up when an EMR is first installed.
Most doctors don't have access to all patients, and most systems will log every record you view anyway. It's kind of disturbing that the doctors let you shoulder surf, though.
What you want is a PACS. These are generally expensive. I can't recommend any specific vendors, but you want to be very careful with HIPAA. They're also FDA regulated, so you also want to be careful about hacking anything together that could be functionally confused with a PACS.
That said, I'd be really surprised if a radiology clinic didn't already have one (that "telerad" you alluded to?). I'd call up the vendor and ask what they can do; any modern system will speak DICOM, and a lot (if not most) of them can grab images from outside the facility.
Your idea isn't going to work, and it's not because of ColdWetDog's "lack of imagination.
is a lot different than having to get something faxed.
This doesn't help people "manage their information", because currently, they don't. As people increase their "management" of their medical record, the information it contains because impossible to act on, either for medical or legal reasons.
Individual control of a medical record is a nice idea, but it entirely defeats the purpose of having one.
I stopped for gas in Chicago not too long ago, and it confuzzled me when the pump asked for my ZIP code. I figured it was a weak attempt to make sure it was me using my credit card, but I almost pried the card scanner off trying to see if it was real or not.
you know what? every single movie, book, or play ever made can be described as derivative of something that came before, even going back to ... the ancient greeks
So quit posting. If all of humanity after Socrates couldn't come up with something original, you sure as hell can't.
The fastest possible way to store and retrieve data of all shapes and sizes is B-trees
You're kidding, but you haven't heard of MUMPS. It's time-shared B-trees, and is a lot more widespread than you'd believe.
(Though if you're in marketing, you'd call it "The World's Fastest Object Database" or "post-relational" rather than "lots of arrays.")
Crap... Since when were there different kinds of bootlanders?!
Maximum PC did an article on this thing. They managed to print a whistle (with the captive pea inside). One Cathal Garvey, a geneticist, is using it to stave off having to buy a few million worth of lab equipment; see the dremel-powered centrifuge or the microlathe.
So, it's not perfect or self-replicating, but you can do some cool stuff with it. Non-geneticists might appreciate being able to machine replacements for all the brittle plastic shit that can break, or just get their own Master Chief statue.
I wanted to see your image, but didn't have a Facebook Gold account ;_;
It's worth noting that while Nike supports stronger anti-counterfeiting laws (natch), they wrote Senator Wyden asking him not to break the internet. From the letter:
"The Internet is too important to our economy and to advancing American values to be inappropriately regulated and censored under the guise of protecting IP"
I wrote that small businesses get squashed by regulation, but big businesses can avoid it. Why would you conclude, in an article about Facebook and Goldman Sachs avoiding regulation, that I thought both of them were "small"?
Going public means having to comply with Sarbanes-Oxley. Compliance is an entire industry unto itself, so the law of unintended consequences happens:
Without SarbOx, something this complicated and dangerously-close-to-illegal would just be stupid, and Facebook would be publicly traded, with all the oversight that entailed. But, maybe all that extra regulation everyone's dodging already prevented a second Enron~
If you are unwilling to assume responsibility for a device intended solely to kill human beings, you shouldn't have one.
Damn right. Guns' intended purpose, and therefore only purpose, is violence and murder. Just like torrent clients can only be used for piracy, jailbreaking can only be used for hacking, laser pointers can only be used for blinding people, and cough syrup can only be used for making crystal meth.
In fact, I shot three blind, meth-addled hipster pirates just on my morning commute yesterday.
Taken literally, "I could care less" does mean you at least care a little bit right now. See this continuum of caring I found.
Although "I couldn't care less" is the original form, "I could care less" is classic American sarcasm - a positive phrase meant negatively. I wouldn't consider it any more "wrong" than phrases like "Lucky you!" (said to someone suffering misfortune), or "Tell me about it!" (said when you've heard it all before and really don't want to be told all about it.)
This page was also interesting.
During college, I briefly had a Facebook account to collaborate with classmates who were awful at checking e-mail. I thought exactly as you did and made myself one of the 30-odd Rurouni Kenshins already facespacing under an assumed alias.
Scary thing is, it doesn't even matter. From the classmates I added, Facespace knew I was a college student, where I went to school, that I lived on campus, and had a good fix on my age.
Even more was possible when Beacon was active. Did you buy anything online after logging into Facebook? Stream any TV? They know your gender and age. If you bought textbooks, they know your field of study.
Even for a /.er my paranoia:something-to-hide ratio is unhealthily high. But, it's not paranoia if they really are out to get you(r marketing demographics).
The "giant pool of money" theory is probably the best I've heard for explaining the current housing crisis.
When large financial institutions and countries sit on trillions of dollars (or the appropriate local currency), fractions of a percent of a percent of interest start to add up. So you invest, but in something safe like US treasury bills - you can't exactly bet your country's treasury on GM. Then interest rates plummeted, and people (and countries) started looking for better investments.
Well, real estate is always a safe investment, right? Housing prices always go up. So, a smart financier bundled a few thousand mortgages together, and started selling shares of that bundle to interested parties. Buying shares of mortgages was a hit. So much so, in fact, that there was greater demand for mortgages than there were actual mortgages.
So, there was an interesting business opportunity - issue as many mortgages as possible, because fucktons of people wanted to buy them. Doesn't matter if the person you issue the mortgage to has no money, because the whole mess will be off your hands before you worry about collecting a single payment. Then, suddenly, none of the people who received the no income, no job or assets (NINJA) mortgages could make payments, and the rest of the dominoes fell like a house of cards. Checkmate.
Although NPR phrased it a lot more eloquently. And they were probably sober at the time, too.
there isn't really much beyond that I would actually want, given that I was doing something I actually enjoyed
And there's the rub - most of us don't get paid for our hobbies. If someone pays you for doing what you love, you're either incredibly blessed or incredibly dull.
Put another way, "good" pay is necessary but not sufficient for job satisfaction. And if you can retire in your forties, you can work if you want as opposed to being compelled by necessity.
"I can even see color with it" ...is this supposed to be odd or something?
Yes, because only the cones in the center of your eye are capable of perceiving color (the rods on the outside perceive only black and white.) Your brain senses everything in the periphery of your vision in black and white, but "fills in" best-guess colors from what your cones perceive directly in front of you.
I remember that from a psychology lecture only because a fellow classmate, like the parent poster, couldn't believe the color in his peripheral vision was an illusion. So, the professor drew an "X" in the middle of the chalkboard and asked him to stare at it without looking away. He then held up a colored note card directly in front of the "X" and asked him to name the color. (Of course, he named it correctly.)
The professor held up another note card, a bit further away from the X, and asked him to say what color that card was. And then he held up the next card, a bit further away from the X than the last one. And he kept holding the cards further and further towards the edge of his field of vision.
After about the fifth card, the kid was convinced that any card the professor held up was either a shade of gray, or the same color as the chalkboard. Once the note cards were in his peripheral vision, he couldn't tell what color they were, and couldn't tell that he couldn't tell what color they were. Great professor.
You want to watch a "real" programmer wet his pants in fear you hand him a huge 14 page VB mess written by a half a dozen guys over the years ...
Do you want to see real bedwetting? If you're most anywhere in America, your healthcare depends on a few gigabytes of VB6. That it works speaks to the value of good development practices.
Walmart gives away basic medications because it PROFITS THEM
I don't care if Sam Walton thought it would get him 72 virgins. I'm pretty sure he's given away more medication than you have.
I miss two things about disc-and-box games: Being able to resell them, and the box. I do prefer my first-sale doctrines un-eroded, and I'm sitting in front of a bookshelf of old MicroProse games.
Steam is very palatable DRM because Valve is working on adding features to their platform - your save games follow your Steam account, you can install a game infinity times on infinity computers, you can still patch your games after the developer's site goes down, and Steam games don't make you hunt for a Ventrilo server.
Steam games permit 3rd party DRM, but games with extra DRM are labeled as such in the store and most publishers remove their DRM for the Steam version. Besides being unobtrusive and having a bunch of nifty features, Steam games typically feature less DRM.
It's really a matter of how badly you think Gabe Newell wants to delete your games. Given what he's done to other publishers, and done for indie gaming, I'm willing to give him the benefit of the doubt. As an unapologetic "Steam cultist", I'd say it is good DRM.
The Social Security Administration is not "cheap", and it's not a "mutual fund." Even if you consider it an "investment", it's flirting with bankruptcy. If it's still around 50 years from now, by design only the impoverished will collect more than what they put into it.
Prior to an awful lot of politically-motivated feature creep, it was simply "old age insurance" designed to keep fully half of our nation's elderly from starving to death.