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I work in Health IT, and I'll tell you the industry is at least a decade behind every other industry in part because of how paranoid CIOs are about letting rese
by fny 9y ago
I work in Health IT, and I'll tell you the industry is at least a decade behind every other industry in part because of how paranoid CIOs are about letting researchers play with their data, even when the use cases are perfectly legal. The reason Health IT seems vibrant is because health systems are only now waking up from their stupor.*
Also many providers still avoid the cloud (despite proven PHI compliance) and run their own inefficient, in-house server farms with thousands of tech staff because of this irrational fear. This causes a number of problems:
- It assumes a hospital system is better at infrastructure security and maintenance than Amazon or Microsoft
- Server costs per project are stupidly expensive. A VM that goes for $10/mo in the cloud ends up costing $200/mo to whatever department that foots the bill.
- You can't deploy a VM or app with a click. Instead you need to file a demand, then someone needs to make sure they have the resources available, then someone needs to manually spin up a VM for you...
- You can't build services that dynamically scale: this ends up being a problem for computationally expensive ML work
- Tech spending on a hospital is overwhelmingly spend on maintenance and uptime rather than innovation or purchasing solutions
I could go on forever.
* This is also complicated by the fact that the industry isn't really incentivized to improve your health. Why run a predictive model and intervene to reduce your need for a stent when I make money from that operation?
- greenyoda 9y ago"This is also complicated by the fact that the industry isn't really incentivized to improve your health. Why run a predictive model and intervene to reduce your need for a stent when I make money from that operation?" The healthcare industry has two sides: the providers and the insurers. A hospital may not have the incentive to steer you away from unnecessary surgery, but your insurance company definitely does, since they'll be the ones paying for it. And your insurance company may have even more information to base its models on, since it knows about all the procedures you've had at any provider. So I'd expect insurance companies to be pioneering this kind of health-improvement software, not hospitals.
- redler 9y agoOne big problem is that insurance companies are looking to optimize financial outcomes, not health outcomes. Sometimes these coincide but often they do not.
- altstar 9y agoFor health insurers it is exactly the same thing.
- greenyoda 9y agoIf you're currently healthy, your insurance company maximizes its profits if you stay healthy (nothing to pay for except routine checkups, etc., which cost far less than the thousands of dollars in premiums your employer pays for you every year). But if you have cancer, the insurance company might maximize its profits if it refuses to pay for expensive treatments, causing you to die sooner. Over the long run, it would seem to be in the insurer's best interest to keep everyone healthy for as long as possible.
- nradov 9y agoMedical "insurance" barely even exists anymore in the US. Most large employers and other group buyers self insure and hire an insurance company mostly to just administer claims. So the insurance company isn't really paying, although they still have an incentive to hold down costs and prevent unnecessary procedures for competitive and quality reasons.
- Spooky23 9y agoThe consolidation of providers into big networks broke that virtuous cycle. Your health provider has zero financial incentive to improve your health, and your employer or insurer will get more ROI from nitpick things like delaying claims or pushing out prescription fulfillment to reduce the spend this quarter.