18 ms·

Big Tech Is Going After Health Care

138 points by SREinSF 9y ago

ynonym00s 9y ago
Would love to get some insight into the work at Verily or DeepMind Health for a software developer interested in working in healthcare.
mtgx 9y ago
And it's going to throw your medical privacy out of the window in the process. I suppose we'll also see some major deregulation similar to the net neutrality repeal in the healthcare industry before long.
- rossdavidh 9y ago
  Maybe, but in this case there's an entrenched interest (health care companies) that might want to use medical privacy as a way to keep themselves from being Uber-ized.
- rafinha 9y ago
  Not necessarily. You can still provide decent services collecting anonymized data.
zitterbewegung 9y ago
They are going after health care because they either ran out of customers or people to advertise to. Hopefully they can make some progress but so far I don't see much.
- Clubber 9y ago
  It's an immensely lucrative and recession proof industry.
hacker_9 9y ago
This article is pretty devoid of content, and really only mentions that the Apple watch can be used as a constant heart monitor. Big deal, you aren't going to get much information from measuring just your heart beat and knowing next to nothing else of whats going on in the rest of your body too. The real technological breakthrough will come when we have the ability to measure in real time what is going on in our various organs, such as enzyme production and transportation of molecules, but that's a long way out yet.
- lovemenot 9y ago
  Toto, the producer of fancy toilets in Japan, is believed to be developing some kind of back-end analytic system.
blhack 9y ago
Good. I spent a few years working in a medical IoT startup, and the current state of the "mainstream" medical monitoring technology is not inspiring. During a brainstorming meeting, I asked one of our cofounders, a physician, to tell me about some of the problems he had seen in health. Don't try and solve it, just lets talk about problems. He said that by far one of the most common causes for re-hospitalization is congestive heart failure. It's a super common problem, and it's actually really easy to catch (it has strong indicators). When your heart begins to fail, depending on what side of it fails, your body will retain fluid (in the form of blood) in either your heart or your organs. Regardless, you will bloat up, and gain weight quickly. So if a patient is at risk for CHF, a nurse will monitor their weight every day (or multiple times a day) and watch for spikes. If their weight spikes, a doctor will intervene in whatever way is necessary. Can you imagine my frustration at hearing this? It's this massive problem with an obvious (CHEAP!! SO FUCKING CHEAP!!) solution. I spend $30 on a scale from amazon immediately, and about an hour after it arrived I had it connected to an android tablet and broadcasting its readings to a webservice. We never went to market with that (long story). Please, if you have the means to take something like that and scale it, do so. You could save lives. I'm currently trying. More people should be trying. This stuff is so easy, and the impact that you could have is massive. Also: please call your grandparents and just talk to them. Ask them how they are feeling. Social isolation (full disclosure: this is what my current project is trying to solve) is probably the area where we as software people could have the biggest impact.
- hacker_9 9y ago
  The monitoring devices are the real problem, not the people. Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. A lot more specialist equipment is going to be needed to come to a final conclusion (Questioning from experts, MRIs, XRays, even Microsurgery with cameras). What consumers can currently access are weighing scales, and heartbeat monitors. Maybe even temperature monitors. Do you think this stuff is useful for diagnosing medical conditions? There is a whole lot going on under the surface that we simply can't see at all, that's the real problem.
mjfl 9y ago
Yeah, nothing's going to happen. Compliance costs are too high for any of Silicon Valley's business models to work.
- adventured 9y ago
  The way you fix the existing system, is by not trying to change it. You replace it instead. You build new, lighter, more nimble approaches to old problems, rather than trying to convince existing power structures to change. That's where any gains will come from by big tech entering the fray, if there end up being any. Trying to change something like the hyper regulated, hyper stagnant, special-interest dominated US healthcare system, is a folly of an idea. You kill it instead by routing around it with new solutions wherever possible. Simple example: the rapidly growing market for direct primary care subscription services [1]. Pair that up with guaranteed catastrophic coverage for all by the US Govt or state governments, and the US healthcare system as we know it is dead due to a simple route around that would dramatically lower costs. It's far easier to implode a failed bureacracy by replacing it in that manner, than by trying to change the existing bureacracy. You see that in everything from old media (which held a cartel stranglehold on broadcast access, the Internet routed around them), to the taxi medallion cartels (which Uber & Lyft murdered by routing around them instead of trying to convince them to change). [1] http://www.businessinsider.com/direct-primary-care-a-no-insurance-healthcare-model-2017-3 http://www.businessinsider.com/direct-primary-care-a-no-insu...
  - snomad 9y ago
    As the MOOCs found out, you can't just "replace" certain societal services - especially those beset with volumes of regulation and numerous groups of powerful stakeholders happy to reach out to politicians and the public (AARP, Insurance, numerous govt entities, drs groups, nurses groups). 2/3 of healthcare is paper pushing, the easiest thing the tech community can automate is boring old CRUD paper pushing. I hope one day we as consumers have the chance to get a USB stick to store and retain our own medical records. Walk into dr's office / hospital, hand over device, boom their is your whole history including previous surgeries, allergies, etc. Whatever is done gets imprinted on device, walk out with an updated history. That is some seriously productive low-hanging fruit.
oh-kumudo 9y ago
If there is one industry that needs to be disrupted, that is US's health care industry, it is too expensive.
- epmaybe 9y ago
  I don't think tech disruption is necessary to reduce costs, a multidisciplinary approach could do something similar. Edit: apparently my comment never finished, lol. What I meant to say is that disruption could work, but I think that optimization and regulations with the tools we have today would also alleviate many problems we have.
dawhizkid 9y ago
As someone who most recently worked in product at a healthcare startup I found the most difficult thing about innovation in the space is the cost of compliance/regulation. When you work in an industry that is so highly regulated, and assuming you are working at a company that follows the rule of law, how do you actually "disrupt" a set of problems in this industry when there is so little wiggle room for doing things differently? Following legal guidelines in healthcare means reenforcing bad norms rather than disrupting them. One of the biggest WTF moments I had when I first started was realizing that fax communication is HIPAA-compliant whereas email/SMS are not, even though in theory anyone could walk by a fax machine at any time and take medically sensitive information sent over.
- newman8r 9y ago
  I'm pretty sure email can be HIPAA compliant as long as you implement the system using the established guidelines.
  - toomuchtodo 9y ago
    Indeed it is as long as you’ve configured your email system to use TLS and not downgrade to no encryption if the handshake fails for mail systems where HIPAA-governed information is departing to. Source: Not a lawyer, not your lawyer. Sign off provided by non profit bio research orgs lawyer before I set it up.
    - newman8r 9y ago
      This is my understanding as well. Additionally, I believe you can send encrypted attachments over an unencrypted connection. Furthermore, https://www.gpo.gov/fdsys/pkg/FR-2013-01-25/pdf/2013-01073.pdf https://www.gpo.gov/fdsys/pkg/FR-2013-01-25/pdf/2013-01073.p... suggests that it's acceptable to send patients unencrypted PHI if they've explicitly agreed to accept the risks associated with that (although I'd be extremely cautious in those situations)
    - Spooky23 9y ago
      That’s more for B2B use cases. Like between a medical practice and hospital. The unreliability of delivery to destinations that don’t support TLS will create customer service issues in B2C scenarios.
659087 9y ago
I don't want "big tech" anywhere near my doctor's office or anything else having to do with my health.
- Clubber 9y ago
  Too late. HIS is Health Information Systems and have been around for decades. Also, thanks to the patriot act, doctors and hospitals share your health information to the federal authorities without a warrant. So there's that. https://cdt.org/insight/law-enforcement-national-security-access-to-medical-records/ https://cdt.org/insight/law-enforcement-national-security-ac...
aviv 9y ago
It's unfortunate that people think "tech" is what health care needs, when in reality society would benefit tremendously if something as simple as a 5-10 day water fast became mainstream [again], as it used to be, before modern medicine took over.
mxwll 9y ago
There are some major hurdles for these SV companies to overcome if they want any level of success in this arena. EPIC and Cerner together hold over 50% market share of EHR systems in American hospitals. Their interoperability and patient facing applications are a joke. EPIC actively makes it difficult for third parties to build on top of their system. Sure, these SV companies have figured out how to build great tech at scale but transitioning an entire hospital network to a new EMR is a massive undertaking -- both technically and organizationally. Many doctors had their world rocked by the forced transition to using EMR systems and they run the other way from those claiming a novel technology will solve all of their problems. There are much greater issues at play here and IMO the organizational problems within hospitals are far greater than the technical ones. To be successful hospitals will have to become tech companies. They aren't exactly the hottest place for top tech talent to end up. I think the patient first approach that Apple and Samsung have been taking are likely to win out. If they can build a system that captures an individual's personal health record doctors will want that data. Hospitals will have no choice but to begin integrating that data even if it lives outside of the walls of EPIC, Cerner, et al.
- jeremylee 9y ago
  Both Epic and Cerner are making at least some strides toward opening up their platforms (Epic with App Orchard, and Cerner with Ignite, SMART on FHIR etc.) Athena has MDP ("More Disruption Please.") I get the feeling these organizations have at least come to the realization that they need to open up--granted their denial up to this point leaves them with a lot of catching up to do. But access to the data that exists in those systems is a pretty big carrot for integration partners to help push adoption.
  - methehack 9y ago
    Sorry, dude, but I think you fell for it. These entities try to make you think they're open, but really they are keeping entrants at bay. Here's an interesting episode of the weeds podcast that gives some context by exploring why the fax machine is still so prevalent in US healthcare. https://player.fm/series/voxs-the-weeds/fax-reform-bonus https://player.fm/series/voxs-the-weeds/fax-reform-bonus
esotericsavage 9y ago
This is overdue. There has been a lot of talk recently that we need a new type of health care professional.. physicians that specialize in engineering. Also related to this is Atul Gawande's TED Talk, which is incredibly insightful and highly recommended.
fiveFeet 9y ago
I am all for it if someone can make the doctors use emails instead of faxes.
- dqv 9y ago
  The problem is that we don't have a key server for doctors. I really wish someone would lobby the HHS to provide a key server that maps to providers' NPI. Then setting up PGP for email can be streamlined. As it stands now, everything is fragmented because companies want to lock practitioners and health care orgs in. I'd love to see them start issuing "HIPAA compliant" seals for the implementation of open and secure standards that make it easier for health care systems to communicate and transfer data easily. That way all these closed solutions will have an incentive to actually make communication between practitioners easy and secure. The biggest joke is secure messaging. There are all these apps for secure messaging between practitioners. Of course, you have to be using the same app to open a communication channel. I know at least one of these companies is using XMPP on their backend, so it's likely others are as well. They are literally using open source solutions to make a problem that the open source solution was supposed to solve! There's no reason why $SecureMessenger can not communicate with $MessageSecure. They just don't want that to happen because they think it will cause them to lose business.
dawhizkid 9y ago
I am a big believer that we have already discovered a safe, free, plentiful lever against some of the most high profile diseases (cancer, Alzheimer’s, some mental illnesses) out there in fasting/calorie restriction/keto. I highly doubt it will ever become mainstream for the simple reason that no healthcare or big tech co can make money from telling people to eat in a way that induces ketosis. Science of Fasting doc: https://www.amazon.com/Science-Fasting-Sylvie-Gilman/dp/B075848T5T https://www.amazon.com/Science-Fasting-Sylvie-Gilman/dp/B075...
- aviv 9y ago
  Insane how we both get downvoted isn't it? Oh well. Another decade or two before people wake up. Agree with you, so much of our economy and social structure is built on the fact that people get sick - and either stay sick or get medicated for the foreseeable future. Sad. All we can do is mention it, even though we get shut down quickly be it online or IRL. Mandatory anecdote: I cured severe arthritis in the knee 6 years ago through a 30-day water fast. It was gone by day 20 or so, and stayed gone for 6 years now. It's sad that so many people suffer needlessly.
  - dawhizkid 9y ago
    Step one is getting to consensus on sugar = toxic, then refined carbs = bad, then getting people to stop believing we were evolved to eat consistently throughout the day everyday It’s amazing that “you are what you eat” has become so controversial
    - aviv 9y ago
      The old "a calorie is a calorie" that Reddit/HN geeks like to point out wearing their science hat. LOL. Oh man... Sometimes I think we've gone too far. My kids have a hard time finding classmates to play tag with because most of them are overweight and prefer to sit in the shade and eat their Costco bought school lunch. It's really sad what's happening.
bawana 9y ago
Physician here. SV Tech will win because it is customer centric. Traditional Healthcare tech is enterprise centric - the precept on which they base their strategies is 'economies of scale'. People are not widgets. Economies of scale (aka corporate controlled healthcare) do not apply. As institutions grow larger, eddy currents of dominance develop - fiefdoms that compete for control, power and share of the budget. There are so many layers of middle management that the most popular complaint is that everyone is a manager. Our hospital actually has 5x as many employees as there are patients in it. I know of no other industry where this skewed statistic exists. Can you imagine an airliner with twice as many stewards as passengers? Perhaps the legal profession is an exception, where you have so many bodies tending to a trial. In healthcare, patients are lost in this machine and the cacophony of voices speaking to them is a disservice. Perhaps tho in this era of the consumer age, some patients conflate quantity with quality and might actually feel 'more is better'. If healthcare is delivered through a watch on your wrist instead of an army of servants, the layperson might be able to focus his/her understanding on the single voice their device has. The other secret weapon of SV is that it promises to get people to open up their pocketbooks to actually pay for their own healthcare. Government will adore them for that. If you think that will never happen, just stop and think for a minute. People shell out hundreds of dollars a year for the privilege of being tracked and being advertising targets. All because the mobile device caters to their impulse for 'connectedness'. Imagine if this device promised a longer life, better sex, better sleep, less disease. And it showed you with colorful cartoon graphs how much better you were every time you asked it. Forget the fact that many of these parameters are only relevant to the big picture. Statistics apply to populations and any attempt to assign characteristics from population studies to a given individual carry uncertainty. They never tell you how big the error bars are, do they? Certainly a better diet and more exercise confer health benefits. But trying to 'gamify' this data will just add a cognitive burden and most likely will lead to more popular misconceptions and misinterpretations. Or perhaps it will be a new social nexus?When I am in a Starbux or Panera, there are always a few conversations my ears cannot avoid as people share their health problems over a sandwich and a coffee. And I cannot help laughing at how ironic the whole HIPAA thing is. Ultimately I fear that tech will foster the return of snake oil salesmen, on a massive scale. We are in a deregulation mania now and I think healthcare will soon fall under Trump's razor and he will encourage SVTech to make their move.
perpetualcrayon 9y ago
Why hasn't Big Tech made a bigger dent in the insurance industry?
- tim333 9y ago
  Insurance has quite a lot of specialist knowledge that isn't really tech.
Apocryphon 9y ago
I wonder if this will prove to be an opportunity for cities outside of SV to grab a bigger piece of tech. Nashville? https://www.bizjournals.com/nashville/news/2017/09/22/health-care-is-growing-quickly-in-nashville-but.html https://www.bizjournals.com/nashville/news/2017/09/22/health...
AngeloAnolin 9y ago
Interesting to see the big players like Apple, Google and Amazon making significant investments in this area. The big problem though still lies in the maze of regulatory bodies with which all these innovative solutions have to navigate before they even get mainstream. Small players who does not have enough financial leeway ends up burying what could be a groundbreaking solution. Of course, governments need to do their due diligence as public health is the one at stake but there needs to have a certain compromise where the end result is the good of the public and humanity.

138 points by SREinSF 9y ago

Would love to get some insight into the work at Verily or DeepMind Health for a software developer interested in working in healthcare.

mtgx 9y ago

And it's going to throw your medical privacy out of the window in the process. I suppose we'll also see some major deregulation similar to the net neutrality repeal in the healthcare industry before long.

rossdavidh 9y ago
Maybe, but in this case there's an entrenched interest (health care companies) that might want to use medical privacy as a way to keep themselves from being Uber-ized.
rafinha 9y ago
Not necessarily. You can still provide decent services collecting anonymized data.

zitterbewegung 9y ago

They are going after health care because they either ran out of customers or people to advertise to. Hopefully they can make some progress but so far I don't see much.

Clubber 9y ago
It's an immensely lucrative and recession proof industry.

hacker_9 9y ago

This article is pretty devoid of content, and really only mentions that the Apple watch can be used as a constant heart monitor. Big deal, you aren't going to get much information from measuring just your heart beat and knowing next to nothing else of whats going on in the rest of your body too. The real technological breakthrough will come when we have the ability to measure in real time what is going on in our various organs, such as enzyme production and transportation of molecules, but that's a long way out yet.

lovemenot 9y ago
Toto, the producer of fancy toilets in Japan, is believed to be developing some kind of back-end analytic system.

blhack 9y ago

Good. I spent a few years working in a medical IoT startup, and the current state of the "mainstream" medical monitoring technology is not inspiring. During a brainstorming meeting, I asked one of our cofounders, a physician, to tell me about some of the problems he had seen in health. Don't try and solve it, just lets talk about problems. He said that by far one of the most common causes for re-hospitalization is congestive heart failure. It's a super common problem, and it's actually really easy to catch (it has strong indicators). When your heart begins to fail, depending on what side of it fails, your body will retain fluid (in the form of blood) in either your heart or your organs. Regardless, you will bloat up, and gain weight quickly. So if a patient is at risk for CHF, a nurse will monitor their weight every day (or multiple times a day) and watch for spikes. If their weight spikes, a doctor will intervene in whatever way is necessary. Can you imagine my frustration at hearing this? It's this massive problem with an obvious (CHEAP!! SO FUCKING CHEAP!!) solution. I spend $30 on a scale from amazon immediately, and about an hour after it arrived I had it connected to an android tablet and broadcasting its readings to a webservice. We never went to market with that (long story). Please, if you have the means to take something like that and scale it, do so. You could save lives. I'm currently trying. More people should be trying. This stuff is so easy, and the impact that you could have is massive. Also: please call your grandparents and just talk to them. Ask them how they are feeling. Social isolation (full disclosure: this is what my current project is trying to solve) is probably the area where we as software people could have the biggest impact.

hacker_9 9y ago
The monitoring devices are the real problem, not the people. Do you think all weight spikes simply equate to having CHF? You can't just rely on such a basic measurement when dealing with an incredibly complex system such as the human body. A lot more specialist equipment is going to be needed to come to a final conclusion (Questioning from experts, MRIs, XRays, even Microsurgery with cameras). What consumers can currently access are weighing scales, and heartbeat monitors. Maybe even temperature monitors. Do you think this stuff is useful for diagnosing medical conditions? There is a whole lot going on under the surface that we simply can't see at all, that's the real problem.

mjfl 9y ago

Yeah, nothing's going to happen. Compliance costs are too high for any of Silicon Valley's business models to work.

adventured 9y ago
The way you fix the existing system, is by not trying to change it. You replace it instead. You build new, lighter, more nimble approaches to old problems, rather than trying to convince existing power structures to change. That's where any gains will come from by big tech entering the fray, if there end up being any. Trying to change something like the hyper regulated, hyper stagnant, special-interest dominated US healthcare system, is a folly of an idea. You kill it instead by routing around it with new solutions wherever possible. Simple example: the rapidly growing market for direct primary care subscription services [1]. Pair that up with guaranteed catastrophic coverage for all by the US Govt or state governments, and the US healthcare system as we know it is dead due to a simple route around that would dramatically lower costs. It's far easier to implode a failed bureacracy by replacing it in that manner, than by trying to change the existing bureacracy. You see that in everything from old media (which held a cartel stranglehold on broadcast access, the Internet routed around them), to the taxi medallion cartels (which Uber & Lyft murdered by routing around them instead of trying to convince them to change). [1] http://www.businessinsider.com/direct-primary-care-a-no-insurance-healthcare-model-2017-3 http://www.businessinsider.com/direct-primary-care-a-no-insu...
- snomad 9y ago
  As the MOOCs found out, you can't just "replace" certain societal services - especially those beset with volumes of regulation and numerous groups of powerful stakeholders happy to reach out to politicians and the public (AARP, Insurance, numerous govt entities, drs groups, nurses groups). 2/3 of healthcare is paper pushing, the easiest thing the tech community can automate is boring old CRUD paper pushing. I hope one day we as consumers have the chance to get a USB stick to store and retain our own medical records. Walk into dr's office / hospital, hand over device, boom their is your whole history including previous surgeries, allergies, etc. Whatever is done gets imprinted on device, walk out with an updated history. That is some seriously productive low-hanging fruit.

oh-kumudo 9y ago

If there is one industry that needs to be disrupted, that is US's health care industry, it is too expensive.

epmaybe 9y ago
I don't think tech disruption is necessary to reduce costs, a multidisciplinary approach could do something similar. Edit: apparently my comment never finished, lol. What I meant to say is that disruption could work, but I think that optimization and regulations with the tools we have today would also alleviate many problems we have.

dawhizkid 9y ago

As someone who most recently worked in product at a healthcare startup I found the most difficult thing about innovation in the space is the cost of compliance/regulation. When you work in an industry that is so highly regulated, and assuming you are working at a company that follows the rule of law, how do you actually "disrupt" a set of problems in this industry when there is so little wiggle room for doing things differently? Following legal guidelines in healthcare means reenforcing bad norms rather than disrupting them. One of the biggest WTF moments I had when I first started was realizing that fax communication is HIPAA-compliant whereas email/SMS are not, even though in theory anyone could walk by a fax machine at any time and take medically sensitive information sent over.

newman8r 9y ago
I'm pretty sure email can be HIPAA compliant as long as you implement the system using the established guidelines.
- toomuchtodo 9y ago
  Indeed it is as long as you’ve configured your email system to use TLS and not downgrade to no encryption if the handshake fails for mail systems where HIPAA-governed information is departing to. Source: Not a lawyer, not your lawyer. Sign off provided by non profit bio research orgs lawyer before I set it up.
  - newman8r 9y ago
    This is my understanding as well. Additionally, I believe you can send encrypted attachments over an unencrypted connection. Furthermore, https://www.gpo.gov/fdsys/pkg/FR-2013-01-25/pdf/2013-01073.pdf https://www.gpo.gov/fdsys/pkg/FR-2013-01-25/pdf/2013-01073.p... suggests that it's acceptable to send patients unencrypted PHI if they've explicitly agreed to accept the risks associated with that (although I'd be extremely cautious in those situations)
  - Spooky23 9y ago
    That’s more for B2B use cases. Like between a medical practice and hospital. The unreliability of delivery to destinations that don’t support TLS will create customer service issues in B2C scenarios.

659087 9y ago

I don't want "big tech" anywhere near my doctor's office or anything else having to do with my health.

Clubber 9y ago
Too late. HIS is Health Information Systems and have been around for decades. Also, thanks to the patriot act, doctors and hospitals share your health information to the federal authorities without a warrant. So there's that. https://cdt.org/insight/law-enforcement-national-security-access-to-medical-records/ https://cdt.org/insight/law-enforcement-national-security-ac...

aviv 9y ago

It's unfortunate that people think "tech" is what health care needs, when in reality society would benefit tremendously if something as simple as a 5-10 day water fast became mainstream [again], as it used to be, before modern medicine took over.

mxwll 9y ago

There are some major hurdles for these SV companies to overcome if they want any level of success in this arena. EPIC and Cerner together hold over 50% market share of EHR systems in American hospitals. Their interoperability and patient facing applications are a joke. EPIC actively makes it difficult for third parties to build on top of their system. Sure, these SV companies have figured out how to build great tech at scale but transitioning an entire hospital network to a new EMR is a massive undertaking -- both technically and organizationally. Many doctors had their world rocked by the forced transition to using EMR systems and they run the other way from those claiming a novel technology will solve all of their problems. There are much greater issues at play here and IMO the organizational problems within hospitals are far greater than the technical ones. To be successful hospitals will have to become tech companies. They aren't exactly the hottest place for top tech talent to end up. I think the patient first approach that Apple and Samsung have been taking are likely to win out. If they can build a system that captures an individual's personal health record doctors will want that data. Hospitals will have no choice but to begin integrating that data even if it lives outside of the walls of EPIC, Cerner, et al.

jeremylee 9y ago
Both Epic and Cerner are making at least some strides toward opening up their platforms (Epic with App Orchard, and Cerner with Ignite, SMART on FHIR etc.) Athena has MDP ("More Disruption Please.") I get the feeling these organizations have at least come to the realization that they need to open up--granted their denial up to this point leaves them with a lot of catching up to do. But access to the data that exists in those systems is a pretty big carrot for integration partners to help push adoption.
- methehack 9y ago
  Sorry, dude, but I think you fell for it. These entities try to make you think they're open, but really they are keeping entrants at bay. Here's an interesting episode of the weeds podcast that gives some context by exploring why the fax machine is still so prevalent in US healthcare. https://player.fm/series/voxs-the-weeds/fax-reform-bonus https://player.fm/series/voxs-the-weeds/fax-reform-bonus

esotericsavage 9y ago

This is overdue. There has been a lot of talk recently that we need a new type of health care professional.. physicians that specialize in engineering. Also related to this is Atul Gawande's TED Talk, which is incredibly insightful and highly recommended.

fiveFeet 9y ago

I am all for it if someone can make the doctors use emails instead of faxes.

dqv 9y ago
The problem is that we don't have a key server for doctors. I really wish someone would lobby the HHS to provide a key server that maps to providers' NPI. Then setting up PGP for email can be streamlined. As it stands now, everything is fragmented because companies want to lock practitioners and health care orgs in. I'd love to see them start issuing "HIPAA compliant" seals for the implementation of open and secure standards that make it easier for health care systems to communicate and transfer data easily. That way all these closed solutions will have an incentive to actually make communication between practitioners easy and secure. The biggest joke is secure messaging. There are all these apps for secure messaging between practitioners. Of course, you have to be using the same app to open a communication channel. I know at least one of these companies is using XMPP on their backend, so it's likely others are as well. They are literally using open source solutions to make a problem that the open source solution was supposed to solve! There's no reason why $SecureMessenger can not communicate with $MessageSecure. They just don't want that to happen because they think it will cause them to lose business.

dawhizkid 9y ago

I am a big believer that we have already discovered a safe, free, plentiful lever against some of the most high profile diseases (cancer, Alzheimer’s, some mental illnesses) out there in fasting/calorie restriction/keto. I highly doubt it will ever become mainstream for the simple reason that no healthcare or big tech co can make money from telling people to eat in a way that induces ketosis. Science of Fasting doc: https://www.amazon.com/Science-Fasting-Sylvie-Gilman/dp/B075848T5T https://www.amazon.com/Science-Fasting-Sylvie-Gilman/dp/B075...

aviv 9y ago
Insane how we both get downvoted isn't it? Oh well. Another decade or two before people wake up. Agree with you, so much of our economy and social structure is built on the fact that people get sick - and either stay sick or get medicated for the foreseeable future. Sad. All we can do is mention it, even though we get shut down quickly be it online or IRL. Mandatory anecdote: I cured severe arthritis in the knee 6 years ago through a 30-day water fast. It was gone by day 20 or so, and stayed gone for 6 years now. It's sad that so many people suffer needlessly.
- dawhizkid 9y ago
  Step one is getting to consensus on sugar = toxic, then refined carbs = bad, then getting people to stop believing we were evolved to eat consistently throughout the day everyday It’s amazing that “you are what you eat” has become so controversial
  - aviv 9y ago
    The old "a calorie is a calorie" that Reddit/HN geeks like to point out wearing their science hat. LOL. Oh man... Sometimes I think we've gone too far. My kids have a hard time finding classmates to play tag with because most of them are overweight and prefer to sit in the shade and eat their Costco bought school lunch. It's really sad what's happening.

bawana 9y ago

Physician here. SV Tech will win because it is customer centric. Traditional Healthcare tech is enterprise centric - the precept on which they base their strategies is 'economies of scale'. People are not widgets. Economies of scale (aka corporate controlled healthcare) do not apply. As institutions grow larger, eddy currents of dominance develop - fiefdoms that compete for control, power and share of the budget. There are so many layers of middle management that the most popular complaint is that everyone is a manager. Our hospital actually has 5x as many employees as there are patients in it. I know of no other industry where this skewed statistic exists. Can you imagine an airliner with twice as many stewards as passengers? Perhaps the legal profession is an exception, where you have so many bodies tending to a trial. In healthcare, patients are lost in this machine and the cacophony of voices speaking to them is a disservice. Perhaps tho in this era of the consumer age, some patients conflate quantity with quality and might actually feel 'more is better'. If healthcare is delivered through a watch on your wrist instead of an army of servants, the layperson might be able to focus his/her understanding on the single voice their device has. The other secret weapon of SV is that it promises to get people to open up their pocketbooks to actually pay for their own healthcare. Government will adore them for that. If you think that will never happen, just stop and think for a minute. People shell out hundreds of dollars a year for the privilege of being tracked and being advertising targets. All because the mobile device caters to their impulse for 'connectedness'. Imagine if this device promised a longer life, better sex, better sleep, less disease. And it showed you with colorful cartoon graphs how much better you were every time you asked it. Forget the fact that many of these parameters are only relevant to the big picture. Statistics apply to populations and any attempt to assign characteristics from population studies to a given individual carry uncertainty. They never tell you how big the error bars are, do they? Certainly a better diet and more exercise confer health benefits. But trying to 'gamify' this data will just add a cognitive burden and most likely will lead to more popular misconceptions and misinterpretations. Or perhaps it will be a new social nexus?When I am in a Starbux or Panera, there are always a few conversations my ears cannot avoid as people share their health problems over a sandwich and a coffee. And I cannot help laughing at how ironic the whole HIPAA thing is. Ultimately I fear that tech will foster the return of snake oil salesmen, on a massive scale. We are in a deregulation mania now and I think healthcare will soon fall under Trump's razor and he will encourage SVTech to make their move.

perpetualcrayon 9y ago

Why hasn't Big Tech made a bigger dent in the insurance industry?

tim333 9y ago
Insurance has quite a lot of specialist knowledge that isn't really tech.

Apocryphon 9y ago

I wonder if this will prove to be an opportunity for cities outside of SV to grab a bigger piece of tech. Nashville? https://www.bizjournals.com/nashville/news/2017/09/22/health-care-is-growing-quickly-in-nashville-but.html https://www.bizjournals.com/nashville/news/2017/09/22/health...

AngeloAnolin 9y ago

Interesting to see the big players like Apple, Google and Amazon making significant investments in this area. The big problem though still lies in the maze of regulatory bodies with which all these innovative solutions have to navigate before they even get mainstream. Small players who does not have enough financial leeway ends up burying what could be a groundbreaking solution. Of course, governments need to do their due diligence as public health is the one at stake but there needs to have a certain compromise where the end result is the good of the public and humanity.