4 ms·

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

by mjfl 9y ago

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.
  - eat_veggies 9y ago
    There'd need to be a lot of work making sure that it's safe in that: a) Losing it should not expose your entire medical history to whoever picks it up b) Losing it should not mean losing your data forever. Giving the consumer the responsibility for backups is not a solution either, since those can be lost or stolen as well. c) It has to be tied to the person's identity, so you can't borrow/steal your friend's to get meds d) Can't be tampered with or forged to fake conditions or clear conditions e) Records who edits it, when, and a diff of changes. f) Records who reads it, and when g) Resistant to physical damage or water. I should be able to go swimming with this device or have it go through the wash without worrying about its safety. These are all pretty hard problems on their own, and together, you'd have to design pretty much the world's safest storage device. If it existed, I'd put my SSH keys on it too!
  - bawana 9y ago
    actually, most of my patients were not interested in reimbursing me for the cost of the usb stick, although they would gladly accept it for free. I was willing to provide their ENTIRE medical record, but they were not interested. I think people are just as happy to be spoon fed and not knowing what they are eating as long as its free.
Forge36 9y ago
I'm with you on that. For reference I pulled up Google's announcement that "Google Health" is being shutdown. https://googleblog.blogspot.com/2011/06/update-on-google-health-and-google.html https://googleblog.blogspot.com/2011/06/update-on-google-hea... I could see Big Tech enter in other areas (Apple Watch and and their research app are promising)
- lern_too_spel 9y ago
  The post doesn't say that they shut it down due to compliance costs. It says they shut it down because almost nobody found it useful.
  - acdha 9y ago
    I think the argument is that the problems are too challenging for the management culture common at places like Google. Getting a product developed, certified, and deployed is likely be longer than it takes for them to get bored, forget what they were doing, and move on to something else.
nradov 9y ago
Obviously that's false. There have been many successful Silicon Valley healthcare companies creating software, drugs, biotech, medical devices, etc. Just drive around and look at the names on some buildings.
tim333 9y ago
The companies mentioned in the article "Apple, Google, Microsoft and other tech giants" have quite a bit of money for costs. Though for hospital they may need more of an IBM/Oracle corporate type model rather than apps.

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

by mjfl 9y ago

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

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.
- eat_veggies 9y ago
  There'd need to be a lot of work making sure that it's safe in that: a) Losing it should not expose your entire medical history to whoever picks it up b) Losing it should not mean losing your data forever. Giving the consumer the responsibility for backups is not a solution either, since those can be lost or stolen as well. c) It has to be tied to the person's identity, so you can't borrow/steal your friend's to get meds d) Can't be tampered with or forged to fake conditions or clear conditions e) Records who edits it, when, and a diff of changes. f) Records who reads it, and when g) Resistant to physical damage or water. I should be able to go swimming with this device or have it go through the wash without worrying about its safety. These are all pretty hard problems on their own, and together, you'd have to design pretty much the world's safest storage device. If it existed, I'd put my SSH keys on it too!
- bawana 9y ago
  actually, most of my patients were not interested in reimbursing me for the cost of the usb stick, although they would gladly accept it for free. I was willing to provide their ENTIRE medical record, but they were not interested. I think people are just as happy to be spoon fed and not knowing what they are eating as long as its free.

Forge36 9y ago

I'm with you on that. For reference I pulled up Google's announcement that "Google Health" is being shutdown. https://googleblog.blogspot.com/2011/06/update-on-google-health-and-google.html https://googleblog.blogspot.com/2011/06/update-on-google-hea... I could see Big Tech enter in other areas (Apple Watch and and their research app are promising)

lern_too_spel 9y ago
The post doesn't say that they shut it down due to compliance costs. It says they shut it down because almost nobody found it useful.
- acdha 9y ago
  I think the argument is that the problems are too challenging for the management culture common at places like Google. Getting a product developed, certified, and deployed is likely be longer than it takes for them to get bored, forget what they were doing, and move on to something else.

nradov 9y ago

Obviously that's false. There have been many successful Silicon Valley healthcare companies creating software, drugs, biotech, medical devices, etc. Just drive around and look at the names on some buildings.

tim333 9y ago

The companies mentioned in the article "Apple, Google, Microsoft and other tech giants" have quite a bit of money for costs. Though for hospital they may need more of an IBM/Oracle corporate type model rather than apps.