4 ms·

I got some good advice about a decade ago, which I've used for guidance and, on reflection, has served me well. You're not well-positioned to understand the cor

I got some good advice about a decade ago, which I've used for guidance and, on reflection, has served me well. You're not well-positioned to understand the core nature of problems, and which are most important, from the outside. Until you have this clarity, do what you can to become part of the core community driving the thinking in your field of choice. There's a strong case for the social importance of many problems in energy and AI, and likely enough there are problems that would interest you in healthcare. So my answer is to not worry so much about which field you dive into, and focus more on trying to get to the center. As someone who has been orbiting two poles of education and CS for my whole career, I'd also suggest reflecting on why energy and AI are currently more attractive to you than healthcare. There doesn't have to be a reason, but sometimes I feel like the attraction of pure science fields is that they don't involve the messy human issues that come with social science, like identity and culture, power and your own positionality.

casper345 8y ago
> You're not well-positioned to understand the core nature of problems, and which are most important, from the outside Great point. What startups that are trying to infiltrate "old/traditional" industries like hospitals or healthcare are realizing. Need to shadow doctors to see their workflow, not just propose a solution based on your observation or reading articles about hospital shortcomings.
- omg_ketchup 8y ago
  You mean... make software for the people who use it, not the people who make it?
- crankylinuxuser 8y ago
  Ive also noticed that even though the industry has done things X way for a long time, sometimes those are done because "well We've always done it that way". It's cargo culting, and nobody has a good reason why its done. Being an outside can sometimes mean that you call attention to that, and show better ways. And with the internet and publications, can be an effective way to do that. Most of the times however, there are reasons and you should at least understand why. But for those cases where "why" isn't defined, poke at them.... You're likely to find something interesting.
  - dragonsky67 8y ago
    Agreed. It is very easy to try to disrutpt a process without understanding the reasons behind the current process. A lot more difficult to understand the current process then propose changes that address that processes shortfall. There is always a reason why things are done a particular way "It's always been done that way" is shorthand for "I don't know why it's done that way". Like history, you need to understand the reasons behind a process before you can effectively change it, otherwise you are doomed to make the same mistakes and very soon your shiny new process will start to look as cobbled together as the previous one.
- aaavl2821 8y ago
  More than that, you need to figure out how administrators view your offering, i.e. How much money does it make them. Some things doctors like cause the hospital to lose money -- like actually spending time getting to know patients and understand their condition, or keeping them out of the hospital. Doctors aren't always the people running things
- wolco 8y ago
  Following doctors will only provide you with better tools for doctors. You need to shadow the admin side and understand the painpoints they experience because ultimately they pay bill. The way the system works in whatever country you live in has shortcomings. Finding ways to fix those issues higher up the chain will provide the most value.
quanticle 8y ago
The reason energy and AI are more attractive than healthcare has little to do with "identity", "culture" or "positionality". It has much more to do with the fact that the field is chock full of incidental complexity that makes doing any kind of good work an extremely unrewarding slog. Look at the 834 EDI format [1], for example. Does anyone want to work with a file format as nasty as this? Does anyone want to work in an industry where data is exchanged by uploading files to FTP servers, and waiting a day to see if it was successfully processed? And finally, does anyone want to work in an industry where they have absolutely zero power to change any of the above? As engineers and humans, we like to do good work, in a field where we have the autonomy to choose best practices. Health care makes it difficult to do that. I don't think it's productive to call people out for choosing not to work in a field where they have to deal with arbitrary and capricious rules, ignorant bureaucracies, and massive amounts of incidental complexity which has nothing to do with the primary objective: keeping people healthy. [1]: https://en.wikipedia.org/wiki/ANSI_834_Enrollment_Implementation_Format https://en.wikipedia.org/wiki/ANSI_834_Enrollment_Implementa...
- anthonyriggi 8y ago
  this is one of the main reasons I drifted away from healthcare and towards engineering. It's hard to deal with limitations that seem purposefully aimed at preventing you from getting the job done, and done right. My time on earth is limited and so is my patience.
- dstick 8y ago
  Wait a second... what’s stopping you from changing —this— situation then? Solve the data format problem. Make it easier for everyone to exchange data in meaningful, efficient ways. Sounds like a terrible pain that you understand well enough to be able to solve. When you have, it might remove a major bottleneck and open the floodgates for more smart people to join, ultimately benefitting healthcare in a massive way. Make people want to work in that industry :)
  - status_quo69 8y ago
    I used to work with a healthcare company and dealt the 837 file format and FTP batches and wrote a pretty neat-o parser for it, the reason is simple- inertia. And it's not like people aren't trying because there's been a huge push to get REST-like APIs in place, but when you have close to 40 years of software infrastructure in place it's non-trivial to explain to the boss why you need to spend money on something that gets everyone paid either way. I think it would be truly revolutionary if we could change the format, but what I think would be almost a better step is to write open source parsers that can accurately translate X12 into something sane and keep the interchange the same so that everything can be balanced out like a checkbook. Check out the 835 format for this part as it's supposed to be a data stream of transactions. Too bad the dozens of flavors of X12 are locked behind licensing and thousands of dollars of books for the rules :/ Additional reading on this god-awful data format: https://docs.oracle.com/cd/E19398-01/820-1275/6ncv5s178/index.html https://docs.oracle.com/cd/E19398-01/820-1275/6ncv5s178/inde...
ahussain 8y ago
I like this. The only worry is that sometimes it can take a long time to get to the center and in the process of making that journey you may realise that you chose the wrong center to go towards.

casper345 8y ago

> You're not well-positioned to understand the core nature of problems, and which are most important, from the outside Great point. What startups that are trying to infiltrate "old/traditional" industries like hospitals or healthcare are realizing. Need to shadow doctors to see their workflow, not just propose a solution based on your observation or reading articles about hospital shortcomings.

omg_ketchup 8y ago
You mean... make software for the people who use it, not the people who make it?
crankylinuxuser 8y ago
Ive also noticed that even though the industry has done things X way for a long time, sometimes those are done because "well We've always done it that way". It's cargo culting, and nobody has a good reason why its done. Being an outside can sometimes mean that you call attention to that, and show better ways. And with the internet and publications, can be an effective way to do that. Most of the times however, there are reasons and you should at least understand why. But for those cases where "why" isn't defined, poke at them.... You're likely to find something interesting.
- dragonsky67 8y ago
  Agreed. It is very easy to try to disrutpt a process without understanding the reasons behind the current process. A lot more difficult to understand the current process then propose changes that address that processes shortfall. There is always a reason why things are done a particular way "It's always been done that way" is shorthand for "I don't know why it's done that way". Like history, you need to understand the reasons behind a process before you can effectively change it, otherwise you are doomed to make the same mistakes and very soon your shiny new process will start to look as cobbled together as the previous one.
aaavl2821 8y ago
More than that, you need to figure out how administrators view your offering, i.e. How much money does it make them. Some things doctors like cause the hospital to lose money -- like actually spending time getting to know patients and understand their condition, or keeping them out of the hospital. Doctors aren't always the people running things
wolco 8y ago
Following doctors will only provide you with better tools for doctors. You need to shadow the admin side and understand the painpoints they experience because ultimately they pay bill. The way the system works in whatever country you live in has shortcomings. Finding ways to fix those issues higher up the chain will provide the most value.

quanticle 8y ago

The reason energy and AI are more attractive than healthcare has little to do with "identity", "culture" or "positionality". It has much more to do with the fact that the field is chock full of incidental complexity that makes doing any kind of good work an extremely unrewarding slog. Look at the 834 EDI format [1], for example. Does anyone want to work with a file format as nasty as this? Does anyone want to work in an industry where data is exchanged by uploading files to FTP servers, and waiting a day to see if it was successfully processed? And finally, does anyone want to work in an industry where they have absolutely zero power to change any of the above? As engineers and humans, we like to do good work, in a field where we have the autonomy to choose best practices. Health care makes it difficult to do that. I don't think it's productive to call people out for choosing not to work in a field where they have to deal with arbitrary and capricious rules, ignorant bureaucracies, and massive amounts of incidental complexity which has nothing to do with the primary objective: keeping people healthy. [1]: https://en.wikipedia.org/wiki/ANSI_834_Enrollment_Implementation_Format https://en.wikipedia.org/wiki/ANSI_834_Enrollment_Implementa...

anthonyriggi 8y ago
this is one of the main reasons I drifted away from healthcare and towards engineering. It's hard to deal with limitations that seem purposefully aimed at preventing you from getting the job done, and done right. My time on earth is limited and so is my patience.
dstick 8y ago
Wait a second... what’s stopping you from changing —this— situation then? Solve the data format problem. Make it easier for everyone to exchange data in meaningful, efficient ways. Sounds like a terrible pain that you understand well enough to be able to solve. When you have, it might remove a major bottleneck and open the floodgates for more smart people to join, ultimately benefitting healthcare in a massive way. Make people want to work in that industry :)
- status_quo69 8y ago
  I used to work with a healthcare company and dealt the 837 file format and FTP batches and wrote a pretty neat-o parser for it, the reason is simple- inertia. And it's not like people aren't trying because there's been a huge push to get REST-like APIs in place, but when you have close to 40 years of software infrastructure in place it's non-trivial to explain to the boss why you need to spend money on something that gets everyone paid either way. I think it would be truly revolutionary if we could change the format, but what I think would be almost a better step is to write open source parsers that can accurately translate X12 into something sane and keep the interchange the same so that everything can be balanced out like a checkbook. Check out the 835 format for this part as it's supposed to be a data stream of transactions. Too bad the dozens of flavors of X12 are locked behind licensing and thousands of dollars of books for the rules :/ Additional reading on this god-awful data format: https://docs.oracle.com/cd/E19398-01/820-1275/6ncv5s178/index.html https://docs.oracle.com/cd/E19398-01/820-1275/6ncv5s178/inde...

ahussain 8y ago

I like this. The only worry is that sometimes it can take a long time to get to the center and in the process of making that journey you may realise that you chose the wrong center to go towards.