4 ms·

Have you worked in an ICU a lot?

INTPenis 6y ago
No but one of my clients is a major health care provider with over 35000 employees. I don't manage their MT systems but I know about them and I hear about them from co-workers. And just going on common sense I don't see how a computer could prevent a hospital from admitting a patient. We're talking about admission, not any special treatment. So it's an honest question to the community, not trying to be dogmatic here. I'm honestly asking, what in a computer system could prevent a patient from being admitted for care? As far as I can reason, no drugs are being held hostage by a computer. Doctors can still use their training without a computer. Humans have been treating ailments for thousands of years without the aide of computers. It would be really sad if this woman died because hospital staff felt hopeless without computers. Edit: Going beyond just the human dependence on computers, it would be a good exercise in society readiness to be able to treat patients during a blackout for example.
- unionpivo 6y ago
  Its not that they cant be admitted for care, its that they can't provide care, if devices that they need to provide the care don't work. A lot of devices in hospitals work on vendor provided machines that are not up to date. If anything happens on either end, you can't use device. I am talking about CT, MRI, endoscopy, and other devices. If you have integrated single sign on with access cards, and AD dies, you can't login, and if you can't login you cant use the device. The reason I am pointing AD out, is because I am working in integrating such device in our software as we speak. more here: https://news.ycombinator.com/item?id=24514441 https://news.ycombinator.com/item?id=24514441
- afarrell 6y ago
  > just going on common sense I don't see how a computer could prevent a hospital from admitting a patient. Common sense is knowledge gained by experience. Thats' why kids "don't have any". > I'm honestly asking, what in a computer system could prevent a patient from being admitted for care? This is a good question for us to have more detailed understanding of.
  - Funes- 6y ago
    >Common sense is knowledge gained by experience. Thats' why kids "don't have any". I'd say it has more to do with sound logical reasoning, and not only with accrued information.
    - withinboredom 6y ago
      If you don't know what a DAG is, it won't be common sense to use one when you should. It's a mix.
      - Funes- 6y ago
        >It's a mix. That's exactly why I said "not only" instead of "not".
        afarrell 6y ago
        You are right about the general definition. In our specific case when someone says > I don't see how X Then what's often lacking is an experience or knowledge that would allow them to imagine X.
- StreamBright 6y ago
  > Humans have been treating ailments for thousands of years without the aide of computers. And now computers are in many cases deciding about life and death. Very trivial example: Boeing 737 MAX. Not able to turn off automation can cause death. > Going beyond just the human dependence on computers, it would be a good exercise in society readiness to be able to treat patients during a blackout for example. I agree but this does not mean that we are ready for that.
  - INTPenis 6y ago
    The Boeing was a major scandal though. We didn't blame the pilot or the software developers. We blame Boeing and the Air regulation authorities for not doing the necessary QA. >I agree but this does not mean that we are ready for that. Yes, well then this issue is even more important. Because the german police are treating this as a type of homicide. So they seem to be going after the hackers as the cause of death here. Then it becomes even more important to clarify why the woman was turned away. Others have pointed this out but it could be as simple as general policy, or a manager not willing to risk treating her without the proper tools. Either way, european countries have been talking about society readiness lately and this is key for society preparedness. Therefore I'm not sure we should be pointing fingers at the hackers here, seems like an easy scapegoat for a deeper issue. Even if they have to manually operate a ventilator for 4 hours in shifts, they are still a hospital. The most qualified place to save a life, and they turned it away.
  - akkawwakka 6y ago
    Automation can also go very far in saving lives. We hear about fatal plane crashes in the news, but don’t really hear about the times that automation and computer systems catch or report a pilot overspending the aircraft, making an unsafe maneuver, deviating from standard operating procedures, or touching down too hard. The Boeing situation is an interesting. With the Max, Boeing broke a core tenant of aircraft design that’s been a major factor in making airliners so safe. The MCAS system’s inputs (from angle of attack sensors) were not redundant. They should have been at least doubly-redundant given that the ultimate design of MCAS could pitch the aircraft down to such a degree that the pilot could not overcome it using their own control inputs. While Boeing probably should have redesigned its airframe instead of adding MCAS, it wasn’t a fundamentally bad idea to employ automation. The system behavior changed, but the company failed to re-assess the safety implications. All Airbus products are fly-by-wire and there’s always some level of automation in play. It degrades to employ less protections when system faults occur. There’s a lesson there for Boeing!

No but one of my clients is a major health care provider with over 35000 employees. I don't manage their MT systems but I know about them and I hear about them from co-workers. And just going on common sense I don't see how a computer could prevent a hospital from admitting a patient. We're talking about admission, not any special treatment. So it's an honest question to the community, not trying to be dogmatic here. I'm honestly asking, what in a computer system could prevent a patient from being admitted for care? As far as I can reason, no drugs are being held hostage by a computer. Doctors can still use their training without a computer. Humans have been treating ailments for thousands of years without the aide of computers. It would be really sad if this woman died because hospital staff felt hopeless without computers. Edit: Going beyond just the human dependence on computers, it would be a good exercise in society readiness to be able to treat patients during a blackout for example.

unionpivo 6y ago
Its not that they cant be admitted for care, its that they can't provide care, if devices that they need to provide the care don't work. A lot of devices in hospitals work on vendor provided machines that are not up to date. If anything happens on either end, you can't use device. I am talking about CT, MRI, endoscopy, and other devices. If you have integrated single sign on with access cards, and AD dies, you can't login, and if you can't login you cant use the device. The reason I am pointing AD out, is because I am working in integrating such device in our software as we speak. more here: https://news.ycombinator.com/item?id=24514441 https://news.ycombinator.com/item?id=24514441
afarrell 6y ago
> just going on common sense I don't see how a computer could prevent a hospital from admitting a patient. Common sense is knowledge gained by experience. Thats' why kids "don't have any". > I'm honestly asking, what in a computer system could prevent a patient from being admitted for care? This is a good question for us to have more detailed understanding of.
- Funes- 6y ago
  >Common sense is knowledge gained by experience. Thats' why kids "don't have any". I'd say it has more to do with sound logical reasoning, and not only with accrued information.
  - withinboredom 6y ago
    If you don't know what a DAG is, it won't be common sense to use one when you should. It's a mix.
    - Funes- 6y ago
      >It's a mix. That's exactly why I said "not only" instead of "not".
      - afarrell 6y ago
        You are right about the general definition. In our specific case when someone says > I don't see how X Then what's often lacking is an experience or knowledge that would allow them to imagine X.
StreamBright 6y ago
> Humans have been treating ailments for thousands of years without the aide of computers. And now computers are in many cases deciding about life and death. Very trivial example: Boeing 737 MAX. Not able to turn off automation can cause death. > Going beyond just the human dependence on computers, it would be a good exercise in society readiness to be able to treat patients during a blackout for example. I agree but this does not mean that we are ready for that.
- INTPenis 6y ago
  The Boeing was a major scandal though. We didn't blame the pilot or the software developers. We blame Boeing and the Air regulation authorities for not doing the necessary QA. >I agree but this does not mean that we are ready for that. Yes, well then this issue is even more important. Because the german police are treating this as a type of homicide. So they seem to be going after the hackers as the cause of death here. Then it becomes even more important to clarify why the woman was turned away. Others have pointed this out but it could be as simple as general policy, or a manager not willing to risk treating her without the proper tools. Either way, european countries have been talking about society readiness lately and this is key for society preparedness. Therefore I'm not sure we should be pointing fingers at the hackers here, seems like an easy scapegoat for a deeper issue. Even if they have to manually operate a ventilator for 4 hours in shifts, they are still a hospital. The most qualified place to save a life, and they turned it away.
- akkawwakka 6y ago
  Automation can also go very far in saving lives. We hear about fatal plane crashes in the news, but don’t really hear about the times that automation and computer systems catch or report a pilot overspending the aircraft, making an unsafe maneuver, deviating from standard operating procedures, or touching down too hard. The Boeing situation is an interesting. With the Max, Boeing broke a core tenant of aircraft design that’s been a major factor in making airliners so safe. The MCAS system’s inputs (from angle of attack sensors) were not redundant. They should have been at least doubly-redundant given that the ultimate design of MCAS could pitch the aircraft down to such a degree that the pilot could not overcome it using their own control inputs. While Boeing probably should have redesigned its airframe instead of adding MCAS, it wasn’t a fundamentally bad idea to employ automation. The system behavior changed, but the company failed to re-assess the safety implications. All Airbus products are fly-by-wire and there’s always some level of automation in play. It degrades to employ less protections when system faults occur. There’s a lesson there for Boeing!