3 ms·

Have you worked with any of the things you listed? I ask mostly because this is largely a list of words associated with healthcare tech rather than any coheren

Have you worked with any of the things you listed? I ask mostly because this is largely a list of words associated with healthcare tech rather than any coherent statement about the complexity. For example - LOINC, ICD9/10, SNOMED, and RX-Norm are all methods of coding various things. A few of them have overlaps or translations and I’ll agree they are a bit of a pain. But using the same tool to express that a patient had their left hand amputated and to describe the dosage and form of the pain meds they are given doesn’t make sense. Similarly - Epic, Cerner, All Scripts are companies. They compete. That’s like saying that we only need one news company. And you’re attacking hl7 v2, honestly outside of FHIR (which my professional involvement largely stopped at dstu2) it’s the least awful. Sure it’s funky and a hair old but it’s fairly easy to work with. I will say I much prefer FHIR but it has its own warts (extensions can be a pain) There are certainly problems in healthcare but blaming just the tech is akin to blaming the hammer when your house is framed wrong. Sure maybe it was the hammer but maybe the fact that the contractors were drunk was a bigger issue than they tried to use a banana as a hammer.

sk5t 6y ago
> Have you worked with any of the things you listed? Yes, and I offer the (indeed rather scattered) list as a sampling of the formats and taxonomies one encounters--sometimes by essential need to code wildly different concepts like "struck on head by tortoise" vs "lower back pain, moderate" vs "Lisinopril 5mg oral tablet", sometimes by separate efforts across time or geography or organization to do sort of the same thing. From the outside it might seem a lot more tractable space than it is after you get into the weeds. Although my time with HL7 v2 over the years amounted to probably less than 100 focused hours, it didn't take long to encounter folks mangling the spec in ways HAPI rejects, mashing giant base64-encoded PDFs into ORU records, etc., and worst of all, using the "flexibility" of the records/segments to ram through rubbish not aligned to any nomenclature. Ugly pipehat serialization without schema or validation. I'm sure someone with 10 years at MGH would have a very different impression, but this one is mine.

sk5t 6y ago

> Have you worked with any of the things you listed? Yes, and I offer the (indeed rather scattered) list as a sampling of the formats and taxonomies one encounters--sometimes by essential need to code wildly different concepts like "struck on head by tortoise" vs "lower back pain, moderate" vs "Lisinopril 5mg oral tablet", sometimes by separate efforts across time or geography or organization to do sort of the same thing. From the outside it might seem a lot more tractable space than it is after you get into the weeds. Although my time with HL7 v2 over the years amounted to probably less than 100 focused hours, it didn't take long to encounter folks mangling the spec in ways HAPI rejects, mashing giant base64-encoded PDFs into ORU records, etc., and worst of all, using the "flexibility" of the records/segments to ram through rubbish not aligned to any nomenclature. Ugly pipehat serialization without schema or validation. I'm sure someone with 10 years at MGH would have a very different impression, but this one is mine.