10 ms·
Simulated Hospital
- nhinck2 3y agoThis is pretty cool, but the pathway logic where the juiciest part is and it looks like it has been gutted for public release.
- deleted 3y ago[deleted]
- potatoman22 3y agoHow can you know if the fake data is sufficiently similar to real data? I wonder what Google's use case for this is.
- deleted 3y ago[deleted]
- anaganisk 3y agoBaiting healthcare forcussed devs/startups for acquiring? Analyzing how people are building apps using this data to build their own? Free training data for their next product? Amazon is kinda growing in healthcare and maybe Google doesn't want to be behind.
- anon84873628 3y agoWell it certainly was built for some future product, but it was probably released as open source solely so an engineer could have "community contributions" on their promo packet.
- throwaway_qcjal 3y agoI don't believe this would count as a community contribution, which is generally I believe about contributions to Google's community. While I don't think it's a bad career move, and that may have been part of their consideration, I find the trivialization of the work put in by someone here to open source something they thought would be a positive contribution hurtful.
- axutio 3y agoGoogle has a whole bunch of products/tools in the healthcare space, and it seems like their contribution there is only growing. I've been working with FHIR/EHR adjacent tooling lately for a personal project, and a good number of both open source resources and SAAS products I've seen have been from Google. More broadly, all big 3 cloud providers (Azure, AWS, and Google) have offerings for FHIR data storage and API access, as well as common NLP based healthcare data analysis workflows. Many of these seem relatively new, or as if they have had a lot of recent attention focused on them. I'm definitely interested in how/why these companies (as well as some other VC funded ones, like Medplum), are entering this space with products that are not directly sellable, but are rather things that other tools would have to build upon. It seems like AWS works directly with end-customers to use their APIs to build products, but I'm not sure what Azure and Google are doing. This one's probably too complex for my use case, but I thought the concept looked very neat and wanted to share.
- potatoman22 3y agoI'd probably use this to estimate the effect of staffing changes or the impact of modifying staff workflows.
- zegerius 3y agoUltimately this is just an orchestration tool for publishing HL7v2 messages. You have to write your own pathways and segments, or push preconfigured HL7v2 messages. Take a look at the dashboard, you'll see what I mean[1]. Fairly sure they built this to test their HL7v2 store[2]. Also presuming it hasn't been very active given that Google surprisingly shut down their Healthcare division (and probably restarted it somewhere)[3]. [1] https://github.com/google/simhospital/blob/master/docs/dashboard.md https://github.com/google/simhospital/blob/master/docs/dashb... [2] https://cloud.google.com/healthcare-api/docs/concepts/hl7v2#hl7v2_stores https://cloud.google.com/healthcare-api/docs/concepts/hl7v2#... [3] https://www.businessinsider.com/google-health-shutting-down-david-feinberg-leaves-2021-8 https://www.businessinsider.com/google-health-shutting-down-...
- fredsmith219 3y agoThis would be super useful once you can set up your own pathways. It will also need FHIR and the ability to generate CCDs (which FHIR is capable of) to more fully represent current health care integration technologies.
- adolph 3y agoThe large EHR vendors have fairly open sandbox environments for “partner” (loosely defined, can be anyone) development purposes. The advantage of these is that they use real implementations instead of the standard as hypothetical implementation.
- neom 3y agoLooks like this is related to their Care Studio product: https://health.google/caregivers/care-studio/ https://health.google/caregivers/care-studio/
- cosmic_shame 3y agoThis would be such a great use case for an LLM.
- IG_Semmelweiss 3y agoNice effort, and its something. But something may not be good enough to solve hard problems. Can simulated hospital simulate efforts by staff to quickly add into many charts a medication Rx - by taking one patient note and copying 1 note, then pasting that into several? Does it simulate staff forgetting the dosage was not edited after pasting into all those charts ? Or staff not logging out of their userID, to avoid the need to log in every time someone needs to add a note/document into a chart? So that , in fact, the doc added by Dr Smith, was actually done by his assistant Tully? Life is complicated. People use systems in wild and unexpected ways. Real solutions require real data.
- temporal828 3y ago> Can simulated hospital simulate efforts by staff to quickly add into many charts a medication Rx - by taking one patient note and copying 1 note, then pasting that into several? What CPOE system involves notes? None of the handful I've used in the US. No modern EMR here involves any copy pasting for orders.
- wilg 3y agoIn your view, what was the purpose of your comment? Who are you lecturing?
- IG_Semmelweiss 3y agoTo warn developers of potential blind spots and wasting time, hoping this helps them contribute meaningfully to fix healthcate
- foota 3y agoPresumably you could try to simulate these kinds of mistakes.
- m3kw9 3y agoIs the patient data coherent? Like if you have a history some illness may have high prob to occur given certain history.
- m3kw9 3y agoProbably could also train anonymous patient data on LLM and have it generate.
- jenadine 3y agoThis has nothing to do with Theme Hospital https://en.wikipedia.org/wiki/Theme_Hospital https://en.wikipedia.org/wiki/Theme_Hospital
- a_bonobo 3y agoFun link: Theme Hospital is the follow-up to Theme Park, Theme Park was co-created by Demis Hassabis, Demis Hassabis founded DeepMind, DeepMind was acquired by Google, DeepMind has been incorporated into Google Health, surely Simulated Hospital sits within Google Health.
- agos 3y agofor those who miss Theme Hospital, the recent Two Point Hospital is a (good) spiritual sequel
- DonHopkins 3y agoOnly $885 to cure Bloaty Head! https://www.youtube.com/watch?v=Le_znuXcP2M https://www.youtube.com/watch?v=Le_znuXcP2M
- TacticalCoder 3y agoThought it was a clone of that one too! I never played much of the "sim" games but Theme Hospital was a good one.
- deleted 3y ago[deleted]
- mvuksano 3y agoNice effort. Would love to see more open source work from tech companies in this space. I remember working on a healthcare product (which involved HL7) years ago and it was a pain. The lack of documentation and any supporting tooling was "mind blowing".
- no-dr-onboard 3y agoWhen I did pentesting I couldn’t tell you how many times I’ve reviewed apps that used real patient data in their UTM and dev environments. Absolutely a big HIPAA violation to anyone who isn’t a covered entity. This is going to be a huge suggestion in reports for that kind of work.
- ape4 3y agoWhen they say "Most EHRs use a message format called HL7v2, which is ugly and tedious to type." they aren't kidding, here's an example of it: MSH|^~\&|FROM_APP|FROM_FACILITY|TO_APP|TO_FACILITY|20180101000000||ADT^A01|20180101000000|P|2.5| EVN|A01|20110613083617| PID|1|843125^^^^MRN|21004053^^^^MRN~2269030303^^^^ORGNMBR||SULLY^BRIAN||19611209|M|||123 MAIN ST^^CITY^STATE^12345| PV1||I|H73 RM1^1^^HIGHWAY 01 CLINIC||||5148^MARY QUINN|||||||||Y||||||||||||||||||||||||||||20180101000000|
- QuercusMax 3y agoI've worked a lot with DICOM which has plenty of warts (as expected with a 30 year old living standard), but HL7 is a bit much for me. At least FHIR and DICOMweb are considerably saner.
- lostlogin 3y agoYou haven't lived until you've tried to debug it. The array isn't zero based. The line breaks have different characters for breaking the lines, and you get to guess which ones are doing it. Certain characters are ok (ASKII) but when a Mac gets a nice ' into the field, all hell breaks loose. Things like "lesion at 9 o'clock" then break the system, as does Mr O'Leary. The hours spent chasing down how some failure happened are countless. Pity those working with HL7.
- ethbr0 3y agoHealthcare is the perfect storm of layered, ossified systems created across decades + input data that's normal just often enough... that everyone thinks bounds are actually handled. And then Mr. O'Leary checks in. Fuzz testing tools would be great, but I haven't seen many institutions that have functional 1:1 lower environments (i.e. including all system-system integrations working in test).
- viraptor 3y agoAdd to that the fun bits like "let's attach a whole base64 encoded PDF as a field of the hl7 message". Which honestly is not a terrible solution given you want to keep it all together, but still... It would be nice if you could attach binaries after the ASCII content.
- duffpkg 3y agoI am frequently asked about why systems in institutional healthcare are so hard to modernize, this has come up a lot related to pricing transparency. While HL7 is in theory a standard, in practice it is a semi-parseable "email" between two parties that know each other. Widely used systems like EPIC have bugs and quirks that have existed so long that the bugs themselves have become their own standard. Because HL7 relationships typically happen between longterm consistent partners both parties tend to evolve the format to suit localized needs and this business logic and the reasons for it are lost to time. It isn't that rare to find HL7 interfaces that have been in use for 20+ years that have become vital black boxes. HL7 2.x, still widely used, was originated in 1989. In a lot of case modernization like FHIR is nothing more than taking the old garbage and putting it in a new fancier bag. As whacky as HL7 may seem it is really nothing compared to its much bigger uglier older brother, X12 837/835, used for communication of billing information from performing entity to insurer.
- ArtWomb 3y agoBizarro-world that doctors actually defend EPIC! They all complain about the ASP.NET 1.0 UI. It's just the convenience of viewing all patients from all hospitals in one virtual "chart" ;)
- devilbunny 3y agoAs a doctor, Epic is mediocre software that just happens to be less mediocre than most of the alternatives. My biggest problem with Epic is that things are so heavily silo'ed by your job description (RN, MD, PharmD, etc.) and job context (without getting too deep into the weeds, it is a fact that the Epic implementation at my hospital does not allow anyone other than anesthesia personnel to see an intraoperative anesthetic record - not even the surgeon who performed the surgery (!); and that certain contexts do not allow a nurse who is running the schedule in one area to edit their case status board, which is a view of all cases in that area that allows them to see what's been done, what's left to be done, etc., - but if they switch context, they can change things, make their own boards, and then change back to the "proper" one and use the ones they've made).
- deleted 3y ago[deleted]
- martyvis 3y agoInteresting. Having just been discharged from hospital after a 22 days stay, I would hope an awful lot of data is in my record. I had blood taken daily, I think standard obs (observations) at least 4 times a day, electronic scans (CT, Xray, EEG, ECG), lots of medicine via IV, oral and subcut. Multiple discussions daily with doctors and nurses (usually with the Drs, there was one asking questions, one listening, and another directly transcribing on a PC on a mobile workstation/crash cart. As meds and other care changed daily, presumably back room consulting resulted in treatment plan updates. BTW I'm very happy with the direction my health is heading, and feeling a lot better (and there is data being that up). I haven't checked what my record is on our (Aussie) national health record yet [1]. I'll have a limited view for sure, but when I meet with my GP (general practitioner, MD, physician) to discuss my discharge summary on Monday, I might ask him to see what he has access to, and his complete it is.. I know I have been disappointed at what seemed to be quite devoid of info, despite all the controversy that ensued when it was introduced a few years back. [1] https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record https://www.digitalhealth.gov.au/initiatives-and-programs/my...
- lostlogin 3y agoAustralia doesn't have a unified system. Across the ditch we don't either, but at least we have a patient identification system that allows the searching of different systems for an individual via the National health Index number (NHI).
- viraptor 3y agoSo I work with Oz GP practices. It's not very likely you'll get a reasonable export of your data. It's doable, but may require some convincing. Your practice will likely get a copy of at least some of the hospital documents - that's common. You could ask for the same export of your data that they'd send when moving you to another clinic if you want a complete view (you may get it on a CD though...). It's not that there's really any issue, it's just that the staff likely never handled this request for the patient and wouldn't be sure how to do it. There shouldn't be any issue to view all the received documents on the screen during your visit though.
- moffkalast 3y ago> Disclaimer: This is not an officially supported Google product. It's okay Google, we know you'd abandon it a few months anyway.
- brap 3y agoEvery time I dip a little into healthcare tech I want to throw up. It's so bizarre, and even offensive, how convoluted and outdated these systems are. It's patches on top of patches on top of patches for decades. To the brave engineers working on maintaining these systems, I salute you. Hospitals, banks, government... just think of the tech these heavily regulated industries could have had, and how it could have improved our experience, if they actually had a strong incentive to improve. And it goes far beyond the tech stack. In the long term, regulation often kills competition, which inevitably kills innovation.
- adolph 3y agoAs someone working in this arena, I offer an alternative perspective for your consideration: healthcare was an early adopter of information technology and as a result many of its most core technologies come from a nearly unrecognizable time in computing. These systems are “outdated” as a result of success. The current prevalence of these venerable technologies may be in part due to regulation, but more often has to do with their success. HL7v2 is just token delimited ascii. Not unlike the similarly primitive but ubiquitous csv. The fields within it are defined by standards documents and once you use it a little, you can read enough to get the gist of most messages. As you might guess, modules in your language of choice are used to parse and compose HL7v2 so its detail isn’t that important. [Edit: looks like the project has written Synthea out in favor of an integrated data generator] Something I’d like to point out about Google Hospital is that under the hood it uses MITRE’s Synthea to generate synthetic patient data. https://www.healthcareittoday.com/2017/09/13/open-source-tool-offers-synthetic-patients-for-hospital-big-data-projects/ https://www.healthcareittoday.com/2017/09/13/open-source-too... https://synthetichealth.github.io/synthea/ https://synthetichealth.github.io/synthea/
- dalbasal 3y agoThat's a thoughtful perspective. It's also useful for expecting similar in future industries. Ultimately, I think it doesn't even matter if the reason is regulatory complexity, industry rigidity, or technical debt. The question is how do we dig out of such holes. If we were starting from scratch, it's almost certain we'd have better software, better firms, norms, standards and such within a short period of time. How do we do that when not starting from scratch?
- ensemblehq 3y agoAre there any decent parsers in Python/Java/Ruby that someone can recommend?
- owenmarshall 3y agohttps://hapifhir.io/ https://hapifhir.io/ for open source. Mirth is the commercial offering many people use - it is nice because it handles the MLLP protocol, gives you a mapping system, lets you transform and call your own endpoints. That’s also why it sucks: it’s a big heavy system.
- ThaDood 3y agoWell there is the FOSS Mirth option and the NextGen Mirth Option which is the "premium" corporate-backed version. Mirth is like the glue for healthcare in the US. Most of the companies I've worked with use it. Whats another options? Redox? HAPI? Qvera? It might not be great but I think its better then most offerings.
- cmiles74 3y agoRedox has already priced themselves so high, it's unclear what value they are providing. A big reason to go with Redox is that you don't have to setup a VPN with the target hospital, have staff monitoring the VPN to ensure it's up and you don't have to parse your own HL7v2 messages. IMHO Redox is now so expensive that you have to wonder if you might be better off doing all of this work yourself. As others have mentioned, there is a free Mirth offering and parsing HL7v2 is not that bad.
- owenmarshall 3y agoI think it really depends on your scale. If I'm a small healthtech startup and I can interchange with people hooked up to the candidate QHINs like eHealth and CommonWell I just saved thousands of independent VPN setups and HL7 mappings. But I already have thousands of independent VPN setups and API integrations, so the cost is harder to justify at scale.