5 ms·

Show HN: An open-source safety net for home hemodialysis

45 points by qweliantanner 7mo ago

qweliantanner 7mo ago
Hi HN, I’m building an open-source digital safety net for home hemodialysis patients. This operates ostly as a portfolio piece but i thought it worth sharing. The Why: Home dialysis gives patients freedom, but introduces a terrifying risk of isolation. If a patient's blood pressure crashes or a line disconnects while a caregiver is asleep in the next room, the machine sounds an alarm, but it only beeps in the room. It doesn't text the spouse, it doesn't alert the clinic, and it doesn't notify emergency contacts. I lost my mother to a disconnect in home care, so I decided to build the safety net I wish we had that night. Of course, who knows how effective this may have been if it existed. The Tech: It's built on Elixir and Phoenix LiveView. Active dialysis sessions are backed by OTP GenServers to maintain state. If an anomaly is detected (like a hypotensive drop), Phoenix.PubSub instantly broadcasts the event over WebSockets to a LiveView dashboard and triggers SMS alerts to the patient's "Care Network." Because proprietary medical devices are locked down, I also built a mock IoT server in Rust that streams medically plausible, simulated telemetry to test the pipeline. The Reality Check: I shared the first build with a dialysis community on Reddit and got rightfully roasted by a caregiver. He pointed out that exhausted patients don't want another "app" or a GitHub link—they just want to tame the chaos of medical documents and get help when they need it. It was a humbling UX lesson that forced me to pivot. I immediately simplified the onboarding and built "Community Hubs" so users can upload their own knowledge bases and machine manuals. It’s currently in Pre-Alpha (using the Rust simulator for data). I would love any feedback on the Elixir/OTP architecture, the LiveView real-time dashboard, or the overall UX flow. Repo: https://github.com/qweliant https://github.com/qweliant (Note: To test the dashboard and simulator, you do have to create an account so the database can build your Care Network topology. You can use fake info!)
- chromatin 7mo ago
  Incredible; I'll let my patients* on Home HD know about this. *not a nephrologist but have several pts on home hd
mech422 7mo ago
That's actually a pretty cool - especially for a portfolio piece. While it's not for common use (yet?), it gives prospective employers an idea of how you would work with safety critical code, as we as the 'normal' CRUD/web stuff.
- qweliantanner 7mo ago
  thank you so much
westurner 7mo ago
FHIR HL7 data would probably be worth adding. I did some quick research on this: /? dialysis: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=dialysis&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu... "Ask HN: What's a good electrical UPS for a home dialysis machine?" (2024) https://news.ycombinator.com/item?id=40925980 https://news.ycombinator.com/item?id=40925980 "Mother used her EV to power son's dialysis machine amid storms and a blackout" (2024) https://news.ycombinator.com/item?id=38939110 https://news.ycombinator.com/item?id=38939110 "Can an Artificial Kidney Finally Free Patients from Dialysis?" (2024) https://news.ycombinator.com/item?id=37782941 https://news.ycombinator.com/item?id=37782941 : "Feasibility of an implantable bioreactor for renal cell therapy using silicon nanopore membranes" (2023) https://www.nature.com/articles/s41467-023-39888-2 https://www.nature.com/articles/s41467-023-39888-2 ... gscholar citations: https://scholar.google.com/scholar?cites=5830456480534079550&as_sdt=5,43&sciodt=0,43&hl=en https://scholar.google.com/scholar?cites=5830456480534079550... "Dialysis machine inspired by juice dispenser wins UK engineering prize" (2024) https://news.ycombinator.com/item?id=32077498 https://news.ycombinator.com/item?id=32077498 . dialysis · GitHub Topics · GitHub https://github.com/topics/dialysis https://github.com/topics/dialysis orroo/DEEP-NEPHRO: DEEP_NEPHRO is a university-led project focused on enhancing dialysis care through intelligent monitoring and optimization. By integrating machine learning and real-time data analysis, https://github.com/orroo/DEEP-NEPHRO https://github.com/orroo/DEEP-NEPHRO kidney-disease · GitHub Topics · GitHub https://github.com/topics/kidney-disease https://github.com/topics/kidney-disease alwinw/epocakir: Clinical coding of patients with kidney disease using KDIGO clinical practice guidelines https://github.com/alwinw/epocakir https://github.com/alwinw/epocakir "KDIGO guidelines" https://kdigo.org/guidelines/ https://kdigo.org/guidelines/ kdigo · GitHub Topics · GitHub https://github.com/topics/kdigo https://github.com/topics/kdigo danribes/renalguard: https://github.com/danribes/renalguard#system-integration-how-renalguard-ai-works-in-primary-care https://github.com/danribes/renalguard#system-integration-ho... ; FHIR HL7 and HL7v2 for labs FHIR: "The case for open source solutions in HIPAA" re: FHIR https://news.ycombinator.com/item?id=42230270 https://news.ycombinator.com/item?id=42230270 (2024) >> /? awesome clinical open source: https://www.google.com/search?q=awesome+clinical+open+source https://www.google.com/search?q=awesome+clinical+open+source "V2 to FHIR - HL7 Version 2 to FHIR v1.0.0" https://build.fhir.org/ig/HL7/v2-to-fhir/ https://build.fhir.org/ig/HL7/v2-to-fhir/ HL7/v2-to-fhir: https://github.com/HL7/v2-to-fhir/ https://github.com/HL7/v2-to-fhir/ "Overview - FHIR v5.0.0" https://www.hl7.org/fhir/overview.html https://www.hl7.org/fhir/overview.html /? hl7 fhir dialysis https://www.google.com/search?q=hl7+fhir+dialysis https://www.google.com/search?q=hl7+fhir+dialysis "hemodialysis or peritoneal dialysis" - Protocols for Clinical Registry Extraction and Data Submission (CREDS) IG v1.0.0 https://build.fhir.org/ig/HL7/fhir-registry-protocols-ig/ValueSet-HemodialysisOrPeritonealDialysis.html https://build.fhir.org/ig/HL7/fhir-registry-protocols-ig/Val... renalguard/mcp-server at main · danribes/renalguard · GitHub https://github.com/danribes/renalguard/tree/main/mcp-server https://github.com/danribes/renalguard/tree/main/mcp-server healthcare-ai · GitHub Topics · GitHub https://github.com/topics/healthcare-ai?l=typescript&o=desc&s=updated https://github.com/topics/healthcare-ai?l=typescript&o=desc&... Hisham-InfoGleam/openclaw-clinical-interop-poc: OpenClaw-native clinical interoperability POC with HL7 v2 parsing, FHIR mapping, and secure webhook orchestration. https://github.com/Hisham-InfoGleam/openclaw-clinical-interop-poc https://github.com/Hisham-InfoGleam/openclaw-clinical-intero... : > Shows healthcare interoperability patterns using HL7 v2 parsing and FHIR resource mapping openclaw-clinical-interop-poc/agents/openclaw/skills: https://github.com/Hisham-InfoGleam/openclaw-clinical-interop-poc/tree/main/agents/openclaw/skills https://github.com/Hisham-InfoGleam/openclaw-clinical-intero... hl7v2 · GitHub Topics · GitHub https://github.com/topics/hl7v2 https://github.com/topics/hl7v2 fhir · GitHub Topics · GitHub https://github.com/topics/fhir https://github.com/topics/fhir Dialysis (disambiguation) https://en.wikipedia.org/wiki/Dialysis https://en.wikipedia.org/wiki/Dialysis Kidney dialysis https://en.wikipedia.org/wiki/Kidney_dialysis https://en.wikipedia.org/wiki/Kidney_dialysis Hemodialysis https://en.wikipedia.org/wiki/Hemodialysis https://en.wikipedia.org/wiki/Hemodialysis "Interoperability in Dialysis Platforms: Leveraging FHIR and Cloud APIs for Seamless Data Exchange" (2026) https://gprjournals.org/journals/index.php/ajt/article/view/485 https://gprjournals.org/journals/index.php/ajt/article/view/... : > Conclusion: Siloed dialysis EHR systems significantly hinder coordinated care for patients with ESKD, increasing the risk of adverse clinical outcomes. "The Application of Mobile Health in Self-Management Among Patients Undergoing Dialysis: Scoping Review" (2026) https://www.jmir.org/2026/1/e76880 https://www.jmir.org/2026/1/e76880 /? how to format hemodialysis messages as FHIR HL7 https://www.google.com/search?q=how+to+format+hemodialysis+messages+as+FHIR+HL7 https://www.google.com/search?q=how+to+format+hemodialysis+m... Procedure - Dialysis - JSON Representation - AU Core Implementation Guide v2.0.1-ci-build https://build.fhir.org/ig/hl7au/au-fhir-core/Procedure-dialysis.json.html https://build.fhir.org/ig/hl7au/au-fhir-core/Procedure-dialy... /? how to format hemodialysis procedure stats messages as FHIR HL7 - Google Search https://www.google.com/search?q=how+to+format+hemodialysis+procedure+stats+messages+as+FHIR+HL7 https://www.google.com/search?q=how+to+format+hemodialysis+p... ; Observations Hemodialysis Machine Availability (physical object) Observation Example - JSON Representation - QI-Core Implementation Guide v8.0.0-ballot https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/en/Observation-example-nonpatient-hemodialysis-machine.json.html https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/e... These aren't for home care, but the same quality measures: ESRD-QIP + HL7 https://www.google.com/search?q=ESRD-QIP+HL7 https://www.google.com/search?q=ESRD-QIP+HL7 Dialysis facilities - ESRD Quality Incentive Program (QIP) | Provider Data Catalog https://data.cms.gov/provider-data/topics/dialysis-facilities/esrd-quality-incentive-program https://data.cms.gov/provider-data/topics/dialysis-facilitie... : > The clinical measures are [...] The reporting measures are:
thebeardisred 7mo ago
FYI, the "Explore the docs" link in README.md links back to the repo and not actual documentation.

45 points by qweliantanner 7mo ago

Hi HN, I’m building an open-source digital safety net for home hemodialysis patients. This operates ostly as a portfolio piece but i thought it worth sharing. The Why: Home dialysis gives patients freedom, but introduces a terrifying risk of isolation. If a patient's blood pressure crashes or a line disconnects while a caregiver is asleep in the next room, the machine sounds an alarm, but it only beeps in the room. It doesn't text the spouse, it doesn't alert the clinic, and it doesn't notify emergency contacts. I lost my mother to a disconnect in home care, so I decided to build the safety net I wish we had that night. Of course, who knows how effective this may have been if it existed. The Tech: It's built on Elixir and Phoenix LiveView. Active dialysis sessions are backed by OTP GenServers to maintain state. If an anomaly is detected (like a hypotensive drop), Phoenix.PubSub instantly broadcasts the event over WebSockets to a LiveView dashboard and triggers SMS alerts to the patient's "Care Network." Because proprietary medical devices are locked down, I also built a mock IoT server in Rust that streams medically plausible, simulated telemetry to test the pipeline. The Reality Check: I shared the first build with a dialysis community on Reddit and got rightfully roasted by a caregiver. He pointed out that exhausted patients don't want another "app" or a GitHub link—they just want to tame the chaos of medical documents and get help when they need it. It was a humbling UX lesson that forced me to pivot. I immediately simplified the onboarding and built "Community Hubs" so users can upload their own knowledge bases and machine manuals. It’s currently in Pre-Alpha (using the Rust simulator for data). I would love any feedback on the Elixir/OTP architecture, the LiveView real-time dashboard, or the overall UX flow. Repo: https://github.com/qweliant https://github.com/qweliant (Note: To test the dashboard and simulator, you do have to create an account so the database can build your Care Network topology. You can use fake info!)

chromatin 7mo ago
Incredible; I'll let my patients* on Home HD know about this. *not a nephrologist but have several pts on home hd

mech422 7mo ago

That's actually a pretty cool - especially for a portfolio piece. While it's not for common use (yet?), it gives prospective employers an idea of how you would work with safety critical code, as we as the 'normal' CRUD/web stuff.

qweliantanner 7mo ago
thank you so much

westurner 7mo ago

FHIR HL7 data would probably be worth adding. I did some quick research on this: /? dialysis: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=dialysis&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu... "Ask HN: What's a good electrical UPS for a home dialysis machine?" (2024) https://news.ycombinator.com/item?id=40925980 https://news.ycombinator.com/item?id=40925980 "Mother used her EV to power son's dialysis machine amid storms and a blackout" (2024) https://news.ycombinator.com/item?id=38939110 https://news.ycombinator.com/item?id=38939110 "Can an Artificial Kidney Finally Free Patients from Dialysis?" (2024) https://news.ycombinator.com/item?id=37782941 https://news.ycombinator.com/item?id=37782941 : "Feasibility of an implantable bioreactor for renal cell therapy using silicon nanopore membranes" (2023) https://www.nature.com/articles/s41467-023-39888-2 https://www.nature.com/articles/s41467-023-39888-2 ... gscholar citations: https://scholar.google.com/scholar?cites=5830456480534079550&as_sdt=5,43&sciodt=0,43&hl=en https://scholar.google.com/scholar?cites=5830456480534079550... "Dialysis machine inspired by juice dispenser wins UK engineering prize" (2024) https://news.ycombinator.com/item?id=32077498 https://news.ycombinator.com/item?id=32077498 . dialysis · GitHub Topics · GitHub https://github.com/topics/dialysis https://github.com/topics/dialysis orroo/DEEP-NEPHRO: DEEP_NEPHRO is a university-led project focused on enhancing dialysis care through intelligent monitoring and optimization. By integrating machine learning and real-time data analysis, https://github.com/orroo/DEEP-NEPHRO https://github.com/orroo/DEEP-NEPHRO kidney-disease · GitHub Topics · GitHub https://github.com/topics/kidney-disease https://github.com/topics/kidney-disease alwinw/epocakir: Clinical coding of patients with kidney disease using KDIGO clinical practice guidelines https://github.com/alwinw/epocakir https://github.com/alwinw/epocakir "KDIGO guidelines" https://kdigo.org/guidelines/ https://kdigo.org/guidelines/ kdigo · GitHub Topics · GitHub https://github.com/topics/kdigo https://github.com/topics/kdigo danribes/renalguard: https://github.com/danribes/renalguard#system-integration-how-renalguard-ai-works-in-primary-care https://github.com/danribes/renalguard#system-integration-ho... ; FHIR HL7 and HL7v2 for labs FHIR: "The case for open source solutions in HIPAA" re: FHIR https://news.ycombinator.com/item?id=42230270 https://news.ycombinator.com/item?id=42230270 (2024) >> /? awesome clinical open source: https://www.google.com/search?q=awesome+clinical+open+source https://www.google.com/search?q=awesome+clinical+open+source "V2 to FHIR - HL7 Version 2 to FHIR v1.0.0" https://build.fhir.org/ig/HL7/v2-to-fhir/ https://build.fhir.org/ig/HL7/v2-to-fhir/ HL7/v2-to-fhir: https://github.com/HL7/v2-to-fhir/ https://github.com/HL7/v2-to-fhir/ "Overview - FHIR v5.0.0" https://www.hl7.org/fhir/overview.html https://www.hl7.org/fhir/overview.html /? hl7 fhir dialysis https://www.google.com/search?q=hl7+fhir+dialysis https://www.google.com/search?q=hl7+fhir+dialysis "hemodialysis or peritoneal dialysis" - Protocols for Clinical Registry Extraction and Data Submission (CREDS) IG v1.0.0 https://build.fhir.org/ig/HL7/fhir-registry-protocols-ig/ValueSet-HemodialysisOrPeritonealDialysis.html https://build.fhir.org/ig/HL7/fhir-registry-protocols-ig/Val... renalguard/mcp-server at main · danribes/renalguard · GitHub https://github.com/danribes/renalguard/tree/main/mcp-server https://github.com/danribes/renalguard/tree/main/mcp-server healthcare-ai · GitHub Topics · GitHub https://github.com/topics/healthcare-ai?l=typescript&o=desc&s=updated https://github.com/topics/healthcare-ai?l=typescript&o=desc&... Hisham-InfoGleam/openclaw-clinical-interop-poc: OpenClaw-native clinical interoperability POC with HL7 v2 parsing, FHIR mapping, and secure webhook orchestration. https://github.com/Hisham-InfoGleam/openclaw-clinical-interop-poc https://github.com/Hisham-InfoGleam/openclaw-clinical-intero... : > Shows healthcare interoperability patterns using HL7 v2 parsing and FHIR resource mapping openclaw-clinical-interop-poc/agents/openclaw/skills: https://github.com/Hisham-InfoGleam/openclaw-clinical-interop-poc/tree/main/agents/openclaw/skills https://github.com/Hisham-InfoGleam/openclaw-clinical-intero... hl7v2 · GitHub Topics · GitHub https://github.com/topics/hl7v2 https://github.com/topics/hl7v2 fhir · GitHub Topics · GitHub https://github.com/topics/fhir https://github.com/topics/fhir Dialysis (disambiguation) https://en.wikipedia.org/wiki/Dialysis https://en.wikipedia.org/wiki/Dialysis Kidney dialysis https://en.wikipedia.org/wiki/Kidney_dialysis https://en.wikipedia.org/wiki/Kidney_dialysis Hemodialysis https://en.wikipedia.org/wiki/Hemodialysis https://en.wikipedia.org/wiki/Hemodialysis "Interoperability in Dialysis Platforms: Leveraging FHIR and Cloud APIs for Seamless Data Exchange" (2026) https://gprjournals.org/journals/index.php/ajt/article/view/485 https://gprjournals.org/journals/index.php/ajt/article/view/... : > Conclusion: Siloed dialysis EHR systems significantly hinder coordinated care for patients with ESKD, increasing the risk of adverse clinical outcomes. "The Application of Mobile Health in Self-Management Among Patients Undergoing Dialysis: Scoping Review" (2026) https://www.jmir.org/2026/1/e76880 https://www.jmir.org/2026/1/e76880 /? how to format hemodialysis messages as FHIR HL7 https://www.google.com/search?q=how+to+format+hemodialysis+messages+as+FHIR+HL7 https://www.google.com/search?q=how+to+format+hemodialysis+m... Procedure - Dialysis - JSON Representation - AU Core Implementation Guide v2.0.1-ci-build https://build.fhir.org/ig/hl7au/au-fhir-core/Procedure-dialysis.json.html https://build.fhir.org/ig/hl7au/au-fhir-core/Procedure-dialy... /? how to format hemodialysis procedure stats messages as FHIR HL7 - Google Search https://www.google.com/search?q=how+to+format+hemodialysis+procedure+stats+messages+as+FHIR+HL7 https://www.google.com/search?q=how+to+format+hemodialysis+p... ; Observations Hemodialysis Machine Availability (physical object) Observation Example - JSON Representation - QI-Core Implementation Guide v8.0.0-ballot https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/en/Observation-example-nonpatient-hemodialysis-machine.json.html https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/e... These aren't for home care, but the same quality measures: ESRD-QIP + HL7 https://www.google.com/search?q=ESRD-QIP+HL7 https://www.google.com/search?q=ESRD-QIP+HL7 Dialysis facilities - ESRD Quality Incentive Program (QIP) | Provider Data Catalog https://data.cms.gov/provider-data/topics/dialysis-facilities/esrd-quality-incentive-program https://data.cms.gov/provider-data/topics/dialysis-facilitie... : > The clinical measures are [...] The reporting measures are:

thebeardisred 7mo ago

FYI, the "Explore the docs" link in README.md links back to the repo and not actual documentation.