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Comment: Re:Billionaire saved by taxpayer (Score 1) 104

And yet, the federal government makes loans to grad students in the 6% to 7% range. A failing tech company with a billionaire owner gets low interest loans because of the potential for the future, but low and middle income grad students, who really are the future get high rate loans.

To be fair, these are unsecured loans. Yes, the rate is higher than the ~4% you would get for a mortgage, but it's better than the 18% you would pay on a credit card and on par with the rate you pay on a car loan. The crazy part is that you are barred from refinancing your student debt.

Comment: Re:HHS Asleep At The Switch (Score 1) 184

In the US, there are two overriding issues with the EHR - getting a bill out and getting a bill out.

There's a distinction here that is being missed between a Electronic Health Record (EHR) and a Practice Management System (PMS). The PMS usually handles scheduling, billing, claims, remittances, and maybe registration -- the business side of healthcare. The EHR holds the patient's actual clinical data. These systems can and should talk to each other: the EMR will need the ADT (Admit/Discharge/Transfer) feed from the PMS and the PMS will need the procedure codes to bill for from the EHR. However, the PMS is not a health record and shouldn't be used as one. You can't get a proper continuity of care record out of a financial tool and likewise will have a hard time doing billing with a clinical tool: they're specialized for different use cases.

Unless you are at family practice, the docs don't usually mess around in the practice management software: it's more of a tool for the front desk and accountants. On the PMS side we've had pretty good standardization of formats dues to HIPAA. The government had a pretty good lever here to force compliance: Medicare. When HIPAA went into effect, CMS set a deadline that sometime in 2004 (IIRC) they would no longer accept non-X12 claims. Since Medicare/caid are such a huge part of everyone's revenue stream, everyone had a real motivation to comply. This worked so well that when I left my previous job in 2012, our claims clearinghouse division was actually shrinking because the software to connect directly to insurers had become a commodity feature in most practice management systems.

There is, as far as I know, no equivalent government body that everyone interacts with for clinical data that could force a similar standardization across EHR vendors. I know where I worked we tried to support the IHE profiles as much as we could, but I don't know how wide-spread that behavior is.

Comment: Re:Oh yeah, don't forget MUMPS (Score 3, Interesting) 184

Sorry for double posting, but one other thing to note is this...behind all the whizzy new web interface screens, many EHR systems are based on some of the oldest, creakiest standards imaginable, including a programming language-and-database combo called MUMPS. Look it up - it's positively ancient, and it should be obvious why they have trouble finding people willing to specialize in writing code for it.

When I first started in the healthcare industry almost in 1997 as an intern, my first job was writing MUMPS interface routines to extract referral data for a web interface. The system in question was running on a VAX/VMS cluster and ran a major midewestern HMO's operations.

The funny thing is when NoSQL became a buzzword a few years ago, thanks to my exposure to MUMPS, I instantly recognized it for what it was: 70's-era hierarchical database technology, repackaged for a new generation.

Comment: Re:Feds (Score 3, Interesting) 184

There are already industry standards for EMR

Common Document Architecture (CDA) - provides formats for the interchange of data built on the OASIS schema.
Integrating Healthcare in the Enterprise - defines profiles for implementing technologies in an interoperable manner.
Open eHealth - open source baseline implementation of the above.

That's just for clinical data. There are a whole other set of standard for financial/claims records (X12) and pharmacy records/scripts (NCPDP).

The problem is that medical data is pretty complicated and often the context of the document is as important as the content. You almost always have to massage documents coming in even if they are ostensibly formatted to a standard you consume. You have to normalize units, make sure all the fields are part of the subset of the standard your system supports, etc.

And that doesn't even begin to get into tracking patient consent, tracking identity across multiple orgs, depts, and visits (MPI,PIX/PDQ), plus access restrictions and emergency access exceptions.

Comment: Re:Time for men's liberation (Score 4, Insightful) 369

by flink (#49068927) Attached to: Two New Male Birth Control Chemicals In Advanced Stages

It would be awesome if this could be part of a men's liberation movement, like how women were liberated in the 60s when the pill became available.

Was it the pill that led to women's liberation? Or was it penicillin? The pill allows women to have sex without getting pregnant. Penicillin allowed people to have sex without getting diseases. AIDS has somewhat rolled that back.

Before HIV, there was still always Herpes, Hepatitis, HPV.... e.g. anything viral. People were just more ignorant of STDs 50 years ago, but that doesn't meant they still weren't getting them. You're still going to want a condom on the first date no matter how many new types of contraception get invented.

Comment: Re:Is semver too simplistic for kernels? (Score 3, Informative) 199

by flink (#49047419) Attached to: Torvalds Polls Desire for Linux's Next Major Version Bump

Version Numbers in general are outdated for application. The line between a Major and Minor version is huge.
We have been on Mac OS X (10) for 14 years. with have been getting point updates over the time.
Microsoft during that time has had 4 Major updates (That is with the insane longevity of XP).

It depends on what you are talking about. The internal version number for Windows 7 is 6.1.x (Windows 8.1 is v6.3). So if we are going by marketing-driven release numbers, then there have been 6 or so major Windows NT release since 1996 (Windows NT 4.0, Windows 2000, Windows XP, Vista, 7, 8). However, if you go by the engineering version number there have been just 2: Window 2000 was NT v5.0 and Windows Vista was NT v6.0.

Comment: Re:Or do something to eliminate journeys? (Score 1) 481

by flink (#48989901) Attached to: DOT Warns of Dystopian Future For Transportation

How about putting in place policies that incentivize people to live near their workplaces, don't have to drive to go to a shopping mall, reduce the need for long-distance business travel, etc. Not only would that improve "traffic", but actually make people's lives easier and better as a bonus. Worth a thought, eh?

Except there is no long-term employment stability anymore. I am not going to uproot my family, sell my house, have my kids change schools, and spend thousands of dollars to move every time I change jobs just so I can live within a car-free commuting distance of my work place. I live very close to the T in Boston and I used to have a nice 30-minute commute downtown. That job evaporated and my new place in Cambridge, which is two trains and one bus transfer away by public transit. This is over 90 minutes each way. Or I could drive 30 minutes, which is what I do.

Comment: Re:Mod parent up. (Score 4, Insightful) 958

by flink (#48966021) Attached to: Science's Biggest Failure: Everything About Diet and Fitness

Most GPs aren't scientists. They are basically "meat mechanics". They learn the best practices in their field when they go to school and if they are good they keep up with changes to practices. But they are people too and are still susceptible to falling prey to fads and superstition even if their education provides them some resistance.

Comment: Re:For all of you USA haters out there: (Score 1) 378

by flink (#48935695) Attached to: Why ATM Bombs May Be Coming Soon To the United States

I think the basic problem is that getting rid of them would require an act of Congress. That's a place filled with old guys who fondly remember using pennies to pay for bottled cokes back in the '50's.

Hey, as recently as the 80's when I was a kid, you could still buy penny candy in the literal sense (e.g. $0.01 = 1 Swedish Fish). I don't know if that's true anywhere anymore though.

Comment: Re:m -rf "$STEAMROOT/"* ??? (Score 1) 329

by flink (#48830819) Attached to: Steam For Linux Bug Wipes Out All of a User's Files

And a little advice to Valve, next time have developers familiar with Linux working on your Linux client. That /* is how a Windows developer would write the command to delete a directory if they simply looked up the equivalent command for Linux.

A competent Windows developer would probably just write:
if exist "%STEAMROOT%" rmdir /Q /S "%STEAMROOT%"
no dangerous glob needed.

It kind of floors me that they aren't doing some kind of check that the directory tree they are about to delete actually looks like a Steam install before deleting it. e.g. check that ClientRegistry.blob file or SteamApps directory exists under $STEAMHOME.

Comment: Re:This could be fun.... (Score 2) 164

by flink (#48812541) Attached to: Man Saves Wife's Sight By 3D Printing Her Tumor

How does the FDA draw the line between 'must be approved' and 'not our problem' for devices that connect to a greater or lesser degree to other equipment?

I can only speak to IT software since I am a software developer, but I worked for many years in the field writing both practice management (scheduling, claims processing, etc) and clinical (IHEs, patient records, RX) software. The way it worked at the time is that you basically told the FDA if you wanted to be regulated. i.e. it was up to the company to say: yes, this software constitutes a medical device and should be regulated.

Comment: Re:How about ignoring it? (Score 2) 484

by flink (#48633709) Attached to: Colorado Sued By Neighboring States Over Legal Pot

I can't believe anyone can be stupid enough to think cannabis is dangerous enough to merit criminalization.

What you can or cannot believe isn't important, the truth is that cannabis can have a devastating effect on the developing teenage mind. Even if you don't consider that enough to warrant criminalization, that does not justify insulting those of us who do.

By that measure, so is alcohol, or any number of other drugs that are sold over the counter. Yes it should be age restricted, but the point is that it is not any more dangerous than plenty of other substances that are legal. It's certainly less dangerous than cigarettes.

Don't tell me how hard you work. Tell me how much you get done. -- James J. Ling