I've worked for the past two years as a software engineer at athenahealth. The experiences that you described are well known throughout the R&D people that I work with. I actually *have* been to clinics and followed doctors, PAs, and other staff around as they went about their day. I've seen them working with other EHR software that looks like it was built in the early 1980s. I've listened to them describe their ideal software solutions and what their biggest pain points are. AFAIK, my company is the only EHR out there that does these "site visits" regularly and encourages people to sign up and go. It's difficult to design EHR software that meets everyone's needs when every clinic likes to do things their own way. Your comments about the over saturation of documentation requirements is spot on, and there are teams at my work that focus on reducing the time spent doing documentation. Especially the "after hours" documentation that you mentioned is something we are trying to kill completely. Whether or not we've been doing a good job making that better, I don't know since I work on something completely different. But I think at least our hearts and our minds are in the right place. Healthcare is a very complex and difficult thing to manage. I wish it was an easy thing to fix, but it is an absolute juggernaut of a problem. I know my company certainly isn't perfect, and some things were designed in a downright idiotic fashion. But I think at least our hearts and our focus is in the right place, and I've seen a ton of improvements in the past two years since I started there. I just wanted to share my perspective as one of those EHR programmers. We're trying to make things better, not worse. But it is a business, and most EHR businesses are focused only on making more money, not making better products. Sometimes, that means they make decisions that harm the industry (like refusing to share patient data outside their systems) because they are afraid it will hurt their checkbooks. Sad, but true.

I also got a copy of the book for free about a year or two ago from winning a contest on GameDev.net. I'm not much of a fiction reader but I gave it a shot. My review is overwhelmingly positive. I can count with one hand how many books I've read that I truly, truly enjoyed and this is one of them. It really did hook me in a way that few books ever have. I gave this book to my mother (who can barely use a computer) and she loved it just as much as I did. I highly recommend this book to anyone, geek or non-geek alike.

I'm an Obama supporter living in Texas and I think this is actually a great thing to have both McCain and Obama's names removed from the ballot. Texas is a very conservative state, which makes my vote here virtually worthless. But if neither is on the ballot, then the chances of Obama winning the state because of write-ins or Barr (or another 3rd party candidate) winning because their name is on the ballot increases. Basically if John McCain doesn't win Texas, its a very deep blow for him and this lawsuit is pretty much the only shot we have at it.

When will we abolish this stupid electoral college?