kgrin
Joined 17 years ago
Joined 17 years ago
Apparently it's a sort-of-known issue, the workaround is to turn off WiFi before starting your call (wtf?) or use another carrier.
Google, wyd?
We're a custom dev agency, specializing (but not exclusively) in Django. We work with a diverse roster of interesting clients, across different industries (everything from healthcare to rock'n'roll).
We've been in business for 12 years, and the company is profitable. We're currently three full-time developers, looking to add an additional developer and our first in-house full time designer to the crew.
Details: https://www.activefrequency.com/join-us
kevin _at_ activefrequency.com
It gets into some (though hardly all) of the issues of why EHR software is the way it is, and why (some) doctors hate it. (Among my friends who are doctors, some hate Epic, and some absolutely love it - depends on specialty, age, institution, how it's configured, etc.)
Among some interesting issues:
- As others in this thread have noted, the buyer (administrator concerned with maximizing billing) is not the user. That's the easy one that's common to a lot of enterprises.
- Epic makes it easier for medical directors to track population health and impose standard protocols of care. Individual practitioners don't always like that! I am not expert enough in those fields to say who's right, and I suspect there's not always an obviously correct answer.
- A lot of doctors dislike the underlying mechanic - being forced to actually write down everything they're doing and why - on top of sub-par UIs. The goals of the system conflict with the goals of the practitioner.
- Interoperability sucks, but it's true that standards aren't really there, and it's hard to get consensus... plus everything you put in prod needs to be back-compatible approximately forever. A lot of institutions got burned by maintaining internal software built over decades that you can't turn off because lives depend on it, and Epic/etc. are part of trying to avoid repeating that mistake.
There's more. I only have a toehold in that world now, but love to chat about it. Email in profile.
There are a lot of details, though, that make this complicated and not necessarily viable for all states (MA is both relatively wealthy, has relatively wealthy neighboring states, and has a somewhat unusual healthcare market).
nslookup techblog.netflix.com 8.8.8.8
Yes, eventually you'll (hopefully) upgrade all your projects to the newest and shiniest versions of all your dependencies, but if you need to maintain some semblance of stability, that's not always immediately possible/practical.
Rough ballpark: 300 million combos - let's say you buy 6000 tickets/hour (which I think is actually optimistic probably by a full order of magnitude), for 25 hours a day (assume shifts and magic days), you're still looking at 2,000 person-days.
There are of course also the extreme cases of specifically asking for a given prescription, but like the parent mentioned, just having a few patients persistently ask the doc about X is enough of a motivator to get the doctor to pay [marginally] more attention to the doctor-facing literature/ads/sales force.
[ my public key: https://keybase.io/kgrinberg; my proof: https://keybase.io/kgrinberg/sigs/WEI_d3HGjUIUBsOtsfBAyLlxPP2GxVWvgMAg5oxxwJE ]