birdog1960 Posted January 27, 2015 Posted January 27, 2015 This is cute. A user thinking computers are magic. Arguing with an engineer who thinks the users should just do what he says. if what i'm requesting is magic, then useful and efficient ehr's are a pipe dream. i don't believe it requires magic. ibm has a computer that can beat humans in jeopardy. i used a program 25 years ago (written by a physician) that spit out a pretty thorough and accurate differential diagnosis based on symptoms and findings. yet a program that parses notes and collates information already entered into it in whatever form (notes, lab reports, X-rays) is not possible. i dictate that someone had a flu shot this year in a note and the computer can't pick that up a put it in a preventive flow sheet? that's magic? a number is entered for a blood thinner range from the lab and the program can't automatically populate a blood thinner flow sheet with that info? that's magic? i want to search for every imaging study done on the chest of cancer patient in the last 5 years and i can't do it using a search function? that's magic? no, that's not ready for primetime and the product of a scrub squad of programmers.
DC Tom Posted January 28, 2015 Posted January 28, 2015 if what i'm requesting is magic, then useful and efficient ehr's are a pipe dream. i don't believe it requires magic. ibm has a computer that can beat humans in jeopardy. i used a program 25 years ago (written by a physician) that spit out a pretty thorough and accurate differential diagnosis based on symptoms and findings. yet a program that parses notes and collates information already entered into it in whatever form (notes, lab reports, X-rays) is not possible. i dictate that someone had a flu shot this year in a note and the computer can't pick that up a put it in a preventive flow sheet? that's magic? a number is entered for a blood thinner range from the lab and the program can't automatically populate a blood thinner flow sheet with that info? that's magic? i want to search for every imaging study done on the chest of cancer patient in the last 5 years and i can't do it using a search function? that's magic? no, that's not ready for primetime and the product of a scrub squad of programmers. I'm not even reading beyond the first sentence. You're asking a computer to exercise judgement. Computers don't do that. Computers do repetitive tasks very, very well. If computers could exercise judgement, we wouldn't need you. God, I wish computers could exercise judgement.
birdog1960 Posted January 28, 2015 Posted January 28, 2015 I'm not even reading beyond the first sentence. You're asking a computer to exercise judgement. Computers don't do that. Computers do repetitive tasks very, very well. If computers could exercise judgement, we wouldn't need you. God, I wish computers could exercise judgement. no need for judgement. algorithms could achieve all the tasks i mentioned. i'm happy to provide the judgement. in fact, i thought i just did.
TakeYouToTasker Posted January 28, 2015 Posted January 28, 2015 (edited) I'm not even reading beyond the first sentence. You're asking a computer to exercise judgement. Computers don't do that. Computers do repetitive tasks very, very well. If computers could exercise judgement, we wouldn't need you. God, I wish computers could exercise judgement. It sounds like he's looking for growing "intelligence" OCR software, fully customized for the wants of every individual doctor in the country; but doesn't grasp that computers don't actually think, and doesn't realize the margins of error in even the best data grab and collation software. Further, it's obvious that he doesn't want to buy an "off the shelf" shell. Something tells me that he doesn't want to pay the costs and proprietary maintenance costs of a fully customized system, however. Edited January 28, 2015 by TakeYouToTasker
B-Man Posted January 28, 2015 Posted January 28, 2015 (edited) U.S. anti-fracking interests: Shills for Russian oil. Foreign Firm Funding U.S. Green Groups Tied to State-Owned Russian Oil Company. “A shadowy Bermudan company that has funneled tens of millions of dollars to anti-fracking environmentalist groups in the United States is run by executives with deep ties to Russian oil interests and offshore money laundering schemes involving members of President Vladimir Putin’s inner circle. . . . No one knows where that firm’s money comes from. Its only publicly documented activities have been transfers of $23 million to U.S. environmentalist groups that push policies that would hamstring surging American oil and gas production, which has hurt Russia’s energy-reliant economy.” . Edited January 28, 2015 by B-Man
OCinBuffalo Posted January 28, 2015 Posted January 28, 2015 Holy shcit there's a lot of wrong, and a lot of right in this exchange. I will fix the wrong. If I don't say anything about something that's because it's right. no point in reproducing all that garbage. the answer to your question is 1 when the programmers/designers realizre that they need to build sytems around the way medicasl professionals have been taught to think for generations not the way these nonclinical people believe we should think. 2 they should have first studied how clinicians process/disseminate/collate and historically have documented information and designed a system around that, not designed around how they think it should be done and then have the clinicians adapt. oh, and 3 how bout a bit of artificail intelligence in the prorams so they can parse the info on their own? it also seems no one designing these things has experience with a search function. i've yet to see a system with even a primitive one allowing search for a specific test or series of tests of even a keyword in notes. so the answer to your question is they'll be ready for primetime when you and your collleagues decide to make them. they're not even close now. they're embarrisingly rudimentary and simplistic. and most people aren't using these things like cookie cutters because they don't want to stand out. they do it because the programs are designed to produce cookie cutter results. the desigers were no where near sophisticated enough in medical matters to produce anything else. stop blaming the victims (clinicians forced to use these pos tools). First bolded: That when is now. Not only have I done that, I've done you 2 better. First, the notion that all of you think the same, or were all trained the same, is utter garbage, and I proved that 10 years ago. So, beginning any design with "how medical professionals have been taught to think", is homogenous, is crap. Rather we begin with how you, and only you, are thnking, right now. That's 1 better. 2 better is that you can change your mind/how you think, with 0 consequences. EVERY other software in this world, custom or cookie press, costs you $ and/or makes you wait for the next version to change your thinking. And often the new version F's with the way you liked things. We do none of that, ever. 2nd bolded: I did exactly that, for 3 years, nights and weekends before I designed a single thing. I smelled the poop, and saw the blood. I volunteered in whatever capacity got me near the care. I filled out forms I'm not supposed to fill out, and I even passed meds one time. I never told them I was really a project manager. I was essentially a candy striper. Good enough? Thus, what you are describing is merely "up to standard" methodology, for the professionally trained enterprise consultant. You don't know that, because you've never seen one. You work in health care. I've been here long enough to start making some moves.. Which means you will see things moving in the direction you've described. They will have to. Hey, I've already turned down 2 offers to buy us out for cash. I've heard about a third one/"offer I can't refuse" coming soon. Too bad for them: I'm not going anywhere, and neither are your(my) ideas about how things sould run in health care. It is they who will have to adapt to us. 3rd bolded: You're using the word AI, but you really mean a properly deployed, persistent workflow and a business rules engine, both of which can be modified in real time, used in conjunction with hand held data recording that tracks every task that is performed for the patient or facility. You want the tasks you care abot delivered when you need them, and nothing else. Already done. And yes, one of it's many capabilities is doing exactly what you describe both here above and below this. We are going to realease a free version of this soon. Can't say when because I won't approve it until I am happy with it, and it's driving everybody(clients, board, employees, family, friends) nuts, but I do not care. They think it's ready now. They do not have my knowledge or expereince. I say it is not. I will blame every single one of you idiots that has been enabling these awful software companies, by buying their crap, instead of demanding better. If you would stop being so penny wise and pound foolish, these problems would have been solved years ago. That's why I'm doing a free version. That takes the final idiot health care excuse away. So, we've already done everything you've asked, and probably better than you have imagined it, and soon you'll have a free version to play around with. The not-AI stuff you are asking about costs $ though, for the simple reason that our time costs $, and listening to your specific needs costs time. But, you still have total control of most things in the free version, if you want to do it yourself. Or, you can pay to have us train you, or just do it for you. The other reason we make you pay for the "AI" stuff is you don't know it, and would probably F everything up. Look I just read an article written by supposed "health care workflow experts" They have no idea WTF they are doing/takling about. I would give you access to the workflow part before them. This is cute. A user thinking computers are magic. Arguing with an engineer who thinks the users should just do what he says. What's cuter? You have the exact opposite of my thinking defined here. In fact, my sofware worn't run at all unless the user "tells" it what to do. The only compliance we require is some sort of authentication. User/Pass, swipe card/RFID...whatever. After that, it literally begins with a blank page. And it's not engineer. It's Project Manager, Enterprise Technical Architect, CEO, or sir, to you, son. I'm not even reading beyond the first sentence. You're asking a computer to exercise judgement. Computers don't do that. Computers do repetitive tasks very, very well. If computers could exercise judgement, we wouldn't need you. God, I wish computers could exercise judgement. Computers can learn, and therefore, learn from mistakes .Not repeating mistakes is one definition of judgement. Just sayin' if what i'm requesting is magic, then useful and efficient ehr's are a pipe dream. i don't believe it requires magic. ibm has a computer that can beat humans in jeopardy. i used a program 25 years ago (written by a physician) that spit out a pretty thorough and accurate differential diagnosis based on symptoms and findings. yet a program that parses notes and collates information already entered into it in whatever form (notes, lab reports, X-rays) is not possible. i dictate that someone had a flu shot this year in a note and the computer can't pick that up a put it in a preventive flow sheet? that's magic? a number is entered for a blood thinner range from the lab and the program can't automatically populate a blood thinner flow sheet with that info? that's magic? i want to search for every imaging study done on the chest of cancer patient in the last 5 years and i can't do it using a search function? that's magic? no, that's not ready for primetime and the product of a scrub squad of programmers. Yeah, as I said above. Already done. About to go live for free, and no magic involved. Our "reports" which really aren't, are basically what you would call a search function. We just sorta help you out, passively, like Google search does.
TakeYouToTasker Posted January 28, 2015 Posted January 28, 2015 (edited) OC: Are you using the ABBYY engine, or did you build this entire thing yourself? Edited January 28, 2015 by TakeYouToTasker
/dev/null Posted January 28, 2015 Posted January 28, 2015 OC: Are you using the ABBYY engine, or did you build this entire thing yourself? He didn't build that. Somebody else made it happen
birdog1960 Posted January 28, 2015 Posted January 28, 2015 Holy shcit there's a lot of wrong, and a lot of right in this exchange. I will fix the wrong. If I don't say anything about something that's because it's right. First bolded: That when is now. Not only have I done that, I've done you 2 better. First, the notion that all of you think the same, or were all trained the same, is utter garbage, and I proved that 10 years ago. So, beginning any design with "how medical professionals have been taught to think", is homogenous, is crap. Rather we begin with how you, and only you, are thnking, right now. That's 1 better. 2 better is that you can change your mind/how you think, with 0 consequences. EVERY other software in this world, custom or cookie press, costs you $ and/or makes you wait for the next version to change your thinking. And often the new version F's with the way you liked things. We do none of that, ever. 2nd bolded: I did exactly that, for 3 years, nights and weekends before I designed a single thing. I smelled the poop, and saw the blood. I volunteered in whatever capacity got me near the care. I filled out forms I'm not supposed to fill out, and I even passed meds one time. I never told them I was really a project manager. I was essentially a candy striper. Good enough? Thus, what you are describing is merely "up to standard" methodology, for the professionally trained enterprise consultant. You don't know that, because you've never seen one. You work in health care. I've been here long enough to start making some moves.. Which means you will see things moving in the direction you've described. They will have to. Hey, I've already turned down 2 offers to buy us out for cash. I've heard about a third one/"offer I can't refuse" coming soon. Too bad for them: I'm not going anywhere, and neither are your(my) ideas about how things sould run in health care. It is they who will have to adapt to us. 3rd bolded: You're using the word AI, but you really mean a properly deployed, persistent workflow and a business rules engine, both of which can be modified in real time, used in conjunction with hand held data recording that tracks every task that is performed for the patient or facility. You want the tasks you care abot delivered when you need them, and nothing else. Already done. And yes, one of it's many capabilities is doing exactly what you describe both here above and below this. We are going to realease a free version of this soon. Can't say when because I won't approve it until I am happy with it, and it's driving everybody(clients, board, employees, family, friends) nuts, but I do not care. They think it's ready now. They do not have my knowledge or expereince. I say it is not. I will blame every single one of you idiots that has been enabling these awful software companies, by buying their crap, instead of demanding better. If you would stop being so penny wise and pound foolish, these problems would have been solved years ago. That's why I'm doing a free version. That takes the final idiot health care excuse away. So, we've already done everything you've asked, and probably better than you have imagined it, and soon you'll have a free version to play around with. The not-AI stuff you are asking about costs $ though, for the simple reason that our time costs $, and listening to your specific needs costs time. But, you still have total control of most things in the free version, if you want to do it yourself. Or, you can pay to have us train you, or just do it for you. The other reason we make you pay for the "AI" stuff is you don't know it, and would probably F everything up. Look I just read an article written by supposed "health care workflow experts" They have no idea WTF they are doing/takling about. I would give you access to the workflow part before them. What's cuter? You have the exact opposite of my thinking defined here. In fact, my sofware worn't run at all unless the user "tells" it what to do. The only compliance we require is some sort of authentication. User/Pass, swipe card/RFID...whatever. After that, it literally begins with a blank page. And it's not engineer. It's Project Manager, Enterprise Technical Architect, CEO, or sir, to you, son. Computers can learn, and therefore, learn from mistakes .Not repeating mistakes is one definition of judgement. Just sayin' Yeah, as I said above. Already done. About to go live for free, and no magic involved. Our "reports" which really aren't, are basically what you would call a search function. We just sorta help you out, passively, like Google search does. well, that's awesome. i'll be very happy to see it as will legions of clinicians. search "ehr fail" and see what comes up. there's almost no one that cares for patients that thinks this technology has met any of it's promised goals. in most cases, it's made things worse. except for the insurance companies that have all that valuable data and are exempt from hippa. makes you kinda wonder what the real purpose was and why people aren't screaming about privacy when huge corporations have their intimate details. why the feel better about those companies access than the gov'ts is a mystery to me... and i never bought into the amateur hour (years) of ehr's primitive infancy and i suppose, now, adolescence. my employer did when the incentives and disincentives became too large to ignore. i was rightly convinced when in private practice that the available systems would neither benefit me nor my patients. i truly hope you prove the naysayers (including me) wrong. unlike others here, i believe it is possible. it's a question of priorities. it amazes me that a $300 phone can incorporate voice recognition to find wegman's in fairfax, tell me when it's open and give me turn by turn directions but that currently available ehr's can't recognize the voice recognition produced words "flu shot" and collate them. same for sophisticated investment programs and defense systems. i gotta think the designers of these things are better paid and more highly sought after than the majority of those working for the aptly described "awful software companies". why is that? is the health of friends and family such a low priority? at any rate, good luck. if it works as planned, everybody here can say "i used to argue with that guy" when we see you at national meetings and being interviewed on cnbc.
4merper4mer Posted January 28, 2015 Posted January 28, 2015 (edited) Holy shcit there's a lot of wrong, and a lot of right in this exchange. I will fix the wrong. If I don't say anything about something that's because it's right. First bolded: That when is now. Not only have I done that, I've done you 2 better. First, the notion that all of you think the same, or were all trained the same, is utter garbage, and I proved that 10 years ago. So, beginning any design with "how medical professionals have been taught to think", is homogenous, is crap. Rather we begin with how you, and only you, are thnking, right now. That's 1 better. 2 better is that you can change your mind/how you think, with 0 consequences. EVERY other software in this world, custom or cookie press, costs you $ and/or makes you wait for the next version to change your thinking. And often the new version F's with the way you liked things. We do none of that, ever. 2nd bolded: I did exactly that, for 3 years, nights and weekends before I designed a single thing. I smelled the poop, and saw the blood. I volunteered in whatever capacity got me near the care. I filled out forms I'm not supposed to fill out, and I even passed meds one time. I never told them I was really a project manager. I was essentially a candy striper. Good enough? Thus, what you are describing is merely "up to standard" methodology, for the professionally trained enterprise consultant. You don't know that, because you've never seen one. You work in health care. I've been here long enough to start making some moves.. Which means you will see things moving in the direction you've described. They will have to. Hey, I've already turned down 2 offers to buy us out for cash. I've heard about a third one/"offer I can't refuse" coming soon. Too bad for them: I'm not going anywhere, and neither are your(my) ideas about how things sould run in health care. It is they who will have to adapt to us. 3rd bolded: You're using the word AI, but you really mean a properly deployed, persistent workflow and a business rules engine, both of which can be modified in real time, used in conjunction with hand held data recording that tracks every task that is performed for the patient or facility. You want the tasks you care abot delivered when you need them, and nothing else. Already done. And yes, one of it's many capabilities is doing exactly what you describe both here above and below this. We are going to realease a free version of this soon. Can't say when because I won't approve it until I am happy with it, and it's driving everybody(clients, board, employees, family, friends) nuts, but I do not care. They think it's ready now. They do not have my knowledge or expereince. I say it is not. I will blame every single one of you idiots that has been enabling these awful software companies, by buying their crap, instead of demanding better. If you would stop being so penny wise and pound foolish, these problems would have been solved years ago. That's why I'm doing a free version. That takes the final idiot health care excuse away. So, we've already done everything you've asked, and probably better than you have imagined it, and soon you'll have a free version to play around with. The not-AI stuff you are asking about costs $ though, for the simple reason that our time costs $, and listening to your specific needs costs time. But, you still have total control of most things in the free version, if you want to do it yourself. Or, you can pay to have us train you, or just do it for you. The other reason we make you pay for the "AI" stuff is you don't know it, and would probably F everything up. Look I just read an article written by supposed "health care workflow experts" They have no idea WTF they are doing/takling about. I would give you access to the workflow part before them. What's cuter? You have the exact opposite of my thinking defined here. In fact, my sofware worn't run at all unless the user "tells" it what to do. The only compliance we require is some sort of authentication. User/Pass, swipe card/RFID...whatever. After that, it literally begins with a blank page. And it's not engineer. It's Project Manager, Enterprise Technical Architect, CEO, or sir, to you, son. Computers can learn, and therefore, learn from mistakes .Not repeating mistakes is one definition of judgement. Just sayin' Yeah, as I said above. Already done. About to go live for free, and no magic involved. Our "reports" which really aren't, are basically what you would call a search function. We just sorta help you out, passively, like Google search does. I have no idea why I bet the under. How could I take the under? Edited January 28, 2015 by 4merper4mer
Tiberius Posted January 30, 2015 Posted January 30, 2015 http://www.nytimes.com/2015/01/31/us/politics/most-americans-support-government-action-on-climate-change-poll-finds.html?hp&action=click&pgtype=Homepage&module=photo-spot-region®ion=top-news&WT.nav=top-news&_r=0 Liberals and scientists are winning the debate on this it looks like
Chef Jim Posted January 30, 2015 Posted January 30, 2015 http://www.nytimes.com/2015/01/31/us/politics/most-americans-support-government-action-on-climate-change-poll-finds.html?hp&action=click&pgtype=Homepage&module=photo-spot-region®ion=top-news&WT.nav=top-news&_r=0 Liberals and scientists are winning the debate on this it looks like Because the majority of Americans (who pretty much know nothing about the subject) agree with them? I think you've been watching American Idol.
Azalin Posted January 30, 2015 Posted January 30, 2015 Because the majority of Americans (who pretty much know nothing about the subject) agree with them? I think you've been watching American Idol. The majority of Americans are unaware of the most prevalent greenhouse gas in our atmosphere, but could easily be frightened into banning its use: http://www.dhmo.org/facts.html
Dante Posted January 30, 2015 Posted January 30, 2015 Now global warming causes volcanoes! http://time.com/3687893/volcanoes-climate-change/
KD in CA Posted January 30, 2015 Posted January 30, 2015 Remember when the liberals told us there wouldn't be any more snow because of Global Warming Climate ChangeTM? I sure wish it would get here; I've shoveled 3 times in the past week! http://www.nytimes.com/2015/01/31/us/politics/most-americans-support-government-action-on-climate-change-poll-finds.html?hp&action=click&pgtype=Homepage&module=photo-spot-region®ion=top-news&WT.nav=top-news&_r=0 Liberals and scientists are winning the debate on this it looks like Winning the debate on getting bullsh-- published in the NY/DNC Times? Wow.
DC Tom Posted January 30, 2015 Posted January 30, 2015 Now global warming causes volcanoes! http://time.com/3687893/volcanoes-climate-change/ Good. The resulting atmospheric aerosols should reduce global warming.
Tiberius Posted January 30, 2015 Posted January 30, 2015 Because the majority of Americans (who pretty much know nothing about the subject) agree with them? I think you've been watching American Idol. Wait a second! The vast majority of people--unlike you--that DO know the subject, are experts on it, say it's happening! Let's face it, you are going to believe Rush (American Idiot) over anyone anyway, so who cares what you and Rush think?
Chef Jim Posted January 30, 2015 Posted January 30, 2015 Wait a second! The vast majority of people--unlike you--that DO know the subject, are experts on it, say it's happening! Let's face it, you are going to believe Rush (American Idiot) over anyone anyway, so who cares what you and Rush think? To your first point. What on earth does that statement have to do with the article you posted? To your second point. What does Rush have to do with me? Oh those pesky questions again.
/dev/null Posted January 31, 2015 Posted January 31, 2015 Now global warming causes volcanoes! http://time.com/3687893/volcanoes-climate-change/
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