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A cry for help
3 points by G6P on June 22, 2012 | hide | past | favorite | 5 comments
This is my cry for help.

Browsing HackerNews I read about geniuses creating the most amazing, seamless, intuitive tools year after year in the start-up scene. The results are absolutely astonishing, and frankly otherworldly, to a person like me.

I then close my browser window and begin my work in medical research, attempting to shed light on healthcare outcomes - how to change our current practices to be more evidence-based and directed toward the concerns of the patient. More often than not this research requires of me to look in 7 different places in 3 or 4 separate electronic medical records databases for something as simple as the time a surgery starts (This is at a single institution). It is this way for many reasons, the most relevant of which is that there exists no tool today that addresses the concerns of those taking part in every element of the healthcare delivery process, and so we're left with each element picking their own favorite tool and gluing them together as best we can.

In this day and age we have more data than we know what to do with, and sadly even if we knew what to do with it (And many of us have some great ideas) an army of people would be required just to figure out where the data are at. My cry for help is probably not going to do much - we all know how confusing this system can be, even if we're not in the healthcare field - my hope is simply that all of you with this unique gift of being able to create amazing things with programming will at least give this huge problem a second thought.

If this problem were tackled you and your team will have helped millions of people receive superior healthcare delivery, and will have indirectly saved some lives in the process.




I associate with you!

At one of my last startups that I was employed at, I implemented a system that would provide one place for all types of lookups a front-desk person would want to have. This included integration with business searches for places like pharmacies etc., healthcare code systems like RVUs, LCDs, NCDs, NPIs, etc. with the end goal to save time to lookup - as well as cross-link similar data between these datasets. We gave the online access to this system for free in the hope that customers would buy our patient eligibility solution. Alas, after 5 years of constant living in the shadows of pre-established institutions (hospitals) the investors gave up fiscal support; the startup was no more.

Your cry for help can IMO be addressed by "think like a or even become a programmer", I say this because once you've programmed to solve your need, you can share your solution with others. I did not have this privilege in the healthcare space because of licensing restrictions that say AMA would impose.

For other HN readers (who knows some might be working at Dr Chrono or some such place), know that the healthcare system is rich with data lookups that mean a lot semantically. Yes you may not understand these independent data points, but there is immense value for the curators of these codes CMS, AMA and other health care agencies to defining the interfaces between them to simplify management.

Oh by the way.. USA is still on ICD-9-CM standard, whereas the rest of the world uses ICD10. I don't know when but from a governance standpoint, there's a hard date that all healthcare systems should honor ICD10 codes by that date.

So healthcare integrator's.. you may have a decent chance in this migration to assist with making improvements!

I'm not a business hacker, but really the disparity in 2012 in the healthcare scene exists because there isn't a business hack that can convince ceo's of health care institutions that profits can be made with a new way of thinking. I am observing and reporting what I have thus far witnessed first hand from the front-office and back office operations of some organizations that work in the healthcare industry.


It's a tough problem, but it's going to need more than just 3 engineers in a garage.

The type of project you're describing requires domain expertise - lots of domain expertise. It's not just about solving the problem from a technical standpoint, its about penetrating countless, complicated bureacracies with sales teams that have maneuvered that space before.

The reason that your software sucks is that the purchasing decision is not made by the person using the software. Facebook, Twitter, Google and the other great success stories of the digital age all counted on providing a great user experience to the end user in order to win their markets. But enterprise healthcare is not like that. Enterprise healthcare does not require great software, it requires great sales teams. The quality of the user experience is not a high priority to the either the company developing the software or the company buying the software.

It leads me to think that the way to penetrate this market is to get the individual patients more involved. An iPad app that allows you to chart your own medical history could make a lot of sense. If a nurse comes in to give you a short of morphine, and you put into your iPad that you're about to receive a shot of morphine, and the iPad screams because you just had a shot of morphine an hour ago, then that could be a way to solve a lot of problems in healthcare.

But, sadly, not your problem.


If you can actually get the potential users clamoring for your software, that can certainly make the sales team's job easier. It's a higher bar before you start even having an impact, though.


Can you provide some specific pain points ? Is it just the fact that there are several silo databases or records but there is no single centralized repository of EMR ? The question is: what is the incentive for a medical instituion to adopt such system ?





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