[PLUG] Open source and medical care (was Downturns ... )

Keith Lofstrom keithl at kl-ic.com
Wed Nov 26 18:16:36 UTC 2008


( note - this is about open source, but may need to move to plug-talk
anyway)

Keith Lofstrom wrote:
>If you wanted to do more open source in your newly expanded spare
>time, what would help you do so?

On Wed, Nov 26, 2008 at 01:55:25AM -0800, M. Edward (Ed) Borasky wrote:
> Low-cost health insurance. :)

You are onto something.  There is a great opportunity here.   How many
of you would be willing to trade coding labor for doctor labor?  How
many of you would be willing to re-educate yourselves,  replacing bad
health ideas with good ones, in return for helping doctors replace
bad I.T. ideas with good ones, and use automation and the Internet to
multiply medical effectiveness?

Start with the amazing (but true) idea that 90% of your health outcomes
are dependent on your own efforts, independent of medical procedures.  
There are some powerful interests that are infantilizing you, filling
you with fear (and junk food and physical passivity) while fostering an
unhealthy dependency on professional-provided services.  Kinda like the
way M$ and others spread the FUD that individuals can't do software,
only big companies can.  

In both cases, individuals are disempowered.  The solution in both cases
is individual re-empowerment.  Health care is easier.  It is easier to
learn good health habits than learn to write world class software.  It
is easier to help a sick friend than to de-virus a computer.  In most
cases, bad computer outcomes can be minimized through user training
and proper programming.  The same is true with health.

Doctors aren't completely unnecessary, but most of what they can do for
you is diagnostic ("stop worrying, it's XXX, and you will heal naturally
in a week or two") and patient training ("Twinkies are not health
food").  The latter is difficult - Hostess spends billions training us
to eat Twinkies - but we own the Internet, and we can use it for our
own training.  A lot of the training is outside the talent set of INTJ
borderline-Asperger technologists, but there are a lot of non-techies
available to help.  The really good news is that most of the solution
is informational, and we are really good at slinging information.

Let's talk specifics.  There are a lot of really bad clinical
infosystems - so bad that they kill people and drive clinics out of
business.  The coders that wrote them may mean well (or not), but they
arrogantly assume that 100+ years of medical practice developed by some
really smart and talented people can be replaced by a few fill-in forms,
and that the subject matter of medicine ( the incredibly complex human
body ) can be reduced to a few simple algorithms.  It's like expecting
to find the complete schematic of an Intel processor on a postit note.  

But not all infosystems are like that - the Veteran Administration's
"VistA" software is an example of a fairly successful evolving system
constructed on open source principles, a collaboration between doctors
and coders.  While there is a closed source fake derivative called
"Open Vista", the real open effort is "World VistA", which is being
developed mostly overseas (with a few coders in the US).  VistA is
written in the "M" language, and VistA needs to be re-written in more
commonly used languages.  VistA needs small clinic capabilities.  It
needs better HIPAA compliance.  It needs better patient communication. 
But it is a great start. 

Somebody is going to figure out how to exchange coding effort on World
VistA for doctor services.  In economic downturns, doctors struggle for
money, too.  Perhaps there are some open-source projects out there that
demonstrate a way to structure these exchanges, so that both doctors
and coders can help each other outside of institutions and without a
lot of money shuffling.

No, such exchanges won't pay for a pacemaker, but they might lead to
less need for pacemakers.  And if we can design and build open source
graphics cards, why not pacemakers, someday?

Most importantly, the entire medical process can be refocused on
teaching individuals to maintain their own health, make their own
informed decisions regards procedures, etc.  There is a huge
opportunity for open source software here, working in collaboration
with individual doctors and scientists (and educators and marketers
and exercise trainers and ... ) to build the software systems that
we can use to reprogram our mental systems and escape the cycle of
fear and helplessness that train us to damage ourselves.  That 
damage is only partially fixable by expensive medical procedures -
it is better to avoid it.

And guess what?  Developing these systems will make us excellently
prepared for great vocations in the future.  More importantly, it
will help free all people from dependence on employer/government
provided medical insurance, and from most of the diseases that we
fear, the fear which drives us to that dependence.  Competent and
expensive medical care will still be needed in some situations, but
open source software can help us make those situations a lot rarer.  

Saving your life, saving the world, and maybe getting rich.  Not
a bad way to spend your unemployed time.

Keith

-- 
Keith Lofstrom          keithl at keithl.com         Voice (503)-520-1993
KLIC --- Keith Lofstrom Integrated Circuits --- "Your Ideas in Silicon"
Design Contracting in Bipolar and CMOS - Analog, Digital, and Scan ICs



More information about the PLUG mailing list