[PLUG-TALK] About the medical software you see in your physician's office

Keith Lofstrom keithl at kl-ic.com
Sun Dec 23 14:27:16 PST 2018


On Sun, Dec 23, 2018 at 07:28:08AM -0800, John Jason Jordan wrote:
> If there needs to be interoperability but the commercial entities
> involved refuse to create same, then you need to force them to do so,
> i.e., laws. 

Laws are the problem, "solutions" imposed by self-anointed
busybodies on the harried and overworked doctors and rare-
but-responsible software professionals trying to manage 
this mess.

There is NOTHING stopping the professionals reading this 
from contributing their volunteer expertise and labor to
helping Legacy and Providence connect their systems.  The
system may suck, but lazy selfish programmers suck worse.

A larger issue is that the two systems have staffs with
different needs and approaches to medicine.  Creating
interoperable superset data representations, and sharing
the techniques for doing so (RATHER THAN imposing one-
size-fits-all "standards"), will foster innovation rather
than permanent stagnation. 

Medicine is advancing rapidly, and many of us (including
John) would be dead if advances were halted two decades
ago by a frozen interface and data description.  Right
now today, the federal government is trying to enforce the
ICD-10 coding and billing system, with a precise number
designated for every malady and medical treatment. 

Imagine the federal government coming up with a similar
coding system to specify computer programs.  Or sentences.
Or books, inventions, artworks, musical compositions ...

The imposition of uniform metrics simplifies bureaucracy,
because it blinds us to the exceptional.  No wonder robot
diagnosis scores so well in artificial competition.  In
real life, what doctors need is time to listen and time
to ponder.  What the patient says (especially if it is
misguided) is the pathway to collaborative healing. 
Patients do not speak in ICD-10 codes.

People are creative.  Doctors encountering surprising
patient problems are among the most creative.  Indeed,
before the federalization of medical discovery and the
litigious punishment of creative exploration, individual
doctors discovered 90% of the medical advances we rely
on today.  Bureaucracy is the antithesis of creativity.

Keith

-- 
Keith Lofstrom          keithl at keithl.com


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