Health Software Manifesto 1.0 (2012)

Your health records are scattered. They reside in various healthcare provider clinics, are separated by field of health, and are virtually inaccessible to you unless they are kept in a paper file at home. They are generally unavailable during times of emergency or when you need to relay your health history to a physician.

The average American past the age of retirement receives care from seven physicians within four separate organizations. Even if a clinic uses electronic health record (EHR) software it is unlikely that the data can be downloaded or transferred to another provider. Collation of health records is difficult when hundreds of companies, hospitals, and physician practices use proprietary, unconnected software. Our current systems are inoperable and incompatible with one another.

Disparate storage of health records prevents completeness of any one health record. There is no complete document anywhere, which means thorough analysis or processing of your health data is impossible. Even under CCR and HL7, the industry standards for health record formats, transferring records is nearly impossible. Diagnosis and feedback is slow and prone to error, with medical error leading to roughly 100,000 deaths in the US per year. In 2008, around 1.5 million were injured by just medication error alone, and these errors cost over $3.5 billion. The cost of all medical errors combined resulted in 6.3 million medical injuries and $19.5 billion.

Especially in the United States, the cost of healthcare is unsustainable. Politicians believe the answer lies in legislation. The older generation of EHR software developers and advocates believe the answer lies in making current systems more communicative, or formalizing a “better” health record format. The answer truly lies in the patients.

A compelling alternative to EHRs is a patient driven collation of health data, commonly known as personal health record (PHR) software. A PHR can log health data from prenatal stages until end of life. A record that is controlled and moved by the patient dodges problems caused by the multitude of fragmented EHR systems. Undoubtedly, better care will be provided to individuals whose health data is comprehensive and can be easily administered by themselves, parents, caregivers, or their network of doctors.

Consumers are already taking charge over their health data. Patients arrive at the doctor’s office prepared, having thoroughly consulted WebMD or Wikipedia for conditions they fear they have or treatments they think they need. According to Dr. Eric Topol of Scripps Research Institute, “Consumers are increasingly accessing health and medical information and progressively getting empowered.” Patients are beginning to desire better tools for keeping track of their health data.

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Staying-Up-Late Rules

Rule 1: If staying up past midnight, it must be work related

Rule 2: If staying up late to work on something, it must be something that cannot be put off until tomorrow

Rule 3: If staying up late to work on something that could be put off until tomorrow, but is more exciting to do now due to inspiration, that is OK

Hypothesis for future if  following these rules: Always stay up late

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A Declaration to Always Make Things Btter

After reading through Steve Blank’s “Why Facebook is Killing Silicon Valley”, I’ve finally decided to put into words some thoughts on what I want to do with my life. If you ask any of my friends what kind of dreams I have, they’ll probably tell you something about healthcare. If you talk to my mom, she’ll tell you I’ve had this dream since I was 16. United States healthcare is notoriously expensive and inefficient compared to other developed nations. This chart is very telling:

As a computer programmer and designer, the solutions that intuitively come to mind in terms of healthcare have to do with health records and databases. The great thing about being a computer programmer today is that there is huge variety in available tools, and most of those tools are very high quality. You can learn Ruby on Rails, and learn how to make a Twitter-clone from a free 12 chapter online PDF. You can buy a subscription to Unreal Engine 4 for $19 a month, which gives you access to  some of the best tools in the game industry. But as Steve Blank points out, a lot of time, energy and money is being spent towards quick-return, social media apps. Few web engineers tackle the bigger data issues or make solutions for academia or healthcare. Facebook has managed to organize social data of over a billion people. Let’s use these awesome tools and do the same for healthcare and education.

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Hello world!

This is my first post. Hello world!

What is Hello World and where does it come from? This is what Wikipedia has to say:

“Hello world” program is a computer program that outputs “Hello, world” on a display device. Because it is typically one of the simplest programs possible in most programming languages, it is by tradition often used to illustrate to beginners the most basic syntax of a programming language. It is also used to verify that a language or system is operating correctly.

In addition, hello world can be a useful sanity test to make sure that a language’s compilerdevelopment environment, and run-time environment are correctly installed. Configuring a complete programming toolchain from scratch to the point where even trivial programs can be compiled and run can involve substantial amounts of work. For this reason, a simple program is used first when testing a new tool chain.

The example program from that book prints “hello, world” (without capital letters or exclamation mark), and was inherited from a 1974 Bell Laboratories internal memorandum by Brian Kernighan,Programming in C: A Tutorial,[1] which contains the first known version.

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