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Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @02:07PM (#17108975)
Nothing we lose nothing. It's so frustrating...people LOVE to drum up fear about technology. But technology is an enhancer! It doesn't prevent anyone from doing anything they did before. If you want to use a horse and cart go for it. If you want to use a old fashioned rolodex instead of Facebook go for it. Use the tech or don't. The problem is people resist change even if it's for the objective scientifically proven better.
Re:What we lose with data-driven medicine by cassowary37 on Saturday May 19, 2018 @02:15PM (#17109017)
sorry, but this exhibits a complete disregard for (or lack of understanding of) the practice of medicine. Many of us love technology - some of us even read hn. But physicians have very little choice regarding use of this kind of technology, other than to leave medicine or go into private practice where we only take care of wealthy people. And re EHR in particular: is this technology an enhancer as you claim? Because it sure isn't reflected in any objective measures of clinical outcomes.
Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @04:29PM (#17109595)
I can't even fathom how EHR is not better for patients.

Having a patients entire history at your fingertips collected through their lifetime.

Being able to apply machine learning to their symptoms to find possible obscure issues

Being able to combine data from populations to find new symptoms for illnesses

Being able to identify outbreaks alot faster

Better ability to analyize complex data to prevent drug interaction

And so many more.

No I think primary care and internal medicine physicians are threatened by technology and are resisting it, because 95% of what their job consists of is exactly what computers are really really good at, crunching data to find statistically likely outcomes.

Tech is going to do to medicine what is already happening in Law. Put 90% of physicians out of business by making the few employed physicians infinitely more productive.

In a 20 years we're going to view having a physician diagnose you as primitive as having a physician bleed you with leeches.

Re:What we lose with data-driven medicine by danielh96 on Sunday May 20, 2018 @12:01PM (#17113333)
Those things aren't being done with the EHR data, at least in the real world yet. Those benefits aren't being realised yet (which is far more likely due to regulation of the data rather than EHR uptake). To doctors, an EHR is just a replacement for paper with a clunky, hard to use interface. It's hard to beat the flexibility of paper.

From what I've seen from EHRs and other related software, they're absolute garbage to use. I wouldn't want to use one either.

Re:What we lose with data-driven medicine by epmaybe on Saturday May 19, 2018 @02:19PM (#17109031)
I agree, but what if the ideal for EHR just hasn't been realized yet? Regulation or not, there must be ways to improve. We probably don't see those innovations because most hospitals stick to the juggernauts such as Epic for their software.
Re:What we lose with data-driven medicine by nicodjimenez on Saturday May 19, 2018 @02:26PM (#17109055)
You poor thing, it must be really hard having so much job security and such inflated salaries, due to artificial constraints on the supply of doctors by the medical mafia. You're not going to get a ton of sympathy here on HN, where your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper.
Re:What we lose with data-driven medicine by dang on Sunday May 20, 2018 @12:48AM (#17111281)
It's not ok to attack a fellow user like this on HN, and we ban accounts that do it, so please read https://news.ycombinator.com/newsguidelines.html and follow the rules from now on. That means posting civilly and substantively, or not at all.
Re:What we lose with data-driven medicine by econochoice on Saturday May 19, 2018 @03:36PM (#17109362)
> your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper.

Anyone that works to eat is in the same boat.

Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @04:31PM (#17109601)
Exactly and it will remove the artificial physician monopoly and put them in the same boat with the rest of the world
Re:What we lose with data-driven medicine by himom on Saturday May 19, 2018 @03:50PM (#17109424)
Yup. The article presents a luddite’s false dichotomy. Evidenced-based medicine and critical-thinking skills are complementary. Moreover, I’d prefer automation and optimization of as much of the repetitious work as possible... checking drug interactions, CADx comprehensive differential diagnonsis symptoms listing, CADe in radiology as a second-opinion and more.

It is also annoying when professional “priests” commit what amounts to claiming only they have the mystical gifts to interpret what aren’t “tea leaves,” when it’s usually done out of fears of job security, special power and/or change of a legally-protected professional class.

Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @04:51PM (#17109668)
Exactly. Medicine is taking a set of data (symptoms) about an ill patient and determining the statistically likely problem.

It's a basic data analysis which is exactly what computers are good at.

No Tea Leaves involved.

This whole pushback by physicians is about status, jobs, wealth, etc.

In a 20 years we're going to view having a physician diagnose you as primitive as having a physician perform bloodletting or trepanation on you.

Re:What we lose with data-driven medicine by xapata on Saturday May 19, 2018 @03:47PM (#17109410)
Requiring technology means requiring capital investment, which means few solo practitioners (already happened) and practices controlled by massive bureaucracies.

This has benefits and costs.

Re:What we lose with data-driven medicine by mr_toad on Saturday May 19, 2018 @10:37PM (#17110879)
Free and Open source software has existed in the medical sector for decades. E.g:

https://en.m.wikipedia.org/wiki/VistA

https://www.open-emr.org

FOSS software suffers from the same problems gaining a foothold in healthcare as it does in most sectors - namely a lack of money to spend on sales, and a malaise of FUD.

Re:What we lose with data-driven medicine by xapata on Sunday May 20, 2018 @01:20AM (#17111370)
That's some of the issue. Also probably some usability and integration problems. Zocdoc tells some good stories about how hard integration with medical software is.
Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @04:45PM (#17109640)
I use the same technology for my personal projects (AWS, Rails, C#) that my company does for it's enterprise projects.

My social worker friend already uses a SaaS for his billing and patient management.

I think technology will massively enable solo practitioners.

Re:What we lose with data-driven medicine by xapata on Saturday May 19, 2018 @06:35PM (#17110094)
Ask a medical doctor or dentist how much they pay for the various technology they use in their office. Even electronic medical records, as useful as they are, will have some negative effects for patients via the economics of medicine. EMRs are net positive, of course.

Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow.

Re:What we lose with data-driven medicine by nickthemagicman on Saturday May 19, 2018 @10:23PM (#17110831)
I don't trust physicians or dentists opinions on this subject, because they have a vested interest in preventing technology from disrupting their field.

Its better to be the oracle with the Tea Leaves garnering the accompanying salaries and status.

>> Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow.

You're right it's today. There's a bunch of HIPPA compliant, reasonably priced SaaS's available to do just this. Google it.

The obstacle lies in getting medical professionals to give their status, cush jobs, and money over to a machine for the betterment of patients and the field, which is going to be a hard won battle.

I for one can't wait until a nurse with good beside manner takes my samples and symptoms, sends them to a lab/records them in an EHR, and a machine with zettabytes of data and years of machine learning diagnosis me with more accuracy than a human ever could imagine.

Re:What we lose with data-driven medicine by xapata on Sunday May 20, 2018 @01:39AM (#17111418)
> I don't trust physicians or dentists opinions on this subject, because they have a vested interest in preventing technology from disrupting their field.

You don't need to trust, but only use a little logic. Would a doctor prefer to reduce expenses and increase profits? Of course there's some interest in preserving status quo, but as that "Cult of the Root Cause" [0] article pointed out, there can be many system dynamics working simultaneously.

[0] https://news.ycombinator.com/item?id=17109114

Re:What we lose with data-driven medicine by nickthemagicman on Monday May 21, 2018 @04:49PM (#17121714)
I agree they would prefer to reduce expenses and increase profits however that's not what the long term outcome of medical automation is going to do. It's going to put them out of business.
Re:What we lose with data-driven medicine by xapata on Tuesday May 22, 2018 @01:13AM (#17123870)
Exactly, enabling the market to be controlled by a handful of large corporations, which has some negative consequences for patients (in addition to the benefits of technology).

Just consider all the conversations people have about Google. Life is just so much better with Google Search and YouTube -- learning things is so easy now. Yet, there are some nagging doubts about what we gave up to have that access to information.

Re:What we lose with data-driven medicine by nickthemagicman on Thursday May 24, 2018 @09:59AM (#17144012)
It could go numerous ways. It could be centralized, it could be a bunch of contractors working for a large corporation like uber health, or technology could do what it did for the record industry and enable the small provider.
Re:What we lose with data-driven medicine by Para2016 on Saturday May 19, 2018 @02:24PM (#17109050)
I'm curious, what examples did you see in the article that were indications we were "losing nothing"?