This was from when I tried to “prove” to Steve that “you can’t just write stuff on scraps of paper.”
Basically, the conclusion of this conversation was (as Steve will attest), “your egghead airforce crap is all ‘lazers and shit,’ but here on the ground I have a wall of bodies here beating down the door and every dumbshit chuck-a-chuck two bits to an NPI is gunning down every open phone line to get me to sign something or read something and then refuses to pay me and meanwhile I have two infant children and people in the hospital, so get this fucking billing out. I can’t just type this into a computer, patients hate that, and I’m dying here.” But as you can see from previous posts, Steve and I have mutually made some progress.
Basically: I’ll trust you that this shit works… if you trust me to give me the shit that actually works now.
This was “why you can’t just throw a nurse at it.” There was another board where I showed that every staff member you add that isn’t a provider themselves adds overhead downstream of the actual event which accumulates exponentially per unit medical provided. The idea here was that it greatly mattered in medicine how easy it was to enter the data into the iPhone because there was an inflection point where technology just required too much attention and the doctor has to revert to paper, and that if you can’t reliably overcome that activation energy of attention, then all your computer systems are worthless.
Haha, this was from when I taught Steve binary; I think because he asked something about “why 128 ASCII characters?” or something like that, so I made him figure it out over the course of the day. This was also a bad day; I remember some real estate agent had tried to sell Steve a “great unfinished property in an upcoming neighborhood” in the cold rain, and over subsequent lunch with the agent at Greenwich Hospital, I told the agent to his face that his property was a “knock down piece of shit” and then listed the construction and neighborhood flaws I had noticed, and then I scolded him for wasting my time. So this hotshot thirty something blueshirt is sitting there while some kid in a t-shirt deconstructs his entire psyche over salads. This agent now tries to avoid me —for some reason— when he tries to pitch Steve other real estate opportunities.
My goal is to build a “solid state” medical office. The idea is that if everything in “one unit doctor” can be represented by a graph of [web addresses] (emails, HTTP requests, ICD, CPT, and medical keyword addressing), and that this “one unit doctor” itself operates at a profit independently, that one could then continue to add doctors to the system without incurring the overhead which currently keeps medicine local while “solving medicine” as we currently know it via graph analysis.
This is hard to do in practice.
I’m posting some of my ideas because frankly: I need more help because I’m tapped on activation energy running both the office and my personal life which, as a preview, here’s how I spent today:
- Woke up in a hotel to “engineering” demanding to know from behind me door if “my floor is damp.” Why am I in a hotel? Yes. Is my floor damp? Not that I noticed, but considering that yesterday the problem was “the fire alarms keep going off because ‘they’re drawing too much power in the conference room’, this was an improvement. I bet you that this hotel costs more per day than a mortgage for a house.
- Waited for an hour to get expensive salad. Tried to connect to Internet.
- Waited for an hour to get a car pickup.
- While in the hotel lobby waiting for said car, had to track down the contact information for a patient on my iPhone internet, call several times from three different phones while in the hotel lobby trying to get past the patient’s family’s screen of “telephone calls are always solicitors and debit collectors”, and inform irate “member of the family who handles persistant phone calls” that the patient had an INR of [GO TO THE EMERGENCY ROOM, NOW] to “GO TO THE EMERGENCY ROOM, NOW.”
- Car took me to other side of town to car rental agency, car agency refused to rent me a car without a credit card because a debit card is not acceptable by “Connecticut law?” The girl at the desk at this dank car depot wanted me to produce paystubs and home utility bills “like, from the Internet or something.” I told her no. Car drove me back to hotel.
- Called another car, $20 cab ride to office; it is now 3pm.
- Started doing work, but then an elderly patient wandered into the office because I forgot to lock the door and I scheduled an appointment for her and talked with her about “life.”
- Locked door.
- Wrote these posts.
So yah, could use a little help… and unless you’re into the unemployed-if-not-now-then-soon mortgage derivative finance blueshirt scene… not really much of a culture here in Connecticut that doesn’t make you want to go all Tyler Durtin all the time.
In software, I’m currently writing authenticated robots to navigate insurer websites for Google App Engine. (I’ll share my code so far at Google I/O for anybody into Python Google App Engine.) This is hard because insurance is not in the business of telling you how to bill them for money. Also, this is hard because of the organic profitability of incompetence and a culture of “typing is for secretaries.” This is also hard because I can’t effectively do data entry and write software to do the data entry at the same time from the back of a cab.
- Lecture 9: Human Genetics | Video Lectures | Introduction ... - April 20th, 2016
- Human Physiology/Genetics and inheritance - Wikibooks ... - April 20th, 2016
- Iowa Institute of Human Genetics :: University of Iowa ... - April 20th, 2016
- Myths of Human Genetics: Earlobes - April 20th, 2016
- Contact Us - Welcome to the Department of Genetics at ... - March 7th, 2016
- Genetics Conferences | Human Genetics Conferences | Europe ... - March 6th, 2016
- Genetics - Rutgers New Jersey Medical School - February 25th, 2016
- The Human Genetics Project - February 19th, 2016
- Human Genetics Association Of Nj Inc - NonProfitFacts.com - January 26th, 2016
- Human Genetics - University of Illinois at Chicago - December 28th, 2015
- New Jersey Biology Tutoring: Top-Rated Biology Tutors - December 22nd, 2015
- Home Institute for Human Genetics at UCSF - November 3rd, 2015
- Recent Articles | Human Genetics | The Scientist Magazine - October 24th, 2015
- Human Genetics Graduate Programs | Pitt Public Health - October 7th, 2015
- European Journal of Human Genetics - September 29th, 2015
- Genetics - Smithsonian's Human Origins Program - September 24th, 2015
- Human Genetics Alert - Technologies which may contribute ... - August 24th, 2015
- HOME - deCODE genetics - August 19th, 2015
- European Society of Human Genetics: Home - August 8th, 2015
- UCLA Human Genetics - July 15th, 2015
- Program Information | Johns Hopkins - Institute of Genetic ... - July 15th, 2015
- human genetics | biology | Britannica.com - July 8th, 2015
- Department of Human Genetics | University of Chicago - July 8th, 2015
- Human Genetics Association of NJ - hganj-1 - May 17th, 2015
- 01:447:481 Topics in Human Genetics - Rutgers University - May 8th, 2015
- Oldest Neanderthal DNA - April 14th, 2015
- The genetics of psychiatric disorders - April 14th, 2015
- Color Blindness - Human Genetics Assignment - Video - April 13th, 2015
- Eisai and Genomics plc to Collaborate in Analyses of Large-Scale Genotype/Phenotype Data to Inform Drug Development - April 13th, 2015
- Nine early career researchers awarded for research presented at fruit fly conference - April 11th, 2015
- Human Stem Cells Shape a New Approach to Autism Research (Op-Ed) - April 11th, 2015
- Oldest Neanderthal DNA Found in Italian Skeleton - April 11th, 2015
- Interleukin Genetics Appoints Mark B. Carbeau as CEO - April 7th, 2015
- High Throughput ChIP Sequencing - April 6th, 2015
- HGANJ_genetic_services_directory - April 6th, 2015
- On who we are genetically and how we define ourselves | Florin Stanciu | TEDxBucharest - Video - April 5th, 2015
- AncestryDNA: New Ancestor Discoveries - Video - April 5th, 2015
- Apewoman who could outrun a horse was 'not human', according to DNA tests - April 5th, 2015
- American College of Medical Genetics and Genomics Announces New Board Members: Dr. Louanne Hudgins is ACMG President ... - April 2nd, 2015
- First human studies promising for made-in-Canada Ebola vaccine - April 2nd, 2015
- Study finds new genetic clues to pediatric seizure disorders - April 2nd, 2015
- Broad, Bayer expand partnership to develop therapies for cardiovascular disease - March 31st, 2015
- 2,636 Icelandic genomes pinpoint risk for Alzheimers, other diseases - March 31st, 2015
- Learning from Traditional Societies - Video - March 30th, 2015
- The Human Genetics Association of New Jersey (HGANJ) - March 28th, 2015
- Amgen Sequences Iceland's Genome - March 27th, 2015
- Position statement on promise, challenges of non-invasive prenatal testing - March 27th, 2015
- What if the severity of our seasonal influenza were related to our genetic background? - March 27th, 2015
- Human Genetics Lab Part 3 Vid - Video - March 26th, 2015
- ASHG and ESHG issue position statement on non-invasive prenatal screening - March 26th, 2015
- Icelandic genome offers clues to human diversity, gene-disease links - March 26th, 2015
- Position statement on non-invasive prenatal screening issued - March 26th, 2015
- Landmark DNA study in Iceland reveals new insights into evolution and disease - March 26th, 2015
- Human Genetics Lab Part 4 Vid - Video - March 25th, 2015
- Human Genetics Lab Part 1 Vid - Video - March 25th, 2015
- Human Genetics Lab Part 2 Vid - Video - March 25th, 2015
- Asuragen to Present Innovations in Fragile X Testing at Upcoming American College of Medical Genetics and Genomics ... - March 25th, 2015
- Researchers find link between genetic variation and alcohol dependence - March 25th, 2015
- Dr. Luria, Mori and Robak receive Pfizer/ACMG Foundation Translational Genomic Fellowship Award - March 25th, 2015
- Medical Fish Skin Company Kerecis Receives Annual Innovation Through Knowledge Award From President of Iceland - March 24th, 2015
- chemagic 360 - High Quality DNA/RNA Isolation - Video - March 22nd, 2015
- Quei "21 Pensieri" sulla Giornata per i Down - March 22nd, 2015
- Chromosome shattering may be a hidden cause of birth defects - March 19th, 2015
- Victor McKusick (Human Genetics) - Video - March 18th, 2015
- Study: Wealth and power key to men's genetic success - March 18th, 2015
- Janet Rowley (Cancer Genetics) - Video - March 18th, 2015
- JKH partners Colombo Unis HGU to sequence rice variety genome - March 18th, 2015
- Human Anatomy (Award Winning) Home Study Course - Video - March 15th, 2015
- Heres How 23andMe Hopes to Make Drugs From Your Spit Samples - March 14th, 2015
- Genetics company plans research unit - March 13th, 2015
- Peter Donnelly PMWC 2015 UK (April 15-17) Introduction - http://2015uk.pmwcintl.com - Video - March 10th, 2015
- Sewage testing can predict obesity rates - March 10th, 2015
- New genetic syndrome found, tied to errors in 'master switch' during early development - March 9th, 2015
- ASHG and ReachMD launch educational series on genetics and genomics - March 8th, 2015
- Our Taste for Alcohol Goes Back Millions of Years - March 8th, 2015
- "Big Brain" Gene Allowed for Evolutionary Expansion of Human Neocortex - March 8th, 2015
- Yale researchers map 'switches' that shaped the evolution of the human brain - March 8th, 2015
- Adams Keegan Launches New Recruiting Division - March 6th, 2015
- Welcome and Introduction - Treating Disease with Sugars - Video - March 5th, 2015
- Scientist in Human Genetics to Skin Care Guru: A Beautiful Journey - March 5th, 2015