True, which is why, according to the New York Times,
Barack Obama, the Democratic Party, and Priorities USA Action Super PAC raised $80 million more than Mitt Romney, the Republican Party, and Restore Our Future Super PAC(1). Though they also claim that Romney and his peeps spent about $7 million more.
Am I the only one who thought judith faulkner's quote was hillarious?
"Let’s say a patient is coming from U.C.L.A. and going to the University of Chicago, an Epic-to-Epic hospital. Boom. That’s easy"
Well no kidding! Your company wrote the software. Its like saying its easy to mix 2 packets of Grape Jello together to make a larger serving. Of course that will work! I would be slightly terrified if it wasn't possible. Plus, they wrote Epic Care Everywhere to exchange data between healthcare providers. Its part of the selling point of their software! "Buy us, we have half of 'Merica covered so you can exchange patient records like relz easy." (not an actual quote).
There are no enforceable standards and no governmental body has come together to figure out the standards for data transfer. I don't think its going to readily happen either. Currently, each company (the Epics, GEs, etc) will ALWAYS say that their product is the best and their standards should be the ones used. No one wants to give so they don't play nice with each other. They are leveraging the built in incompatibilities to make more money and there is nothing wrong with that. Plus, there are no economic reasons (like fines and quite frankly most patients don't need to go between large systems for care so there is no driving force from patients) to force them to play nice.
In this case, the free market can be the solution. In this fact, Judith Faulkner is wrong (and she is passing the buck). The government does not need to get involved and write standards. Especially if it is anything like the way the government has done other standards. If they did they would invite in the manufacturers to sit on a committee and each one would push and pull until the standard includes all of the features of their respective software systems. Before you know it, the standard is bloated, useless, and costly to implement. The solution is the free and open market. Some enterprising group of healthcare providers and practitioners, along with their IT teams, need to come together and form a group (away from the influence of the software manufacturers) to write the spec. They then need to form an alliance organization that calls on its members to require their systems to implement the group's specification. That way as a group (much like health insurance pooling) they have a large enough force to get manufacturers to listen to their needs. Because it costs millions to implement an EHR/EMR this path would not provide instant results for those who have already implemented a system or are in the process of implementing one. But as healthcare practitioners and providers upgrade to new versions they would gain the functions of their spec.
As someone who works in this field, there actually are government standards and working groups that involve all the vendors. I'm talking about in the U.S. - Europe has a much more varied ecosystem and standards appear harder to agree upon. In the U.S. the standard is the Consolidated Clinical Document Architecture (C-CDA)(http://www.healthit.gov/policy-researchers-implementers/cons...). The government body involved is the ONC (Office of the National Coordinator)(http://www.healthit.gov/newsroom/about-onc). The only problem at the moment is the finalization of the draft proposals and the vendor-specific interpretations of the standard. It's getting there but obviously the details are slow to work out.
Thats a good point. In the US the ONC/HIT at HHS has put out recommendations and rules for the schemas for data storage. Which is what the documents you reference are about they are about defining the building blocks used to store and capture health data. But, they do not define how they are transported or exchanged. The C-CDA even notes this, the "CDA DOES NOT specify how documents are transported, simply how critical data elements should be encoded for exchange and interoperability". Its the same thing for HL7 and all those great ICD9 and ICD10 codes. They are just building blocks not rules for transport. (I also know a thing or two about the field. We are magnetic buddies.)
First, the author makes the claim that the team was given the McDonalds for use for this particular mission but that, as far as I know, is false. They have had the space for some time while they were restoring lunar orbiter images.
Second, the team's/company's news updates show that they had to buy more equipment than an old radio, a mac laptop and some parts to fix a broken tv, specifically, a software defined radio (sdr).
The team bought the old McDonalds for use as a hackerspace, and also to prevent it from being torn down.
Their $159,602 crowdfunding on http://www.rockethub.com/42228 paid for necessary equipment and services, the most expensive being access to large radiotelescopes to transmit commands and receive telemetry.
I know they are doing this as a community service... because, I assume they feel it is their honor and duty to do so... but why the hell do these guys NOT have at least a donate link/button on their site!!!!! This is crazy. I know they are going to get awesome press which would have normally cost thousands but it never hurts to throw up a link and see how much your appreciated.
You'd donate to a business for the same reason you'd donate to an individual: to give resources to a cause that you support and to incentivize a direction of work.
You might be surprised to learn that the business world already has tons of donation buttons and trust networks. For accounting reasons they're often called contracts.
or you could just buy some of what they are selling... which is really the point, the public attention and goodwill created by giving this away, leads to sales and greater revenue than would be received if they just put a donate button up.
I've had sites with a fair amount of traffic, never received a donation, not ever, not even once. Much more effective to sell a sticker than to place a donate button. A friend of mine recently avoided my advice and replaced his twitter feed with a donate button, he said it was a horribly stupid mistake.
Maybe the legal/tax implications of a for-profit entity accepting donations outweigh the benefits? I really don't know; I'm just brainstorming possibilities.
Your chances of recovery from Malaria are far higher than recovering from Ebola. Malaria is more of a regional issue and does not necessarily have the ability to reach pandemic levels where Ebola, because of its communicability, does.
Edit: Though you are correct it is not necessarily something to be freaking-out over at the current moment. That said its a serious problem that we should not assume is benign. We should be working to contain it outside of the US.
I've heard consistently that ebola is incapable of becoming a pandemic in first world countries. This is because it lacks the resiliency to survive outside of the human body for long periods of time.
The problem is a virus have a nasty habit of evolving - just because all the past ebola strains have had a particular property does not mean that any new strain will behave in the same way.
There does seem to be something about the strain in this latest outbreak that is different to past outbreaks.
The odds of any particular mutation are small. The odds of any mutation are high. The odds of a meaningful mutation, somewhere between the two. The fact that we're seeing more spread than usual is already some evidence that this strain has some relevant mutation - though I don't know enough to quantify how much evidence.
No I don’t worry about AIDS becoming airbone, but when you look at the historical record of pandemics they are much more a problem than would appear of first glance. Pandemics that wipe out 1/3 to 1/2 the population and that appear out of nowhere are far too common over the last 2500 years for us to be complacent.
That would be the case if it were not for the fact that it is really good at surviving in the human body.... until the person is dead or until they have developed antibodies to fight it. Some people do survive Ebola (aka the plague or the black plague). But not many. Ebola spreads, and fast at that, in areas where there are high population densities, areas where people are in close contact (areas like NYC). Because of the symptoms, it is possible that someone may be infected, spreading the disease, but think they have the flu or some other common ailment. That is the reason why the hospital in the original article didn't take chances and put the person in involuntary quarantine (the article didn't say it but I can guarantee that is the case (and the patient may not know it because if you had Ebola you would have to be insane to decline care)). The only effective way to fight Ebola is quarantine. You section off an area, don't let anyone in or out, and wait out the sickness until it runs it course. After that you safely and securely destroy everything.
Plague refers to several types of bacterial infections. The Black Death is believed to involved bubonic plague because of the characteristic symptom described in all sorts of records:
I guess a hemorrhagic fever can't be ruled out though.
Ebola, in the form that requires fluid transfer, won't spread all that quickly in the U.S., where people aren't all that skeptical of doctors and tend to react to disease threats by avoiding touching things (as I understand it, burial practices involving touching the bodies are a significant source of infection in the current outbreak).
Update: Man Most likely does NOT have Ebola but they are still testing him/waiting for tests to come back.
"A New York City hospital is examining a sick patient who recently returned from a West African country where the deadly Ebola virus has been spreading, but authorities said it's unlikely that the man has Ebola."
The HN title is linkbaity (and editorialized). The original is better:
"Patients’ Symptoms Raise Concern About Ebola in New York"
Which is true, and still interesting. At this point, I wouldn't bet against the disease showing up in an international city, and it's nice to know the state of things.
It is much more likely than not that the patient has something much more common like malaria, but until they are certain the authorities will only say it is unlikely even if they are pretty sure he has ebola. To do so would just generate panic while doing very little to help track down all the people who recently came in contact with the patient.
The [NYC] Health Department issued this statement on the Mount Sinai patient suspected of Ebola: "After consultation with CDC and Mount Sinai, the [NYC] Health Department has concluded that the patient is unlikely to have Ebola. Specimens are being tested for common causes of illness and to definitively exclude Ebola."
Where in this article did it state that the experiment was unethical?
Only 2 people objected over what was essentially 2 different committees (with different people on those committees). Both committees approved two different, yet closely similar, plans. The person they quoted, who objected on the similar plan 2 years ago, seemed to object based on nothing but his feelings. In the article he stated, “We’re killing baby monkeys.” That is not anything near a reasoned, logical, scientifically backed statement on why their plan was unethical. Would it have been ethical if they proceeded with their plan, let it run its course for the year, then let the monkeys live until their natural deaths?
Sorry, I thought it was implied. Like an article about baby eating or something. If your argument is that you're a nihilist and don't value life (be it baby monkey or human) then that's something I can reason with, but if you're saying it's ethical to kill baby monkeys and not humans, re-read my post.
[edit] (1) http://elections.nytimes.com/2012/campaign-finance