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lbhnact

234 karma · joined February 21, 2015

Data enthusiast trying to get medical data more standardized and interpretable. MD, MPH. dlevinbrown.com
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lbhnact··on RC1 ArangoDB 3.4 – What’s new?
I can't speak for all graph stores, but in addition to ADB being json-native as described below, many graph users describe the types of any value, not just floats or ints, as a relation or property to the value itself.

So you'd never have any value; object, key, value of a string, int, float, or reference, without associated meta-data typing it elsewhere in the graph, and would be unlikely to operate on that data without making reference to those properties.

lbhnact··on RC1 ArangoDB 3.4 – What’s new?
Love each of the new releases. Would appreciate hearing any stories of performance implications with the 'Distributed COLLECT' improvements.
lbhnact··on Wading Through AccuWeather’s Response
weather.gov/5digitzip will take you straight to what you want and is just about as easy as an app for most folks.

Using well-designed government services feels like a good habit these days.

Try it on your desktop or mobile browser, easy as pie: http://weather.gov/10018

lbhnact··on I Bought a Book About the Internet from 1994 and None of the Links Worked
If you want to go all the way back, UNC still hosts ibiblio.org, which has links to the first website at CERN http://info.cern.ch/ and TBL's first page.
lbhnact··on Launch HN: 70MillionJobs (YC S17) – Job board for people with criminal records
Just want to add support. One of my childhood friends has a felony from when he was an overly-rambunctious teenager that he still gets punished for - including being kicked off AirBnB - for something he stole more than 20 years ago. Despite this, he's a very successful leader in mental health services management.

So many people deserve a chance to redeem themselves from being 'branded', yet are denied the exact opportunities that would allow them to do so. This problem goes back a long, long ways.[1]

Anything you can do to help is great. Best of luck!

[1] https://en.wikipedia.org/wiki/Branded_Man

lbhnact··on Some doctors think EHRs are hurting their relationships with patients
>>It's just new to physicians, or something they didn't think they'd have to deal with.

Bingo.

lbhnact··on Some doctors think EHRs are hurting their relationships with patients
FHIR is probably the best we are going to do for a long while to come.

If you're ever interested in learning more, my company builds the national reference implementation of SMART on FHIR for the Harvard DBMI, in support of the NIH 'Sync For Science' Pilot - happy to talk all about FHIR and data exchange standards!

The participating vendors will be launching pilots this year and things are proceeding well. If we can give them some positive attention for it, maybe we'll see some progress. I sure hope so!

[]https://www.healthit.gov/buzz-blog/health-innovation/nih-and...

lbhnact··on Some doctors think EHRs are hurting their relationships with patients
Without bickering over MU requirements, you'd probably note that MU has been almost entirely ineffective at solving actual care problems with data exchange.

Of 50 state exchanges, most have collapsed, with only occasional use of the ad-hoc implementations and networks that remain. And people dying everyday while vendors like ECW get wrist-slaps for lying to CMS about their MU compliance.

-http://www.healthcareitnews.com/news/eclinicalworks-pay-155-...

lbhnact··on Some doctors think EHRs are hurting their relationships with patients
No they were not. The quote, by David Blumenthal who designed the HITECH legistlation said this:

"Before you can create interoperability, you have to create operability"[1]

I'll leave it to you to decide whether this was a wise philosophy to underpin a major national IT project.

[1]http://www.healthcareitnews.com/news/blumenthal-look-stage-1...

lbhnact··on Some doctors think EHRs are hurting their relationships with patients
Just-graduated MD/MPH and former EMT and ED admin here. I empathize strongly, since the first time I watched a 16-year girl who'd been in a MVC and first transported to Duke, who needed sub-specialty consults at UNC get re-scanned.

I'd read about CT dosing and realized that we had just increased this girls lifetime likelihood of ovarian or endometrial cancer by perhaps about 1/1000. For absolutely no reason other than the fact we couldn't get the images 8 miles down the road from the Duke ED, and the attending wanted to 'just be sure'.

I asked the resident why they couldn't send them digitally and they just laughed. That was 2009.

It's 8 years and a few hundred billion of national EMR spend later - and you know what? We still can't send an image between the two EDs. UNC and Duke were the first two nodes/servers on Usenet back in 1980[1], and 37 years later we can barely exchange medical data using our combined 1.3 billion dollars of Epic EMR implementations.

This problem harms people needlessly every day. Please use your voice as a provider to remind people whenever possible.

[1]https://en.wikipedia.org/wiki/Usenet

lbhnact··on ArangoDB 3.2 GA RocksDB, Pregel, Fault-Tolerant Foxx and Satellite Collections
The new release looks packed full of features - especially excited about Keylines and encryption.

FYI, a minor copy edit suggestion: "HIPPA", should be "HIPAA".

-https://en.wikipedia.org/wiki/Health_Insurance_Portability_a...

lbhnact··on Study finds Lumosity users show no improvements in cognitive performance
Yeah, it's interesting. We have decades of research into standardized tests in the academic setting, and yet most people generally feel that these metrics have very limited utility.

The notion that a startup has A: deep insights into the nature of cognitive function that others do not; and B: devised and tested a paradigm that sustainably improves it, was always a little shocking to see claimed.

lbhnact··on Apple Watch can detect arrhythmia with 97% accuracy, study says
Hi Brandon-

I can't find good tables in the article or on your teams site. [edited]

I know you guys take your numbers seriously but I'd love to see anything allowed out pre-publication.

[edit]Thanks to poster below I see this is AUC. Thanks!

lbhnact··on Louisiana’s Governor Declares State Of Emergency Over Disappearing Coastline
While the ACOE has a complicated role in all this, they must serve many competing interests. The State of Louisiana, the needs of the maritime industry, oil and gas interests, and the federal government that allows the situation to continue, because of the temporary economic benefits we all reap from inaction.

An incredible overview of the problem was written 20 years ago by John McPhee[1], as part of his book "The Control of Nature". Unfortunately, solving the problem in the long term means essentially undermining the entire economy of South Louisiana, and leaving the City of New Orleans destitute.

I served in Baton Rouge for 3 years and spent a lot of time on the Mississippi River. It's an extraordinary resource that much of America silently takes for granted. I with there were better solutions to save it and protect the people of Louisiana, but I don't feel like I have better answers to these questions that anyone else. It's a tough situation.

[1]: http://www.newyorker.com/magazine/1987/02/23/atchafalaya

lbhnact··on What city is the microbrew capital of the US?
Probably. Their RateBeer data indicates only 12 breweries, which seems like it's off by 2-4 fold? There must be at least 30 places within city limits, no? Maybe another 20 or so within 5-10 miles?

They also don't note the brands with East Coast production there like, say, Sierra Nevada and Oscar Blues, which would be hard to argue don't count as breweries.

Anyway, Santa Rosa is so small, it could really be the winner. But per capita, it would be hard to imagine anywhere else besides Asheville would be the spot.

lbhnact··on RightHand robotics has automated a new type of warehouse work
Yeah. I worked next to these guys in the Harvard iLab when they were getting going. They had the opportunity to cut corners and cash out early on, but seemed to remain focused on building a truly robust, broadly capable picker.

I often noted with them at the time similar notions of the implications for the job market. There's so much hype out there, but I think RHR will be one of the companies that actually illustrates to the public where things are headed.

lbhnact··on The Mumps Programming Language
Interesting. What 'modules' are they going to push webtech to? Within the general UI or as subcomponents like the 2015 search add-in?
lbhnact··on Programmers should not call themselves engineers (2015)
>I don't think anyone died as a result of a lack of proper collaboration and regulation in software development.

Come work in healthcare, you may change your mind.

In healthcare, a lack of domain expertise, rigor, collaboration, and regulation kills people every day. And inhibits our science. And is the root cause of billions a week in waste.

Yes, most web content and it's delivery we could do well, or be better off, without. But in many jobs, the software constrains or enables behaviors that have real consequences.

lbhnact··on Ask HN: Where is AI/ML actually adding value at your company?
I know a few companies riding the ml/nn train. Any chance you are based in NYC?
lbhnact··on Show HN: Get Well Soon – AI-based online diagnosis
"If anything, there should be law outlawing websites like this."

There is, don't worry. This would be 'Standalone Software' that is labeled as:

"intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals"

So, by claiming to be a Medical Device, it's regulated. And since it seems to be a pretty lousy, unapproved, medical device, it's actually illegal.

Maybe when Theranos.com comes available, these guys could try to snag it though!

[1]http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidanc...

lbhnact··on Show HN: Get Well Soon – AI-based online diagnosis
This site demonstrates quite efficiently why it's plainly illegal to advertise the claims that it makes in the headline.
lbhnact··on The mathematics of science’s broken reward system
Yeah, maybe 'Quantitative Epistemology'. You'd probably be thrown right out of the Philosophy department though.
lbhnact··on The mathematics of science’s broken reward system
I've always wanted a good word for the 'science of studying science'.

Never really got past 'Scientology', and that probably won't stick.

What's a better term than the vapid 'Metascience', or the clunky 'scientometrics'.

How about 'Superscience'? That would be an awesome Doctorate to hang on the wall.

lbhnact··on Ways Data Projects Fail
>anybody hiring in C̶h̶i̶c̶a̶g̶o̶? New York.

always looking to meet smart people!

lbhnact··on YC Changes
can always count on a zinger from idlewords :)
lbhnact··on Poor and Uninsured in Texas
It's frustrating to a lot of us. We are a big country made of states that have a degree of autonomy often surprising to outside observers. The result is surges of progress, and pockets of injustice, all over.

And even in other states that didn’t adopt the expansion, like North Carolina and Missouri, patients like Oregón still have hope of a transplant in a life-or-death situation. That’s because these states allow for a “medically needy” pathway, or a “spend-down” program, whereby patients can meet the Medicaid limit by deducting certain items, including unpaid medical bills, from their income.

In NC at least, these mostly happen not because of the spend-down rule. They happen because we have a public university, with a public hospital, that is supported through the state by the public to provide care for the poor.

lbhnact··on The Limited Role of Utility Calculations in Moral Judgment
What words would you use to tell your friends and family about why someone shouldn't stick a gun in your face and take anything they want?

And if the complicated and often contradictory paths through considerations of ethics are 'annoying' to you, why? Are they 'wrong' on some moral plane that 'doesn't exist?'.

Ethics, life, and why we are all here is hard stuff. But if you think there's no point, then please don't vote in the rest of our elections this fall!

lbhnact··on Machine Learning and Ketosis
We are working with a few groups to make this sort of this possible. Feel free to reach out if you are interested.
lbhnact··on PatientBank (YC S16) Is Creating a Unified Medical Record System
Yes exactly. Like the answer to pretty much every question about data, a treatment, a test, etc - the answer is, "Well, it depends on the problem".
lbhnact··on PatientBank (YC S16) Is Creating a Unified Medical Record System
Is there anyone trying to compete with the giants in healthcare to make sure there is clean data to pull from in the first place?

We are. :)

I empathize with your problem with CCD/HL7v2 as much as you can imagine; which is why we support FHIR infrastructure across a number of use-cases. Feel free to reach out, I always enjoy chatting with people experienced in the space.

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