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Cocoa Crispies posted:"i don't need a union, i'm a _-~* doctor *~-_ given the power over life and death themselves" doctors have a union and medical residency is how they keep people out
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Oct 26, 2015 15:13
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ayn rand hand job posted:im not sure if you are aware but there are about 3 regions to the east coast lol everyone is so jealous of Touchdown Tom
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Oct 26, 2015 15:14
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also one of the primary reasons for the long shifts is poor record keeping. if a doc left mid treatment the next doc coming in would probably be missing like 50% of the information they need to treat the patient.
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Oct 26, 2015 15:18
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BeOSPOS posted:are you trying to differentiate between the east coast and New England? there's people who like to pretend "east coast" only refers to the tri-state area and maybe down to dc if they're feeling generous.
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Oct 26, 2015 15:20
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Shaggar posted:also one of the primary reasons for the long shifts is poor record keeping. if a doc left mid treatment the next doc coming in would probably be missing like 50% of the information they need to treat the patient. i'm not sure how "it takes a while to figure out what's going on" translates to "you are assigned to work 28 hours today" but okay sure
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Oct 26, 2015 15:23
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Endless Mike posted:there's people who like to pretend "east coast" only refers to the tri-state area and maybe down to dc if they're feeling generous. those people are real dumb
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Oct 26, 2015 15:26
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if you think about it its really all just one big coast man 
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Oct 26, 2015 15:28
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long shifts maintain the same doc on the same patient for as long as possible to reduce the number of handoffs and thus reduce the amount of data lost. if you switched to 8 hour shifts a patient staying for 24 hours would have 3 different docs and 2 chances for data loss. if they had better record keeping it wouldn't be a problem and they could go to 8 hour shifts without risks to patient care.
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Oct 26, 2015 15:28
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Shaggar posted:lol everyone is so jealous of Touchdown Tom Nintendo Kid posted:those people are real dumb shaggar and fishmech both right!!
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Oct 26, 2015 15:29
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Shaggar posted:also one of the primary reasons for the long shifts is poor record keeping. if a doc left mid treatment the next doc coming in would probably be missing like 50% of the information they need to treat the patient. handoff is by far the biggest source of medical error. you would think fatigue would play a larger role in doctors loving up, but many studies have borne out that this isn't the case
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Oct 26, 2015 15:29
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ask me about the hospital that wanted our help in monitoring their critical lab values in order to lower their existing 30% delivery failure rate.
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Oct 26, 2015 15:30
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critical lab values being the subset of all lab results that returned a critical value that affects treatment and delivery failure meaning that the critical value wasn't delivered to a treating physician before the patient was discharged.
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Oct 26, 2015 15:32
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Shaggar posted:long shifts maintain the same doc on the same patient for as long as possible to reduce the number of handoffs and thus reduce the amount of data lost. if you switched to 8 hour shifts a patient staying for 24 hours would have 3 different docs and 2 chances for data loss. software in the medical field is almost universally terrible due mostly to the barriers to entry and how they're sourced, billed. If you go to a modern hospital, even an excellent one they're still going to be doing things like running some tests on win 98 machines and charging at least a few hundred for the privilege. Someone should fix that, it'd be a good way to make money but it'd be boring. It would be sweet if hospitals had modern systems and doctors with nice tablets and apps, but in a lot of cases they're working with really poor digital tools and paper records.
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Oct 26, 2015 15:33
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tl;dr: hospitals are terribly run and providers are the only source of all cost problems in healthcare.
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Oct 26, 2015 15:34
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Broken Machine posted:software in the medical field is almost universally terrible due mostly to the barriers to entry and how they're sourced, billed. If you go to a modern hospital, even an excellent one they're still going to be doing things like running some tests on win 98 machines and charging at least a few hundred for the privilege. Someone should fix that, it'd be a good way to make money but it'd be boring. It would be sweet if hospitals had modern systems and doctors with nice tablets and apps, but in a lot of cases they're working with really poor digital tools and paper records. lots of them have already paid for modern systems but they don't use them because they aren't required to by hospital policy. for example: a customer of ours wants us to be able to access patient records in their EMR so our nurses on the phone can access the latest patient information. Great. That's a common requirement and there are standards for getting that data in and out of their hospital's EMR. The integration end points are a standard part of the hospitals specific EMR. The hospital is actively using them when transmitting patient data thru their state health info exchange. Great! this must mean we can get access to those standard endpoints to get the data, right? noooooooppe. The hospital refuses to believe they've already paid for this and wants our 200 nurses to all have accounts in the EMR so they can sign in to them EMR via a citrix like thing and then use the full EMR to find the patient record. If they would take 5 minutes to send an email to their EMR provider and say "hey, shaggar's company wants to do this integration can you talk to him about getting it done?" we would get it done correctly without costing the hospital anything but they are so loving incompetent that it wont happen.
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Oct 26, 2015 15:38
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one of the things you need to remember when hospital staff talk about EMRs being hard to use or understand is that those people are borderline retarded
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Oct 26, 2015 15:42
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Shaggar posted:lol everyone is so jealous of Touchdown Tom nah I just deal with pats fans all day my team is 2-2 against the patriots in the last decade or so
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Oct 26, 2015 15:44
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Parallel Paraplegic posted:i also used the s from bullshit oh ok, sorry for missing it.
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Oct 26, 2015 15:54
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Shaggar posted:lol everyone is so jealous of Touchdown Tom he's the best handegg player of all time, op
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Oct 26, 2015 16:01
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Smythe posted:my chick in APB had huge knockers and it played the curb your enthusiasm intro when i killed someone. it was epic as hell cat this_post > things_smythe_finds_epic.rst
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Oct 26, 2015 16:13
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Broken Machine posted:software in the medical field is almost universally terrible due mostly to the barriers to entry and how they're sourced, billed. If you go to a modern hospital, even an excellent one they're still going to be doing things like running some tests on win 98 machines and charging at least a few hundred for the privilege. Someone should fix that, it'd be a good way to make money but it'd be boring. It would be sweet if hospitals had modern systems and doctors with nice tablets and apps, but in a lot of cases they're working with really poor digital tools and paper records. good software exists. the biggest problem is that ceos and cfos want to see ROI on poo poo and since IT doesn't directly make them money they don't give a gently caress. i've seen hospitals where some nurse who knows how to click through a couple system config wizards is suddenly the primary it person. see hughmorris in the cavern of cobol for living proof of that poo poo.
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Oct 26, 2015 16:21
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once they all get pushed out of fee-for-service you're gonna see them do a full about face and anyone not using the EMR correctly gets punted.
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Oct 26, 2015 16:26
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prefect posted:i would vote trump ahead of any of the other republican candidates, if those were my only options trump is a literal fascist who seems to be modeling his campaign after it can't happen here there is no such thing as an irony vote when we're talking about somebody who is literally arguing for genocide
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Oct 26, 2015 16:33
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Shaggar posted:also one of the primary reasons for the long shifts is poor record keeping. if a doc left mid treatment the next doc coming in would probably be missing like 50% of the information they need to treat the patient. yea that's the stated reason - that handoffs are where most medical errors occur *handwaves away 36 hour surgical shifts* and yet somehow first world countries handle both of these things just fine
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Oct 26, 2015 16:36
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Shaggar posted:one of the things you need to remember when hospital staff talk about EMRs being hard to use or understand is that those people are borderline retarded i love how hard older doctors fight against EMRs b/c they're hunt and peck typists and are afraid of the internet
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Oct 26, 2015 16:38
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theflyingexecutive posted:handoff is by far the biggest source of medical error. you would think fatigue would play a larger role in doctors loving up, but many studies have borne out that this isn't the case i like how the typical response to this study is "welp we have to minimize handoffs then" instead of "how can we better communicate patient handoffs" then again the typical hospital physician probably would respond "modafinil" to both
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Oct 26, 2015 16:38
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theflyingexecutive posted:handoff is by far the biggest source of medical error. you would think fatigue would play a larger role in doctors loving up, but many studies have borne out that this isn't the case extremely skeptical since these studies are done by the AMA and oh how weird for some reason american doctors die from stress-related illnesses way more often compared to their international peers
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Oct 26, 2015 16:43
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H.P. Hovercraft posted:yea that's the stated reason - that handoffs are where most medical errors occur do we know that they do or are they just willing to accept the added risk? Its definitely a real problem that does exist, but: hobbesmaster posted:the typical response to this study is "welp we have to minimize handoffs then" instead of "how can we better communicate patient handoffs"
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Oct 26, 2015 16:44
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H.P. Hovercraft posted:extremely skeptical since these studies are done by the AMA and oh how weird for some reason american doctors die from stress-related illnesses way more often compared to their international peers attention and fatigue are really weird things that act counterintuitively
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Oct 26, 2015 16:51
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Parallel Paraplegic posted:so i live on the gulf side of of Florida am i east coast? redneck Florida or corporate Florida? you're not in international Florida
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Oct 26, 2015 17:23
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hobbesmaster posted:i like how the typical response to this study is "welp we have to minimize handoffs then" instead of "how can we better communicate patient handoffs" we see the same poo poo in computing tbqh look at snack homeworkflow by jef fatwood, they have a single point of failure sql server with like a terabyte of ram and 100 cores that cost like $500,000 because they don't want to just eliminate the spof with some goddamn data design and thinking about the cap theorem the doctor problem can't be solved with longer shifts, it needs critical thinking and industrial engineering work nobody wants to do
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Oct 26, 2015 17:30
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duTrieux. posted:trump is a literal fascist who seems to be modeling his campaign after it can't happen here at least he is good at business and a self-made man oh wait
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Oct 26, 2015 17:36
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Cocoa Crispies posted:redneck Florida or corporate Florida? you're not in international Florida uhh corporate? it's Tampa.
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Oct 26, 2015 18:02
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Parallel Paraplegic posted:uhh corporate? it's Tampa. judging from being there last week thats peak old people florida
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Oct 26, 2015 18:05
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Panty Saluter posted:carson is the really scary one yeah carson has some hosed up opinions but he's a religious soft-spoken "good one" so iowans friggin love him. he's basically black huckabee. trump kinda owns though for destroying jeb
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Oct 26, 2015 18:08
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Cocoa Crispies posted:we see the same poo poo in computing tbqh sounds like it's still cheaper than hiring people to fix it? I mean, it seems like they don't do much more than adding new stacks or whatever they're called and that can't be too expensive to hire for
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Oct 26, 2015 18:10
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Elder Postsman posted:trump kinda owns though for destroying jeb
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Oct 26, 2015 18:11
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it would be cheaper in the long run to hire people to fix it but hospitals get paid stacks for each service so theres no incentive for them to fix it other than patient care and lol they don't give a poo poo about that.
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Oct 26, 2015 18:12
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Elder Postsman posted:trump kinda owns though for destroying jeb a toddler could destroy jeb. his push-back to trump pointing out that 9/11 occured on dubya's watch is basically "nuh uh" and he has no articulatable answer for why dubya gets a pass on 9/11 but clinton and obama get hammered for the actions of benjamin ghazi
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Oct 26, 2015 18:17
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Shaggar posted:also one of the primary reasons for the long shifts is poor record keeping. if a doc left mid treatment the next doc coming in would probably be missing like 50% of the information they need to treat the patient. doctors are bad
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Oct 26, 2015 18:18
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