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null_flavour commented on Ask HN: Is there a webapp to input/store your blood test results?    · Posted by u/apatheticonion
colechristensen · 2 years ago
Something basic wouldn’t be that hard to put together
null_flavour · 2 years ago
Its not hard to put together something basic, a personal electronic health Record is actually super easy. The adoption is the problem. Here is why:

1. People are far more likely to store and curate their vacation pictures than healthcare data. There is a behavioral aspect to this. There isn't a lot of 'feel good' attached to storing a good HDL/LDL reading. Quite the opposite when it's bad.

2. Most countries develop their own version of a EHR, sometimes controlled by patients. Success rates vary but they remain a very useful tool for managing chronic conditions and patient peri-operative journeys. Once governments (local or national level) take over, there is very little incentive for anyone to develop.

3. There have been many attempts to create a patient-led EHR by companies but it is difficult to get off the ground and sustain due to data ownership, security, sharing and commercial complexities.

4. Storing the data itself is trivial. FHIR covers this well and within haematology at least, the support for standardization is strong. LOINC, SNOMED and UCUM are well established. Just be careful to store the initial units and reference ranges.

5. My personal take is that personal EHRs will take off once a good open source p2p toolkit implements superb encryption-led access control across workflows with top institutions comes into play. This is unlikely because of how EMRs lock up provider data.

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null_flavour commented on India's Alphonso mangoes are virtually impossible to find in America (2018)   vice.com/en/article/gyw4z... · Posted by u/shubhamjain
nine_zeros · 2 years ago
If you haven't had this mango, I urge you to have it. It is truly one of those fruits that can replace any dessert.
null_flavour · 2 years ago
Seconded.

I live in a country which fortunately gets Alphonso mangoes from India. On the few occasions I have offered it to uninitiated guests and colleagues (making sure they aren't allergic first), the reaction has been a wide eyed disbelief of how good this variety is. Of course there are other varieties that are good (Langda is a close second).

If you ever get a box at home, unless rules are set and respected, it quickly becomes a free for all and people who hate welding a knife or peeling a fruit quickly become adept at it.

It is that good.

On a separate note: we live in interesting times where I can almost have a culinary-credo like I want to try the amazing food each place has to offer. Someone needs to put a list of these things - fruits, dishes, what have you and we need a serious conversation about how some of us can sample them from far away.

null_flavour commented on My dad built a cool thing but never boasted about it   robotsinplainenglish.com/... · Posted by u/ripe
null_flavour · 2 years ago
My condolences.

I wish the author could explain why he chooses to disclose that he is a _Bramhin_.

The author seems to have emigrated to a different part of the world but still mentions labels used for the longest running discrimination of humans in history.

null_flavour commented on A Drum Machine with Congenital Heart Disease   heartbeatdrummachine.com/... · Posted by u/giuliomagnifico
null_flavour · 3 years ago
Beautiful work.

I run a startup that links patients with specialists and surgeons around the world called [Me2MD](https://Me2MD.com). I cannot tell you the number of people who come to us with little to no idea of what to do. There is a lot of knowledge out there but no real practical advice.

Paediatric Cardiology pathways are fairly well developed and treatments for VSD and ASD are well defined.

It's just that parents (especially in developing countries) don't know how to access practical advice from experts and, more importantly, past-patients.

null_flavour commented on Patients can now access all their health records digitally   statnews.com/2022/10/06/h... · Posted by u/andsoitis
Dig1t · 3 years ago
One big limitation of this standard is imaging data. X-Ray radiographs, MRI scans, PET scans, etc are not part of the USCDI standard V1 that'll be available to US patients. The current story for getting these scans still sucks and isn't close to being actually available to patients in the US. The best you can get is a set of DVD's containing that stuff, if you are lucky.

The problem is that the protocol used by imaging devices (DICOM) is ancient, and connecting with a DICOM server is a pain. There is a sort of modern standard that I've heard talked about called DICOMweb, that I think will be hooked up with FHIR and be made apart of the USCDI eventually (probably). But we still aren't very close to being able to see X-rays on our phones.

Also, one funny anecdote I've heard from working in this space is that some doctors do not like the Clinical Notes story (https://build.fhir.org/ig/HL7/US-Core/clinical-notes.html) since it means that their personal notes about their patients will be made available directly to the patient, something that was not possible in the past. Doctors often write down their real thoughts about the patient in there and can say some things the patient might not be happy with.

null_flavour · 3 years ago
Having built workstations in imaging that used DICOM extensively, I disagree with the fact that DICOM is ancient and painful to work with. Yes, it is difficult to understand but there are plenty of great toolkits and examples to get started (DCMTK, dcm4che). And it also has open source implementations (dcm4chee).

DICOm has a portable media extension which let's anyone transport studies using USB, keep it in a folder. And it works well when it needs to be fed into a PACS, RIS l

It has stood the test of time when stuff like HL7 went from V2 to V3, CDA and related tailspins till FHIR came about (and let's not talk about ISO13606, OpenEHR).

It's UID space is well defined that's it's used in the aircraft inventory space.

u/null_flavour

KarmaCake day8January 14, 2014View Original