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How do you view the medical world from programmer's eye?

MedicalProgrammer
Wednesday, July 09, 2003

With fear. If I have a bug, someone might miss $100 in inventory. You have a bug and someone might miss life all together. :-\

Marc
Wednesday, July 09, 2003

I found it to have a very "old school" view of the business world...

"We've been doing it this way with 14,000 forms for the past X years!  What do we need one of those new-fangled Internet's for, anyway!?"

With all the cool automation out there, they couldn't get past the fact that the technology was accessible to them at a reasonable cost - all the efficiencies of electronic automation were things that "other companies" did.

This one company is my only experience in medical, however.  Most of their vendors seemed to be the same way, though.

Jeff MacDonald
Wednesday, July 09, 2003

Do you mean what lessons can be learned from the medial world, or in general how does a programmer view the medical world?

I would suspect that a average programmer views the medial world the same as any other person like a teacher, cab driver or whatever. I don’t think we have any particular different view from the general public at large.

However, if you are talking about ones experiences developing software in a medal environment, and what lessons can be learned?

Or, what type of things to you change when working on medial software?


I can think of many:

When you are doctor faced with a very important operation the next day,  you can’t go out and party the night before. To do first rate, excellent important work, you need to be  rested and well feed. This also applies for me when I have a  important day of programming work ahead. I get a good rest, and make sure eat very good food.

If I am too tired, or run down, then the code I write the next day will be second rate. So, just like the doctor must be rested to do a good job, the sample applies to developing software.

Another similarity is that small mistake can cause really big problems. In the case of a doctor leaving a set of claps or a small sponge in the patent and closing up is a disaster. Missing reading the dosing on an amount of medicine to apply can be a disaster. You have to be about your wits every day. If you feel you are having a bad day, you probably should not go to work.

The same applies to software. A small bug can really be a big disaster. If I have bug that miss-books a whole bus load to people to a different hotel, it is not life threatening but that small bug can cause 50 people to be very mad. It can ruin their trip.

Often, we don’t think about a very small bug can cause a lot of hassle.

In medial software, this can be very important.

For example, I had a patient billing system in which we had a very small bug that could file the wrong patent bill under the wrong person. Of course it is was a real minor bug from a CODE point of view.

However, this tiny bug means that the wrong patient diagnosis could get filed under the wrong patient. (oh, gee, you are not dying to cancer, you just have a sore foot!).

I remember while coding this system I took a normal software development approach. The thought of the consequences of a small bug did not cross my mind. When we found the bug, two medical clinics and a bunch of staff had to review a 4 days worth of billings. It was incredible night mare to see all the extra staff in place on a Saturday morning going through original diagnoses records.

So, now, just like a doctor, I ALWAYS ASK what is the consequence if something goes wrong. Messing up a small bill or invoice is not a big deal. However, a report that a company is going to use to set their advertising budget for the next year can have disastrous consequences if that budget report is incorrect. The company might budget $35,000 for one part of the companies advertising when they should only be budgeting $20,000. Opps, that is a $15,000 mistake.

So, the lesson I learned while writing software in the medical field is that you must ALWAYS ask what the consequences are.

I now ask this questions for all my applications....


Albert D. Kallal
Edmonton, Alberta Canada
kallal@msn.com
http://www.attcanada.net/~kallal.msn

Albert D. Kallal
Wednesday, July 09, 2003


There is a lot of applications that can be termed "medical".

The world of medical that performs claims processing is also very old school.  Very much rule and regulation driven and quick to shy away from anything new.  Technology is also something that normally stays on the back burner.

Joe AA
Wednesday, July 09, 2003

I really like the responses.

Few expansions  of the original question:

Medical World v/s Programming world
How programming can help the medical world.
Analogy of Medical Profession/Computer Profession
in terms various duties/responsibilities

Thinking with seriousness of being a doctor or pilot and prepare for programming is not something programmers have thoguht.. They have emerge by involving themselves with late-night computer acitivities. But I really like the seriousness approach to develop the healthy programming practices.


MP

MedicalProgrammer
Wednesday, July 09, 2003

I work in a company that does medical training apps. We were founded by a top surgeon and work extensively with medical people.

Surgeons are interesting characters. They are very smart and very capable. On the other hand they are prima-donnas.  They will not admit their own lack of understanding and will crucify people for not being experts in their field.

Nurses are cool, almost all hard working good people. Very tough.

The programming world primarily helps the medical work with better back database stuff. But also image analysis and training are beomcing more and more important.

Medman
Wednesday, July 09, 2003

I work for a group of seventy doctors.

We don't have any surgeons, but the attitude medman describes is certainly there in a lot of doctors.

Most of problems stem from a few "old school" type doctors who refuse to use the electronic medical record system except when forced to, and a few prima donnas who insist that the EMR be changed to work they way they are used to.  Then there are the rest that run the gamut, with a few enthusiastic users and few who would rather not have to learn something new.  Basically, doctors appear to be human.

Most of our groups benefits come on the data side.  An EMR system makes a patient's record available in real time to the entire group no matter what location they are in.  So we get to avoid losing charts and all the other paper induced hassles.

We can also monitor all of our doctors and nurses to make sure that they are following the protocols set in place for treatment and we can easily produce documentation of that protocol being followed groupwide when needed.

It also makes drug trials quite a bit easier.  Imagine if you were trying to conduct a drug trial on diabetic patients, over the age of 65, on a particular set of meds, and not on another particular set of meds, who also had some uncommon (but not rare) secondary disease, using paper charts.  It would take literally months to find enough people.  Using an EMR it took about 30 minutes (it was a complex query).

Basically, the medical world in many ways is not different from any other, as we had almost all of the same problems and benefits listed above when I was working in manufacturing. 

Steve Barbour
Wednesday, July 09, 2003

[Surgeons are interesting characters. They are very smart and very capable. On the other hand they are prima-donnas.  They will not admit their own lack of understanding and will crucify people for not being experts in their field.]

Amen to that. Last year I worked for the Neuro dept of a large military hospital and it was _very_ tough dealing with the Doctors. Of course their field is very stressful and I admired their work ethics. That being said I'd rather not deal with them directly. To deal with them you must be an excellent communicator and considered an equal. (Good luck on th equal part)

I think I'll post anonymous this time
Wednesday, July 09, 2003

One day, software will replace the medics. Medics are only  intermediaries between scientists and patients.

People think medics are gods. We replace people, we are the real gods.

programmer: the only man irreplaceable.
Wednesday, July 09, 2003

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