dpayonk · HackerTrans

Headless EMR resonates best with me because of the parallel to other cms solutions like contentful. I’d spend time making sure you validate your point of view on the persona of the technical decision makers. The EMR decision for an early stage healthtech company is 10x more important than your initial cloud provider.

dpayonk

5 anni fadiscuss

Cloud formation

dpayonk

5 anni fadiscuss

You end up with the crazy profile system of salesforce. And if you’re the platform winner, people get certifications for your low code platform.

dpayonk

5 anni fadiscuss

Bundled payments still help stablize the cost for an outcome. The bundled payment should make it easier to purchase a “knee replacement” as a consumer because you won’t need the clinical knowledge to understand the professional details of how. It has downsides as you mentioned above, but it can make consumer choice easier. Complexity is one of the fundamental challenges of paying for healthcare today.

dpayonk

5 anni fadiscuss

This is what bundled payments are attempting to accomplish. These bundles take into account the procedure (cot codes) in addition to transmissions and rehab costs generally. Disclaimer: not an expert on this specifically.

dpayonk

5 anni fadiscuss

There is obviously a ways to go to create a system where price transparency is feasible, but I’m very interested in how the community might think it would affect the value based healthcare industry with respect to total cost of care management and bundled services? You cannot always look at a service in isolation because of complications on episodes like joint replacements or the impact of chronic conditions over the longitudinal total cost.

dpayonk

5 anni fadiscuss

Another selling point is if you are not using AWS infrastructure at all. If you are trying to build a service that you do not want to utilize the tech giants AWS or Google, it’s a selling point.

dpayonk

5 anni fadiscuss

The market was designed as a system for human interaction. I think the atomic unit of time should be at the clock speed of humans. It increases the transaction cost, but in a more responsible, sustainable way imo.

dpayonk

5 anni fadiscuss

WSL2 has been awesome so far. I just recently decided to buy a surface book instead of a Mac because it felt like Microsoft was embracing linux more while Mac was drifting away.

After a month, other than keybindings, I’m very pleased. For me, the python experience made the difference. It’s 1st class with VSCode and remote debugging over WSL.

dpayonk

6 anni fadiscuss

If we only had to use 1st party data, that might be easier. But then again, if you’re building your product incrementally, you’re still going to have instrumentation holes that you may or may not be able to partially backfill.

dpayonk

6 anni fadiscuss

I believe that’s specific to drug prices. Services are interesting in that they just dictate it.

dpayonk

11 anni fadiscuss

There are many ways to design plans around this nowadays. With Obamacare making health insurance guaranteed issue (they have to cover you), you really would just try to foot the bill for at most 12 months before you could go on a marketplace insurance plan. While it might be gaming the system, it's now law.

Nowadays, health insurance is really "assurance" sprinkled in with a doctor subscription (as daniel-cussen mentioned). With that in mind, a hypothetical plan design would collect premiums that bundle reserves, a concierge medicine program, like HealthTap, and critical illness insurance, cancer, and/or accident insurance. These insurances only cover specific incidents for the immediate term. Once someone triggers one of these events, you could push them onto the exchange where the larger risk pool would then cover it on an ongoing basis.

Whether or not that would be ethical is up to you...

From an economical standpoint, depending on your area's availability (read urban centers), you could likely put together this entire package for a collective and pay the ACA tax for less than an ACA approved plan.

dpayonk

11 anni fadiscuss

I use an internal (in my head) algorithm that bases (in part) on the domain name of the site I log into. For example, ycombinator.com could be z4O9999asdf Which represents

[1 letter after domain][c is 3rd letter of alphabet][numeric letter representation][last 4 SSN][pseudo counter] It might not be as high tech as software, but I think it offers a reasonable security / ease of use combo.

Note: This is nowhere near my algorithm and tokens have been made up for the purposes of this example.

dpayonk

12 anni fadiscuss

As a satisfied JRuby user for over 3 years in production environments, I can say this has translated into real life for me, as far as the variants I've used (Ruby 2.1, JRuby / Torquebox, Torqbox, Puma, Trinidad / Rails, Sinatra, Cuba, Straight Rack)

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