Yes, it can be done, and yes people are doing it.

PCR Machine

Hood

Various reagents and chemicals … Continue Reading »

I would like to take this moment and remind readers that the Think Gene Certificate of Decision is still for sale. On a sliding scale of evidence (which I, too, have long been advocating), there is no potential that this certificate will cause you harm. Thus, I am only held responsible to that same level of efficacy. This is true because medicine is expensive. (Email me for a discount code up to 95% off retail. We now also provide Certificates of Allergy Elimination under special circumstances for select customers.)

Buy now!

Be sure to keep your Certificate of Decision on your person at all times such that in the unfortunate event you are admitted to the Integrative Medicine Emergency Room.

(See Steven Knope)

PS: what the hell is “natural” supposed to mean, anyways? Molecules are molecules.

I use jargon. Here is some of it:

Yahble

Yet Another Huge Binder of LegalesE

These are binders of documentation, policy, plans, and law that you can’t throw out Or Else, but neither you nor anyone else ever reads, and generally are entirely worthless in practice despite being Very Important in theory.

Yahbles collect in the system like lead or mercury. Lovingly, they are passed along the foodchain until everybody dies of heavy metal toxicity induced bureaucratic insanity.

Government agencies and consultants love to make Yahbles. When you force a pile of hot, sweaty consultants into a small, closed space overnight, expect a fresh steaming new Yahble in the morning, there! revealed to thee yonder in the glaring flouresent din of 7:48AM upon ye humble coffee-stained hard white plasix conference table.

It’s also understood that Yahbles are gradually churned into existance from the bowels of The Back Office, but like invention of a new race or ethnicity, nobody has ever witnessed the complete Yahble evolutionary process of a generally accepted Yahble outside of an artifically imposed environment.

HIT

Health Information Technology

This is a common industry term in health-related information technology. In practice, it refers to all the information transmission and processing generally associated with “The Health Care Industry” that doesn’t really work well or that isn’t well understood. Stuff that actually works is just called by its real name, or generally: “software.” Note: HIT does make for cool-sounding portmanteau like “HITman” and “HITbox.”

For example:

Mozilla Firefox web browser: firefox, or just “the browser”

Command-Response terminal simulation system to display text and pictures from a server on another machine over a network that only runs on Windows XP and requires the installation of several vendor-specific plug-ins: HIT

===

Linux: linux, or just “the server”

???: HIT

===

email: email

web 2.o patient physician medical communication cloud computing enterprise suite: HIT

Bubblecon

Internet bubble convention

Bubblecon is some marketing convention for some new hyped technology or industry. Attending bubblecons is a popular means by which one may accumulate a significant collection of business cards titled “CEO,” “Founder,” and “President” —and sometimes, all three at once!

Fact: nobody has ever gotten funded because they attended a bubblecon. I did get laid, though. So YES: in my rigorous scientific sampling of exactly myself, you are more likely to get LAID by a GIRL at a NEW TECHNOLOGY BUSINESS CONVENTION than you are to get your tech startup funded with odds of 1/0 == infinity %. That’s science.

BIZDEV!

Business Development, often predicated by “Vice President” (VPBIZDEV!)

BIZDEV! is always appended with an exclaimation point.

BIZDEV!s love bubblecons because they are concrete and documented evidence of attendance at a work-related events. That’s because documented attendance means work, which is why they are the CEO and visionary entrepreneur, and definitely not bullshit, which is why they are not delusionary aging jock losers that couldn’t cut it at a regular sales job. This Very Important Job is colloquially known as “networking,”and it is the Most Important Job at all startup companies. Also, see “ideas” and “twitter.”

Solid State

in a HIT context, it means a unit of health care organization that is maximally automated with the utmost elegance and efficiency. It is the platonic ideal of how “things should work”. Generally, see Solid State.

You want a policy that will force health care to work? Fine. This will work.

All licensed medical third-party payers must publish a public, free, unrestricted web service from which anyone can simulate any and all medical insurance decisions. These insurance decisions include:

• Determination of coverage and all policy purchasing qualifications
• Premiums, co-pays, deductibles, and all other payer financial details
• Reimbursement per submission, necessary medical documentation and justification, and all other medical provider-submitted details

No health insurance decision can be executed that cannot be publicly simulated via this web service in advance. Any simulation can be authorized by a patient policy holder and medical provider to become an executed health insurance decision. All documentation necessary to simulate all possible decisions must be published on a public, free, unrestricted website.

Each submission optionally includes a simulated date of submission. The web service will return the decision as of that date. In effect, one could map a decision given a submission from now each day back until the date of service implementation. Submissions without a date specified will be assumed to be for the current date.

Any health insurance decision that does not comply with this policy is grounds for a declaration of Policy Corruption by the federal government. Continued violations will result in the forced restructure of the third party payer. This restructuring will resemble an FDIC restructuring an insolvent bank, including a federally-insured ceiling policy in the event of an insurer failure.

Simply: given this submission, what do you do? In a payer contract, any inability to give an absolute answer to this question immediately can only be for two reasons:

• flagrant incompetence (bad)
• fraud (bad)

Why would there be any ambiguity? Think: there is no medical decision making. There is no clinical participation. There is no interaction with patients, the human body, or the environment. It’s simply: discrete data in, discrete data out. And: SOMEHOW decisions are being made. Are these decisions made by:

A) a consistent, understandable, fair, contract of discrete cause and effect? (good)

or

B) “some guy” making some arbitrary decision about who gets what whenever? (bad)

Because if you want A (good) and not B (bad), this test enforces it with an obvious true / false test without divulging trade secrets or private health information and without snowing regulators. (i.e. the Law and Order “we’ll fill your office with boxes of incomprehensible paper forms —that will teach you to mess with the Bureaucracy!” trick) And there is no need for new regulatory committees, laws, and policies. Any medical provider could very simply verify the integrity of the system: here’s what we submitted, here’s what you said you would do, did you do it? Y/N.

Further, it solves the incentive to health care providers to submit their claims electronically, and it stimulates entrepreneurs to build high-tech businesses using the new wealth infrastructure.

And finally, it’s a policy that can actually be DEFINED and ENFORCED to create real WEALTH and directly SOLVE THE PROBLEM of modernizing American health care by empowering the public with concrete data and services —rather than some vague and useless policy like “it is illegal to be inefficient, and you (somebody?) must complete all these forms to prove it.” That crap only makes more Yahbles. Yahbles are intellectual toxins that gradually weighs us down and makes our institutions sick. The Solid State health system clears the air and plants seeds of innovation and productivity.

The fashion in health care’s “policy sphere” is to fix logistical problems by making having the problem itself illegal. That’s… not going to work. Consider, from Forbes: “How Safe Are Your Medical Records?”

Notification laws are slowly changing as part of the stimulus bill, which has mandated new accounting rules. Physicians will now be required to track disclosures of a patient’s medical information and disclose security breaches in some cases. The new rules won’t go into effect until 2014.

Really. So, if problem is a policy lapse due to an bloated, unresponsive, overloaded health care bureaucracy, then the solution is to force all medical providers to keep Yet Another Huge Binder of Legalese (Yes, the dreaded Yahble) for which you are Legally Liable to Keep A Copy In Your Office At All Times

Genius! I’ll just organize another meeting and invent another acronym. That will be ten million dollars to my Health Care Information Technology consulting firm, please. (Unless, of course, you don’t mind being declared a Federally Deficient Medical Provider. Can you really afford that legal liability? Oh, by the way, we noted in our report that your hospital has a ten million dollar budget discrepancy this year. We advise a hiring freeze in IT, investment in a clock-punch payroll system for physicians, and cuts in “loss-leading” non-surgical, non-specialist departments like primary, preventative, and hospice care.)

Listen: it’s silly to make things that are already illegal “double illegal.” For example, it’s already clearly against “company policy” to steal cash from the cash register at a medical office —not to mention illegal. There’s no need to Really Really say so in a Yahble. That’s true for cash; that’s true for medical records.

It was illegal in Soviet Union to be inefficient, too. That didn’t make their institutions more productive. That just gave anybody an excuse to prosecute political and economic deviants because, hey, there’s policy for everything. Everybody’s already criminal. We just haven’t gotten around to prosecuting you yet —and do you really want to fight this battle? (ref: U.S. intellectual property law.  ever been accused of “trademark” or “patent” infringement? you’d understand)

Please excuse this interruption for this important news bulletin:

Do not learn Dvorak!

Deep in the tomes of Ancient Geek from beyond Last Thursday, it is rumored to be written that the True Geek shall achieve divine productivity through careful dedication to the art of Dvorak Typing. Type faster with less stress! Dvorak: the rational keyboard —not that abominable scrabble-bag QWERTY layout that The Man grinds into garrulous school children to Keep The Good Word Down.

These are LIES.

I learned Dvorak touchtyping three years ago. It is true: it is a bit less stressful to type in Dvorak than QWERTY.

The problem: all computers and applications are designed for QWERTY. (enjoy trying to use emacs or vim on a QWERTY lettered keyboard reconfigured to type Dvorak. I did learn Dvorak emacs —what a waste of my life)

So, finally, before it was Too Late, I switched back from Dvorak to QWERTY when I converted to OS X with the purchase of a new MacBook last month.

Listen: I have been hamstrung for weeks because I can’t type fluently. You do NOT want to scramble your touchtyping mental wiring during an important project. You will need to dedicate hours each day carefully retraining your fingers. You will not have this time because you are already behind because you’re unable to type your work efficiently. This is bad.

There is one time to learn a keyboard layout: school. Unless you have nothing better to do than practice typing an hour each day —precisely the description of an elementary school typing class— DO NOT DISTURB YOUR TYPING MUSCLE MEMORY!

However, I do strongly recommend occasional typing drills to keep your typing skills sharp. I use this flash drill. The keyboard is the human connection to cyberspace. Don’t get left behind because you’re too lazy to type well.

Josh and I will be attending Fairfield County Medical Association’s “Federal Red Flags, HIPAA Security Rules and Fraud Prevention”  presented by the by Kenneth C. Citarella at Tiburon Restaurant at 333 Wilton Road, Westport, CT 06880.

We’ll be traveling up from New York City, so if you’re in the area and want to hack health care, this guy would probably know something about doing that, so email us and tag along. I’m a member of Fairfield County Medical Association, so the cost is $50.

Event Registration Fax Form (pdf)