Tag: rant

The Future of Healthcare

Based on what’s going on in the medical community, a series of consistent themes emerges that provides some insight into what the future of medicine will look like.

Here are some things rising to the top of the discussion of future medicine:

Digital Records

Currently, this is kind of a mess. Some hospitals and doctors can share patient records with each other, some can’t. The ones that CAN often don’t. Usually the patient is cut out of the equation entirely, and will only see their own records if they demand to. There needs to be legislation about this soon, to standardize secure digital medical records and require all health care providers to use them, and make them more easily available to patients. It also needs to ensure patient privacy and make sure insurance agencies won’t take advantage, while at the same time perhaps making anonymized records more available to researchers. Shared data can be incredibly powerful, and increase knowledge about human health as a whole.

Cheap Sensors

Inexpensive sensors can provide continuous monitoring where previously a patient would have to come in and only get a single measurement.

Doctors seem to be both excited and terrified by this prospect. This is unfamiliar territory for many of them. They are used to seeing, for the most part, single data points when a patient comes in for care. They aren’t sure what to do with more data, because they may not have a very good grasp of what is “normal”. They are concerned that more data will reveal “false positives” where, for example, someone’s blood pressure may spike several times a day – this might be normal in a healthy person but doctors fear it might be mistaken for high blood pressure.

This is why doctors don’t like full-body MRI scans. They are presented with a vast amount of data, and there may be numerous things that appear to be wrong that are actually fine for that person. They don’t have any easy way to sort through these false positives, so they’d rather not use the system at all.

This is a short-sighted view. As I like to say, more data is more fun. What if doctors had yearly full-body MRIs for all their patients, done as part of a yearly check-up? The vast amount of data not only for a single patient but all patients globally would provide huge insights into human health, and what is normal for each person. As we get more data, our methods of parsing it become more refined, software becomes more sophisticated.

Cheap Labs

Right now labs are slow, expensive, and generally inaccessible to consumers. Doctors are afraid to order tests because of cost, and afraid not to order tests because of lawsuits. But new tests are being developed that are not only better, but cheaper. What used to take a large lab might soon be a small piece of paper, or a cheap “lab-on-a-chip”. Instead of sending samples to a remote lab, tests can be done directly at the point of care, or even remotely, administered by the patients themselves.

Genetic Testing

Along with cheap labs comes the possibility of cheap genetic testing. The Army already has a portable genetic analyzer, used mainly for identifying bodies on the battlefield. Currently most doctors wouldn’t know what to do with genetic data if a patient gave it to them. But as the process gets cheaper and faster, genetic testing may become a standard part of medical care. Databases of genetic information cross-referenced with conditions and gene mapping will make this genetic data more and more useful. Maybe science will even begin to understand epigenetics.

Cellphones

Cellphones are one of the most prevalent pieces of technology in the world. Each generation is more sophisticated. Essentially, nearly every person either owns or has access to a tiny portable computer connected to a global network. Hospitals will take advantage of this, and be able to combine the use of cheap sensors, cheap labs, and cellphones, allowing patients to upload medical data directly from home. In poorer countries, mobile care facilitators – not doctors but volunteers – could serve communities with a backpack with cheap sensors, cheap labs, and a cellphone. Diagnostics could either be run directly on the cellphone, or data could be sent to a server and results returned to the cellphone.

Decentralized Medicine and Preventative Care

All of this inexpensive and networked medical technology also means the individual has more control over their own health care. Feeling sick? Pop over to CVS and pick up a lab-on-a-chip test that tests for all known viruses and bacteria. Then either view the results locally, or transmit them to your doctor.

Some doctors fear this, believing that individuals cannot handle their own care, that they will freak out over every piece of data. Undoubtedly, some people will obsess over this, but you can’t let a few hypochondriacs ruin the entire concept of personal care. The vast majority of people will benefit from greater patient education and more access to their own health care data.

Currently, the medical system is a reactive one. When I go to my doctor for an annual checkup, he is literally uninterested if there is nothing wrong with me. If there is nothing wrong with you, there is no problem to solve, no puzzle to sort out, so nothing that interests the doctor. But with probability maps from genetic testing and increased focus on national health, this may shift to a more proactive view.

Regenerative Medicine

This is just starting to take off now, but has already made impressive strides. It is currently possible to grow a replacement bladder for a patient. Replacement muscle tissue and hearts are in the experimental phases. Through collagen lattices and cloned tissue, it may soon be possible to replace most internal organs with healthy new ones grown in a lab. And since they are based on the patient’s own genetic material, they don’t have the same problems with rejection that make organ donation so tricky.

It may seem like science fiction, but research is already underway, with lots of military funding – the goal eventually being that a soldier who comes home with a leg blown off could simply grow a new one.

And after that, the next logical step is to get the body to do its own repairs, or assist the body in this, so that instead of involving a lab, a patient’s own body can repair damaged organs.

Inkjet Printers

Ok, so this one isn’t directly obvious, but indirectly it’s amazing the applications medical researchers have found for standard off-the-shelf inkjet printers. The aforementioned replacement organs can essentially be PRINTED, layer by layer, from a standard inkjet printer. And those paper lab kits can also be created on an inkjet printer. This means that the technological advancements could end up being extremely cheap to implement.

Suspended Animation

I had to mention this one after seeing an incredible TED talk on it. Researchers are currently in human testing phases of using a normally toxic gas in very low doses, along with cold, to basically put people into a state of suspended animation. The patient’s body slows to a point of almost stopping, like a sort of hibernation. In this state, the patient needs very little oxygen and can survive damage or blood loss that would normally cause fatal shock. And revival from this state is simply a matter of putting the patient into a warm room and letting them “thaw out”. We may soon see all ambulances and emergency crews equipped with this, allowing them to basically “pause” critical patients so they can get to the hospital to get treatment.

Correction

When I said Eclipse was the only IDE I knew that didn’t support soft text wrap, that was a misstatement. There was one other…

I refer to you a post from August 21, 2002:
Why InterDev Sucks

Of course, I’d betcha Microsoft has added soft text wrap to InterDev since then, while in that same time, Eclipse is still bereft of it.

Right now I’m learning a little Objective-C and using XCode, it has an interface loads better than Eclipse. If only Zend made a “Zend Studio for XCode”… but alas, all they make is “Zend Studio for Eclipse”, so I’m stuck with that for PHP development at work.

Eclipse suckage

So I tried the upgrade from the standalone Zend Studio 5.5 to the Zend Studio 6.0 plug-in for Eclipse.

Eclipse is somewhat nice, but, like many open source projects, sadly flawed in some basic functionality.

One feature, in particular, has me livid.

It doesn’t have soft text wrap.

What does this mean?

Well, say you have a long line of code.
In any other IDE, which is to say, GOOD ones, you can turn soft text wrap on, which puts a virtual line feed at the edge of the window. Anyone who has used any text editor, from Word to Xcode, is familiar with this. It means when you are typing, when you hit the edge of the window, the cursor comes back to the beginning of the line, even though you didn’t hit return. When you resize the window, the text re-flows to wrap at the new window size.

However, apparently no one who wrote Eclipse could figure it out, despite the fact that EVERY OTHER FUCKING TEXT EDITOR IN EXISTENCE HAS IT!

It means that for code on a long line, you must constantly use the horizontal scroll bar. Which is extremely annoying to me. It may seem like nitpicking, but when you code for a living like I do, it’s important that the text editor you use for coding is comfortable and efficient and doesn’t waste your time with a lot of extra unnecessary clicking and scrolling.

Some people like scrolling horizontally, the people who wrote Eclipse LOVE IT, but for god’s sake, don’t force everyone to use your preferred settings! Any decent IDE would have a simple checkbox at least, to turn soft text wrap on or off.

So far the only thing I’ve found is a hack someone wrote which *sort of* enables soft text wrap in Eclipse. Except from what I read, it breaks some other things, and is buggy. And hasn’t been updated since it’s first alpha release in 2006.

Sigh.

Just, sigh.

And, GAHHH!

Update:

I just read through the feature request on the Eclipse website, apparently people have been clamoring for soft text wrap for YEARS (starting around 2002), but the developers didn’t build the feature in at the beginning, and now can’t figure out how to add it. So their solution is to just ignore requests for it.

Choice excerpts of user comments from the feature request:

“I can’t personally think of any other text editor that does not support this. ”

“I don’t suppose it could be given priority over other features, as an
embarrassing design omission of a REALLY REALLY basic text editor feature?

I don’t mean to be obnoxious, but it feels to me like “putting doorknobs on the
doors will be hard to fit in because there’s so many doors, and we’re really
busy putting pool tables in the game room, and rotating shelves in the library,
and auto-darkening windows.” (Please take that in the humerous spirit it was
written…)”

“I would say this problem is the most critical in eclipse text editor as I don’t
know ANYONE who does not want that.”

“It’s a pain to see Eclipse missing such basic features.”

“I think it doesn’t sound good for an all-round development tool
like Eclipse to miss a basic function like this one.”

“There is a real demand and lots of people are surprised that Eclipse
does not do such a simple thing.”

“Ok, so despite 78 votes for this bug (which probably makes it one of the top
voted for Eclipse bug, if not the first), this was not scheduled for 3.2, for
3.3 and now not for 3.4…”

Grr…

Another HPV story, these just make me mad – basically HPV has been identified as a major cancer-causing agent for a number of different types of cancer, but efforts have only focused on protecting women, not men. Women have screening tests and a vaccine. Men have… nothing.

According to the article, when asked about making a vaccine and test for men, makers of the vaccine said “cervical cancer is really the focus.” In other words, “we don’t really care about male health.”

What does the CDC have to say to men concerned about HPV? Here’s what they say on their website:
“There is currently no vaccine licensed to prevent HPV-related diseases in men.” and “There is also no approved screening test…” and “HPV is very common.” Ah, yes. Very helpful.

So basically what they are saying is there is a virus that causes cancer, and lots of people probably have it, but men have no way of telling if they have it, and only women should be protected from it anyway. Very nice. Very proactive. Fuckers!

They don’t even have important information about throat cancer (like HPV is a 10x greater risk than SMOKING!) on their site – apparently the CDC doesn’t have time to be current on, you know, Disease. Certainly not Control (the only advice they offer men is “not having sex is the only sure way to avoid HPV” — so clever of them, guess they can cancel skin cancer research and just tell people to live underground out of the sun). Maybe they should just be called “Center“.

Overall the CDC, drug companies, and medical industry’s response to HPV show that they learned NOTHING from the outbreak of AIDS. Imagine if they found a vaccine for AIDS, but decided to only test it and release it for women. Well, that’s what they’ve done with HPV.

Thing is, the current vaccine for women would *probably* work fine on men, too. But no one has bothered to do a study to find out. Because apparently no one cares.

Back in 2006, Bradley Monk, a professor at University of California-Irvine published an article in a medical journal where he recommended using the vaccine on men as well as women, saying: “To have a vaccine that prevents cancer and not use it would be one of the greatest tragedies.”

Guess no one listened to him. Two years later, still no work on testing it on men.

Sigh.

More lazy programmers

I downloaded the Photoshop demo installer from Adobe, and IT WON’T INSTALL!
Reason?

Adobe doesn’t support case-sensitive file systems!

I didn’t know it would cause such problems to install with case-sensitive turned on, but apparently there are a lot of lazy fucking programmers out there.

Sigh… there is no way to switch to a non-case sensitive filesystem, the only option is to wipe the system and install everything from scratch, which I’d rather not do.

Only other options are to put in an additional HD with non-case-sentitive FS selected, or create a disc image to install onto…

Bleh. None of those are good options.

Lazy programmers suck.

For the record, I do not believe “FILE.TXT” is the same as “file.txt”.
Adobe and H&R Block, however, think they are exactly the same.

Please Destroy the Environment

We were in the process of throwing junk into the dumpster, when it occurred to us that some items might not be allowed, so we checked the list. CRTs they would take, but might charge extra for. Ok. Paints and household cleaners were not allowed.

Hmm. So that leaves us with around 8 cans of paint and a large container of scented Tide, which I bought accidentally (I usually get unscented) and the scent makes me nauseous.

I guess since Tide goes down the drain during normal use, it’s safe to pour down the drain, probably in small doses so as not to overflow the drain with suds.

I called up the Worcester Department of Works to find out how to dispose of paint.

Latex paint: use newspapers or a drying agent (commercial paint drying powder, or kitty litter) to dry the paint, then dispose of the cans in standard Worcester bags. Ok. Not so bad.

Oil paint: this is considered hazardous waste, so cannot be disposed of.

Huh?

Well, you can dispose of it, but only once a year. This year it was July 2nd. So if you miss that one day, you have to wait a whole year to get another shot at it. And that day is not advertised, so unless you know to ask, and know WHO to ask, you wouldn’t even know when your one shot at it was.

So I can’t dispose of it in a rented dumpster, and the City won’t take it. I look on Lowe’s site – they sell oil-based paint, but don’t offer any disposal method.

So essentially, the only options seems to be: dispose of the paint illegally, or hire a hazmat team for who knows how much money to dispose of it.

Now, I *think* all the paint we have is latex, so it’s probably not an issue, but look at the message being sent here.

Oil-based paint is, I gather, a toxic substance harmful to the environment. But rather than make it EASY to dispose of it in an ecologically responsible manner, the government makes is nearly impossible to dispose of, and private companies have no incentive to dispose of it, even if they sell it.

It’s no wonder people dump waste material like this illegally – they are essentially given no choice.