5 ms·

You have no idea how a hospital or modern medicine works. It needs to be online.

by et2o 2y ago

freehorse 2y ago
Why would a machine that is required for a MRI machine to work (as one of the examples given in the thread here) need to be online? I understand about logging, though even then I think it is too risky. Do all these machines _really_ need to be online, or just nobody bothered after all the times something happened or, even worse, software companies profit in certain ways and would not want to change their models? Can we imagine no other way to do things apart from connecting everything to some server wherever that is?
- compiler-guy 2y ago
  You don’t print the images an MRI produced, you transmit them to the people who can interpret them, and they are almost never in the same room as the big machine, and sometimes they need to be called up in a different office altogether.
  - freehorse 2y ago
    The comment [0] mentioned that they could not get at all the mri outputs even with the radiologist coming on site. Obviously, software that was processing/exporting the data was running on a computer that was connected online, if not requiring internet connection itself. Data transfer can happen from another computer than the one the data is processed/obtained. Less convenient, but this is common practice in many other places for security and other reasons. [0] https://news.ycombinator.com/item?id=41009018 https://news.ycombinator.com/item?id=41009018
    - salawat 2y ago
      I mean, this is incentivized by current monetization models. Remove the need to go through a payment based aaS infra, and all the libraries to do the data visualization could be running on the MRI dude's PC. -aaS by definition requires you to open yourself to someone else to let them do the work for you. It doesn't empower you, it empowers them.
      - freehorse 2y ago
        Yeah I suspect -aaS monetisation models are one of the reasons of the current all-to-internet mess. However, such software running in the machine using a hardware usb key as authenticating is not unheard of either in software like that. I wish that decisions on these subjects were done based on the specific needs of the users rather than the finance people of -aaS companies.
  - deleted 2y ago
    [deleted]
- jmcgough 2y ago
  Our critical devices were fine. But epic and all of our machines were down. How do you transmit radiology images without epic?
  - freehorse 2y ago
    Is that an ironic question? Or serious one? I fail to detect the presence or absence of irony sometimes online. I just hope that my own healthcare system has some back-up plans for how to do day-to-day operations like transfering my scan results to a specialist in case the system they normally use fails.
- kanonade 2y ago
  MRI read outs are 3d, so can't be printed for analysis. They are gigabytes in size, and the units are usually in a different part of the building. So you could sneakernet cds every time an MRI is done, then sneakernet the results back. Or you could batch it and then analysis is done slowly and all at once. OR you could connect it to a central server and results/analysis can be available instantly. Smarter people than us have already thought through this and the cost-benefit analysis said "connect it to a server"
  - turtlebits 2y ago
    Ever heard of a LAN? You don't need internet access for every single machine.
    - ikiris 2y ago
      Do you think everyone involved is physically present? The gp was absolutely accurate that you guys have no idea how modern healthcare works and this had nothing to do with externally introduced malware.
      - dopylitty 2y ago
        This sounds a bit like someone just got ran over by a truck because the driver couldn’t see them so people ask why trucks are so big that they’re dangerous and the response is “you just don’t know how trucks work” rather than “yeah maybe drivers should be able to see pedestrians”. If modern medicine is dangerous and fragile because of network connected equipment then that should be fixed even if the way it currently works doesn’t allow it.
        ikiris 2y ago
        This is a completely different discussion. They absolutely should be reliable. The part that is a complete non starter is not being networked because it ignores that telemedicine, pacs integration, and telerobotics exist. If you don't understand why it has to be networked with extremely bad fallback to paper, then I suggest working in healthcare for a bit before pontificating on how everything should just go back to the stone age.
rsync 2y ago
"It needs to be online." No, it doesn't. Some have chosen - for reasons of efficiency and scale and cost - to place it online. However, this is a trade-off for fragility. It's not insane to make this trade-off ... ... but it is insane to not realize one is making it.

You have no idea how a hospital or modern medicine works. It needs to be online.

by et2o 2y ago

You have no idea how a hospital or modern medicine works. It needs to be online.

Why would a machine that is required for a MRI machine to work (as one of the examples given in the thread here) need to be online? I understand about logging, though even then I think it is too risky. Do all these machines _really_ need to be online, or just nobody bothered after all the times something happened or, even worse, software companies profit in certain ways and would not want to change their models? Can we imagine no other way to do things apart from connecting everything to some server wherever that is?

compiler-guy 2y ago
You don’t print the images an MRI produced, you transmit them to the people who can interpret them, and they are almost never in the same room as the big machine, and sometimes they need to be called up in a different office altogether.
- freehorse 2y ago
  The comment [0] mentioned that they could not get at all the mri outputs even with the radiologist coming on site. Obviously, software that was processing/exporting the data was running on a computer that was connected online, if not requiring internet connection itself. Data transfer can happen from another computer than the one the data is processed/obtained. Less convenient, but this is common practice in many other places for security and other reasons. [0] https://news.ycombinator.com/item?id=41009018 https://news.ycombinator.com/item?id=41009018
  - salawat 2y ago
    I mean, this is incentivized by current monetization models. Remove the need to go through a payment based aaS infra, and all the libraries to do the data visualization could be running on the MRI dude's PC. -aaS by definition requires you to open yourself to someone else to let them do the work for you. It doesn't empower you, it empowers them.
    - freehorse 2y ago
      Yeah I suspect -aaS monetisation models are one of the reasons of the current all-to-internet mess. However, such software running in the machine using a hardware usb key as authenticating is not unheard of either in software like that. I wish that decisions on these subjects were done based on the specific needs of the users rather than the finance people of -aaS companies.
- deleted 2y ago
  [deleted]
jmcgough 2y ago
Our critical devices were fine. But epic and all of our machines were down. How do you transmit radiology images without epic?
- freehorse 2y ago
  Is that an ironic question? Or serious one? I fail to detect the presence or absence of irony sometimes online. I just hope that my own healthcare system has some back-up plans for how to do day-to-day operations like transfering my scan results to a specialist in case the system they normally use fails.
kanonade 2y ago
MRI read outs are 3d, so can't be printed for analysis. They are gigabytes in size, and the units are usually in a different part of the building. So you could sneakernet cds every time an MRI is done, then sneakernet the results back. Or you could batch it and then analysis is done slowly and all at once. OR you could connect it to a central server and results/analysis can be available instantly. Smarter people than us have already thought through this and the cost-benefit analysis said "connect it to a server"
- turtlebits 2y ago
  Ever heard of a LAN? You don't need internet access for every single machine.
  - ikiris 2y ago
    Do you think everyone involved is physically present? The gp was absolutely accurate that you guys have no idea how modern healthcare works and this had nothing to do with externally introduced malware.
    - dopylitty 2y ago
      This sounds a bit like someone just got ran over by a truck because the driver couldn’t see them so people ask why trucks are so big that they’re dangerous and the response is “you just don’t know how trucks work” rather than “yeah maybe drivers should be able to see pedestrians”. If modern medicine is dangerous and fragile because of network connected equipment then that should be fixed even if the way it currently works doesn’t allow it.
      - ikiris 2y ago
        This is a completely different discussion. They absolutely should be reliable. The part that is a complete non starter is not being networked because it ignores that telemedicine, pacs integration, and telerobotics exist. If you don't understand why it has to be networked with extremely bad fallback to paper, then I suggest working in healthcare for a bit before pontificating on how everything should just go back to the stone age.

rsync 2y ago

"It needs to be online." No, it doesn't. Some have chosen - for reasons of efficiency and scale and cost - to place it online. However, this is a trade-off for fragility. It's not insane to make this trade-off ... ... but it is insane to not realize one is making it.