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Nurses Launch Campaign to Alert Public to Dangers of Medical Technology

37 points by nrjones8 12y ago

VMG 12y ago
Very light on substance on how algorithms really destroy medical care, but heavy on how it destroys jobs in the field. Not that this doesn't suck for those affected, but let's be clear about the intentions here. Edit: original title was "Algorithms Destroying Medical Care"
- Terr_ 12y ago
  Also, the hospital "market" has seen massive consolidation / mergers, so the smarmy finance character might be his own separate problem.
- Terr_ 12y ago
  Also, the hospital "market" has seen massive consolidation/mergers, so the smarmy finance character might be his own separate problem.
- nrjones8 12y ago
  I submitted the title with reference to an audio recording that is linked to on the page, having originally heard it played on the radio: http://nationalnursesunited.org/page/-/files/audilo/iorn-radio-ad-personalized-care-algorithms.mp3 http://nationalnursesunited.org/page/-/files/audilo/iorn-rad... Rather than linking directly to the mp3 file, I figured posting the whole article would give more context.
dang 12y ago
As the HN guidelines ask, please do not editorialize titles. (The submitted title was "Algorithms Destroying Medical Care".)
- huhtenberg 12y ago
  This guideline has been ruining HN discussions for a very long time. There should be a way for a submitter to explain why the submission is relevant and what is offered as a discussion topic. The only place to do that is in the title. And the solution has been suggested a million times - keep both the original and moderated titles and let people choose which one to see - any plans to implement something along these lines, preferably soon? PS. Just look at this very submission. "Algorithms ..." version would've made me read through the linked page, because it clearly identifies the relevant part of it. But seeing the "Nurses ..." title and skimming through the opener makes me think that this is some sort of US-specific content that just happens to be of a great local importance.
  - dang 12y ago
    You say "ruining"; I say it's one of the best design decisions PG ever made and that it plays a critical role in establishing the character of this site, which is to focus relentlessly on content, keep distortions and spin to a minimum, and ask readers to engage with articles for themselves. > The only place to do that is in the title. That's obviously untrue. You can post a comment to the thread. > the solution has been suggested a million times There are countless suggestions, but rarely for the same thing, let alone "the solution". > any plans to implement something along these lines, preferably soon? I doubt it, because the guideline is exactly in line with the values of this site, as I described above. Any proposed change needs to take that into account. Very few do. For example, you seem not to consider it. I spend a lot of time thinking about the quality of the front page and, in my opinion, few things would make it worse than opening titles to editorial spin. It would certainly change HN dramatically, and almost certainly disastrously. > Just look at this very submission Indeed. The rewritten title was a severe distortion. The story is a campaign by a trade association to protect its interests. "Algorithms destroying medical care" hits the trifecta of a bad title rewrite: it's editorial spin, it's linkbait, and it's misleading [1]. It's a sensational claim that requires evidence to establish, which the existence of a political campaign falls far short of. (I'm personally sympathetic with the campaign, if that matters.) As long as we're talking about this, it should really be pointed out that I posted a comment saying that we'd reverted the title and what the submitted title was. It's reasonable for people to want to see a trail of what was changed; for now, we've been posting those at the bottom of the threads. 1. https://news.ycombinator.com/item?id=7797166 https://news.ycombinator.com/item?id=7797166.
Houshalter 12y ago
There is no criticism of algorithms in this article at all except saying "they are unproven". I want to be treated by FRANK. A computer might very well be inferior at first, but there's no reason it would suck as bad as portrayed in that substanceless ad. And it could easily be better on some things where statistics matter (and doctors are horrible at them.) Sad to see them lose their jobs, but I would care more if I could afford them in the first place.
- pmoriarty 12y ago
  The article addresses you concern about the affordability of health care: "Cutting costs is now seen as the prime directive in health care. Unwilling to reduce their profits or limit excessive pricing practices, the means to limiting expenses in the healthcare industry is by restricting or rationing care."
mercer 12y ago
While it doesn't invalidate the concerns in this article, I was reminded of an article by the New Yorker I read a while ago on the importance of using checklists (and, by extension, technology) in health care. It's been submitted before: https://news.ycombinator.com/item?id=3360098 https://news.ycombinator.com/item?id=3360098
hershel 12y ago
Medical professionals have used FUD(fear,uncertainty,doubt) and requiring very high burden of proof(trying the technology for a very long term, even though preliminary results show favor ability) for ages as a tactic to scare the public and politicians from accepting innovation and change. I wonder, what are good tactics to fight such efforts ?
- SilasX 12y ago
  Counter tactics? The bill from doing it their way.
- throwwit 12y ago
  Umm... here's a passage from a year old Forbes op/ed: "... about half of real health expenditure growth is attributable to medical technology. The Robert Wood Johnson Foundation goes on to say that advancing technology may have a particularly large impact on spending in the U.S. because of “few requirements that effectiveness be demonstrated before technologies are used broadly and concern that their application tends to go beyond those patients likely to benefit the most from them.”" http://www.forbes.com/sites/realspin/2013/04/03/whos-to-blame-for-our-rising-healthcare-costs/ http://www.forbes.com/sites/realspin/2013/04/03/whos-to-blam...
  - hershel 12y ago
    The things that medical providers block are often things that would reduce costs, for example enabling mid-level workers supported by tech do some of the doctor's jobs at lower costs, and low cost eye exam kiosks. And sure, there's a problem with medical tech increasing expenses. That's another problem that needs solution.
- tapp 12y ago
  I'd start by highlighting the truth at every opportunity, which is this: Medical mistakes kill an estimated 200,000 to 400,000 Americans every year[1], making it the third leading cause of death after heart disease and cancer[2]. "Frank from IT" isn't killing those patients - doctors and nurses are, largely through really stupid stuff like failing to wash their hands adequately, leading to hospital acquired infections. [1] Journal of Patient Safety https://www.documentcloud.org/documents/781687-john-james-a-new-evidence-based-estimate-of.html#document/p1/a117333 https://www.documentcloud.org/documents/781687-john-james-a-... [2] CDC http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
athenot 12y ago
I don't think RNs need to feel threatened. If anything, medical technology will enhance their status and make doctors more dispensable. Nurses are the ultimate interface between the medical system and the patient. Right now, there is a trend to allow NP (Nurse Practitioners) a greater autonomy in what they can do. While they still work under the authority of a physician, that's becoming more and more of a rubber-stamp. More and more doctor activities can be replaced with an algorithm. Diagnoses are made before even seeing the patient and only rely on data from nurses and EMRs. That's the territory of software right there. (Of course this is not to say docs are obsolete, but their work can shift to research. And (at least for now) surgery remains more cost-effective if done by docs than by robots.)
- hershel 12y ago
  > but their work can shift to research. Can we use that much researchers ? what are the other barriers assuming doctors are willing ?
- Brakenshire 12y ago
  I think you're being far, far too gung-ho about the demise of doctors. Their presence might be at risk over 50-100 years, but for the foreseeable future technology will act primarily as an aid, not as an independent decision maker, and time saved for medical staff will just be reallocated to other clinical tasks.
- mathattack 12y ago
  Many times professionals do have valid self interest to fight innovation in their field. Great teachers (and even good ones) shouldn't fear organizational innovations like charter schools, or technological innovation like blended learning. Many times they do fear these, especially when they (teachers) organize.
christianbryant 12y ago
Perspective: http://www.tuxradar.com/content/karen-sandler-full-interview http://www.tuxradar.com/content/karen-sandler-full-interview

37 points by nrjones8 12y ago

VMG 12y ago

Very light on substance on how algorithms really destroy medical care, but heavy on how it destroys jobs in the field. Not that this doesn't suck for those affected, but let's be clear about the intentions here. Edit: original title was "Algorithms Destroying Medical Care"

Terr_ 12y ago
Also, the hospital "market" has seen massive consolidation / mergers, so the smarmy finance character might be his own separate problem.
Terr_ 12y ago
Also, the hospital "market" has seen massive consolidation/mergers, so the smarmy finance character might be his own separate problem.
nrjones8 12y ago
I submitted the title with reference to an audio recording that is linked to on the page, having originally heard it played on the radio: http://nationalnursesunited.org/page/-/files/audilo/iorn-radio-ad-personalized-care-algorithms.mp3 http://nationalnursesunited.org/page/-/files/audilo/iorn-rad... Rather than linking directly to the mp3 file, I figured posting the whole article would give more context.

dang 12y ago

As the HN guidelines ask, please do not editorialize titles. (The submitted title was "Algorithms Destroying Medical Care".)

huhtenberg 12y ago
This guideline has been ruining HN discussions for a very long time. There should be a way for a submitter to explain why the submission is relevant and what is offered as a discussion topic. The only place to do that is in the title. And the solution has been suggested a million times - keep both the original and moderated titles and let people choose which one to see - any plans to implement something along these lines, preferably soon? PS. Just look at this very submission. "Algorithms ..." version would've made me read through the linked page, because it clearly identifies the relevant part of it. But seeing the "Nurses ..." title and skimming through the opener makes me think that this is some sort of US-specific content that just happens to be of a great local importance.
- dang 12y ago
  You say "ruining"; I say it's one of the best design decisions PG ever made and that it plays a critical role in establishing the character of this site, which is to focus relentlessly on content, keep distortions and spin to a minimum, and ask readers to engage with articles for themselves. > The only place to do that is in the title. That's obviously untrue. You can post a comment to the thread. > the solution has been suggested a million times There are countless suggestions, but rarely for the same thing, let alone "the solution". > any plans to implement something along these lines, preferably soon? I doubt it, because the guideline is exactly in line with the values of this site, as I described above. Any proposed change needs to take that into account. Very few do. For example, you seem not to consider it. I spend a lot of time thinking about the quality of the front page and, in my opinion, few things would make it worse than opening titles to editorial spin. It would certainly change HN dramatically, and almost certainly disastrously. > Just look at this very submission Indeed. The rewritten title was a severe distortion. The story is a campaign by a trade association to protect its interests. "Algorithms destroying medical care" hits the trifecta of a bad title rewrite: it's editorial spin, it's linkbait, and it's misleading [1]. It's a sensational claim that requires evidence to establish, which the existence of a political campaign falls far short of. (I'm personally sympathetic with the campaign, if that matters.) As long as we're talking about this, it should really be pointed out that I posted a comment saying that we'd reverted the title and what the submitted title was. It's reasonable for people to want to see a trail of what was changed; for now, we've been posting those at the bottom of the threads. 1. https://news.ycombinator.com/item?id=7797166 https://news.ycombinator.com/item?id=7797166.

Houshalter 12y ago

There is no criticism of algorithms in this article at all except saying "they are unproven". I want to be treated by FRANK. A computer might very well be inferior at first, but there's no reason it would suck as bad as portrayed in that substanceless ad. And it could easily be better on some things where statistics matter (and doctors are horrible at them.) Sad to see them lose their jobs, but I would care more if I could afford them in the first place.

pmoriarty 12y ago
The article addresses you concern about the affordability of health care: "Cutting costs is now seen as the prime directive in health care. Unwilling to reduce their profits or limit excessive pricing practices, the means to limiting expenses in the healthcare industry is by restricting or rationing care."

mercer 12y ago

While it doesn't invalidate the concerns in this article, I was reminded of an article by the New Yorker I read a while ago on the importance of using checklists (and, by extension, technology) in health care. It's been submitted before: https://news.ycombinator.com/item?id=3360098 https://news.ycombinator.com/item?id=3360098

hershel 12y ago

Medical professionals have used FUD(fear,uncertainty,doubt) and requiring very high burden of proof(trying the technology for a very long term, even though preliminary results show favor ability) for ages as a tactic to scare the public and politicians from accepting innovation and change. I wonder, what are good tactics to fight such efforts ?

SilasX 12y ago
Counter tactics? The bill from doing it their way.
throwwit 12y ago
Umm... here's a passage from a year old Forbes op/ed: "... about half of real health expenditure growth is attributable to medical technology. The Robert Wood Johnson Foundation goes on to say that advancing technology may have a particularly large impact on spending in the U.S. because of “few requirements that effectiveness be demonstrated before technologies are used broadly and concern that their application tends to go beyond those patients likely to benefit the most from them.”" http://www.forbes.com/sites/realspin/2013/04/03/whos-to-blame-for-our-rising-healthcare-costs/ http://www.forbes.com/sites/realspin/2013/04/03/whos-to-blam...
- hershel 12y ago
  The things that medical providers block are often things that would reduce costs, for example enabling mid-level workers supported by tech do some of the doctor's jobs at lower costs, and low cost eye exam kiosks. And sure, there's a problem with medical tech increasing expenses. That's another problem that needs solution.
tapp 12y ago
I'd start by highlighting the truth at every opportunity, which is this: Medical mistakes kill an estimated 200,000 to 400,000 Americans every year[1], making it the third leading cause of death after heart disease and cancer[2]. "Frank from IT" isn't killing those patients - doctors and nurses are, largely through really stupid stuff like failing to wash their hands adequately, leading to hospital acquired infections. [1] Journal of Patient Safety https://www.documentcloud.org/documents/781687-john-james-a-new-evidence-based-estimate-of.html#document/p1/a117333 https://www.documentcloud.org/documents/781687-john-james-a-... [2] CDC http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

athenot 12y ago

I don't think RNs need to feel threatened. If anything, medical technology will enhance their status and make doctors more dispensable. Nurses are the ultimate interface between the medical system and the patient. Right now, there is a trend to allow NP (Nurse Practitioners) a greater autonomy in what they can do. While they still work under the authority of a physician, that's becoming more and more of a rubber-stamp. More and more doctor activities can be replaced with an algorithm. Diagnoses are made before even seeing the patient and only rely on data from nurses and EMRs. That's the territory of software right there. (Of course this is not to say docs are obsolete, but their work can shift to research. And (at least for now) surgery remains more cost-effective if done by docs than by robots.)

hershel 12y ago
> but their work can shift to research. Can we use that much researchers ? what are the other barriers assuming doctors are willing ?
Brakenshire 12y ago
I think you're being far, far too gung-ho about the demise of doctors. Their presence might be at risk over 50-100 years, but for the foreseeable future technology will act primarily as an aid, not as an independent decision maker, and time saved for medical staff will just be reallocated to other clinical tasks.
mathattack 12y ago
Many times professionals do have valid self interest to fight innovation in their field. Great teachers (and even good ones) shouldn't fear organizational innovations like charter schools, or technological innovation like blended learning. Many times they do fear these, especially when they (teachers) organize.

christianbryant 12y ago

Perspective: http://www.tuxradar.com/content/karen-sandler-full-interview http://www.tuxradar.com/content/karen-sandler-full-interview