My Medical Records

Medical records need disrupting. I’ve made little quips here and there on Twitter about this. I should own my medical records and they should be shared with physicians and their facilities as needed.

Why? In the words of Joe Biden “None of your business.” Seriously though, why should our medical records be locked in a system we cannot access? We can learn something from Twitter, Facebook, and Google. We should own our medical records — via an open standard — and allow doctors and hospitals to ask our permission to see them. Much like friending someone on a social network. The doctor looks me up, asks if they can see my records, I get a message saying the doctor would like access to my records, and I choose to let them or not. My choice, my records.

Case in point. I have a problem with one of my knees. In 2004 I had surgery to remove cartilage, a bone spur, and some arthritis from that knee. It was a fantastic decision. It made my day to day life much better. Fast forward to 2017 and that knee has become an issue. It hurts — constantly, it swells, on occasion it fails causing me to stumble, and it’s unstable. I don’t trust it and I’m tired of the constant pain it causes.

Getting to the point. I made an appointment with my family doctor to discuss the problem. Before going I tried to locate the doctor that did the surgery back in 2004, but she’s moved on. I contacted her old group to see if they had my records. Nope. All they have are records dating back to 2006. Ok, no proof of the surgery and more importantly I don’t have a record of what was done to the knee. Swell.

I visit my doctor last week. Tell her what’s going on. She puts the knee through some tests and understands there is something going on. Great. I explain there is a history here but I cannot tell her exactly what was done. My only explanation is I had surgery in 2004 to do X, Y, and Z. But I don’t know the exact terms nor do I know where the cartilage was removed or how much.

She orders and x-ray and while she’s doing this she explains she’d like to do an MRI but the Insurance company requires she order an x-ray and order physical therapy before doing the MRI. What?

She knows it’s wrong but her hands are tied. She can’t see what’s already been done to the knee and to top it off the insurance company has it’s checklist she has to fulfill before she can order what she really needs.

Now I get to go through — what I imagine will be quite uncomfortable — physical therapy because my records are lost.

I have to believe if a service existed, based on open standards, I’d be able to share these records with my doctor so she could see exactly what was done in 2004 and the insurance company would also have evidence physical therapy didn’t work back then so why not go right to the MRI and avoid the expense of the x-ray and physical therapy.

This is broken.

I know the EHR is only a tiny fraction of our dated system but I’d like to have a complete medical history. It’s my history.

To fix this will take eons. Medicine is so far behind when it comes to technology. Look at systems like Epic. It is seen as a leader in its field, but it’s a closed system. How does that benefit anyone but Epic? It doesn’t.

We need an Open API with services offered by many providers that are patient driven. Allow data to move between systems. Don’t make your money by holding patient data hostage. Make your money by building the better service.

Hopefully, someday, we’ll have a Single Payer System in America. As part of that system it’s my sincere hope good patient outcomes becomes the center of attention and data is allowed to flow between systems at, at least, national level.

Someone please disrupt this industry with an open system.

Wearing Pants poll results

73% of respondents agree wearing pants does not make you a better Software Developer.

The only puzzling thing to me about this poll is the 27% that voted Yes. Must be management types?

My Young Apprentice

New York Times: “Struggling to fill jobs in the Charlotte plant, Siemens in 2011 created an apprenticeship program for seniors at local high schools that combines four years of on-the-job training with an associate degree in mechatronics from nearby Central Piedmont Community College. When they finish, graduates have no student loans and earn more than $50,000 a year.”

What a great idea. Not all of us are cut out for college and finding a high paying job when you don’t have an education is next to impossible. This is a great alternative.

Twitter Addiction?

I’d like to pick up a new iPhone, 7 Plus or 6s Plus. I’m still using my iPhone 5C. The screen is fine and the green plastic shell has some minor wear and tear on it but it is getting a little long in the tooth.

While Kim and I were driving around last night, running errands, she asked me what I thought was a strange question. She asked “If you could have a brand new iPhone under the condition you couldn’t have Twitter on it, would you take it?”

Interesting question, isn’t it? If you’re addicted to the social network, as I am, it’s a toughie to answer right away. At first I said “These phones aren’t really phones. They’re computers with a phone app. If I can’t install apps, it not worth having a new phone.”

Have a Cup-o-JoeMy wife laughed at me and said “So you’d rather not have a brand new phone, if you can’t have Twitter.”

Yeah.

I thought about it a bit more and came to the conclusion I could live without Twitter on my phone, especially if it meant having a nice shiny new device. I could still use Twitter from my computer (now, if I could get an update to Twitterrific for the Mac that would be grand.)

I’ve only owned two iPhones; an iPhone 4 and an iPhone 5C. Before that I had Palm Centro, which was a great smartphone, and I carried an iPod Touch around. This worked quite well for me. I didn’t have a data plan for the Centro, just text and voice. I used my iPod Touch for everything else.

Indie Itch

AHHHHHH!I’m getting that itch again. I have so many ideas and never enough time to execute on them. I have a feeling this is a fairly common trait in people. We have big dreams but don’t possess the skill, patience, or business acumen to pull it off. It can be quite frustrating and lead to unnecessary stress in your life.

Distracted. That’s me. I have too many ideas and seem to like bouncing around a bit too much. Besides thinking about too many projects I also value an occasional side job that pays a little bit. When I find those jobs they’re prioritized over my own work, but never over the day job.

Lately I’ve been focused on the day job, one side gig I’m advising on (a startup), and my weird obsession to make RxCalc‘s Pharmakokinetics math library cross platform. Ultimately I’d call the last two a distraction from what I’d really like to do, which brings us back to the Indie itch.

I still dream of having a small company, say one to five folks, all dedicated to creating a business graphics like Visio or OmniGraffle

Why? Because I love those apps. I loved my time contributing to Visio and there is plenty of room on the platform for more great productivity tools.

There is, of course, another great option. Go to work for Microsoft or The Omni Group and contribute to these awesome apps. 

This ties neatly back into a post from earlier today. Yeah, I’d love to to to work at Microsoft working on the Mac and iOS versions of Visio, but I kind of doubt Microsoft cares much about porting Visio to either (I’ve heard rumor of an iOS viewer for Visio, which would be great.) 

Sorry for the stream of consciousness dump. Had to get these thoughts off my chest today. I’m felling really restless, this helped calm my mind.

Aging

Hello, Dr. Jones.Garret P. Vreeland: “Ageism is starting to raise its ugly head – people are judging based on wrinkles and hair color (none) now. That totally sucks. Yet my photography skills are burgeoning, and I’m up to my eyeballs in video and video editing again (yay, FCPX!). Got some good web contracts in as well. Yet I’m not comfortable yet. Goal one for my 57th year – achieve satisfaction.”

Then there’s this from a developer I have a lot of respect for.

A couple years back I went through an interview with a company I’d still love to work for. I didn’t get the gig and to this day I still don’t know why. It’s totally possible I did something completely wrong during my interviews but in the end I was told “You’re a good developer and a great communicator, but you’re not a good fit.” I was crushed. At the time I was in a bad place mentally and physically. A lot going on in life at that point in time. I didn’t handle the rejection well. That is my fault of course, but the only reason I could find that fit was I was too old for their group. Sour grapes I suppose.

I have a feeling getting a gig with Google, Microsoft, Amazon, Facebook, and Apple will come down to your ability to do the work. I’ve interviewed with Microsoft and worked for them. I’ve interviewed with Apple and didn’t get through the interview. I know for a fact that Google interviews are notoriously difficult to get through.

The best companies hire the best people. I have no doubt James Thomson could work for any of these companies. He’d probably have to prepare for the interview process, but he could do it.

Binge-worthy TV shows

Scripting News: “Shows I loved and highly recommend”

Dave has a pretty big list of shows he’s binge watched. I will definitely be adding many of these to my list.

Here are a few I’ve really enjoyed missing from his list.

  • The Walking Dead
  • Fear The Walking Dead
  • True Detective – Season one is very good
  • Longmire – I’m only into early season four.
  • Stranger Things – So very good

That’s all I can think of for now, I may add some more later.

On Cycling

Slack Blog: “The key to embarking on the journey to an urban cycling life starts with promptly ignoring Captain Spandex and his merry band of avid cyclists. Instead, seek out like-minded individuals who just get on with it and ask for advice about routes. Get a bike — any old bike — and start practicing. On weekends, in the evenings, to get your head around it. Astronauts need fancy gear and training. The rest of us just need practice and encouragement.”

The piece linked above gives great advice to anyone commuting to work on a bicycle, but I love the paragraph I pasted above. There is one thing about Americans that always feels funny when it comes to cycling. I see folks out on their really expensive bikes outfitted with spandex and all the fancy gear for their commute and I wonder why? European bike culture is so far ahead of ours and most commuters wear their work clothes when they ride. Oh, they also tend to ride very simple bicycles. Why is that?

Would you wear a full fireproof suit, helmet, five point harness to drive to work? Not likely. Why get all duded up for a bike commute?

Dream a Little Dream

A wonderful bouquet of flowers.Bitwise Industries: “In downtown alone, hundreds of lofts will become thousands. Eateries will line the streets. Nightlife will spring up. And on Sunday mornings, the thirty-somethings will sit outside sipping coffee from that shop on Fulton Street and tell tales of how people used to scoff at the notion of downtown revitalization.”

I love this vision. I’ve been dreaming of a vibrant Fresno downtown since we moved back from Seattle in 1997. I loved stepping outside the office and having everything within walking distance. Restaurants and shops, so many to choose from. Scores of people going about their business. It was a beautiful experience and I miss it.

If you’re looking to relocate or build you should consider downtown Fresno. There are amazing old buildings everywhere waiting for someone to show them a little TLC and make them wonderful again. If you need someone to show you, drop me a line, I’ll show you some of my favorites.

Oh, Bitwise has also gone a long way toward fixing this issue. The valley is now very different because of their efforts.

Thank you Irma and Jake — and everyone else involved behind the scenes – you’ve given me hope for a revitalized downtown.

P.S. – Can you guys try to convince Alamo Drafthouse to add a location downtown? I know the perfect space for it! Thanks!

Dumpster Bike: Day 1

When I was a kid my brothers and I were into BMX racing. We were good, big fish in a little pond you might say. We rode for Dick’s Bicycles here in Exeter, California. We were co-sponsored by Vans so our team racing shoes were supplied to us. We just picked a style, back then it was high or low tops. They were blue and gold like the rest of our team uniform. Jerry, my middle brother, was co-sponsored by SE Racing so he had the privilege of riding new gear before SE released it. 

Anywho, long story short, we know bicycles and spent many a day tearing them down, re-greasing, and reassembling them. Good time.

Move ahead almost 40 years and I still admire nice bikes. Especially older steel frames with beautiful lugs. I’ve wanted to rebuild and old steel lug frame into a fixed gear cruiser for a few years know, but I’ve never been able to happen upon a nice steel lug frame (I have one that might be worth something, so I’m afraid to strip it down to bare metal.) 

Recently we had a City cleanup day. Basically you can take anything you want to our local City Yard, pay a $5US fee, and the city properly disposes of it. This year I needed to cut down a dead tree so the cleanup day way the perfect opportunity to dispose of it. 

While I was there I thought to look for some bike frames and parts. I happened across a 2007 Giant Boulder SE. Frame, forks, and cranks just laying on the ground. I adopted it. 

Giant Boulder SE

I spent day one stripping off the chain, derailers, and handlebars. I was unfamiliar with how the forks and headset were assembled so they’re still in the frame and the bottom bracket is pretty rusty so I need a crank puller to remove the cranks. A guy at our local bike shop taught me how to take apart the headset so I can get that taken care of next. 

Once I get this thing stripped down I plan on stripping all the paint and giving it a nice fresh coat of Burnt Orange paint. Then I’ll reassemble it into a nice casual to ride bike. Nothin fancy.

I plan on keeping a little journal as I fix up what I’m calling “Fahrni Dumpster Bike Mark 0.”