[HN Gopher] Doctors who use Google Translate to talk to patients... ___________________________________________________________________ Doctors who use Google Translate to talk to patients want a better option Author : grogu88 Score : 47 points Date : 2022-03-17 18:07 UTC (4 hours ago) (HTM) web link (www.statnews.com) (TXT) w3m dump (www.statnews.com) | rahimnathwani wrote: | This article says they used Google Translate for "Taiwanese to | English, English to Taiwanese", but Google Translate doesn't list | 'Taiwanese' as a language. | | It _does_ list 'Chinese (Traditional)' and I guess that's what | they were using. | thaumasiotes wrote: | Fun fact: Disney movies get separate dubs for Taiwan and for | mainland China. | rahimnathwani wrote: | I'm going to try this next time my son watches a Disney | movie, and see if he notices. | thaumasiotes wrote: | If he's already familiar with the movie, he's pretty | certain to notice if you switch the version. The song | lyrics are completely different. | | I tend to feel that the Taiwan lyrics are better, but I'm | not a native or even fluent speaker. I'd be interested in | native opinions. | johndfsgdgdfg wrote: | In US ALL doctors have to be trained in Spanish so that they can | serve the hispanic population. This type of systemic racism | against hispanics shouldn't be tolerated and we need put an end | to it. | hohoemi8 wrote: | I don't know anything about the person in the article but if you | still don't speak the language X years after immigrating to a | country you have no one but yourself to blame for these kinds of | situations. | freedomben wrote: | I can't imagine being a patient in pain trying to communicate | that to a doctor who didn't speak the same language, especially | when the pain was due to a different issue (as the article | describes). | | The pendulum has fully swung from "pain is a vital sign" to "suck | it up" and "anyone who complains about pain is a liar or a drug | seeker unless they're older than 65 or have a visible external | wound."[1] It's difficult even when you speak the same language. | I'm sure it's nearly impossible when you don't. | | [1]: https://rehabs.com/pro-talk/how-to-get-labeled-a-pill- | seeker... | pseingatl wrote: | A patient who is mentally challenged or who is unconscious may | or won't have the vocabulary that would permit a physician to | take a history. | | Veterinarians deal with this daily as well. | | In both cases, there are professional protocols to deal with | the situation. | atdrummond wrote: | It has become an absolute joke. I have had 6 surgeries for | Crohns, a back surgery due to wear and tear from high level | athletics, and am a long term sufferer of an aggressive | leukaemia. Despite using opioids responsibly for over a decade, | I am regarded as nothing more than a drug seeking pest the very | few times I have actively sought pain relief during in-patient | hospital stays. Prior to being dropped entirely from my | Oxycodone IR script (30 10mg pills a month, truly not a large | amount) without any warning due to my pain doctor finally | simply giving up on the system, I had never asked for an | increase in a dose ever - despite still having plenty of | untreated pain. | | Legitimate chronic pain patients are being abused at this point | in order to save face for the broken, rent-seeking | pharmaceutical system that enabled the prescription opioid | 'crisis' in the first place. | BaronVonSteuben wrote: | Yep, absolutely. My doctor of 10+ years recently retired, | leaving me in search of a new doc. I've been managing my pain | for 15+ years just fine with 10mg Hydrocodone. In 15 years I | only once asked to increase the dose, and it was only from | two pills per day to three to help me get through the | afternoon/evening better. A minuscule dose. | | After doing "new patient" appointments (which by the way were | like $200 to $300 _each_ ) and not having a doc willing to | take me on as a patient unless I dropped the opioids, and | making several calls (who refused to tell me over the phone | whether the doctor was even _open_ to controlled substances | without that $300 "new patient" appointment) I gave up. | Since coming off the opioids my quality of life has plunged. | I struggle with depression and thoughts of suicide now, | especially when I'm unable to leave the house or my bed. I | went from stable and productive and what doctors used to say | is the model patient, to being miserable. Every doc has | offered to give me additional antidepressants or crank up the | doses of those, but none are willing to treat the pain that | is exacerbating it. | | I absolutely believe that what the medical establishment is | doing to people like us (withholding treatment that we know | works) is cruel and borders on torture. It is the epitome of | taking macro-level stats and explanations and applying them | broadly on the micro-level, regardless of the harm caused. | | I believe Hippocrates would be rolling over in his grave to | hear that these people took an oath to "do no harm." | | For the record. I mostly don't blame the doctors. They are | protecting their medical licenses, which the DEA and FDA have | proven they are willing to revoke over the slightest anomaly. | When the feds started throwing pain specialists in federal | prison because some tiny percent of their patients were | abusers, it really drove home that individual doctors are not | allowed to think anymore. You implement government policy, or | you risk financial ruin and even jail time. I don't blame | them for being cowards. I probably wouldn't risk imprisonment | on a stranger either. | atdrummond wrote: | I don't blame the doctors either. My pain doctor was a | rural boy from my hometown who made good, graduated from | Berkeley and finished medical school and finished desirable | postdocs at Harvard. He simply straight up quit pain | management as a specialty rather than be forced to provide | his patients with what he considered subpar care. The loss | of doctors like him hurts particularly badly, as it leaves | us with pain specialists who either knowingly ignore the | decades of successfully treated patients who used opioids | or the remaining (and they do still exist) pill mill | operations, who have simply gotten more sophisticated in | their execution. Regardless of which doctor archetype | chronic pain patients end up with, they're going to suffer. | google234123 wrote: | We also now know that those treatments kill people and | users gain dependence and tolerance to opioids. It's more | than just protecting their medical license. | atdrummond wrote: | The proportion of patients who become addicted from | properly prescribed opioids is extremely small. The | majority of addicts created were provided with opioids | that were not appropriate for their particular medical | situation, in doses that were too high, and on a regimen | that exceeded in length what was supported by the medical | evidence. The proportion of new cancer patients who go on | to receive palliative care that includes opioids who end | up becoming addicted has always been, and remains, in the | low single digits. For patients with a genuine need and | who are properly inducted and maintained on them, opioids | are a powerful and useful medical tool. | | Further, the bulk of use in illegal opioids stateside, | such as fentanyl and its analogues, is not (at least | today) driven by the conversion of the legal opioid user | to an illegal drug user. Fentanyl is now commonly found | in drugs that never previously would have contained an | opioid, such as counterfeit benzos and MDMA. Further, the | majority of fentanyl users on the street arrive at its | use after consuming other illegal/street drugs. For those | who started on other opioids, their first opioid will | tend to be the illegally diverted pills or liquid cough | treatments containing codeine/hydrocodone called "lean". | Very few new users of fentanyl and fentanyl analogues | come from legal opioid users, mainly because very few new | users are now inducted on reckless prescriptions such as | an immediate script for 180 Oxycontin and 240 | benzodiazepene pills a month. Your narrative is about a | decade out of date at this point. | | Thomas Kline is a superb resource if you want to take a | deeper dive into the actual statistics and how the | narrative of a crisis was used to systematically deny law | abiding patients the pain treatment they should receive. | https://twitter.com/thomasklinemd | google234123 wrote: | A meta study of 38 studies from 7 years ago on patients | using opioids for chronic pain found that 21-29% of the | patients misuse the drugs and 8-12% of the patients are | addicted to them. That doesn't seem "extremely small" | like you said, though maybe it's better now. I think | there are reasons why opioids are no longer recommended | for the treatment of most patients with chronic pain that | you aren't fairly acknowledging. | | https://journals.lww.com/pain/Abstract/2015/04000/Rates_o | f_o... | atdrummond wrote: | https://www.nejm.org/doi/full/10.1056/NEJMra1507771 | Volkow is a mainstream researcher, using data from the | peak of the crisis, and cites the rate at just under 8%. | It is not at all unreasonable to assume that with proper | prescribing (unlike what happened in the 90s and 2000s) | that chronic pain patients can have opioid misuse and | addiction numbers near or matching that of palliative | care patients, where addiction rates are closer to 1% | than 10%. | exolymph wrote: | Who fucking cares? This wouldn't be nearly as huge of a | problem if people with a physical dependency -- inclusive | of addicts, but by NO MEANS exclusively addicts -- could | reliably access safe, reliably dosed opioids instead of | getting pushed to street drugs. | google234123 wrote: | If these people have access to a doctor/health care then | there they definitely have options to treat their | addition. Any family physician would be happy to discuss | treatment options. | | The problem of people without health care is a bigger and | separate issue. | fvv wrote: | Sorry if i sound blatantly stupid with my question, maybe | In your case this could not be a sufficient solution for | pain but did you ever tried with something like Marijuana | and if it's illegal in you state considered migrating where | it's legal? Or even considered to relocate to somewhere | where you can get access to proper medication ? | dijonman2 wrote: | You can buy oxy on the street. Super expensive. $1/mg. | throwaway42124 wrote: | I'm sorry you're in this situation. | | Consider buying your medicine from the dark web as a | possible workaround. | Gatsky wrote: | Sorry to hear you have this problem. Chronic pain | understanding and management is medieval, and seemingly | getting worse rather than better over time. | atdrummond wrote: | I really appreciate your kind thoughts. Thankfully | Vipassana meditation has helped keep me sane in spite of | the inane restrictions my doctors have been put under and | also just so happens to help reduce the pain to a somewhat | more manageable level. It's funny that a lot of the | patients most aggressively hurt by simplistic one-size- | fits-all reforms like the 90 MME cap are the patients most | likely to support, and already be utilizing, integrative | medicine. Such patients have been dealing with pain for | years, decades often - they're not going to turn down any | potential solutions that might help. All they ask is for | their doctors to be given the autonomy necessary to | prescribe legal, needed medications when called for. | LAC-Tech wrote: | Is no one going to address the elephant in the room? If you're in | a country where the lingua franca is X, you need to be able to | speak X or life will be difficult. I'm not sure why the onus is | on every hospital to become a kind of mini united nations here. | umeshunni wrote: | Many hospitals advertise internationally and rely on medical | tourism of various sorts. You can't expect a 70 year old heart | patient flown in from Taiwan to Phoenix to learn English for | their surgery. | thaumasiotes wrote: | I think if you're advertising internationally for | international patients, it becomes reasonable to expect you | to have translators on staff. | paxys wrote: | Tourism (including medical tourism) is a thing, as is | telemedicine. In general, doctors and hospitals aren't in the | business of turning away people just because they speak the | "wrong" language. | google234123 wrote: | To be fair, most the people only speaking Spanish in the US | aren't here for tourism. | jka wrote: | People travel recreationally, for business, and sometimes out | of necessity to places where they don't speak the local | language - perhaps you, friends, or family have, or will in | future, experience those kinds of travel. | | Medical emergencies (or, to be honest, routine medical care) | can be required for anyone, anywhere, for no particular reason. | Care workers are no doubt familiar with that. | | For people to want to improve the situation for hospitals | doesn't seem bad if it's possible. Do you think that we cannot | achieve better? | LAC-Tech wrote: | _People travel recreationally, for business, and sometimes | out of necessity to places where they don 't speak the local | language - perhaps you, friends, or family have, or will in | future, experience those kinds of travel._ | | Sure, my wifes English is very good but not perfect. I | accompany her so I can give quick translations to medical | terms she might not know. | | If we ever bring her parents here to live, guess whose job | it's going to be to make sure they understand doctors? Well, | mostly hers... but you get my point. The onus is on us. | | I have no expectation that every hospital should be able to | communicate in every language on earth. | [deleted] | jka wrote: | Thanks - that all makes sense, and I agree that generally | it makes sense to navigate life with realistic | expectations. | | Having optimism, and deciding to challenge existing | limitations can both be useful too, though. | | > I have no expectation that every hospital should be able | to communicate in every language on earth. | | I like the way you stated that. At first it made me think | about how to improve translations. Now it's making me | wonder whether there is a more universal common medical | language (in many situations, I think that human care for | each other doesn't require much communication at all). | jspash wrote: | I recently went to Poland for a quick 2 day holiday. Felt great | before I left. Felt great while I was there. Tested positive | for covid the morning I was supposed to fly home. Fast forward | a bit and I'm in the back of an ambulance while my partner was | on the plane back home. | | They put me up in a hotel for 10 days. Fed me 3 times a day. | Checked on me twice a day. And on day 10, opened the door and I | was on my own. | | How I could have managed that without Google translate, I don't | know. None of the doctors or nurses spoke more than a few words | of English. And I could barely say hello, goodbye or thank you. | (I can now!) | | As you say, life would have been difficult. It was difficult | even _with_ google translate. But it made the interactions much | easier on both parties involved. | | I would hope that if someone was visiting my country on | holiday, or to visit their relatives, and happened to get sick, | that the hospital would do all they could to communicate with | them and not treat them like they shouldn't even be there. | LAC-Tech wrote: | Right, but if you decided to move to Poland - you'd realise | you probably need to speak Polish, right? | slackfan wrote: | There has been a better option for a long time, called on-staff | Medical Interpreters. In fact, my spouse worked as one for | approximately seven years. Unfortunately due to hospitals | consolidating into medical networks and cutting costs wherever | they could, this went from on-staff interpreters, to contract | interpreters, to on-call phone interpreters (works incredibly | poorly), to google translate. | | Blame the beurocrats running your hospital. The systems were in | place, just have been absolutely gutted. | standardUser wrote: | Having multiple full-time paid translators on hand 24/7 at | every hospital in the country would be nice, but probably not | realistic. | not2b wrote: | That approach is best for cases where it works, for example in | areas where there is a large minority of speakers of a given | language (Spanish in the US, for example). But if the patient | speaks a language that is unusual for the area, finding an | interpreter is going to be more difficult, or maybe not | possible in some cases. | pseingatl wrote: | You have a similar problem with respect to criminal trials of | defendants who speak minority languages. You can find a Khmer | interpreter easily enough in Los Angeles, but good luck in | Miami. | sokoloff wrote: | Criminal trials are at least scheduled, permitting travel | or other advance arrangements. | munk-a wrote: | My SO had to seek medical attention in rural southern France | (we were visiting Carcassone) - she initially sought care at | the local emerg where there was not a translator available, she | speaks high-school french but most of the conversation was | carried out through miming and charades. A few days later, as | instructed, she followed up with a local clinic where she | prepared a written version of her condition and brought it in | to show the doctor, they consulted that and again went through | a song and dance to try and mime out the response. | | I think it'd probably be nice if there was an english fluent | person on staff at the emerg but I think it's unreasonable to | expect local clinics to have support for translating especially | when English is a rather unlikely language to be spoken in that | area - having someone German and Italian literate would be nice | and having someone Spanish literate (and, ideally, Basque | literate) would be much more important. | | If you're running a hospital in Vancouver you better have a | French[1], Punjabi and Mandarin translator on staff - outside | of those I think it's reasonable to rely on tools like Google | Translate, it sucks but full language coverage isn't | reasonable. | | 1. I think a French translator might be legally required due to | the bilingual nature of Canada but it's honestly much less | common on the west coast compared to Punjabi and Mandarin. | ipaddr wrote: | Usually your staff comes from the local population which | gives you staff members who speak the languages you would | need. | missblit wrote: | Unless a recent immigrant or tourist has a medical | emergency right? | | Or even a longer-term immigrant who never quite learned | much medical vocabulary. | djrogers wrote: | There are relatively few native French speakers in | Vancouver.. | throwawayboise wrote: | > I think it's reasonable to rely on tools like Google | Translate, it sucks but full language coverage isn't | reasonable. | | Far better than what was possible before, when as a tourist | you maybe had a phrasebook or something similar. | | This is part of the risk of travel into an area where you | don't know the language. | | Also if you are going to permanently move to such a place, | it's incumbent on _you_ to become functionally fluent in the | local language. Nobody there owes you a special accomodation. | munk-a wrote: | > Also if you are going to permanently move to such a | place, it's incumbent on you to become functionally fluent | in the local language. Nobody there owes you a special | accomodation. | | Functional fluency doesn't really cover hospital | interactions though, right? I can live for decades in Paris | without knowing what the word for chest pains or sprained | ankle are. | AmericanChopper wrote: | I've lived in a foreign country where I learned the local | language and was hospitalised twice during the time I | lived there. My vocabulary certainly didn't contain very | much medical vocabulary, and it wasn't an issue at all. | At worst you're Google translating one or two words, or | explaining things in a slightly odd way. | | I could certainly say "chest pain" though. | Talanes wrote: | I've spoken English my whole life and still struggle to | express the exact sensation I'm feeling to a doctor. | djrogers wrote: | No, I doubt you could - 'pain' and it's synonyms, as well | as basic body parts like 'chest' are pretty basic words | for someone who's spent decades immersed in a language... | Cd00d wrote: | I had experience with the charades act. Got food poisoning or | a stomach bug in Sofia, Bulgaria and had to act out vomiting | and diarrhea at the chemists desk. Eventually they got the | drift, opened a box of pills and gave me a sheet of them with | no further instruction. | | I think I could have been successful if I knew some French, | but alas, I opted for Spanish in high school. At the time it | seemed Bulgarians over a certain age had French for their | second (or third) language, and the younger folks had | English. | Xenoamorphous wrote: | > At the time it seemed Bulgarians over a certain age had | French for their second (or third) language, and the | younger folks had English. | | Yes this happens in Spain too. People over 50 or 55 or so | were taught French at school but younger people were taught | English. | | However don't expect most of them to speak much of it. | brianwawok wrote: | > By 2028, it is expected that health care spending in the U.S. | will reach nearly one fifth of the nation's gross domestic | product | | It is a balance of features vs price. Right now, we need to do | absolutely everything we can to keep the price of medical care | as low as possible. | | In the US it might make sense for most hospitals to have people | on staff for Spanish. I don't think we as a country can afford | 270 other languages of full time staff. We should use tech in | any way possible to cut this cost. | w-j-w wrote: | slackfan wrote: | Bluntly speaking, this is not a problem that tech can solve. | Because nothing, no video calls, no vr, no phone calls, can | replace an on-site professional. There are approximately top | 10 languages you want to have staff for, and then the rest | can be handled by contractors. But you have to remember that | most "staff" are actually 1099 contractors now because they | can be paid submarket wages that way. | | Thanks, monopolies. | nradov wrote: | Medicare and most private insurers will pay for medical | translation or interpretation services when necessary. It's | HCPCS billing code T1013. Generally hospitals would make a | small gross profit on it, so I'm puzzled why they would | eliminate those positions if there is enough demand to keep | them busy. | kvathupo wrote: | What are countries with more functional healthcare systems | doing differently? | | When it comes to comparisons with other countries, much of the | dialogue in the US is centered on insurance coverage. That | said, I'm curious if other countries have found better | solutions to similarly fundamental issues, such as doctors | working long hours, doctors being forced to maximize the number | of patients, continued medical education, and patient education | about the doctor-patient relationship. | wswope wrote: | Career healthtech worker; opinions are my own; focusing only | on the provider-specific questions you're asking: | | Biggest problem (w.r.t. provider overwork and availability) | is regulatory capture by AMA and hospital groups. The AMA has | for decades induced an artificial shortage of MDs by limiting | the number of available residency slots. In particular, | there's an acute shortage of slots for primary care providers | (gen practice, family med, internal medicine, OBGYN) - which | combined with financial incentive, leads to an oversupply of | specialists. | | AMA is also very assertive about keeping alternative | providers (e.g. nurse practitioners) from having the rights | to perform certain procedures - again as a form of financial | protectionism. I'm picking the worst possible example, | because it goes wrong _all the time_ , but in many LatAm | countries for example, routine x-rays and ultrasounds are | often read by technologists rather than radiologists. Broadly | speaking, there's a chilling effect of provider liability, in | that your PCP may not be a dermatologist, so instead of doing | a mole screen themselves during your annual office visit, | they send you for a specialist visit instead of doing it in | house (to avoid the unlikely chance they miss something | subtle the derm might've caught) - costing more money, | fueling the oversupply of specialty care, and letting the | "general" skills of GPs atrophy even further. | | TLDR: The American Medical Association kills people. | kvathupo wrote: | I initially thought this was a fringe comment, but I was | surprised to learn that your criticisms have basis, with | adherents like Milton Friedman [1]. It certainly toppled my | presumptive association of the AMA with putting patient | care first. | | P.S. I found this tidbit on tobacco particularly | troublesome [2]. | | [1] - https://en.wikipedia.org/wiki/American_Medical_Associ | ation#C... | | [2] - https://www.sourcewatch.org/index.php/American_Medica | l_Assoc... | oblvious-earth wrote: | Aaron Carroll did a Youtube Series back in 2014 on the topic, | even if you don't want to watch the videos there's a lot of | good links in the description of each one: | https://www.youtube.com/watch?v=yN- | MkRcOJjY&list=PLkfBg8ML-g... | | From what I remember: Insurance is one reason, Hospitals not | engaging in collective bargaining (e.g. vs. NHS in England | which makes decisions about what to spend money on and makes | companies bid on contracts for the whole country), wasteful | premium care that adds little to patient outcomes (e.g. vs | Singapore which has a privatised tiered healthcare system but | heavily regulates healthcare so this doesn't happen), and | simply paying Doctors far more money. | scotty79 wrote: | Why is Google translate still so bad? | | I remember that when it was introduced many years ago it was | horribly bad but it's badness was a hope that things will improve | quickly. | | And after so many years and so much data available to google it's | still that bad. | nitwit005 wrote: | I'm sure it's possible to make their discharge instruction | template, but it seems inevitable they're hand out instructions | to people who won't understand them. | | Even with native speakers, medical instructions can be difficult. | You can find lists of commonly confused English medical terms: | https://www.antidote.me/blog/medical-terms-a-to-z-common-and... | https://www.2ascribe.com/articles/health-wellness/40-words-t... | | And, of course, there are still plenty of illiterate people. | abortionlover69 wrote: | [deleted] | jquery wrote: | Deepl is a better option. It feels several years ahead of Google | Translate in quality. I know enough Japanese to hurt myself, and | Deepl is definitely giving the superior translations, by far, | which is great for my studies. As an analogy, it's like going | from 144p to 360p (a good human translation ranges from 720p to | 4k+). Yeah 360p video is still blurry but it's in a different | league than 144p. | anon_123g987 wrote: | The problem with machine translation is not the obvious general | mediocrity, but the occasional undetected catastrophic failure, | especially in medical context. I don't think DeepL (or any | other fully automated system) is any more reliable in this | sense. | potatoman22 wrote: | Can any automated solution be reliable enough? I don't think | so unless you can prove it does less harm than a professional | medical translator. | atdrummond wrote: | For those who know better than I - does this article, when saying | Taiwanese, refer to Taiwanese Mandarin or the language also known | as Taigi/Taigu? | rahimnathwani wrote: | When speaking: probably not Mandarin, as in that case they | would have no difficulty finding an interpreter. | | When writing: not a relevant question, as Google Translate is | for the written form, not spoken dialects. | LAC-Tech wrote: | Considering they were using google translate, I assume they | meant Taiwanese Mandarin. Though usually when I hear taiwanese | as a language in english it's tai-gi. | atdrummond wrote: | I was doing some research on Hokkien in general the other day | and that's when I noticed some using the endonym Taigu | instead. I'm not sure what the difference, if any, is. | rahimnathwani wrote: | Taigu is a Taiwanese-specific dialect of Hokkien. | | Hokkien is spoken outside Taiwan (e.g. Fujian). | atdrummond wrote: | I'm aware of that, so apologies if that wasn't clear. I | was referring to the Taigu/Taigi distinction as the | source of my uncertainty. | thaumasiotes wrote: | > Hokkien is spoken outside Taiwan (e.g. Fujian). | | It would be pretty shocking if that wasn't the case, | since Hokkien is spelled Fu Jian . | LAC-Tech wrote: | Right, but when people say "Hokkien" in English they | generally mean Min Nan Yu - though I've also heard the | term "Southern Min" used. | LAC-Tech wrote: | I've only heard 'gi', but it looks like alternate | pronunciations[0]. | | I've only really dabbled in the language, but I quickly got | the impression it's not exactly standardised. Even | something as simple as 'I' seems to have two pronunciations | (gua and wa). | | [0] https://www.mkdict.net/results?query=%E8%AA%9E+&page=1& | q_typ... | atdrummond wrote: | Ah, now that you've highlighted the specific | pronunciation divergence the two separate | transliterations now make sense. I really appreciate the | reply, given the relatively low stakes here. | aaron695 wrote: | pseingatl wrote: | Telemedicine is now a "thing," it is not that difficult to find a | medical professional in another country who is fluent in English | as well as the target language. Just as X-Rays are now commonly | sent overseas to be read, you can set up a Zoom call with a | medical colleague who is bilingual. | | On the other hand, if you are complaining about the quality of | Google Translate, that is another matter. Deepl.com's | translations are better, but they support fewer languages. Google | Translate works on the amount of source material available in the | foreign language and what kind of source material. Mandarin can | be quite good. Legal Arabic isn't that bad either, after a United | Nations project to translate all Iraqi laws into English. There's | not that much Burmese; Thai translations are uniformly horrible | and as for Mizo? Forget it. | 1986 wrote: | As with anything in US healthcare, it's never that simple, e.g. | Telehealth providers outside of the US can't bill Medicare | (https://mhealthintelligence.com/news/doctors-outside-us- | cann...) which covers about 1/5 of the population. | [deleted] | atdrummond wrote: | I and some others in the healthcare/healthcare tech spaces | volunteered to create a discharge templating system for many of | the top non-English and non-Spanish languages used in the United | States - specifically the top languages in the Northwest to | start. Our offering utilized data from, and would have been | integrated with, an EMR whose name means "particularly | impressive" even if their response was anything but. After openly | communicating our plans with this firm for many, many months | (over two years for some of us) we were informed right before our | intended trial that we would be denied from providing our | services to the patients (and their providers) who truly needed | it. We were never given a reason and I've not seen any product | released by this firm in the interim to make me think we were | potential competition to any part of their EMR suite. | | It was a truly perplexing and depressing outcome. Worse, as some | of our team hadn't yet had their sense of possibility and belief | in the US medical system destroyed, I saw first hand a number of | talented persons simply walk away from doing any work in health | or healthcare tech. It was a double blow that went beyond just | the loss of the software that was being created; people who | otherwise would have dedicated their lives to improving patient | outcomes instead went elsewhere with their careers or | volunteering lives. | nojito wrote: | Doubt your company is large enough to partner with them. | | The issue with discharge templating is that EVERY single client | under that company gets customized support from them until you | are able to guarantee providing that level of custom support | you don't have a shot in partnering with them. | | There's a reason why Caregility is the solution instead. | | https://www.healthcareitnews.com/news/mount-sinai-eases-tran... | | Touching the templates themselves is never going to scale. | atdrummond wrote: | It wasn't a company - there was zero profit motive here - and | we had received very helpful advice from them and strong | support until we got close to starting a trial, at which | point communication suddenly ceased and it became clear | something had changed with regards to our relationship with | them. | lotsofpulp wrote: | Perhaps when they actually got serious, they escalated it | to legal, and the lawyers shot it down due to your entity | not being able to take enough liability off of their hands | (conjecture). I can see the execution side stringing you | along but no one having actually done the legal due | diligence first, who may have shot it down early enough to | prevent you wasting your time. | pythko wrote: | I'm curious for more details on what your templating system was | and how it worked. If you're up for sharing, I'd love to hear | about it. | | I know the aforementioned EMR puts a lot of emphasis on their | After Visit Summaries, which sounds somewhat similar to what | you describe. | atdrummond wrote: | Feel free to email me. I'm dealing with a death close to me | and some estate related issues so I may take some time to get | back to you but I will. | | For what it is worth, we never saw ourselves as a replacement | for the After Visit Summaries but rather an adjunct that | ensured said Summaries could be understood and utilized by | non-speakers or ESL patients who perhaps are not as confident | in their skills. | sjtindell wrote: | My partner has used an EMR called Epic in her work and it, like | all EMRs it seems, is trash. Government protections and a moat | of network effects, they're untouchable. | potatoman22 wrote: | It's hard to design software that's both flexible and | reliable enough to meet the needs of these medical users. In | an ideal world imo, hospitals could plug in various modules | into an overarching health IT framework -- that way they | could pick and choose what works the best for them. However, | that would mean they're now working with dozens of | systems/companies instead of just one. | bena wrote: | EMR software, like all medical software, suffers from a | variation of the Dead Sea Effect. | | Those who are truly invested in EMR software are not | developers and developers are not invested in EMR software. | So, as a developer, it's a job you take because you need a | job. And if you're competent, you can get a job elsewhere | eventually. If you're not, well, it's not like medical | software has a deep talent pool to draw from. You can coast | for a long time. | | Combined with that, you have to work with doctors and nurses. | Doctors especially operate under the belief that demonstrated | competence in one area correlates to expertise in all areas. | No one bikesheds harder than a doctor. Except a doctor who | fancies himself a programmer as well. | potatoman22 wrote: | Besides pay, is there any reason a dev would be more | invested in any other B2B app? A few people I know work in | medical software, and a lot of them think it's meaningful | work. | analog31 wrote: | A relative of mine is deaf, and relies on Google voice | recognition in order to comprehend her doctors. The doctors are | all amazed that such a thing exists. ___________________________________________________________________ (page generated 2022-03-17 23:00 UTC)