#hospital administration software

[rachvictor05]

Comprehensive Hospital Management System for Enhanced Healthcare Operations

A Hospital Management System (HMS) is a vital tool for streamlining healthcare operations, ensuring that hospitals and medical institutions run smoothly and efficiently. This system integrates various functions such as patient registration, appointment scheduling, billing, medical record management, inventory control, and staff coordination into one cohesive platform. By centralizing all hospital processes, the hospital management services ensures seamless communication between departments, ultimately improving the overall quality of patient care and operational effectiveness.

One of the key advantages of an HMS is its ability to simplify patient management. From admission to discharge, all patient data is securely stored and easily accessible, allowing healthcare providers to offer personalized treatment plans. The system tracks patient history, medical records, lab results, and prescriptions in a digital format, eliminating the risk of errors commonly found in paper-based systems. This not only improves the accuracy of diagnosis and treatment but also speeds up response times.

In addition to patient care, the HMS optimizes hospital resources by managing inventories, equipment, and medical supplies in real-time. The system can automatically track stock levels and notify staff when supplies are running low, ensuring that the hospital never faces shortages. It also helps in scheduling staff shifts, ensuring that medical professionals are available when needed most.

Financial management is another critical component of a hospital’s success, and an hospital information management system supports accurate billing and payments. It helps track insurance claims, payments from patients, and generates detailed financial reports, allowing for greater transparency and better decision-making.

Overall, a Hospital Management System is an indispensable tool for modern healthcare institutions. It not only enhances the efficiency of day-to-day operations but also ensures that patients receive the best care possible while maintaining a high level of administrative accuracy. With the right HMS, hospitals can achieve a significant improvement in both clinical outcomes and operational performance.

[grapesinnovations]

Streamlining Healthcare The Power of Hospital Administration Software | Grapes IDMR

[procify360]

Searching hospital administration software

Procify360, the best healthcare crm solutions can provide valuable insights into the performance of various aspects of the healthcare organization. This is the best hospital facility management software that enable healthcare providers to identify areas for improvement and make data-driven decisions to enhance overall performance.

[sisgaintechnologies]

The Rise of Online Hospital Management Systems

In the fast-evolving world of modern medicine, technology has become an indispensable ally. One of the most transformative innovations in recent years is the Online Hospital Management System. As hospitals and healthcare providers around the globe grapple with the challenges of efficiency, patient safety, data management, and regulatory compliance, this digital solution has emerged as a powerful force driving operational change.

According to a 2024 report by Global Market Insights, the hospital management software market is expected to surpass USD 80 billion by 2030, showcasing the global healthcare industry's urgent demand for smarter, tech-enabled infrastructure. From improving day-to-day hospital workflows to revolutionizing how care is delivered and managed, an online hospital management system is no longer a futuristic tool — it's a present-day necessity.

This article will walk you through the features, benefits, and impact of online hospital management systems and how they fit into the broader landscape of Healthcare Software Services and hospital information systems.

What is an Online Hospital Management System?

An Online Hospital Management System (HMS) is a cloud-based or web-enabled digital platform designed to automate and streamline the administrative, clinical, and financial activities of a hospital. Unlike traditional, paper-based or desktop hospital systems, online HMS tools are accessible from anywhere via the internet, enabling real-time collaboration between departments and seamless access to patient information.

At its core, an HMS serves as the backbone of hospital operations. It typically includes integrated modules for:

Patient Registration and Admission

Electronic Medical Records (EMR/EHR)

Appointment Scheduling

Billing and Invoicing

Pharmacy and Inventory Management

Laboratory and Diagnostic Services

Human Resource and Staff Management

Because it's hosted on the cloud, an online HMS offers robust data backups, regular updates, and enhanced security — a major plus for healthcare institutions handling sensitive patient data.

Core Features That Drive Adoption Globally

The rise of online hospital management systems has been driven by a combination of advanced features and changing expectations in healthcare. Let’s look at the must-have capabilities that make these systems essential:

Electronic Health Records (EHR) Integration

One of the most crucial components of any HMS is its EHR module. With EHRs, hospitals can digitize patient charts, lab reports, radiology images, prescriptions, and treatment plans. This ensures:

Easy retrieval of patient history

Reduced medication errors

Real-time updates across departments

Streamlined insurance and billing documentation

Billing and Insurance Automation

Managing billing manually is time-consuming and error-prone. HMS systems automate billing processes by integrating treatment records, lab services, room charges, and medication data. They also:

Track patient payments and outstanding balances

Support multiple payment modes (cash, card, insurance)

Generate instant invoices and financial reports

Integrate with insurance portals for faster claims

Appointment and Scheduling Management

A cloud-based scheduling tool lets patients book appointments online, while doctors and hospital staff can manage their availability more effectively. Benefits include:

Reduced waiting times

Improved patient satisfaction

Smart allocation of resources

SMS and email reminders for patients

Pharmacy & Inventory Control

HMS tools can maintain a digital record of medicines and supplies. Hospitals can monitor:

Stock levels and expiry dates

Reorder alerts

Vendor management

Billing integration with pharmacy data

This minimizes wastage and ensures continuous supply of critical medications.

Telemedicine Support

Modern HMS platforms are often equipped with telemedicine functionality. Through video consultations, secure chat, and e-prescriptions, doctors can offer remote care services — especially useful during emergencies or in rural areas.

Role-Based Access and User Permissions

Security is paramount in healthcare. An HMS allows user-based role assignments. Doctors, nurses, administrators, and patients access only what they’re authorized to. This reduces misuse, ensures accountability, and supports regulatory compliance.

Benefits of Adopting an Online Hospital Management System

A successful HMS implementation impacts every layer of a hospital’s operation. From the front desk to the ICU, benefits ripple across departments.

Improved Patient Experience

With features like online registration, appointment booking, and instant access to medical history, patients enjoy faster and smoother interactions. Timely communication (e.g., appointment reminders) enhances trust and satisfaction.

Increased Operational Efficiency

An online HMS reduces manual work, automates repetitive tasks, and simplifies data entry — giving healthcare workers more time to focus on patients rather than paperwork.

Real-Time Reporting and Analytics

Administrators and doctors can pull real-time reports on occupancy, financial performance, disease trends, staff productivity, and more. Data-driven insights lead to smarter decisions.

Cost Savings Over Time

Though there's an initial investment, an online system eliminates many hidden costs:

Paper and printing expenses

Staff overtime for manual record-keeping

Revenue leaks from billing errors

Compliance fines due to incomplete documentation

Reduction in Human Errors

With features like auto-populated fields, standard templates, and alerts for missing data, HMS significantly cuts down on:

Medication errors

Duplicated records

Unbilled procedures

Real-World Use Cases: How Hospitals Are Benefiting

Multi-Specialty Hospitals

Large hospitals benefit from seamless coordination across OPD, IPD, pharmacy, and labs. Online HMS ensures smooth patient flow and central data access.

Rural Health Centers

With internet connectivity and mobile devices, remote clinics can deliver expert care via telemedicine and access cloud-based patient data.

Diagnostic Laboratories

Labs can integrate their test equipment with HMS to upload results directly into patient records. It also automates report delivery and payment.

Private Clinics

Smaller facilities use online HMS for managing appointments, prescriptions, and billing with minimal staff, helping them operate efficiently.

Table: Real-World Impact Metrics

Hospital TypeKey Benefit AchievedEfficiency GainMulti-specialtyIntegrated patient management40% reduction in admin workRural health centerRemote patient care via telehealth60% patient reach expansionDiagnostic labAutomated report generation80% faster TAT (Turnaround Time)Private clinicStreamlined appointments & billing50% improvement in scheduling accuracy

Integrating with Other Healthcare Software Services

One of the greatest advantages of modern HMS platforms is their ability to integrate seamlessly with other Healthcare Software Services. These integrations improve interoperability, streamline data exchange, and create a unified digital ecosystem.

Telemedicine Platforms

By integrating telemedicine tools, hospitals can expand their reach and offer remote consultations. This enables:

Secure video calls

Digital prescriptions

Integration of consultation records into the HMS

Laboratory Information Systems (LIS)

When LIS is connected, lab results can be auto-uploaded into patient records. It helps doctors access timely, accurate diagnostics.

Radiology Information Systems (RIS)

RIS integration ensures that imaging reports and scans are linked directly to the patient file, reducing dependency on printed films.

Mobile Health Applications

Patients can use apps to book appointments, access prescriptions, view lab reports, and get health alerts, all connected to the HMS backend.

These integrations are made possible through APIs, HL7 standards, or custom development and allow for highly customizable solutions tailored to each hospital’s needs.

Key Challenges and Considerations Before Implementation

Despite the many benefits, adopting an online HMS isn’t plug-and-play. Hospitals must navigate several hurdles:

Cost and Budgeting

Initial setup — including software purchase, infrastructure, training, and migration — can be expensive. However, cloud models with subscription pricing make it more affordable for small and mid-sized facilities.

Data Migration from Legacy Systems

Hospitals with decades of paper or on-premise digital records face data transfer challenges. Proper planning, testing, and pilot runs are essential.

Training and Change Management

Employees may resist change or find the new system difficult to use. Continuous training, user-friendly interfaces, and internal champions can ease adoption.

Cybersecurity and Compliance

Data breaches in healthcare are serious. Hospitals must ensure encryption, secure access controls, and compliance with regulations like HIPAA, GDPR, or local health data laws.

Vendor Reliability and Support

The quality of customer support, product updates, customization capabilities, and post-launch assistance should be a key factor in vendor selection.

Future of Online Hospital Management Systems

The HMS space continues to evolve with emerging technologies shaping the next generation of digital hospitals:

Artificial Intelligence (AI)

AI tools can analyze vast health data to support clinical decisions, predict disease outbreaks, and optimize staffing levels.

Blockchain Technology

Blockchain can offer tamper-proof records and enhance data sharing between healthcare providers without compromising security.

Voice-Based and NLP Interfaces

Voice commands and natural language processing (NLP) can help clinicians input notes or retrieve patient data hands-free.

Personalized Patient Engagement

Systems will increasingly include features for:

Chatbots for appointment scheduling

AI-based reminders

Real-time treatment tracking via mobile apps

IoT and Remote Monitoring

Wearables and connected devices can feed real-time vitals into HMS, allowing early intervention and better chronic disease management.

Conclusion: Embracing the Hospital of the Future

The digital revolution in healthcare is no longer a prediction — it's unfolding before our eyes. Adopting an Online Hospital Management System is now essential for hospitals striving to remain competitive, patient-centered, and operationally efficient.

From managing appointments to monitoring chronic illnesses remotely, online HMS platforms have redefined what’s possible in patient care. As they continue to integrate with broader Healthcare Software Services, they become the central nervous system of modern medical institutions.

Looking forward, innovations in AI, blockchain, and smart integrations will elevate the hospital information system to an intelligent care delivery platform. For hospitals that embrace this change early, the benefits — in efficiency, care quality, and patient trust — will be significant.

Ready to explore a tailored hospital management solution? Contact us today for a free consultation or product demo that fits your facility’s unique needs.

[mckinlily]

Plot armor but it’s Bruce Wayne’s wealth.

Bruce is one of the richest men in the world. Bruce does not want to be one of the richest men in world.

He starts by implementing high starting salaries and full health care coverages for all levels at Wayne Enterprises. This in vastly improves retention and worker productivity, and WE profits soar. He increases PTO, grants generous parental and family leave, funds diversity initiatives, boosts salaries again. WE is ranked “#1 worker-friendly corporation”, and productively and profits soar again.

Ok, so clearly investing his workers isn’t the profit-destroying doomed strategy his peers claim it is. Bruce is going to keep doing it obviously (his next initiative is to ensure all part-time and contractors get the same benefits and pay as full time employees), but he is going to have to find a different way to dump his money.

But you know what else is supposed to be prohibitively expensive? Green and ethical initiatives. Yes, Bruce can do that. He creates and fund a 10 year plan to covert all Wayne facilities to renewable energy. He overhauls all factories to employ the best environmentally friendly practices and technologies. He cuts contracts with all suppliers that engage in unethical employment practices and pays for other to upgrade their equipment and facilities to meet WE’s new environmental and safety requirements. He spares no expense.

Yeah, Wayne Enterprises is so successful that they spin off an entire new business arm focused on helping other companies convert to environmentally friendly and safe practices like they did in an efficient, cost effective, successful way.

Admittedly, investing in his own company was probably never going to be the best way to get rid of his wealth. He slashes his own salary to a pittance (god knows he has more money than he could possibly know what to do with already) and keeps investing the profits back into the workers, and WE keeps responding with nearly terrifying success.

So WE is a no-go, and Bruce now has numerous angry billionaires on his back because they’ve been claiming all these measures he’s implementing are too expensive to justify for decades and they’re finding it a little hard to keep the wool over everyone’s eyes when Idiot Softheart Bruice Wayne has money spilling out his ears. BUT Bruce can invest in Gotham. That’ll go well, right?

Gotham’s infrastructure is the OSHA anti-Christ and even what little is up to code is constantly getting destroyed by Rogue attacks. Surely THAT will be a money sink.

Except the only non-corrupt employer in Gotham city is….Wayne Enterprises. Or contractors or companies or businesses that somehow, in some way or other, feed back to WE. Paying wholesale for improvement to Gotham’s infrastructure somehow increases WE’s profits.

Bruce funds a full system overhaul of Gotham hospital (it’s not his fault the best administrative system software is WE—he looked), he sets up foundations and trusts for shelters, free clinics, schools, meal plans, day care, literally anything he can think of.

Gotham continues to be a shithole. Bruce Wayne continues to be richer than god against his Batman-ingrained will.

Oh, and Bruice Wayne is no longer viewed as solely a spoiled idiot nepo baby. The public responds by investing in WE and anything else he owns, and stop doing this, please.

Bruce sets up a foundation to pay the college tuition of every Gotham citizen who applies. It’s so successful that within 10 years, donations from previous recipients more than cover incoming need, and Bruce can’t even donate to his own charity.

But by this time, Bruce has children. If he can’t get rid of his wealth, he can at least distribute it, right?

Except Dick Grayson absolutely refuses to receive any of his money, won’t touch his trust fund, and in fact has never been so successful and creative with his hacking skills as he is in dumping the money BACK on Bruce. Jason died and won’t legally resurrect to take his trust fund. Tim has his own inherited wealth, refuses to inherit more, and in fact happily joins forces with Dick to hack accounts and return whatever money he tries to give them. Cass has no concept of monetary wealth and gives him panicked, overwhelmed eyes whenever he so much as implies offering more than $100 at once. Damian is showing worrying signs of following in his precious Richard’s footsteps, and Babs barely allows him to fund tech for the Clocktower. At least Steph lets him pay for her tuition and uses his credit card to buy unholy amounts of Batburger. But that is hardly a drop in the ocean of Bruce’s wealth. And she won’t even accept a trust fund of only one million.

Jason wins for best-worst child though because he currently runs a very lucrative crime empire. And although he pours the vast, vast majority of his profits back into Crime Alley, whenever he gets a little too rich for his tastes, he dumps the money on Bruce. At this point, Bruce almost wishes he was being used for money laundering because then he’s at least not have the money.

So children—generous, kindhearted, stubborn till the day they die the little shits, children—are also out.

Bruce was funding the Justice League. But then finances were leaked, and the public had an outcry over one man holding so much sway over the world’s superheroes (nevermind Bruce is one of those superheroes—but the public can’t know that). So Bruce had to do some fancy PR trickery, concede to a policy of not receiving a majority of funds from one individual, and significantly decrease his contributions because no one could match his donations.

At his wits end, Bruce hires a team of accounts to search through every crinkle and crevice of tax law to find what loopholes or shortcuts can be avoided in order to pay his damn taxes to the MAX.

The results are horrifying. According to the strictest definition of the law, the government owes him money.

Bruce burns the report, buries any evidence as deeply as he can, and organizes a foundation to lobby for FAR higher taxation of the upper class.

All this, and Wayne Enterprises is happily chugging along, churning profit, expanding into new markets, growing in the stock market, and trying to force the credit and proportionate compensation on their increasingly horrified CEO.

Bruce Wayne is one of the richest men in the world. Bruce Wayne will never not be one of the richest men in the world.

But by GOD is he trying.

[hybridpayroll]

Local Payroll Services Denver - Hybrid Payroll

What is HR and payroll services?

HR and Payroll Services

HR and payroll services are essential functions within an organization that involve managing employee-related tasks, financial compensation, and compliance with tax and labor regulations. Here's what the search results reveal:

1. HR Services: Human Resources (HR) departments are responsible for various functions related to employee management. Some key HR services include:

Employee Relations: HR departments handle employee relations, including recruitment, onboarding, training, performance management, and addressing employee concerns.

Benefits Administration: HR manages employee benefits, such as health insurance, retirement plans, and leave policies.

Payroll Processing: While payroll is often considered a separate function, HR departments may also handle payroll processing, including calculating wages, deductions, and ensuring compliance with tax laws.

Compliance: HR ensures compliance with labor laws, regulations, and company policies.

Data Analysis: HR departments analyze employee data to gain insights into workforce trends, performance, and engagement.

2. Payroll Services: Payroll services primarily focus on the financial aspects of employee compensation. Some key payroll services include:

Payroll Processing: Payroll services handle the calculation and distribution of employee wages, including deductions, taxes, and benefits.

Tax Filing: Payroll services ensure accurate and timely filing of payroll taxes and compliance with tax regulations.

Reporting: Payroll services generate reports on payroll-related metrics, such as compensation, deductions, and taxes paid.

Employee Self-Service: Payroll services often provide online portals for employees to access their pay stubs, view and update personal information, and manage benefits.

While HR and payroll services have distinct responsibilities, there are areas of overlap, such as coordinating employee-related information and ensuring confidentiality of sensitive data.

It's worth noting that there are various HR and payroll service providers available, each offering different features and capabilities. Some popular providers include Gusto, Paychex Flex, QuickBooks Online, and ADP.

Remember to consider the specific needs and size of your business when choosing HR and payroll services. Conducting thorough research and evaluating different providers will help you find the best fit for your organization.

[mostlysignssomeportents]

Epic Systems, a lethal health record monopolist

Epic Systems makes the dominant electronic health record (EHR) system in America; if you're a doctor, chances are you are required to use it, and for every hour a doctor spends with a patient, they have to spend two hours doing clinically useless bureaucratic data-entry on an Epic EHR.

How could a product so manifestly unfit for purpose be the absolute market leader? Simple: as Robert Kuttner describes in an excellent feature in The American Prospect, Epic may be a clinical disaster, but it's a profit-generating miracle:

https://prospect.org/health/2024-10-01-epic-dystopia/

At the core of Epic's value proposition is "upcoding," a form of billing fraud that is beloved of hospital administrators, including the "nonprofit" hospitals that generate vast fortunes that are somehow not characterized as profits. Here's a particularly egregious form of upcoding: back in 2020, the Poudre Valley Hospital in Ft Collins, CO locked all its doors except the ER entrance. Every patient entering the hospital, including those receiving absolutely routine care, was therefore processed as an "emergency."

In April 2020, Caitlin Wells Salerno – a pregnant biologist – drove to Poudre Valley with normal labor pains. She walked herself up to obstetrics, declining the offer of a wheelchair, stopping only to snap a cheeky selfie. Nevertheless, the hospital recorded her normal, uncomplicated birth as a Level 5 emergency – comparable to a major heart-attack – and whacked her with a $2755 bill for emergency care:

https://pluralistic.net/2021/10/27/crossing-a-line/#zero-fucks-given

Upcoding has its origins in the Reagan revolution, when the market-worshipping cultists he'd put in charge of health care created the "Prospective Payment System," which paid a lump sum for care. The idea was to incentivize hospitals to provide efficient care, since they could keep the difference between whatever they spent getting you better and the set PPS amount that Medicare would reimburse them. Hospitals responded by inventing upcoding: a patient with controlled, long-term coronary disease who showed up with a broken leg would get coded for the coronary condition and the cast, and the hospital would pocket both lump sums:

https://pluralistic.net/2024/06/13/a-punch-in-the-guts/#hayek-pilled

The reason hospital administrators love Epic, and pay gigantic sums for systemwide software licenses, is directly connected to the two hours that doctors spent filling in Epic forms for every hour they spend treating patients. Epic collects all that extra information in order to identify potential sources of plausible upcodes, which allows hospitals to bill patients, insurers, and Medicare through the nose for routine care. Epic can automatically recode "diabetes with no complications" from a Hierarchical Condition Category code 19 (worth $894.40) as "diabetes with kidney failure," code 18 and 136, which gooses the reimbursement to $1273.60.

Epic snitches on doctors to their bosses, giving them a dashboard to track doctors' compliance with upcoding suggestions. One of Kuttner's doctor sources says her supervisor contacts her with questions like, "That appointment was a 2. Don’t you think it might be a 3?"

Robert Kuttner is the perfect journalist to unravel the Epic scam. As a journalist who wrote for The New England Journal of Medicine, he's got an insider's knowledge of the health industry, and plenty of sources among health professionals. As he tells it, Epic is a cultlike, insular company that employs 12.500 people in its hometown of Verona, WI.

The EHR industry's origins start with a GW Bush-era law called the HITECH Act, which was later folded into Obama's Recovery Act in 2009. Obama provided $27b to hospitals that installed EHR systems. These systems had to more than track patient outcomes – they also provided the data for pay-for-performance incentives. EHRs were already trying to do something very complicated – track health outcomes – but now they were also meant to underpin a cockamamie "incentives" program that was supposed to provide a carrot to the health industry so it would stop killing people and ripping off Medicare. EHRs devolved into obscenely complex spaghetti systems that doctors and nurses loathed on sight.

But there was one group that loved EHRs: hospital administrators and the private companies offering Medicare Advantage plans (which also benefited from upcoding patients in order to soak Uncle Sucker):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/

The spread of EHRs neatly tracks with a spike in upcharging: "from 2014 through 2019, the number of hospital stays billed at the highest severity level increased almost 20 percent…the number of stays billed at each of the other severity levels decreased":

https://oig.hhs.gov/oei/reports/OEI-02-18-00380.pdf

The purpose of a system is what it does. Epic's industry-dominating EHR is great at price-gouging, but it sucks as a clinical tool – it takes 18 keystrokes just to enter a prescription:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2729481

Doctors need to see patients, but their bosses demand that they satisfy Epic's endless red tape. Doctors now routinely stay late after work and show up hours early, just to do paperwork. It's not enough. According to another one of Kuttner's sources, doctors routinely copy-and-paste earlier entries into the current one, a practice that generates rampant errors. Some just make up random numbers to fulfill Epic's nonsensical requirements: the same source told Kuttner that when prompted to enter a pain score for his TB patients, he just enters "zero."

Don't worry, Epic has a solution: AI. They've rolled out an "ambient listening" tool that attempts to transcribe everything the doctor and patient say during an exam and then bash it into a visit report. Not only is this prone to the customary mistakes that make AI unsuited to high-stakes, error-sensitive applications, it also represents a profound misunderstanding of the purpose of clinical notes.

The very exercise of organizing your thoughts and reflections about an event – such as a medical exam – into a coherent report makes you apply rigor and perspective to events that otherwise arrive as a series of fleeting impressions and reactions. That's why blogging is such an effective practice:

https://pluralistic.net/2021/05/09/the-memex-method/

The answer to doctors not having time to reflect and organize good notes is to give them more time – not more AI. As another doctor told Kuttner: "Ambient listening is a solution to a self-created problem of requiring too much data entry by clinicians."

EHRs are one of those especially hellish public-private partnerships. Health care doctrine from Reagan to Obama insisted that the system just needed to be exposed to market forces and incentives. EHRs are designed to allow hospitals to win as many of these incentives as possible. Epic's clinical care modules do this by bombarding doctors with low-quality diagnostic suggestions with "little to do with a patient’s actual condition and risks," leading to "alert fatigue," so doctors miss the important alerts in the storm of nonsense elbow-jostling:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058605/

Clinicians who actually want to improve the quality of care in their facilities end up recording data manually and keying it into spreadsheets, because they can't get Epic to give them the data they need. Meanwhile, an army of high-priced consultants stand ready to give clinicians advise on getting Epic to do what they need, but can't seem to deliver.

Ironically, one of the benefits that Epic touts is its interoperability: hospitals that buy Epic systems can interconnect those with other Epic systems, and there's a large ecosystem of aftermarket add-ons that work with Epic. But Epic is a product, not a protocol, so its much-touted interop exists entirely on its terms, and at its sufferance. If Epic chooses, a doctor using its products can send files to a doctor using a rival product. But Epic can also veto that activity – and its veto extends to deciding whether a hospital can export their patient records to a competing service and get off Epic altogether.

One major selling point for Epic is its capacity to export "anonymized" data for medical research. Very large patient data-sets like Epic's are reasonably believed to contain many potential medical insights, so medical researchers are very excited at the prospect of interrogating that data.

But Epic's approach – anonymizing files containing the most sensitive information imaginable, about millions of people, and then releasing them to third parties – is a nightmare. "De-identified" data-sets are notoriously vulnerable to "re-identification" and the threat of re-identification only increases every time there's another release or breach, which can used to reveal the identities of people in anonymized records. For example, if you have a database of all the prescribing at a given hospital – a numeric identifier representing the patient, and the time and date when they saw a doctor and got a scrip. At any time in the future, a big location-data breach – say, from Uber or a transit system – can show you which people went back and forth to the hospital at the times that line up with those doctor's appointments, unmasking the person who got abortion meds, cancer meds, psychiatric meds or other sensitive prescriptions.

The fact that anonymized data can – will! – be re-identified doesn't mean we have to give up on the prospect of gleaning insight from medical records. In the UK, the eminent doctor Ben Goldacre and colleagues built an incredible effective, privacy-preserving "trusted research environment" (TRE) to operate on millions of NHS records across a decentralized system of hospitals and trusts without ever moving the data off their own servers:

https://pluralistic.net/2024/03/08/the-fire-of-orodruin/#are-we-the-baddies

The TRE is an open source, transparent server that accepts complex research questions in the form of database queries. These queries are posted to a public server for peer-review and revision, and when they're ready, the TRE sends them to each of the databases where the records are held. Those databases transmit responses to the TRE, which then publishes them. This has been unimaginably successful: the prototype of the TRE launched during the lockdown generated sixty papers in Nature in a matter of months.

Monopolies are inefficient, and Epic's outmoded and dangerous approach to research, along with the roadblocks it puts in the way of clinical excellence, epitomizes the problems with monopoly. America's health care industry is a dumpster fire from top to bottom – from Medicare Advantage to hospital cartels – and allowing Epic to dominate the EHR market has somehow, incredibly, made that system even worse.

Naturally, Kuttner finishes out his article with some antitrust analysis, sketching out how the Sherman Act could be brought to bear on Epic. Something has to be done. Epic's software is one of the many reasons that MDs are leaving the medical profession in droves.

Epic epitomizes the long-standing class war between doctors who want to take care of their patients and hospital executives who want to make a buck off of those patients.

Tor Books as just published two new, free LITTLE BROTHER stories: VIGILANT, about creepy surveillance in distance education; and SPILL, about oil pipelines and indigenous landback.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/10/02/upcoded-to-death/#thanks-obama

Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

[13lunarstar]

Planets and careers in Vedic astrology

Surya (Sun) – The King (Ego & Self)

Keywords: leadership, authority, ambition, responsibility, governance

Sun-ruled nakshatras: Kritikka (Aries-Taurus), Uttara Phalguni (Leo-Virgo), Uttara Ashadha (Sagittarius-Capricorn)

Professions & industries:

Government service, IAS/IPS/administrative officers

Politics, ministers, heads of institutions

Judiciary, law enforcement

Leadership roles in corporations (CEO/Director)

Jewellery (like gold, diamonds), luxury goods

Medicine (especially heart-related)

Public sector enterprises

2. Chandra (Moon) – The Queen (Mind)

Keywords: emotions, nurturing, mental stability, public appeal

Moon-ruled nakshatras: Rohini (Taurus), Hasta (Virgo), Shravana (Capricorn)

Professions & industries:

Hospitality & tourism, hotels, catering, restaurants

Healthcare (especially nursing, women's health, psychiatry, obstetrics & paediatrics)

FMCG (fast-moving consumer goods), dairy, liquids, water-based industries

Real estate, especially residential

History research

Teaching and caregiving

Counselling, social work

Public relations, mass communication

3. Budha (Mercury)—the Prince (Intellect)

Keywords: Intelligence, communication, business acumen, analysis

Mercury- ruled nakshatras: Ashlesha (Cancer), Revati (Pisces), Jyeshtha (Scorpio)

Professions & industries:

Finance, accounting, sales, entrepreneurship

Writing, journalism, publishing

Scientific research

IT, software, data analytics

Legal advisors, consultants

Medicine, pharmaceuticals

Teaching, training

Traders, brokers, commission agents

Transportation & logistics

Marketing, advertising, media

4. Shukra (Venus) -the Minister (Pleasure)

Keywords: beauty, aesthetics, luxury, love, comfort, service, creativity

Venus-ruled nakshatras: Bharani (Aries), Purva Phalguni (Leo), Purva Ashadha (Sagittarius)

Profession & industries:

Arts, music, dance, singing, fashion, design

Film and entertainment industry

Cosmetics, spa, beauty industry

Jewellery, luxury goods

Relationship counselling, marriage agencies

Hospitality and tourism

Event management, interior design

Diplomacy, public relations

5. Mangala (Mars) – the Commander (Action)

Keywords: Assertiveness, strength and endurance, ambition, energy, competition

Mars-ruled nakshatras: Mrigashira (Taurus - Gemini), Dhanishta (Capricorn - Aquarius), Chitra (Virgo - Libra)

Professions & industries:

Army, police and defence services

Engineering, mechanical, civil, hardware

Leadership roles in corporations

Logistics, transportation, aviation

Surgery, emergency medicine

Sports and physical training

Firefighting, rescue services

Real estate, construction & maintenance

Weapons, arms, steel, chemicals

Entrepreneurs, especially in competitive sectors

6. Guru (Jupiter) – the Teacher (Wisdom)

Keywords: knowledge, dharma, expansion, ethics, wealth (spiritual and/or material)

Jupiter-ruled nakshatras: Punarvasu (Gemini - Cancer), Vishakha (Libra - Scorpio), Purva Bhadrapada (Aquarius - Pisces)

Professions & industries:

Teaching, education, professors

Religious and spiritual leaders

Law, legal profession, judiciary

Finance, investment, banking, wealth management

Counselling, mentoring, life coaching

Philosophy, publishing, writing

Medical (especially Ayurveda, holistic healing)

NGOs, charitable organisations

7. Shani (Saturn) – the Servant (Worker)

Keywords: labour, discipline, longevity, realism, service, duty, responsibility

Saturn-ruled nakshatras: Pushya (Cancer), Anuradha (Scorpio), Uttara Bhadrapada (Pisces)

Professions & industries:

Labour-intensive industries, mining, agriculture

Factory work, construction, infrastructure

Civil services, judiciary, and social work

Middle and senior management (gradual career advancement)

Law enforcement, auditors, and quality control

Clerks, office staff, and time-management roles

Old-age care, long-term care facilities

Iron, coal, oil, heavy industry

Research, long-term planning roles

8. Rahu - the North Node (Material desires)

Keywords: desire, illusion, mysticism, modernity, forward-thinking & innovation, eccentricity, foreign influence

Rahu-ruled nakshatras: Ardra (Gemini), Swati (Libra), Shatabhisha (Aquarius)

Professions & industries:

Technology, IT, AI, digital platforms

Foreign trade, immigration, import-export, entrepreneurship

Film, media, photography, advertising

Aviation, space, online business

Speculation, cryptocurrency, stocks

Espionage, intelligence, hacking

Political manipulation, lobbying

Unconventional professions (e.g., esoteric)

Psychology

9. Ketu - the South Node (detachment, depth)

Keywords: isolation, introspection, wisdom, renunciation, mysticism

Ketu-ruled nakshatras: Ashwini (Aries), Magha (Leo), Mula (Sagittarius)

Professions & industries:

Spirituality, mystics, monks

Research, investigation, archaeology

Parapsychology, astrology, metaphysics

IT (especially backend or anonymous work)

Healthare: pharmaceuticals, virology, immunology

Security, cyber protection

Medical surgery (especially undercover or obscure fields)

Houses and objects to check in D1 and D10 divisional charts

The D1 Chart:

To check:

10th lord: The main planet for the profession.

Atmakaraka: Soul’s desire—can show core career direction

Amatyakaraka: Advisor planet - signifies profession and working style

1st House (Lagna) -determines your general disposition, leadership capacity, and work style

2nd House - indicates earned income prospects, speech (important in communication careers), and skills

6th House - very important for job-type careers, legal fields, employment, competition, enemies, analysing financial debts

7th House - career involving clients, partnerships, business and diplomacy

10th House - primary house for career, leadership & authority, and recognition in society.

11th House - income prospects from work, professional networks, promotions.

The D10 chart:

10th house's lord in the D10 chart: The main planet for the profession.

Atmakaraka (from the D1 Chart): Soul’s desire—can show core career direction

Amatyakaraka (from the D1 Chart): Advisor planet - signifies profession and working style

1st House (Lagna of D10) - how you project yourself, appear in the professional world, public role

6th House - daily work, office dynamics, overcoming obstacles in career

7t house - dealing with others in career, clients, professional partnerships

9th House - Jupiter’s blessings, ethical conduct, long-term fortune in career

10th House - main house for profession, title, honors, and career legacy

11th House - promotions, gains from profession, social status

[political-us]

The Dow is on track for its worst April since 1932—the bleakest year of the Great Depression. Nearly a century later, markets are once again facing economic turbulence on a historic scale.

Trump's approval rating drops to 42%, the lowest it's been since he became president, according to a Reuters/Ipsos poll.

A cutting-edge microscope at Harvard Medical School could pave the way for major breakthroughs in cancer detection and aging research—but its progress is now at risk. The scientist who created the software to analyze its images, 30-year-old Russian-born Kseniia Petrova, has been held in immigration detention for two months. Arrested in February at a Boston airport, Petrova is now detained in Louisiana, facing possible deportation to Russia, where she says she fears imprisonment for protesting the war in Ukraine. Her case highlights the tension between immigration policy and the U.S.'s reliance on global scientific talent.

The Department of Homeland Security denied Mahmoud Khalil permission to be present for the birth of his first child, which took place Monday at a hospital in New York. Instead, Khalil had to experience the moment over the phone from Jena, Louisiana—more than 1,000 miles away from his wife, Dr. Noor Abdalla, who delivered their baby boy. The case has sparked criticism over DHS's handling of family and humanitarian considerations.

The White House is considering policies to encourage more Americans to marry and have children, including a potential $5,000 “baby bonus,” according to The New York Times. The proposals align with a broader conservative push to address falling birth rates and promote traditional family values. Other ideas on the table include reserving 30% of Fulbright scholarships for applicants who are married or have children, and funding educational programs that teach women about fertility and ovulation.

A group of Venezuelan migrants facing removal under a broad wartime authority challenged the Trump administration’s deportation process at the Supreme Court, arguing the notices they received don’t meet legal standards. The ACLU, representing the migrants, said the English-only notices—often given less than 24 hours before deportation—violate a recent Supreme Court ruling requiring enough time for individuals to seek habeas review.

The Education Department announced it will start collecting student loan payments from over 5 million borrowers who are in default. This means it will begin taking money from federal wages, Social Security checks, and tax refunds. This move comes as pandemic-era protections for student loan borrowers continue to wind down.

Tensions are rising within the Arizona Democratic Party as the state party chair is at odds with the governor and U.S. senators. In response, officials are considering shifting 2026 campaign funds to local county Democrats.

​The U.S. Department of Commerce has announced substantial tariffs on solar panel imports from four Southeast Asian countries—Cambodia, Vietnam, Thailand, and Malaysia—following a year-long investigation into alleged trade violations by Chinese-owned manufacturers operating in these nations. The tariffs, which vary by country and company, are as follows:​

Cambodia: Facing the steepest duties, with tariffs reaching up to 3,521%, due to non-cooperation with the investigation.

Vietnam: Companies may face duties up to 395.9%.​

Thailand: Tariffs could be as high as 375.2%.​

Malaysia: Duties are set at 34.4%.​

Senator Adam Schiff is urging the National Archives to investigate the Trump administration's use of Signal and similar messaging apps. He emphasized the need for NARA to reach out to every federal agency involved to make sure all relevant records are preserved. This comes amid growing concerns over transparency and potential violations of federal recordkeeping laws.

[naamahdarling]

Maybe it isn't that I actually hate medical professionals? They just suck and are weird sometimes, and a lot of them shouldn't be practicing, but I don't hate them as a group, like, personally.

What I hate is their ability to make my life harder in ways that are often completely opaque to me, and a lot of the crap things they do are not really possible to challenge. And I hate the fact that holding them responsible fort dogshit behavior in any way that will actually benefit me is almost always impossible.

And I also hate the fact that they have to do stupid things sometimes because that's how the system is set up, and those things sometimes mean patients actually get harmed. They aren't fond of that part either! They don't want the system to be the way it is! But they don't have a choice, so sometimes people like me get forced by bureaucracy into doing things that are re-traumatizing. And I can't imagine that feels good for them at all, knowing that their patients are sometimes only "consenting" because that bureaucracy will not let them be helped in any other way. Which isn't consent at all. I imagine that must be pretty traumatizing for them, too, sometimes.

If it were easier to actually access medical care without tremendous delays in this country right now I would have much less trouble finding providers who are good at what they do and are not horrible people, and who have clinic staff who can do their fucking job.

Oh and I also don't appreciate how evasive and unwilling to commit they are out of fear of being held to an answer that turns out to be inaccurate, but I can't make an informed decision about my own care unless they give me at least some information about probabilities and trajectories and typicalities. Genuinely, how the fuck am I supposed to navigate that shit. I get that some patients are really fucking difficult, but I should be able to get a special stamp on my file or something that says I understand that sometimes medicine isn't an exact science and the best answers that my doctors can give may not always prove to be accurate in the long term. I know they don't like being in that situation either.

A lot of medical professionals are fucking assholes, and unfortunately the ones who are not are still hamstrung by a system set up to actively prevent people from getting care.

I miss my old doctor. He gave no shits about anything that wasn't the patient. He prescribed scheduled meds based on what the patient needed and not based on fear of consequences potentially being imposed on him by the punitive patient-hostile drugs-are-bad moral panic machine developed to force suffering people into buying more dangerous drugs off the street in order to prevent far fewer people from maybe getting high off of drugs that at least weren't laced with lethal substances. (The purpose of a system is what it does.) Did he get sanctioned and become locally unhireable? Unfortunately yes he did. Does he now provide concierge care to rich people? Yes he does. He found a way to make it work, God bless him.

Everything about the medical system in this country is fucked. Hospitals, doctors, nurses, pharmacies, pharmacists, pharmacy techs, phlebotomists, clinic administrative staff, insurance companies, medical schools and schooling, licensing boards, drug advertising to both providers and patients, pharmaceutical reps, researchers, research, publishing, medical trials, pharmaceutical companies, manufacturers and distributors, medical equipment, charting software, billing and billing codes, diagnostic criteria, charity and low income services, accessible transportation, home care, the lack of independent individual patient advocates, dietitians and nutritionists, access to physical and occupational therapy and physical and occupational therapists, the massive bigotry of every kind rampant in every corner of the medical field, social work, senior care and assisted living, deprioritization of informed consent and harm reduction, disability applications, inaccessibility of medical records, especially psychiatric notes which are specifically allowed to be withheld from patients, lack of continuity of care for disadvantaged people, care that is equitably accessible to disabled people, telemedicine, patient portals, phone systems, clinic hours, every single aspect of inpatient and outpatient psychiatry, facility security, all sorts of things going on with therapists who are nevertheless probably the least malicious group of people in this entire charade, aaaaaand patients themselves.

Also hospital toilets that are too tall and make it literally physically impossible for me to poop while I'm there waiting for somebody to come out of surgery. I just needed to take a crap, guys. You didn't need to make the toilets so tall that my feet didn't even touch the floor. It is very clean but there is no shitting for short people at St Francis.

[rachvictor05]

Transforming Healthcare Operations: The Role of a Comprehensive Hospital Management System

In the ever-evolving healthcare landscape, efficiency, accuracy, and patient satisfaction are paramount. A comprehensive Hospital Management System (HMS) serves as the backbone of modern healthcare facilities, integrating various administrative and clinical functions into a unified platform. By streamlining processes, enhancing communication, and ensuring data accuracy, an hospital management system software significantly contributes to improved patient care and operational efficiency.​

Centralized Patient Information Management

At the heart of an effective HMS is the centralized management of patient information. This system consolidates patient demographics, medical histories, treatment plans, and billing details into a single, accessible database. Healthcare providers can quickly retrieve comprehensive patient profiles, leading to informed decision-making and personalized care. Moreover, centralized data reduces the risk of errors associated with manual record-keeping and enhances coordination among medical teams.​

Streamlined Appointment Scheduling and Resource Allocation

Efficient appointment scheduling is critical to minimizing patient wait times and optimizing healthcare resources. An advanced HMS offers features such as real-time appointment booking, automated reminders, and conflict resolution tools. These functionalities ensure that both patients and healthcare providers manage their time effectively. Additionally, the system can allocate resources like examination rooms and medical staff based on availability, further enhancing operational efficiency.​

Integrated Laboratory and Diagnostic Management

Integration with laboratory and diagnostic services is a significant advantage of modern HMS platforms. These systems facilitate the electronic ordering of tests, real-time tracking of results, and direct updating of patient records. Such integration reduces the risk of errors, accelerates diagnosis, and ensures that healthcare providers have timely access to critical information, thereby enhancing the quality of care delivered.​

Efficient Billing and Revenue Cycle Management

Managing the financial aspects of healthcare services is complex and requires precision. HMS platforms incorporate billing modules that automate the generation of invoices, processing of insurance claims, and tracking of payments. By reducing manual intervention, these systems decrease the likelihood of billing errors and expedite reimbursement processes. Moreover, they provide insights into financial performance, aiding in better budgeting and resource allocation.​

Real-Time Inventory and Supply Chain Oversight

Effective inventory management is vital for ensuring the availability of medical supplies and medications. HMS solutions offer real-time tracking of inventory levels, automatic reordering based on predefined thresholds, and monitoring of supply usage. This proactive approach helps prevent shortages, reduces wastage, and ensures that healthcare providers have the necessary resources to deliver care without interruption.​

Enhanced Data Analytics and Reporting

Modern HMS platforms are equipped with advanced data analytics capabilities that transform raw data into actionable insights. Healthcare administrators can generate reports on various metrics, including patient outcomes, operational efficiency, and financial performance. These insights support informed decision-making, identify areas for improvement, and facilitate compliance with healthcare regulations and standards.​

Robust Security and Compliance Measures

Given the sensitive nature of healthcare data, ensuring its security is paramount. HMS platforms implement stringent security protocols, including data encryption, access controls, and regular audits, to protect patient information. Additionally, these systems are designed to comply with healthcare regulations such as HIPAA, ensuring that healthcare providers meet legal requirements and maintain patient trust.​

Facilitating Telemedicine and Remote Care

The integration of telemedicine functionalities into HMS platforms has revolutionized patient care delivery. Patients can consult with healthcare providers remotely, reducing the need for in-person visits and expanding access to care, especially in underserved areas. These systems support video consultations, secure messaging, and integration with electronic health records, ensuring continuity of care and patient satisfaction.​

Customization to Meet Specific Healthcare Needs

Recognizing that each healthcare facility has unique requirements, many hospital management services platforms offer customization options. Healthcare providers can tailor the system to align with their specific workflows, specialties, and patient populations. This adaptability ensures that the HMS effectively supports the facility's operations and enhances the quality of care provided.​

Conclusion

The implementation of a robust Hospital Management System is a strategic investment for healthcare facilities aiming to enhance operational efficiency, improve patient care, and ensure compliance with regulatory standards. By integrating various functions such as patient management, billing, inventory control, and telemedicine, HMS platforms provide a comprehensive solution that addresses the multifaceted challenges of modern healthcare delivery. As technology continues to advance, the role of HMS in shaping the future of healthcare becomes increasingly significant.

[mariacallous]

As the Trump administration prepared to cancel contracts at the Department of Veteran Affairs this year, officials turned to a software engineer with no health care or government experience to guide them.

The engineer, working for the Department of Government Efficiency, quickly built an artificial intelligence tool to identify which services from private companies were not essential. He labeled those contracts “MUNCHABLE.”

The code, using outdated and inexpensive AI models, produced results with glaring mistakes. For instance, it hallucinated the size of contracts, frequently misreading them and inflating their value. It concluded more than a thousand were each worth $34 million, when in fact some were for as little as $35,000.

The DOGE AI tool flagged more than 2,000 contracts for “munching.” It’s unclear how many have been or are on track to be canceled — the Trump administration’s decisions on VA contracts have largely been a black box. The VA uses contractors for many reasons, including to support hospitals, research and other services aimed at caring for ailing veterans.

VA officials have said they’ve killed nearly 600 contracts overall. Congressional Democrats have been pressing VA leaders for specific details of what’s been canceled without success.

We identified at least two dozen on the DOGE list that have been canceled so far. Among the canceled contracts was one to maintain a gene sequencing device used to develop better cancer treatments. Another was for blood sample analysis in support of a VA research project. Another was to provide additional tools to measure and improve the care nurses provide.

ProPublica obtained the code and the contracts it flagged from a source and shared them with a half dozen AI and procurement experts. All said the script was flawed. Many criticized the concept of using AI to guide budgetary cuts at the VA, with one calling it “deeply problematic.”

Cary Coglianese, professor of law and of political science at the University of Pennsylvania who studies the governmental use and regulation of artificial intelligence, said he was troubled by the use of these general-purpose large language models, or LLMs. “I don’t think off-the-shelf LLMs have a great deal of reliability for something as complex and involved as this,” he said.

[dreaminginthedeepsouth]

LETTERS FROM AN AMERICAN

January 1, 2025

Heather Cox Richardson

Jan 01, 2025

Twenty-five years ago today, Americans—along with the rest of the world—woke up to a new century date…and to the discovery that the years of work computer programmers had put in to stop what was known as the Y2K bug from crashing airplanes, shutting down hospitals, and making payments systems inoperable had worked.

When programmers began their work with the first wave of commercial computers in the 1960s, computer memory was expensive, so they used a two-digit format for dates, using just the years in the century, rather than using the four digits that would be necessary otherwise—78, for example, rather than 1978. This worked fine until the century changed.

As the turn of the twenty-first century approached, computer engineers realized that computers might interpret 00 as 1900 rather than 2000 or fail to recognize it at all, causing programs that, by then, handled routine maintenance, safety checks, transportation, finance, and so on, to fail. According to scholar Olivia Bosch, governments recognized that government services, as well as security and the law, could be disrupted by the glitch. They knew that the public must have confidence that world systems would survive, and the United States and the United Kingdom, where at the time computers were more widespread than they were elsewhere, emphasized transparency about how governments, companies, and programmers were handling the problem. They backed the World Bank and the United Nations in their work to help developing countries fix their own Y2K issues.

Meanwhile, people who were already worried about the coming of a new century began to fear that the end of the world was coming. In late 1996, evangelical Christian believers saw the Virgin Mary in the windows of an office building near Clearwater, Florida, and some thought the image was a sign of the end times. Leaders fed that fear, some appearing to hope that the secular government they hated would fall, some appreciating the profit to be made from their warnings. Popular televangelist Pat Robertson ran headlines like “The Year 2000—A Date with Disaster.”

Fears reached far beyond the evangelical community. Newspaper tabloids ran headlines that convinced some worried people to start stockpiling food and preparing for societal collapse: “JANUARY 1, 2000: THE DAY THE EARTH WILL STAND STILL!” one tabloid read. “ALL BANKS WILL FAIL. FOOD SUPPLIES WILL BE DEPLETED! ELECTRICITY WILL BE CUT OFF! THE STOCK MARKET WILL CRASH! VEHICLES USING COMPUTER CHIPS WILL STOP DEAD! TELEPHONES WILL CEASE TO FUNCTION! DOMINO EFFECT WILL CAUSE A WORLDWIDE DEPRESSION!”

In fact, the fix turned out to be simple—programmers developed updated systems that recognized a four-digit date—but implementing it meant that hardware and software had to be adjusted to become Y2K compliant, and they had to be ready by midnight on December 31, 1999. Technology teams worked for years, racing to meet the deadline at a cost that researchers estimate to have been $300–$600 billion. The head of the Federal Aviation Administration at the time, Jane Garvey, told NPR in 1998 that the air traffic control system had twenty-three million lines of code that had to be fixed.

President Bill Clinton’s 1999 budget had described fixing the Y2K bug as “the single largest technology management challenge in history,” but on December 14 of that year, President Bill Clinton announced that according to the Office of Management and Budget, 99.9% of the government's mission-critical computer systems were ready for 2000. In May 1997, only 21% had been ready. “[W]e have done our job, we have met the deadline, and we have done it well below cost projections,” Clinton said.

Indeed, the fix worked. Despite the dark warnings, the programmers had done their job, and the clocks changed with little disruption. “2000,” the Wilmington, Delaware, News Journal’s headline read. “World rejoices; Y2K bug is quiet.”

Crises get a lot of attention, but the quiet work of fixing them gets less. And if that work ends the crisis that got all the attention, the success itself makes people think there was never a crisis to begin with. In the aftermath of the Y2K problem, people began to treat it as a joke, but as technology forecaster Paul Saffo emphasized, “The Y2K crisis didn’t happen precisely because people started preparing for it over a decade in advance. And the general public who was busy stocking up on supplies and stuff just didn’t have a sense that the programmers were on the job.”

As of midnight last night, a five-year contract ended that had allowed Russia to export natural gas to Europe by way of a pipeline running through Ukraine. Ukraine president Volodymyr Zelensky warned that he would not renew the contract, which permitted more than $6 billion a year to flow to cash-strapped Russia. European governments said they had plenty of time to prepare and that they have found alternative sources to meet the needs of their people.

Today, President Joe Biden issued a statement marking the day that the new, lower cap on seniors’ out-of-pocket spending on prescription drugs goes into effect. The Inflation Reduction Act, negotiated over two years and passed with Democratic votes alone, enabled the government to negotiate with pharmaceutical companies over drug prices and phased in out-of-pocket spending caps for seniors. In 2024 the cap was $3,400; it’s now $2,000.

As we launch ourselves into 2025, one of the key issues of the new year will be whether Americans care that the U.S. government does the hard, slow work of governing and, if it does, who benefits.

Happy New Year, everyone.

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

[quibble-auk]

@thebrokenmechanicalpencil

I finally did it. All of the boys get to be together again. Isn’t that wonderful? Aren’t we so happy about that?

Don’t you just love killing off characters so you can feel some semblance of closure for the story. Like yes, it’s finally done. But it’s not, I’ve still not written or explained half of it.

But I know how it ends. :D

Yeah, I didn’t proofread it, sorry for any errors. And I’m praying that the pacing is alright and everything makes sense.

—

Warnings!!!

Real shocker there’s death.

—

The small office Jeopardy sat in was dark. Any light the moon might have offered through the narrow window was shunned by the closed blinds, casting the room in a heavy gloom. The only illumination came from a dim desk lamp and the sterile glow of a bright monitor. Music lulled in through transported speakers, faint and delicate.

It wasn’t Jeopardy's usual workspace. He had been relocated to the north wing of the hospital when the mysterious plague first broke out—a wing hastily converted into a quarantine zone, where the sick and the dying were kept away from the rest of the population like forgotten ghosts.

Jeopardy was among the first medical officers exposed to the new virus, something that at first seemed like a minor anomaly—some strange mechanical hiccup, degenerating and corroding plating and accompanied by faulty joints. He had been mid-operation, performing a complex joint transplant on what became Patient Zero, when the mech had suddenly offlined. No warning, no instability in the vitals—just silence and a blinking red error across the interface.

At the time, he and his colleagues had chalked it up to a hardware failure due to negligence. But within hours, more patients began to fail in similar ways. Not just malfunctions—systems were shutting down without traceable causes. There was no identifiable strain, not one that they could recognize anyway. They weren’t equipped to identify viruses like this, plagues had been eradicated long before the war began.

But entire wards had been locked down within days.

Now reassigned to the infected wing, Jeopardy found himself behind containment barriers, technically quarantined though not incapacitated. They had no choice—he had already been exposed, and though mostly asymptomatic, no one could say for certain what that meant anymore. The virus wasn’t behaving predictably. It didn’t spread like a pathogen or function like a software bug. It was something in between, and that made it all the more terrifying.

Though Jeopardy’s field had nothing to do with virology or infectious disease—he was a reconstructive mech-surgeon by training—they couldn’t risk transferring him back to his old post. It wasn’t just about protecting others. It was also because, deep down, the hospital administration understood they needed every capable mind available in the isolation zone.

And it wasn’t like Jeopardy was unfamiliar with this kind of medical work, the old mech had been around long enough that he knew how to work in other fields. He had dabbled in all kinds of medical work during the war, and even after it. Not to mention he had treated plenty of diseases and viruses for his organic companions, the descendants of his old friend Cometeater, a Pretender. This knowledge of infectious diseases did give him an advantage over his colleagues.

Jeopardy supposed that was why he was spending so many sleepless nights pouring himself into his work. His time was running short, the plating on his chest already starting to discolor—it meant he was entering into the third stage of infection—he needed to find a cure.

He hadn’t told anyone about the discoloration.

Not yet.

The pallid corrosion spreading across his chestplate was easy enough to cover up with some paint and the occasional joint stiffness he passed off as old age. It wasn't a total lie—Jeopardy was old. His frame was an outdated model, patched and upgraded over the decades, more scrap and memory than anything off a modern assembly line. But the creeping disintegration along his core systems wasn’t age. It was the virus, carving through him like rust with purpose.

Jeopardy watched the simulation run a few more times, let the computer analyze and run tests on the samples he had collected. He clicked the reanalyze button and leaned back, absently tapping along to the beat of the song that played faintly in the room. He sucked in a breath, holding it as the results slowly loaded onto the screen in front of him. He would need to do more personal verification but he had run the machine and gotten a green “cured” result three times now.

He stared at the blinking green word—CURED—his optics narrowing as if willing it to stay true. Three times now. Three separate samples. Three different infection stages.

But he didn’t let himself hope. Not yet.

Jeopardy leaned back in his chair, the joints in his shoulders groaning with the motion. He’d run enough simulations during the war to know how easily false positives could slip through. Especially when the virus in question didn’t behave like anything catalogued before. Still, the samples were stabilizing. Corrosion halted. Regeneration markers returning to baseline. It wasn’t just a patch—it was reversal.

A cure.

He let the breath out slowly, his chassis vibrating faintly with the motion. His plating quivered despite himself. It was a fragile victory, not yet real. Not until he could reproduce it in a physical subject.

The medic let himself smile regardless, it was still progress and the closest thing they had. He plugged in a data chip, quickly downloading the data before continuing with his tests—Jeopardy has had his data accidentally wiped due to a crash too many times to let something like this go unsaved on a personal file. He hummed along to the music as he began to write more diagnostics. He scooted his chair across the long desk and fiddled with some machinery as he prepared for more in depth tests.

A flicker of movement in the reflection of a dim screen caught his eye.

Almost instinctively his medical scanners flared to life. While it wasn’t their technical purpose, Dropmix had taught him ages ago that he could use his integrated scanners for identifying other mechs—similar to how a guardian frame’s scanners worked—and it had become a habit. He reached out, searching for spark signatures around the room absently. It was late, but possible for a nurse to have slipped in to check on his progress or converse.

There was no spark signal, however, nor heat signature.

Jeopardy went back to his work, imputing some data before letting the machine whir to life. It hummed as it began running scanning for more detailed results. The medic continued his quiet humming as he pushed himself back to his monitor, pulling up a blank report to start filling out with his findings.

The cursor blinked on the blank report, waiting for his input, but Jeopardy didn’t start typing. Not right away. He had heard a small tapping noise, slightly off beat from the music, he looked down at his still fingers. He wasn’t attempting to tap along with the rhythm, someone else had to be—but the noise was padded, it didn’t belong to a metal hand of a mech.

He let his heat sensors surge out again, seeking the darkness for any sign of organic life while he kept his attention on the screen before him. There were no hot spots that would indicate another presence in the room—not of a traditional organic anyway. Jeopardy pulled his plating tight against himself for a moment, sucking in a breath as he narrowed his eyes.

In a single fluent motion he spun the chair around slowly, optics moving over the dark room in search of anything out of place. The shadows in the room didn’t move, didn’t shift. Jeopardy frowned, hand moving slowly to pull the data chip out of the computer's port and stash it in the small toolbox of his wrist.

He stood.

Jeopardy’s hand rested on his side, over where his pistol sat—Dropmix’s pistol, one that he had found stashed away that was disguised as a medical tool. It was a bit large but it got the job done. He looked around the room again, scanners seeking for something.

The medic knew that tension was high between Cybertronians and other species in the galactic council, they always had been, but recently there had been news of a potential threat. Jeopardy along with a few of his colleagues had begun to suspect that the current virus they were dealing with could have been synthesized by this other race. If Jeopardy was getting close to a cure there was reason to believe that he could be targeted.

The other race was reptilian by nature, cold blooded. They wouldn’t show up as hot spots on heat sensors, they wouldn’t show up at all, their body temperature would match their surroundings. They would be undetectable to all of his medical scanners.

Jeopardy pulled his pistol out, keeping the disguised weapon held downwards in case someone walked in—his scanners informed him there was currently no one close to the office. There was no one to interrupt. Jeopardy took a hesitant step forward, plating flaring defensively as he looked around the room again. Organics were typically small and easy to look over and there were plenty of places to hide in the office.

He scanned the room one more time, this time not with tech, but with instinct. He had learned over the years that no amount of calibration or sensor strength could replace the simple feeling of being watched. And right now, that feeling crept over his frame like nanomites.

The weapon in his hand warmed slightly, ready to power up at a moment's notice. The desk, the cabinets, even the ventilation shaft above the sealed maintenance closet—all places someone could hide, especially if they were trained. Or worse, if they were patient. The medic flinched as the equipment next to him dinged softly, the results were done.

Jeopardy should know better than to turn his back on a device that would give a small organic cover. He blinked, plates pressing tightly against him and cold dread washed over him, he lifted the pistol up, clicking the safety off with a practiced ease. His spark thrummed in his chest and his finger absently tapped out an old lullaby on the side of his gun. He didn’t have time to panic or let his anxiety get the best of him.

It was too soon for the results to be done.

Someone had stopped it from scanning.

The medic twisted around, raising his pistol to the level of the device and firing at the dark figure that stood next to it on the desk. The loud ring of gunfire echoed in the room, rattling his plates and making a small tremor run through his hands. He flinched, Jeopardy had never liked to fight, he never wanted to hurt others. But he needed to protect what he had discovered or more mechs would die.

The dark figure crumbled, the scent of burning flesh sat thickly in the back of Jeopardy’s throat and he fought the urge to gag. He let out a shaken breath, tapping the lullaby and humming to himself as he tried to calm himself. His hands shook as he stared at the small organic now laying still on the desk.

His vents hitched as his plates shivered. Jeopardy swallowed thickly, forcing himself to take a step towards the broken body. Guilt was already eating away at his spark, a strained whine escaping his throat as he looked at the still form.

He had killed them.

Jeopardy felt sick, his chest aching as his fingers numbed. The medic lowered his pistol, flicking the safety back on and let his frame shake with stressed, silent cries. He had killed before but it never became easier. He still hated it. His medical programs surged to life, already infringing him of the damage he had caused.

He didn’t have time to mourn the loss any further.

A whisper of air moved behind him.

Too soft for servos. Too measured for machinery. It came not from the vents or his overworked systems but from the subtle shift of weight on metal flooring—bare flesh against steel.

Jeopardy’s optics widened. He turned—

—but not fast enough.

A sharp crack! rang out, impossibly loud in the cramped, silent room.

The old mech yelped as pain lanced through his side, right under his auxiliary plating. The weapon was small, silent, and surgical in its intention. Not designed to destroy—designed to incapacitate. Disable.

Electricity surged through his systems, his plates flared out as his vents hitch painfully. Heat and discomfort raced over his lines and he staggered, gasping out and reaching to brace his faltering body on the desk. He tried to flick the safety of his gun off again, but his fingers weren’t responding correctly, they shook and kept locking up. Panic sprang through him, making his spark skip and thrum even louder in his constricting chest. The medic grit his teeth and looked at the source of the weapon.

The hooded figure fired another round, this time it landed on Jeopardy’s chest, right next to where a red “x” had been painted on to show that he had been exposed. Jeopardy cried out again, pain rippling through his systems. His joints locked mid-motion as the round burrowed deep, its contents flooding through his internal systems like acid through old pipes.

Jeopardy staggered forward, his hand loosening on the pistol as his knees hit the ground with a brutal clang. His optics flickered violently, vision narrowing to a red-tinged tunnel. His systems screamed at him—an internal alarm louder than the gunshot itself—but his limbs wouldn’t respond. Warnings flared across his hud, his vents wheezing with stress.

He crumpled to the ground, hissing in pain as he looked around for his aggressor. His spark was impossibly loud, his plates quivering violently as panic settled within his chest.

Another splintering crack rang out and this time Jeopardy’s computer was the target. Any information on it was lost as it burst into an electrical flame, systems overheating and failing. It sparked as metal and plastic alloys warped to the heat.

There was only one copy of the cure left.

Jeopardy’s optics tried to focus through the error haze, HUD alerts crowding his vision with red and white symbols. Critical system failure imminent. Neuro-signal degradation at 37%. He ignored them, forcing his servos to twitch. He still had the failsafe under the desk. The gunshots must have been heard elsewhere in the hospital. He could still—

The assassin crouched beside him.

They didn’t say anything, their slitted eyes quickly examined Jeopardy’s seizing frame. He groaned weakly, attempting to pull away from the attacker but his limbs remained useless and unresponsive. The medic could feel his energon hit and slick below him, painting his chest and the ground a sickly magenta.

The organic reached out, two fingers delicately brushing against the slot on Jeopardy’s wrist. It knew where the data chip was—a total wave of fear washed over Jeopardy as he struggled to pull his wrist away. His movement was too slow, too sluggish and weak to get it out of the other’s grasp. He whined, vocalizer clicking and chirping uselessly as he failed to form words.

The assassin's fingers slid over the edge of Jeopardy's wrist compartment with a precision that made his plating crawl. A soft click. A hiss of depressurization. The compartment opened—too easily.

The chip was exposed.

No—no, no, no.

Jeopardy’s entire body screamed with effort as he forced his good arm to twist, to clamp down over the slot, protect it—anything. But his servos only jittered uselessly. His fingers twitched like dying organics.

The organic was going to take it—Jeopardy was going to lose his one chance to save people.

The assassin didn’t hesitate.

Their hand darted in, prying the chip loose from Jeopardy’s wrist with an efficiency born of practice. They held it up to the low lamplight, narrow eyes glinting as they turned it between their fingers. The soft hum of the hospital’s power grid and the faint music still bleeding through the speakers were the only sounds filling the silence.

Jeopardy gurgled, trying to rise. His frame jerked once—twice—then failed, sagging with a heavy creak as sparks danced along his spine. His processor lagged, struggling to maintain control over basic systems. More clicks escaped him, another pained whine joined the abstract noises. He had lost, they had the cure.

More mechs would die—his mechs, the ones he had trained and cared for, his colleagues and peers, possibly even the Pretenders he had spent his lifetime watching over.

He couldn’t let them destroy that chip.

Not while he still had a functioning spark.

With a final desperate act, Jeopardy accessed the hardwired emergency override in his core—an ancient, wartime backup system buried beneath years of upgrades and adjustments. It wasn’t elegant. It wasn’t fast. But it was brutal.

A harsh grinding whir erupted deep inside his chest as a jolt of raw energy surged through his failing frame, overriding safeties, bypassing locked systems. His HUD flickered violently, momentarily blanking to black. When it returned, the alerts were still there—but dimmer, distant. He had seconds, maybe less.

With a rasping groan, Jeopardy's arm moved—not much, but enough. He twisted his arm, plates spasming as he moved, the assassin didn’t expect him to move. They didn’t react fast enough. They yelped as his hand crashed into their side, pressing them into the ground brutally. A pained scream escaped their scaly lips as Jeopardy forced himself to move, shifting his weight to his arm, to the hand that was pressed flat against the smaller creature’s chest.

The mech cut off his optics, reworking the power to his movement. He could hear something pop and crack beneath his hand, the organics pained wheezing breaths as its chest was compressed under the weight of his hand. Jeopardy tried not to think about it as another scream split the air. The medic choked on nothing, his spark skipping at the sound. Grief seized his chest and guilt swamped his panicking mind.

He ignored it.

Just a little more.

The assassin clawed at his wrist, trying to twist away, but Jeopardy's arm locked like a vice. His own pain was blinding—his circuits burning, his memory caches fragmenting—but he didn’t let go. Couldn’t. He was running on pure instinct now, muscle memory from a war long past and a promise he had once made to never stand by while others suffered.

The data chip was still in the assassin’s hand.

Jeopardy’s optics flickered open again, staticky and dim. His HUD was barely functioning now, warning banners sluggishly sliding across his vision. The world was a blur of dim lamplight and the ugly, rapid pulse of the intruder’s heartbeat. He could see it in the soft flesh of their throat. Could hear it. Could feel it.

With the last of Jeopardy’s strength he grunted and pressed down even more. The organic screamed again—louder this time—as a sick crunching noise rattled through Jeopardy’s frame. The mech whimpered at the noise, eyes closed tightly as he let himself fall limp. Guilt ate at his core, he could feel the organic’s blood stick to his plating, thick and foul smelling. Jeopardy shuddered, a pained cry escaping him.

The assassin didn’t move again.

The room fell into silence, save for the fading echo of the scream, the soft, rattling vents of the medic’s own failing systems, and the gentle lulling of music, deceptively calm.

Jeopardy stayed like that, slumped over the still form, the crackling hiss of damaged circuitry rising from his joints. His body trembled from the strain, from the residual current still arcing through his limbs. The override had bought him a few seconds—nothing more—and now the backlash was arriving in waves. His chest plating was blistering from the heat, inner coolant lines ruptured and leaking. Smoke curled from one of his side vents.

But the chip was still in the room.

When a nurse came in to check on him they would find it, the cure was still theirs. There was still hope.

Jeopardy hadn’t failed.

His vision dimmed further, and though his limbs were dead weight, his spark—weak and sputtering—still pulsed steady. Faint, but not extinguished. The data chip, slick with organic blood and smudged with soot, had slipped from the assassin’s hand in their final moments. It now rested just beneath Jeopardy’s outstretched arm, the glint of its casing catching the flickering desk lamp like a beacon.

He should have been afraid of the ever creeping darkness in the back of his mind, he had been for so long—the idea of dying had terrified him, there was still too much to do. But he was older now, more tired, dare he admit it, Jeopardy was ready. He hadn’t failed, he had earned his rest. Just like Dropmix had, and Coo and Cometeater, the twins, like all of the mech’s old friends had.

Jeopardy weakly smiled to himself, his vision finally fizzling out into darkness as his optics failed. The music was nice and slow, gently whispering to him, keeping him company. He didn’t have the energy to hum along, or tap. For a moment he could have sworn he could hear a different melody being tapped into his plates—which had gone strangely numb—an old lullaby Jeopardy knew too well.

He could hear Dropmix humming softly, feel his heavy hand on his shoulder, fingers tapping gently on his plating. Just like he had done countless times before, slowly lulling Jeopardy off to sleep.

And so, Jeopardy slept.

[mostlysignssomeportents]

Object permanence

I'm on a 20+ city book tour for my new novel PICKS AND SHOVELS. Catch me in PITTSBURGH on May 15 at WHITE WHALE BOOKS, and in PDX on Jun 20 at BARNES AND NOBLE with BUNNIE HUANG. More tour dates (London, Manchester) here.

#15yrsago Satellite photos catch Greek tax-evaders https://www.nytimes.com/2010/05/02/world/europe/02evasion.html

#15yrsago Six reasons to hate Facebook’s new anti-privacy system, “Connections” https://www.eff.org/deeplinks/2010/05/things-you-need-know-about-facebook

#15yrsago Viacom is becoming a lawsuit company instead of a TV company https://www.theguardian.com/technology/blog/2010/may/04/viacom-youtube

#15yrsago Bruce Schneier explains how to prevent terrorist attacks like Times Square car-bomb https://archive.nytimes.com/roomfordebate.blogs.nytimes.com/2010/05/03/times-square-bombs-and-big-crowds/

#15yrsago London cops’ signs in Internet cafe warn against loading porn and “extremism” https://www.flickr.com/photos/doctorow/4581218328/

#15yrsago Windsor Executive Solutions: Bruce Sterling and Chris Nakashima-Brown’s transhuman monarch story https://futurismic.com/2010/05/04/new-fiction-windsor-executive-solutions-by-chris-nakashima-brown-and-bruce-sterling/

#15yrsago BBC to project real-time election results on Big Ben’s tower https://news.bbc.co.uk/2/hi/uk_news/politics/election_2010/8656578.stm

#5yrsago XML inventor quits Amazon over whistleblower firings https://pluralistic.net/2020/05/04/which-side-are-you-on/#tim-bray

#5yrsago The failure of software licensing https://pluralistic.net/2020/05/04/which-side-are-you-on/#tivoization-and-beyond

#5yrsago Wired workers have unionized https://pluralistic.net/2020/05/04/which-side-are-you-on/#solidarity

#5yrsago Hospital CEOs making millions amid cuts https://pluralistic.net/2020/05/04/which-side-are-you-on/#administrative-bloat

#5yrsago Pandemic could make Big Tech our permanent overlords https://pluralistic.net/2020/05/04/which-side-are-you-on/#trustbusting

#1yrago Rosemary Kirstein's "The Steerswoman" https://pluralistic.net/2024/05/04/the-wulf/#underground-fave

[jobyoda-philippines]

Exploring Career and Job Opportunities in Davao City Philippines

Davao City, recognized as one of the Philippines' most progressive cities, continues to experience remarkable economic growth, creating a vibrant job market that attracts professionals from across the country. The city's diverse economy offers numerous employment opportunities, from entry-level positions to executive roles, making it an attractive destination for job seekers at all career stages.

The Business Process Outsourcing (BPO) sector stands as one of the largest employers in Davao City, providing thousands of jobs across various specializations. Companies in this sector actively recruit customer service representatives, technical support specialists, and quality assurance analysts, offering competitive salaries and comprehensive benefits packages. The industry's continued expansion has created numerous opportunities for career advancement, with many organizations promoting from within and providing extensive training programs.

Part-time employment opportunities have also flourished in Davao City, catering to students, professionals seeking additional income, and individuals preferring flexible work arrangements. The retail sector, food service industry, and education field offer numerous part-time positions with varying schedules and responsibilities. These roles often provide valuable work experience and can serve as stepping stones to full-time careers.

The Information Technology sector in Davao has seen significant growth, with many companies seeking software developers, web designers, and IT support specialists. This growth has been fueled by the city's improving technological infrastructure and the increasing number of tech-focused businesses establishing operations in the region. Tech professionals can find opportunities in both established companies and startups, with many positions offering competitive compensation and the possibility of remote work arrangements.

Davao's hospitality and tourism industry continues to expand, creating jobs in hotels, restaurants, travel agencies, and tour operations. The sector offers positions ranging from entry-level service roles to management positions, with many employers providing training and development opportunities. The industry's growth has also sparked demand for professionals in events management and tourism marketing.

The education sector presents numerous opportunities for both full-time and part-time employment. Educational institutions regularly seek teachers, tutors, and administrative staff. The rise of online learning has created additional opportunities for English language teachers and academic consultants who can work flexible hours from home or teaching centers.

Job hiring  in Davao, the digital economy has opened new avenues for employment. E-commerce specialists, digital content creators, and social media managers are in high demand as businesses increasingly establish their online presence. These positions often offer the flexibility of remote work while providing competitive compensation packages.

Professional development resources are readily available in Davao City, with numerous institutions offering skills training programs and industry certifications. Job seekers can access career counseling services, resume writing assistance, and interview coaching through various employment support organizations. These resources prove invaluable in helping candidates prepare for and secure desired positions.

The financial services sector in Davao has also experienced substantial growth, creating opportunities for banking professionals, insurance specialists, and investment consultants. These positions typically offer attractive compensation packages, including performance bonuses and health benefits, making them highly sought after by experienced professionals.

Davao's agricultural sector continues to evolve, combining traditional farming with modern agribusiness practices. This has created opportunities for agricultural technologists, food processing specialists, and supply chain professionals. The sector offers both technical and management positions, with many companies providing specialized training and development programs.

For those entering Davao's job market, proper preparation is essential. Successful job seekers typically maintain updated resumes, prepare comprehensive portfolios, and stay informed about industry developments. Professional networking, both online and offline, plays a crucial role in discovering opportunities and advancing careers in the city.

The future of Davao's job market looks promising, with emerging industries creating new employment opportunities. The city's commitment to economic development, coupled with its strategic location and robust infrastructure, continues to attract businesses and investors, ensuring a steady stream of job opportunities for qualified candidates.

Whether seeking full-time employment or part-time job in Davao City offers a diverse range of opportunities across multiple industries. Success in this dynamic job market often comes to those who combine proper preparation with continuous skill development and effective networking. As the city continues to grow and evolve, its job market remains a beacon of opportunity for professionals seeking to build meaningful careers in Mindanao's premier business hub.