#Software For Long Term Care

[arolesbianism]

Some more concept designs but this time for two guys I’ve never talked abt before oops

[global-research-report]

The Role of AI and Cloud Computing in U.S. Long Term Care Software Market

The U.S. long term care software market size is expected to reach USD 2.95 billion by 2030, exhibiting a CAGR of 11.49% from 2023 to 2030, according to a new report by Grand View Research, Inc. Increasing geriatric population and the growing prevalence of chronic diseases are propelling segment growth. With increasing life expectancy, the healthcare demand of the population is increasing. Long-term care software is widely used to track health data for patients. They are used by LTC facilities such as nursing homes, home healthcare agencies, and senior living facilities for patient assessment, care notes, workflow management, billing, insurance, staff management, and other purposes.

Increasing government efforts to boost software adoption in the healthcare system is likely to augment market growth.The market is influenced by various government programs & initiatives that aim to improve the healthcare infrastructure and provide affordable care solutions to the elderly. For instance, Medicare and Medicaid reimburse long-term care services, boosting the demand for long-term care software. Moreover, implementing the Patient Protection and Affordable Care Act (PPACA) has increased access to health insurance and preventive care for millions of Americans, which is expected to support market growth.

Various strategic initiatives, such as collaborations, mergers, acquisitions, and new start-up funding are favoring the market growth. For instance, in June 2022, August Health raised USD 15 million in Series A funding led by General Catalyst and Matrix Partners. The company is developing a SaaS system for senior living facilities. In October 2022, Sentrics announced the acquisition of Connected Living, a U.S.-based senior living facilities resident engagement platform.

The COVID-19 pandemic severely impacted the LTC centers. As the elderly population was more susceptible to infections, the pressure on SNFs, assisted living facilities, and hospices increased. Nursing homes in the U.S. reported high number of COVID infections among older people. Hence, in order to reduce human interactions, many of these facilities implemented software solutions for managing clinical and administrative functions. This led to high adoption of LTC EHR software.

U.S. Long Term Care Software Market Report Highlights

The cloud-based mode of delivery segment accounted for the largest revenue share of 41.06% in 2022, owing to its cost-effectiveness and high adoption rate in hospitals

On the basis of application, the EHR segment accounted for the largest market share in the year 2022. The segment is further expected to experience the fastest growth over the forecast period. The growth of this segment is attributed to the increased government initiatives for the implementation of EHR in healthcare facilities

The electronic medication administration record (eMAR) segment is expected to witness a significant growth rate during the forecast period owing to the increasing need for solutions for medication management and adherence

Based on the end-use, the nursing home segment dominated the market in 2022. On the other hand, the home healthcare agencies segment is expected to have a significant growth rate during the forecast period

The home healthcare agencies segment is anticipated to exhibit the highest CAGR during the forecast period. This growth can be attributed to the growing preference for receiving care at home among the elderly population and the increasing availability of remote monitoring solutions that facilitate independent living

U.S. Long Term Care Software Market Segmentation

Grand View Research has segmented the U.S. long term care software market based on mode of delivery, application, and end-use:

U.S. Long Term Care Software Mode of Delivery Outlook (Revenue, USD Million, 2018 - 2030)

Cloud-based

Web-based

On-premises

U.S. Long Term Care Software Application Outlook (Revenue, USD Million, 2018 - 2030)

Electronic Health Records

Electronic Medication Administration Record (eMAR)

Revenue Cycle Management

Resident Care

Staff Management

Others

U.S. Long Term Care Software End-use Outlook (Revenue, USD Million, 2018 - 2030)

Home Healthcare Agencies

Hospice & Palliative Care

Nursing Homes

Assisted Living Facilities

Key Players in the U.S. Long Term Care Software Market

Veradigm LLC (Allscripts Healthcare)

Cerner Corporation (Oracle Corporation)

Netsmart Technologies, Inc.

MatrixCare

Yardi Systems, Inc.

VITALS SOFTWARE

PointClickCare

Medtelligent, Inc.

AL Advantage, LLC

Genexod Technologies LLC

Revver, Inc.

Order a free sample PDF of the U.S. Long Term Care Software Market Intelligence Study, published by Grand View Research.

[rohitpalan]

Revolutionizing Healthcare: Long-Term Care Software Market Surges, Projected to Exceed USD 10.9 Billion by 2032

The long-term care software market is expected to reach a significant USD 3,877 million in 2022 and is expected to increase significantly. An even more optimistic picture is painted by projections for 2032, when the expected valuation is expected to surpass USD 10,988 million, representing an outstanding CAGR of 11% for the projected period (2022-2032). This increase reflects a paradigm change in healthcare administration as more and more facilities use advanced software to improve the effectiveness and caliber of long-term care services.

Various government initiatives across the globe to curtail the increasing healthcare cost is the factor which is fueling the growth of the long-term care software market.

To Get Sample Copy of Report Visit: https://www.futuremarketinsights.com/reports/sample/rep-gb-6184

Multiple applications of long-term care software such as the long-term care software analyze millions of data records and quickly spot potential issues before they become problems, and it enables mental health providers to manage remote patient video conferencing, scheduling, and messaging are playing a crucial role in the rapid adoption of long-term care software.

Global Long-term Care Software Market: Drivers and Challenges

Drivers

The digitalization in healthcare technology is the primary factor which is driving the growth of long-term care software market. Also, changing healthcare infrastructure, shortage of medical staff and adoption of technological solutions in the healthcare institutions is the key growth driver of the long-term care software market.

Moreover, limited healthcare specialists and different initiatives taken by the government bodies worldwide to reduce the medical cost are fueling the growth of long-term care software market.

Apart from this, the increase in the number of healthcare organizations and the increasing usage of mobile devices in the healthcare organizations are the major factors which are fueling the growth of the long-term care software market.

Challenges

The high cost of software maintenance is the primary factor which may hinder the growth of the long-term care software market in the near future. Also, the unwillingness of the traditional long-term care providers to adopt new software is one of the major factors which hampers the growth of the long-term care software market in the near future.

Key Players

The prominent players in long-term care software market are: Allscripts Healthcare Solutions, Inc., Cerner Solutions, Omnicare, Inc., Omnicell, Inc., HealthMEDX, LLC, McKesson Corporation, Optimus EMR, Inc., PointClickCare, MatrixCare, and SigmaCare.

Global Long-term Care Software Market: Regional Overview

On the geographic basis, North America is anticipated to capture largest market share, owing to the well developed and established healthcare industry, and higher adoption of long-term care software in the region.

Europe and APAC are also expected to gain substantial market share due to the rapid infrastructural development in the healthcare sector. Also, APAC is expected to be the fastest growing long-term care software market owing to the government initiatives taken in the healthcare sector by the emerging economies such as India, China, and Japan.

The Long-term Care Software market in Latin America and MEA are expected to witness high growth rates in the coming period due to the rise in digital technologies and increasing adoption of mobile devices in the healthcare sector of the region.

The research report presents a comprehensive assessment of the market and contains thoughtful insights, facts, historical data, and statistically supported and industry-validated market data.

It also contains projections using a suitable set of assumptions and methodologies. The research report provides analysis and information according to market segments such as geographies, application, and industry.

Key Segments

By Delivery Modes:

Cloud-based

On-premises

Web-based

By End User:

Assisted Living Facilities

Home Health Agencies

Nursing Homes

By Region:

North America

Latin America

Asia Pacific

Europe

MEA

[mitalipingale]

https://carbonfacesocial.org/blogs/85858/Long-term-Care-Software-Market-Analysis-Size-Share-and-Forecast

The Long-term Care Software Market in 2023 is US$ 3.37 billion, and is expected to reach US$ 8.9 billion by 2031 at a CAGR of 12.92%.

[umadeochake]

Long Term Post-Acute Care Software Market Quantitative and Qualitative Analysis | Industry Challenges and Forecast till 2036

The report on Long Term Post-Acute Care Software Market, encapsulates an in-depth analysis of the vast space of the business sphere. The report features a summary of the industry that includes a snapshot of the business ecosystem, as well as the summary of the market segmentation. The report is also inclusive of the company profiles, not to mention, the product details, production capabilities, the valuation held, and trends. In the light of the prominent competitors in the market, the report encompasses at a minimum, a brief analysis of the competitive dashboard of the leading players, with emphasis on the presence of the various service providers, the diverse product range of manufacturer offerings, as well as the end-to-end production capabilities.

Request Free Sample Copy of this Report @ https://www.researchnester.com/sample-request-5933

Market Segmentation

Segment 1: By Product

Description of characteristics and demographics of this segment.

Explanation of why this segment is important in the long term post-acute care software market.

Segment 2: Application

Description of characteristics and demographics of this segment.

Explanation of why this segment is important in the long term post-acute care software market.

Segment 3: Software Type

Description of characteristics and demographics of this segment.

Explanation of why this segment is important in the long term post-acute care software market.

Regional Analysis

North America

Market Trend: The long term post-acute care software market in North America is experiencing steady growth, driven by the increasing demand for long term post-acute care software market products and services.

Market Opportunity: There is a significant opportunity for long term post-acute care software market companies to expand their presence in North America by targeting specific industries and regions.

Europe

Market Trend: The long term post-acute care software market in Europe is highly competitive, with a focus on innovation and technological advancements.

Market Opportunity: European countries offer a strong customer base and a supportive business environment for long term post-acute care software market companies to thrive.

Request for customization @ https://www.researchnester.com/customized-reports-5933

Asia-Pacific

Market Trend: The long term post-acute care software market in Asia-Pacific is experiencing rapid growth, fueled by the increasing adoption of long term post-acute care software market products and services in emerging economies.

Market Opportunity: Asia-Pacific presents a vast market opportunity for long term post-acute care software market companies, particularly in countries like China and India.

Latin America

Market Trend: The long term post-acute care software market in Latin America is growing steadily, driven by the rising disposable income and changing consumer preferences.

Market Opportunity: Latin American countries offer untapped potential for long term post-acute care software market companies to expand their market presence and cater to the evolving needs of the population.

In a nutshell, the Long Term Post-Acute Care Software Market analysis report is an inherent collection of the market definitions, industry insights, and the overall scope of the report. Information about the numerous industry pitfalls and challenges, in addition to driving parameters influencing the revenue scale of this business, have also been provided in the report.

Access our detailed report @ https://www.researchnester.com/reports/long-term-post-acute-care-software-market/5933

About Research Nester-

Research Nester is a leading service provider for strategic market research and consulting. We aim to provide unbiased, unparalleled market insights and industry analysis to help industries, conglomerates and executives to take wise decisions for their future marketing strategy, expansion and investment etc. We believe every business can expand to its new horizon, provided a right guidance at a right time is available through strategic minds. Our out of box thinking helps our clients to take wise decision in order to avoid future uncertainties.

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[dlxxv-vetted-donations]

Tawfik needs to buy tent covers and other necessities.

My other promos

Updated: Nov 29

Member(s): @dev-tawfik (current), @devtawfik (shadowbanned), @tawfikblog, @90-tawfik (shadowbanned)

Verification: @/90-ghost

Payment methods:

Gfm for education: PayPal, Venmo, Google Pay, credit/debit (donation match $10 USD). Focus on Kofi instead until at least mid-December

Kofi for survival (mentioned here): PayPal, credit/debit. Focus on this until at least mid-December

Tawfik is a Palestinian currently taking online classes at an Egyptian university. His Kofi campaign needs to reach $3,000 to buy tent covers and other necessities for his family (see here). Any additional funds in the gfm and Kofi will go towards the next semester's payments and family care respectively.

More info:

Now he is focusing on getting his Kofi to $3,000 (fees included) to get his family tent covers and other survival needs. See here.

Nov 27: Tawfik has reached the Kofi goal to buy flu medication and a vaccine, so we are now focusing entirely on the gfm. His goal of $10,050 by Nov 28 (hard deadline) for his international student fees were also reached on the same day.

He plans to fundraise for this year's remaining academic fees (which will be significantly less than what we already raised), and hopes that the war will end by the next year so he can get a job and pay himself.

Update Nov 20: More details here. Tawfik has fallen ill with the flu and won't be online much. He needs USD $228 (fees included) for medications and a vaccine. This requires him to reach 71% of his goal on Kofi (which is specifically for non-education related needs). At the same time, he needs $10,050 in his gfm by Nov 28 to pay off his international student fees.

Update Nov 15: We reached the halfway goal for the international student fee of USD $9,050 by Nov 15. Now going for the full fee of $10,050 by Nov 28.

Update Nov 6:

Tawfik got an extension to Nov 30 to pay the international fee. New goals of USD $9,050 by Nov 15 and $10,050 by Nov 28 (to account for transfer time) were set. The final goal was reduced with some backup money. Grades will be withheld until payment is made.

Update Nov 5:

Currently, it seems impossible to raise the required funds ($10,050 - $10,150) by Nov 13. Tawfik has emailed his school to negotiate for more time.

Update Oct 29:

Now @dev-tawfik.

The next goal was $9,250 to pay off international student fees (due Nov 13, see math section below) that Tawfik just found out about.

The family urgently needed $1,000 for healthy food (Tawfik's father has health problems and needs vegetables).

Tawfik initially wanted to use the gfm money for education only as promised, but had to add the sum to the campaign goal (a total of $10,250) because the Kofi he made solely for his family wasn't receiving many donations early on.

There were some issues with the Kofi taking a few weeks to transfer funds, but that's been resolved. It is now for support of Tawfik's family and transfers money relatively quickly.

From Oct 17-27, we fundraised to $7,200 to buy some food for the family. This food money will last roughly 2 weeks.

We are focusing back on international student fees and set a short-term goal of $8,862 in the campaign by Nov 3. There will be another small goal set after this date.

We need roughly $10,050 (an estimate) in the campaign by Nov 13 (hard deadline). Again, this isn't a concrete number and involves some usage of Tawfik's backup money.

Campaign details:

Tawfik is a software engineering student in Palestine trying to continue his education by enrolling in online classes at an Egyptian university.

He already raised roughly USD $2,500 in late July through a now closed Paypal campaign and paid the school as an application and reservation fee. This is nonrefundable.

We fundraised $4,113 (5200 - 1087) and paid off his tuition for the year on Oct 7

The gfm is meant for education only. To support the family, donate to the Kofi. It no longer faces issues with long transfer times.

Tawfik has some extra leftover funds from paying off the tuition, but it isn't much and is to be used for emergencies.

Oct 17: Tawfik bought his textbooks ($800 incl fees → $6,000 in campaign) and got a small discount for being Palestinian. This money saved went into his emergency funds.

Math:

Please let me know if I screwed up the calculation somewhere.

The transfer fee is assumed to be ~$50 per $600 earned. My bad in earlier calculations where I set it after the bank fee rather than before.

Textbooks: base $600

Funds left after:

Gfm for 40 donations: 570.6

~$50 transfer fee: 520.13

12% Bank fee: 458.13

To cover the funds lost to fees, we need an extra $200 (assumed 15 donations). After fees on that, it's only $166 (enough to cover the short-term goal)

So we need 600 + 200 = $800 for the textbooks.

This is $6,000 in the campaign.

Slightly outdated: International student fees: base $2,423

900£ = USD $1,180.93

60k EGP = USD $1,241.29

Funds left after:

Gfm fees for 160 donations: 2304.74

Transfer fee, ~$200: 2,104.74

12% Bank fee: 1852.17

To cover the funds lost to fees, we need an extra $800 (assumed 55 donations). After fees on that, it's only $625 (enough to cover the short-term goal)

So we need 2423 + 800 = $3,223 for the international student fee.

This is $9,223 10,223 in the campaign, rounded up to $ 9,250 10,250

The rate of ~$100 daily is sufficient to get us to this goal before the deadline of Nov 13 (this accounts for the 2 days needed for transfers)

[reasonsforhope]

"When Ellen Kaphamtengo felt a sharp pain in her lower abdomen, she thought she might be in labour. It was the ninth month of her first pregnancy and she wasn’t taking any chances. With the help of her mother, the 18-year-old climbed on to a motorcycle taxi and rushed to a hospital in Malawi’s capital, Lilongwe, a 20-minute ride away.

At the Area 25 health centre, they told her it was a false alarm and took her to the maternity ward. But things escalated quickly when a routine ultrasound revealed that her baby was much smaller than expected for her pregnancy stage, which can cause asphyxia – a condition that limits blood flow and oxygen to the baby.

In Malawi, about 19 out of 1,000 babies die during delivery or in the first month of life. Birth asphyxia is a leading cause of neonatal mortality in the country, and can mean newborns suffering brain damage, with long-term effects including developmental delays and cerebral palsy.

Doctors reclassified Kaphamtengo, who had been anticipating a normal delivery, as a high-risk patient. Using AI-enabled foetal monitoring software, further testing found that the baby’s heart rate was dropping. A stress test showed that the baby would not survive labour.

The hospital’s head of maternal care, Chikondi Chiweza, knew she had less than 30 minutes to deliver Kaphamtengo’s baby by caesarean section. Having delivered thousands of babies at some of the busiest public hospitals in the city, she was familiar with how quickly a baby’s odds of survival can change during labour.

Chiweza, who delivered Kaphamtengo’s baby in good health, says the foetal monitoring programme has been a gamechanger for deliveries at the hospital.

“[In Kaphamtengo’s case], we would have only discovered what we did either later on, or with the baby as a stillbirth,” she says.

The software, donated by the childbirth safety technology company PeriGen through a partnership with Malawi’s health ministry and Texas children’s hospital, tracks the baby’s vital signs during labour, giving clinicians early warning of any abnormalities. Since they began using it three years ago, the number of stillbirths and neonatal deaths at the centre has fallen by 82%. It is the only hospital in the country using the technology.

“The time around delivery is the most dangerous for mother and baby,” says Jeffrey Wilkinson, an obstetrician with Texas children’s hospital, who is leading the programme. “You can prevent most deaths by making sure the baby is safe during the delivery process.”

The AI monitoring system needs less time, equipment and fewer skilled staff than traditional foetal monitoring methods, which is critical in hospitals in low-income countries such as Malawi, which face severe shortages of health workers. Regular foetal observation often relies on doctors performing periodic checks, meaning that critical information can be missed during intervals, while AI-supported programs do continuous, real-time monitoring. Traditional checks also require physicians to interpret raw data from various devices, which can be time consuming and subject to error.

Area 25’s maternity ward handles about 8,000 deliveries a year with a team of around 80 midwives and doctors. While only about 10% are trained to perform traditional electronic monitoring, most can use the AI software to detect anomalies, so doctors are aware of any riskier or more complex births. Hospital staff also say that using AI has standardised important aspects of maternity care at the clinic, such as interpretations on foetal wellbeing and decisions on when to intervene.

Kaphamtengo, who is excited to be a new mother, believes the doctor’s interventions may have saved her baby’s life. “They were able to discover that my baby was distressed early enough to act,” she says, holding her son, Justice.

Doctors at the hospital hope to see the technology introduced in other hospitals in Malawi, and across Africa.

“AI technology is being used in many fields, and saving babies’ lives should not be an exception,” says Chiweza. “It can really bridge the gap in the quality of care that underserved populations can access.”"

-via The Guardian, December 6, 2024

[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

[ecrivainsolitaire]

A summary of the Chinese AI situation, for the uninitiated.

These are scores on different tests that are designed to see how accurate a Large Language Model is in different areas of knowledge. As you know, OpenAI is partners with Microsoft, so these are the scores for ChatGPT and Copilot. DeepSeek is the Chinese model that got released a week ago. The rest are open source models, which means everyone is free to use them as they please, including the average Tumblr user. You can run them from the servers of the companies that made them for a subscription, or you can download them to install locally on your own computer. However, the computer requirements so far are so high that only a few people currently have the machines at home required to run it.

Yes, this is why AI uses so much electricity. As with any technology, the early models are highly inefficient. Think how a Ford T needed a long chimney to get rid of a ton of black smoke, which was unused petrol. Over the next hundred years combustion engines have become much more efficient, but they still waste a lot of energy, which is why we need to move towards renewable electricity and sustainable battery technology. But that's a topic for another day.

As you can see from the scores, are around the same accuracy. These tests are in constant evolution as well: as soon as they start becoming obsolete, new ones are released to adjust for a more complicated benchmark. The new models are trained using different machine learning techniques, and in theory, the goal is to make them faster and more efficient so they can operate with less power, much like modern cars use way less energy and produce far less pollution than the Ford T.

However, computing power requirements kept scaling up, so you're either tied to the subscription or forced to pay for a latest gen PC, which is why NVIDIA, AMD, Intel and all the other chip companies were investing hard on much more powerful GPUs and NPUs. For now all we need to know about those is that they're expensive, use a lot of electricity, and are required to operate the bots at superhuman speed (literally, all those clickbait posts about how AI was secretly 150 Indian men in a trenchcoat were nonsense).

Because the chip companies have been working hard on making big, bulky, powerful chips with massive fans that are up to the task, their stock value was skyrocketing, and because of that, everyone started to use AI as a marketing trend. See, marketing people are not smart, and they don't understand computers. Furthermore, marketing people think you're stupid, and because of their biased frame of reference, they think you're two snores short of brain-dead. The entire point of their existence is to turn tall tales into capital. So they don't know or care about what AI is or what it's useful for. They just saw Number Go Up for the AI companies and decided "AI is a magic cow we can milk forever". Sometimes it's not even AI, they just use old software and rebrand it, much like convection ovens became air fryers.

Well, now we're up to date. So what did DepSeek release that did a 9/11 on NVIDIA stock prices and popped the AI bubble?

Oh, I would not want to be an OpenAI investor right now either. A token is basically one Unicode character (it's more complicated than that but you can google that on your own time). That cost means you could input the entire works of Stephen King for under a dollar. Yes, including electricity costs. DeepSeek has jumped from a Ford T to a Subaru in terms of pollution and water use.

The issue here is not only input cost, though; all that data needs to be available live, in the RAM; this is why you need powerful, expensive chips in order to-

Holy shit.

I'm not going to detail all the numbers but I'm going to focus on the chip required: an RTX 3090. This is a gaming GPU that came out as the top of the line, the stuff South Korean LoL players buy…

Or they did, in September 2020. We're currently two generations ahead, on the RTX 5090.

What this is telling all those people who just sold their high-end gaming rig to be able to afford a machine that can run the latest ChatGPT locally, is that the person who bought it from them can run something basically just as powerful on their old one.

Which means that all those GPUs and NPUs that are being made, and all those deals Microsoft signed to have control of the AI market, have just lost a lot of their pulling power.

Well, I mean, the ChatGPT subscription is 20 bucks a month, surely the Chinese are charging a fortune for-

Oh. So it's free for everyone and you can use it or modify it however you want, no subscription, no unpayable electric bill, no handing Microsoft all of your private data, you can just run it on a relatively inexpensive PC. You could probably even run it on a phone in a couple years.

Oh, if only China had massive phone manufacturers that have a foot in the market everywhere except the US because the president had a tantrum eight years ago.

So… yeah, China just destabilised the global economy with a torrent file.

[elodieunderglass]

this feels like a strange question but in light of your info about how jockeys don't usually know or train with the horses they race on - what are jockeys..... for? what is the jockey doing that the horse couldn't be trained to do independently? does a good or bad jockey make a significant difference to how well a given horse does in a race?

Right?!

In a way, asking what the jockey’s for also asks the question of “why race horses?” Why do it at all, and why horses?

We sort of do it because horses are fast and exciting, and because they do what we tell them, even though it’s not in their nature. Because it’s not their nature, they have a jockey.

I’ve put this under a “Keep Reading” to save your dash.

Horses could be trained to race by themselves to some extent, but it wouldn’t be like greyhound racing - greyhounds are sighthounds, running perfectly reasonable dog software on top of ancient and serviceable dog hardware, practicing a variation of hunting behaviour. Horses wouldn’t do this; they have little desire to chase a mechanical rabbit. they have even less plan than a greyhound about what they’d do if they caught it. (Also, in terms of animal welfare, greyhound racing isn’t widely celebrated; loose animals running around aren’t better off than controlled ones.)

Racing-to-find-a-winner is not herding behaviour, even though some horses do seem to possess a natural interest in the topic. You could train some of them to understand better, and that’s what racehorse training is, but the way we have of training that is to put someone on their back to explain to them what their job is, so it all becomes circular anyway. Why do it? Why not? Why do humans race horses? Why race horses? We could just race snails; it’d be cheaper!

One answer is that when horses just Go, it isn’t super Fun. They mostly Go to pieces.

The jockey is the pilot, or software, who understands the situation and has a goal to achieve. The horse is not an engine, but a thinking animal; they have their own goals and interests, which are often satisfied by just running around in a predator-confusing fashion with their friends for 2 minutes, and then crashing into a car, eating hot chips and lying. Most of them do not really care how long 3 minutes is, what a mile means, what “pacing” is, or what “winning” is. They just have Go, and so they do that for a bit, and then fuck off.

I guess another metaphor would be Mario Kart. There are various combinations of automated and human players in a game of Mario Kart, and if racing was just about going fast, the fastest vehicle should always win. But a decent human player can beat the NPCs even if the human hasn’t bothered min/maxxing a vehicle, just because they can be moderately smart about how to race. An adult can often beat a child at Mario Kart, even if the adult takes a much worse vehicle, because in theory, brains/experience/strategy/planning factor into “who wins a race,” and we LIKE that.

Same with car racing. Why not just race autonomous vehicles? In F1, where they build their own cars, why not include the driving software in the design? Or why not remote-control them? Why bother strapping a poor driver into a flameproof suit? Fans will tell you it’s strategy. The human driver uses tactics and responsiveness and skill - but, below all this, the dark red thread of the human is risking their life and we like that.

In theory, jockeys are more intelligent than thoroughbreds, and have more of a plan: setting pace, knowing what time is, changing strategy, evaluating stamina, conducting the horse safely through traffic and over jumps, and adding a complicating element of human interest. In practice, it’s believed that they have relatively little influence on race outcomes - a bad jockey on a good horse can win or lose a race; a good jockey on a bad horse usually just loses; oh, what the hell, let’s just race snails instead - but without the jockeys, you’d have to change the name of the sport to Horses Wandering Around A Carpark Kicking Lumps Off Each Other.

Here is a bunch of baby steeplechasers practicing the concept of Go in such a way that nobody gets to Go at all. After the un-mounted Snow Dragon wipes out most of the other horses and jockeys, all of the loose horses go faster without the weight of their riders, but after an initial show of interest in the concept, the loose horses all lose interest and focus.

It was funny (because nobody was hurt) but it wasn’t what anyone really wanted. In theory, that’s what the jockey is for: they’re supposed to be the adult, in a game where you can win by doing that.

But none of it has to be happening, any more than Investments need to be Managed, you know? It would also be fine if we didn’t! Michael O’Sullivan, an Irish jockey, just died racing this very week and there’s the dark red thread again: the human is risking their life.

The consumption of animal and human in an ancient sport is fascinating and visceral and compelling; but you’re right to question it; none of it has to be that way.

As for the second half of your question: a bad jockey can make a good horse lose. A good jockey cannot make a bad horse win. But most people and most horses are not particularly exceptional, or particularly anything at all; they are just workers running in a circle.

Top jockeys on average horses win more often than other people on average horses. Top jockeys and champions exist, with year-on-year records and recorded material evidence of their decision-making and risks paying off, indicating that there’s consistency of winning across skill and experience that makes their success better-than/random; it would be worth doing a study controlling for the fact that top people are offered the best mounts.

It’s a test of horsemanship, too. Achieving flow - nonverbal command of an animal and fellow athlete, and sympathy together, such that they respect and trust you - having just met the animal - is an achievement of many skills, and if you broke a jockey’s skills down into different types, most ordinary people couldn’t do any of them. No core strength, no balance, bad hands, bad posture, no sense of body positioning, no internal timer, no ability to psychically mind-meld with an unhinged animal you don’t know personally… they’re all fairly rare, and it’s something else to make it complex and interesting for people who like that sort of thing.

Personally, I just like Killie’s little problems and the drama around them. The racing industry itself could collapse tomorrow, rendering Killie’s story historical fiction, and I’d be just as happy.

[hederasgarden]

tyler owens headcanons? 👀

Tyler Owens is the kind of guy who falls hard and fast for a girl. While he plays into the fun and charming persona on the Wranglers YouTube channel, underneath it all, he has a genuinely soft and open heart. He wants a long-term partner or a wife, and he definitely sees himself with a few kids in the future.

When it comes to his friends, Tyler is an acts-of-service guy. He won’t be gushing over how much they mean to him, but instead, he takes care of them in practical ways. Has Lily been talking about some software she wants for her drone? Tyler buys it for her. When he knows Boone has been feeling down, he’ll stop to get Boone his favorite gas station snacks. Then there was the time Dexter's little hat got swept away in the high winds of a tornado—Tyler headed to the nearest Tractor Supply store to get him a replacement.

Tyler also loves to tease his significant other. Whether he wants to make them squirm and get a little hot under the collar or just enjoys giving them a hard time for some guilty pleasure, you can bet that smart mouth is working overtime.

NSFW, 18+ only thoughts below.

Sex with Tyler is enjoyable and relaxing. He's not above having the type of sweet slow sex with tons of eye contact when he's feeling romantic, but most of the time it's something uncomplicated. It's freeing and very satisfying. He just loves to touch and see your body and wants you to feel comfortable and loved.

When it comes to kinks, I see Tyler being open to try whatever you want. I feel like he wouldn't have a laundry list of things he wanted or needed, except maybe seeing you wear his Cowboy hat while you ride him. He loves it when you're on top because then he gets to see all of you but the prone bone where he can whisper all manner of filthy things into your ear is another fan favorite.

Wanna hear some character headcanons? Send me an ask!

[pennyblossom-meta]

Do you believe L would prefer to be with someone who is smart academic wise or some other brainy smart or would he not mind someone who is “average” but has something outside of academics they may excel at? (history, cooking, art, baking, sports etc)

Hi there anon! Thanks for question. I've actually theorised about this exact topic a couple of times before, and I might actually have an unorthodox opinion about it. But before I start my analysis, I would like to refer you to a few metas that I personally find extremely compelling and which have also shaped my view of L.

Toxic love, by @lunalit-river

An analysis on L's monster speech by lux-mea-lex (lots of great metas in their livejournal)

A short interpretation of the monster speech by @lawlightautismtruther (also check the debate on that one, it's very interesting to see the different opinions across the fandom)

How L and Light judge each other and other people

Just about most of @my-one-true-l 's metas about L, like this one and this one about L's flaws.

@43501 has a great meta about L in a relationship which I agree with wholeheartedly.

Apologies in advance for the length in this rant of mine. I like to analyse L from different angles, as you might've guessed 😛

Short answer:

I think L would appreciate someone who makes an effort to meet him where he's at and accepts him for who he is. Someone he can have a conversation with, but is ultimately kind and trustworthy. These two qualities would be to L like a lifeline, because it's something he's missing on an intimate level. While Watari is loyal to him and cares about his well being, these are different types of relationships.

>>>>>Long answer under the cut

So, one of the things I find that helps me when looking at L from this romantic perspective is to search for clues across canon (manga, anime) and the expanded universe (L:CtW, LA:BB, drama, Spiraling Trap, etc) that explain what's going on in his head and, most importantly, what makes him interested in people.

As per your question:

Do you believe L would prefer to be with someone who is smart academic wise or some other brainy smart or would he not mind someone who is “average” but has something outside of academics they may excel at? (history, cooking, art, baking, sports etc)

Let's approach this in two parts. If we were analysing this from a relationship POV, whether romantic or platonic, I can see two major interpretations:

(Chapter 20: First move) Here's a screenshot of L losing a tennis match to Light. Makes him less daunting, doesn't it? To know even L can lose at not-so-mundane-but-still-quite-normal things he's supposed to be great at.

01: The intellectual allure vs a supportive SO

There's oceans of difference between being a genius and someone who can give L support and companionship, despite not speaking the same "language". This would not be too dissimilar to couples with wildly different career paths (ex: a nurse and a software developer) who meet halfway and actively choose to understand each other. It has to do with common goals and values, your life project together.

Love is something you choose every day. Staying in a long-term relationship is choosing to be vulnerable and to share your life with someone you find kinship with. Unorthodox L may be, but as Fu Takahashi (who plays L in the 2020 musical) said:

(...) despite his superficial image as a smart guy who hates losing, he actually feels lonely and needs affection, I imagine (...) He tries to control his emotions, like the feelings towards his parents, or romantic feelings; that’s why he is sort of dependent on games or battles of the mind.

The above quote is super important, in my opinion, considering how difficult it is to pin down L's true personality. If we go by Spiraling Trap terms, he falls for a main character who pays attention to his (dessert) needs and makes him feel 'seen'. Taken cared of. Someone who is genuinely kind to him and wants to do him a good turn because they care about him. We can extrapolate that this is, perhaps, due to his isolationist tendencies and lack of meaningful contact with the sort who take time to want to know the true L and what he likes. To that kind of person, L isn't just the world's greatest detective or a machine, lacking human emotion --- that person acknowledges that he has feelings, likes and dislikes, and isn't malicious towards him.

Consider that L lies a lot. He'd lie twice saying "good morning" if it suited him, which makes for an unhealthy dynamic. However, for those he truly cares about, I believe he would be far more careful to safeguard the few genuine connections he has in life and thus try to curb some bad behaviours to the best of his ability.

I believe @43501 put it best when they mentioned how L would prefer an [educated, clever partner] but that he'd be drawn to people who are [interesting and offbeat]. I would argue this doesn't mean a double PhD level of intelligence, but rather someone who is curious about the world, who talks to him like an equal (i.e., not as if he's superior or inferior to them). There would need to be something to that person that made them unique to L --- but uniqueness in the context of someone who suppresses their emotions so strongly, and would find themselves to be starving for affection once they found that source of comfort and support, I believe that uniqueness could be kindness.

Accept the man despite his quirks and flaws, in all his intensity, and I believe it would be impossible for L to be indifferent to that kind of genuine devotion. After all, he's been without all his life and likely never thought he'd find it. It's possible that, in his loneliness, a part of him even thought himself to be above such things, but what a tumble it would be, for L to find that he's a man dying of thirst.

...

Now, in manga canon (and throughout the source material closest to it), L and Light find a degree of interest in each other for how similar they are in intellect. This creates a connection, even respect between the two, allowing them to see beyond each other's mask. It's thrilling, a cat and mouse game which they arguably become addicted to. Once L dies, Light even muses how Near is lacking by comparison, undeserving.

However, if we go by what V13:HTR says regarding their relationship, then L does think quite poorly of Light beyond their matching intellect. This is more or less explicit in a couple of scenes in the manga and anime where L muses about how much Light talks, how cheesy he is with his faux morality, putting up an act.

No matter L's interest in the game with Light, he doesn't trust him. Trust is paramount to build a healthy relationship. Theirs would be a toxic, petty relationship standing on foundations of distrust, and a thirst for constant competition.

From this perspective, L arguably wouldn't be in love, but stuck in an addictive powerplay. Very engaging to read about; certainly challenging (and interesting!) to write — but not so good to live through. The best case scenario I can see for such a relationship would be something like the series Vicious with Sir Ian McKellen and Derek Jacobi, in which they settle into a constant clash of snark.

I talk here about the prospect of L being 'out of balance' emotionally, which makes him dive into games of the mind to distract himself from his burdens.

02. Appreciation for another type of individual, the average...Sam?

(Chapter 21: Duplicity) Added this one here because this exchange always makes me chuckle.

I'd like to focus on the 2015 drama to establish a parallel with this 'average' Sam concept.

In this adaptation, Light is far more 'normal' than in any other. He diverges from his original canon self in various ways, though the most interesting for me was how the drama tried to show what Light, as a regular young adult, could be if he wasn't an extreme genius, a perfect guy in the eyes of society --- and how this shift would contrast with L.

Drama Light:

Goes to concerts

Is a fanboy

Is clumsy

Gets bullied

He's not the perfect guy with an immaculate reputation. It brings him further down to the ground, like us common mortals.

Both L and Light found solace and appreciation in the differences of their mindset. A more 'average' Light still managed to connect with L, leading to this scene:

If we consider the drama and then extrapolate a few conclusions from these interactions, we can argue that an 'average' but grounding presence in L's life would do him good. An uber genius might be able to follow L's thought process more easily, but they can still become an issue or more easily turn on him for the intellectual competition and to surpass the world's greatest detective.

...

TLDR; I would argue that an average individual would still be a perfect match for L, perhaps far more than an incredible genius. L would value kindness and care far more than super intellect, especially if he was on the receiving end of this kind of genuine connection.

[rohitpalan]

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[mitalipingale]

https://www.palscity.com/read-blog/304893_long-term-care-software-market-analysis-size-share-and-forecast-2031.html

The Long-term Care Software Market in 2023 is US$ 3.37 billion, and is expected to reach US$ 8.9 billion by 2031 at a CAGR of 12.92%.

[zarla-s]

I just read your TF2 bot post and I’m fascinated. It has left me with a few questions though. Why/how were bots a problem for so long? What was the main incentive for botting (is it botting or boting??) Was it just to be an asshole? What’s your favorite baked good? Have a lovely day and don’t worry about answering my questions if you’re not in the mood :]

The bots were a problem for so long because Valve just didn't care, sorry to say. They just let it happen. I'm not sure when they started coming in in force, maybe after the Jungle Inferno update like six years ago? But they just kept pouring in and Valve just ignored it. It's really shameful how bad they let it get, honestly. They just kept putting out community updates like nothing was wrong.

Eventually after a lot of community pressure a year ago (#savetf2) they tweeted saying they were aware of the problem and then nothing happened. Then there was ANOTHER community movement this June (#fixtf2), and THEN at the end of June they ACTUALLY did something, which is why everyone was so shocked and skeptical at the time. Like the bots got so bad, it's hard to get across just how bad it got if you weren't playing at the time. It was bad. To suddenly go from that to totally bot-free was unbelievable. Frankly I'm still shocked they're gone! No one knows why Valve's acting now or how they're doing it (personally, I think they must have been working on these anti-bot measures for a while... maybe even since their initial tweet, but no one knows), but I hope they keep it up. I can finally teach people how to play in peace!

As for why they'd do this, yeah, it's just to be jerks. They just want to make people miserable. They have websites on Neocities you can find under the tf2 tag (I was looking through it for sites to link to my tf2 site) and they state themselves that they just like making people mad. I don't think they actually hate TF2 so much as they love the power rush from destroying something so famous that so many people love. Kind of a power-trip/control thing, with a dose of being desperate for attention. A lot of the more notorious bot hosters had twitters or youtube accounts where they invited people to rage at them uselessly, they loved it. They've also formed communities around botting and trolling people, so they have kind of a social investment in it (although they were quick to turn on each other when they suspected someone was a mole). Some of them sell their bot software or "bot immunity" for money but I think that was just pocket change, I don't think that was a real motivator.

After having free reign for so long, they reacted violently to the community movement in June. They were positive that nothing would happen to them, so they kept doing more and more outrageous things to prove it. They DDoS'd and DMCA'd the site for the petition multiple times, they doxxed and swatted one of the main bot fighters, they impersonated figureheads and posted illegal links to things, like they were really stepping over the line and gloating about it. They were extremely confident and to be fair, who could blame them? Valve's negligence let them get away with it for years. To suddenly have that power taken away from them without warning made them absolutely furious. They're still seething about it right now and plotting ways to get back in, but they haven't found one yet. It's a matter of pride for them at this point I think, that and a childish tantrum about not being able to ruin other people's fun anymore. Them targeting a baby game version of TF2 (TC2) also points to it being a power trip. If they can't ruin TF2 anymore then by god they've got to ruin SOMEthing!

Even now I'm not sure Valve can hold the line and I keep checking TF2 Casual every now and then to look for bots, haha. It's just hard to believe! I greatly enjoy hearing about bot hosters raging about it and suffering though, they deserve nothing less. Die mad about it!!!

In terms of baked goods though I like all kinds, although right now I'm thinking about brownies so I'll say that. |D