The Medical Quack

March-29-2014

21:02

Well somebody had to say it and sure we are experiencing the return of virtual reality which there’s nothing wrong with it for gaming or viewing let’s say a movie or just a more vivid experience.  When virtual reality first came out, well it was pretty definitive as everyone knew the game plan.  You check in and become someone you want to be in a virtual world and play around, have some fun, meet some other virtual people and hopefully when you are done you return back to your normal “real world” self.  Some people really got into and a few even got into a little trouble a few years back with getting confused but those were kind of isolated cases.  Again everyone understood that when you checked in to your virtual world it was just that, virtual.

Well let’s move forward a few years and look at where things have gone.  Technology is moving via leaps and bounds and just two years ago we didn’t have what we have today.  Two years ago some of the technologies we have out there today were not even thought of yet.  There’s more elements out there today with virtual reality to mix with and unfortunately it’s getting folks confused with where values are.  I have made the comments that if I had to choose between being connected to Facebook or using a Bill Gates toilet, well the real world tells me I need a toilet first if you will:) 

We see stock values way over inflated on what we place on virtual technologies.  When you take social networks, for the most part, what do you have?  You have a bunch of apps that connect you to something or someone and it’s all code, data and queries stored on servers.  No tangibles here to speak of other than the cost of the hardware and yet we see stocks go way out of line here.  Sure there’s value but not to the levels of what we are seeing.  Come on, huge stock price values and IPOs on data and apps sitting on servers somewhere?  They are intangibles and they are out of balance with the values placed on the “real world”.  We need both, and boy am I seeing some very confused folks out there any more. 

Data has value, no doubt but you are marketed as well and and your value as a human compared to an algorithm, well it’s not very good.  With complexities today and marketing, watch people on a dating site.  It’s like going into a store with way too many decisions and then you are given more opportunities for some “click bait” to view even more and the site makes money as you move through a series of pages through ad exposure.  You have some very smart mathematicians that know how to work you and keep you coming back.  In other words don’t find your match, just keep coming back as the site will entertain you and keep you convinced that you need it.   This is another form of the “gray” areas as meeting someone online is hard enough as you meet them a fraction at a time.  So add on all the other money making noise and they got you. 

It was kind of funny today that I read an article that Google is doing to do a study “to learn how people work” so is that ironic?  They seem to hire quite of them and after how many years in business they don’t know how people work?  I read another article that said employees at Google can’t separate their work from their personal lives..hmmm..a little gray here too?  It’s kind of funny they need a study as we all kind of know, and self included you have to shut it for a few hours, days, etc. to get your feet totally back in the real world. 

Heck even last year the Algorithms were not educated enough at Google and said I was a real duck and suspended me as the machines did not recognize it as a surname, that worked everywhere else in the world and I had to deal with the virtual Google Plus world and substantiate that I was “real”.  In the virtual world I could not exist there without a “machine compliant” name.  See how the virtual world messed with me and next time it could be something serious like a credit report or background virtual issue, as flawed data is on the rise due to the current data selling epidemic we have. 

“I’m Sorry Your Google Plus Name Does Not Comply With Google “Names Policies”…Barbara “Duck Algorithm” & Was Using My Real Name All Along…Killer Algorithms Chapter 52

I keep talking about one topic over and over too and that is “people don’t work that way” and I reference that when I keep reading about how developers and companies in the mHealth business can’t hook the consumers.  There’s a few reason besides just not wanting to be involved and that includes the data selling aspect as we all pretty much know it’s double sword and there’s the danger of some of your information getting out there and being used out of context.  You know with data and what  ever context you decide to apply, you can make a person look like a hero or a zero, only the query monster knows for sure. 

This strangeness has even spread to TED, and if this happens I’m done with TED:)  It’s an X-Prize (AI X-Prize) to do a Ted presentation with artificial intelligence.  I agree again with Larry Ellison (more below) who’s business is technology that people are more interested in people.  Sure the virtuals are not going away but with what I see and the gray areas growing, do we need to create bigger gray areas.  So what’s next, quantified virtual worlds? 

I have never seen a time when people jump all over statistics like magpies.  I’m not saying they are all bad by any means, but anymore it’s like the peanut gallery that jumps up and rolls off numbers over and over.  A Los Angeles Time writer recently commented on that too saying “consumer are drowning in data” and we are.  I see it and get tired of it, so add on a bunch of magpie type repeats and it’s like “gosh how do I get away from some of this”:)  I like to read studies and statistics but I don’t want to be drowning in them with maximum doses in my face all the time.  Some of the studies and articles are just pure bunk too.  We end up with way too much quantitated justifications for things that are not true, usually because someone is trying to sell something.  Now I’m not saying it’s all bunk because it is not but it gets mixed in with the good stuff, and duped you are. 

Here we go again with the “gray” areas that constitute a lot of confusion with folks not knowing where’s the real and virtual worlds, and where you draw the line?   If you like this clip below then venture down to the footer and watch the entire video #1, it’s one of the best out there to make this point.  What did I read and is that credible?  A question that’s worth a mention today before you suck in everything as some is good and some is marketing. 

Press releases though are usually a good spot to place statistics and that’s respectable as you can link what the “sell” aspect is with the studies or stats mentioned, but when we get these wild statistic news stories that are not attached, what is their point you do have to wonder? 

Larry Ellison gave some really good feedback, kind off the cuff in his lecture given at his HCM conference.  He’s very disturbed with kids that are just spending their time on video games, so we go back to the virtual worlds again.  Go to the end at the Q and A for his “personal” comments at the link below. 

Larry Ellison, CEO Oracle, HCM Conference Keynote–”Be Careful About Virtual Relationships With Artificially Intelligent Pieces of Software That’s Smarter Than You“, It’s Really All About People”–Algo Duping and the Killer Algorithms Living Amongst Us…(Update) Video

He’s says there’s a virtual ball instead of a real ball with games and everyone gets to be LeBron with virtual reality.  Kids are confused he says, everyone thinks they are LeBron. If your game playing or life is more fun in the virtual world, it’s a danger.  Virtual relationships..again we go back to dating sites.  The impact of technology on children right now he says is both fabulous and terrible. 

In the end Ellison says, we are really more interested in people even with our interest in technology and I think he’s right on that and there’s a bit of rub as some of that is being lost with the pace we have with technology today.  We can’t slow technology down but we can control the rate at which we absorb it personally.  We can’t control though how it evolves around us and it confuses people.  What’s real and what’s virtual?  

Again go hang around a dating site and you see all these areas to click and read and look at pictures and then are presented with more, or there’s little amusements there to ask a person to upload more pictures, and that will keep you busy if you want to appease all of the requests:)  The sites can keep you very busy and you can lose your focus as why you are there.  The funniest one was a site that sends you a flow sheet to visualize it for you, again the interactions until you move off the site and meet someone in person, it’s all virtual.  I sit there and kind of laugh at some of that as if want to know me better, then talk rather than give me some kind of virtual busy work to do:)  It’s how you get sucked in.  If a person loaded up fake pictures, then they’ll probably load up some more fake pictures for you:)

The movie HER, and really all you need to see is the trailer and you can get the message on how this guy substituted a real relationship with a virtual one that made him happy, so there we go with some of those “gray” areas.  This is worth embedding the trailer here again to make the point.  Sometimes folks don’t even realize they are just living for this bit of attention on the web and then lose touch with what’s real out there.

Movie “HER”– Good Example On How Folks Can’t Separate And/Or Unite The Virtual With The Real World, Billionaires Are Made Out of Those Who Know How to Keep These Areas “Gray” With Creating and Maintaining The Addictive Code That Does It…

If you go back a few months you can also read where Bill Gates said “the internet will not save the world” so again maturity here with technology and where it can really benefit.  Both Bill Gates and Larry Ellison were the early pioneers and understand “data mechanics” better than anyone else out there and again have the maturity to see beyond the end of their nose by all means and we should listen to both of them. 

So again virtual reality has it’s place but when the lines get gray that help you determine where the virtual worlds leave off and where the real world kicks back in, it gets pretty fuzzy out there.  I run into people all the time with what I call weird or strange perceptions as they carry some of this over into the real world and there are companies that profit richly from it, so be careful.

HER Movie

And here’s one more clip..Mike Osinski “with software you can do something about everything” but you have to live in the real world and he knows a bit about virtual worlds as he wrote the software all the banks used for the mortgage scam that banks used improperly and drug so many of us into a virtual world.  The big refinance was all mastered and created in a “virtual world”.  So keep that thought if you will. 

The whole country was sucked into that virtual world where banks did real stock transactions where the sales and models were not representative of the real world, (I’d call it virtual risk at this point) but hopefully we are little smarter now.  If you like the clip then go down to the footer and watch video #2, the Quants of Wall Street to learn more about how that virtual world functioned.  As Larry Ellison said on his HCM talk, we though we were Lebron.  This video was made about 3 years ago, so not new knowledge here at all. 

So with all the tech insanity we seem to be experiencing of late, well time to keep it in check and allow consumers time to digest some of it and not “dummy down” folks for profit either. 

This video from Dr. Sean Gourley, physicist and CEO of QUID might make you think a little bit.  He tells us last year 51% of the traffic on the internet were bots, the rest humans.  Last year it's up to 61% bots and the rest humans, so what's going on here.  He uses a chart to show the human value with the value of the bot, and it's doing better than human value.

Dr.  Gourley states we do need algorithms to manage the complex world, but who's algorithms are they, and will I benefit one could ask as well.  We know in this process that bot are going to get more access for sure and the human access looks like it will dwarf that.  So again trying to look and dig deep, there's some good questions or things to think about here for sure. 

So who's going to be the biggest benefactor here?  Is the next number going to be stating 71% of the internet is bots and the rest humans, so what is the real function to connect Facebook with drones?  Who’s going to really benefit?  A lot of bots and the company that owns them and makes money from them…bots are worth about $100 and humans are worth zero and are basically tech slaves.  Sure some folks will get internet connectivity and that’s not a bad thing but at a cost and it will support the growing world of bots and their profitability not the humans as we become what Dr. Gourley states, the techno slaves that only fill in where the bots can’t go. 

“Generation Like”, the Relentless Marketing of Teenagers Online and The Money It Makes, “Fake Like Farms” and The Money Generated There As Well..(Videos)

Anyway I hope I made the point here about the growing “gray” areas we have with virtual technologies and be aware as you might accidentally find yourself subscribing to the virtual values and losing some of your own “real world values”.  All those new folks getting access will be able to be LeBron too.  The essay below is great and worth reading, be a skeptic when you need to be and you might ask is it real or is it virtual sometimes to help keep your balance, I do it:)  I want to be aware and cognizant of when thing venture out of the virtual world and have impact on what’s going on in my real world, the one that really counts.    Talking with quants and mathematicians who design and model a lot of the virtual worlds out there can be big help too as t

“On Being a Data skeptic- Modelers Have A Bigger Responsibility Now Than Ever Before”–A Must Read Essay, Start “Sniffing the Data”…

March-29-2014

20:30

The hospital had emerged from bankruptcy a couple years ago and it appears that money could not be made here due to the fact that a big percentage of the payments come from Medicare.  The compensates imagethe hospital with 66 cents for every dollar spent so there’s the gap.  The hospital relies on Medicaid funding.  The state has underpaid for years so again we have hospitals like UMPC making a billion in excess profits for a non profit and then we have one like this that can’t keep their doors open.  Profits and losses for hospitals are all over the books. 

The state audited their books after bankruptcy. Fund would be available if the state declares the hospital a “critical care” facility but the hospital has to be 25 miles away from the next nearest acute center care hospital, and it is 23 miles so someone has to change a law I guess.  Just a few days prior the Governor said the hospital should survive.  500 jobs were lost.  Makes politicians look useless when the money’s gone.  On Tuesday the hospital officials said it would close on Friday and that it did.  Northern Berkshire Healthcare is the parent company of the hospital.  BD


NORTH ADAMS, Mass. (WWLP) – Questions that many people in Berkshire County are asking include how did the hospital get into this financial crisis? Can anything be done to get out of it?

North Adams Regional Hospital filed for bankruptcy back in 2011 and their finances were audited by the attorney general’s office. The state may have contributed to the root of their financial issues.

SEIU Union Spokesperson Jeff Hall told 22News that 46% of the hospitals patients were on Medicare and that the state only reimburses the hospital about 66-cents for every dollar of care provided, leaving the hospital with a gap that can be filled only through donations.

http://wwlp.com/2014/03/28/why-is-north-adams-regional-hospital-closing/

March-29-2014

18:24

Sometimes that happens to where no matter what you do with an engineered system, if too much of of the coding uses doesn’t work well then you could be wasting a lot of time trying to fix it.  Sometimes it may be just a module that you can re-write and replace to work with the other modules but from what I am reading here it might be past the point of return here if this is the latest decision, plus fixing it might be more expensive too than a total new system and you still have some corrupt floating around even after a repair.  You can read below where the subsidiary of United Healthcare was called in to see what they could do. 

Maryland State Insurance Exchange Brings In United Healthcare Subsidiary QSSI To Help Repair The System, Their Main Contractor Is Also Owned By Insurance Company, Insurers Have Truckloads of Subsidiary Companies You May Not Be Aware Of

If perhaps the model used in Connecticut is similar enough to where it can work with the needs of the state of Maryland, perhaps it could be used.  Each state model was different and had different contractors and some same and some different technologies used.  Deloitte is the one being called in to fix this one and they have had some bad situations too so there’s big hero contractor that can fix all. 

In Depth Story of the Maryland Insurance Exchange & How It Failed, Sebelius Syndrome Existed Here Too-Government Digital IT Illiteracy And Politics Just Don’t Mix Well..

This would be the first state to chuck it with the entire system, although we know, but nobody has told us officially that there are parts of Healthcare.Gov that were re-written modules too.  That’s just how it works.  If nothing else, folks are finding out how complex IT infrastructures are today and you just run it up the flagpole and give a due date and expect everything to be fine.  The federal program is still having issues with code working with other code and I said the other day that pretty much all of healthcare is just a bunch of algorithms that won’t or can’t work together.  In saying that too, we also add in politics and other situations that make it difficult as folks don’t seem to realize that you can work forever on the verbiage of laws, but the code running on servers 24/7 is what executes. 

The fear of acknowledging this fact was pretty clear a couple years ago when the director of HHS, came out and gave a talk that said “hurry it up”:)  It kind of has some satire and humor to it in the fact that most of the time developers and those writing code are working at 150% anyway so add that novice perception into the batch and the technologists just look at who’s talking and say “huh”…or they get aggravated at the level of digital illiteracy when such speeches are made to the public with politicians with a bunch of bees in her bonnet basically with the fear of this real issue making her look bad, but nothing you can do about it. 

Speed Up Rate of Change in Health IT?–“Short Order Code Kitchen Burned Down a Few Years Ago and There Was No Fire Sale”..IT Infrastructure Chance and Revisions Takes a Lot of ”Code”, “Time” and “ Most Importantly Money”

Here too this “audit” is yet another weird perception as how many experts does the OIG have to accomplish this with the Feds, and last I looked the White House when the site failed had to go searching for them, but that’s the weird and kind of goofy stuff you hear from folks with zero data mechanics knowledge or experience and they try to either explain or do a CYA.

Sebelius Asks Inspector General To Review Healthcare.Gov, How Many JBoss, Red Hat, Linux, Oracle, MarkLogic And Other Experts Does OIG Have? Time Elements of Baking A Cake From Scratch With Writing Custom Code Was Just Not There..

The exchange in Maryland has worked but again if they are ready to chuck it, well that tends to say there’s some truckloads of bad code still hanging around that’s not worth fixing.  It’s like buying a house that is in really bad need of repair with everything run down and not working versus leveling it and starting over.  Same thing works for code and get the right algorithms to work.  BD 


Maryland officials are set to replace the state’s online health-insurance exchange with technology from Connecticut’s insurance marketplace, according to two people familiar with the decision, an acknowledgment that a system that has cost at least $125.5 million is broken beyond repair.

The board of the Maryland exchange plans to vote on the change Tuesday, the day after the end of the first enrollment period for the state’s residents under the 2010 Affordable Care Act.

But unlike Maryland, where the system crashed within moments of launching and has limped along ever since, Connecticut’s exchange has worked as smoothly as any in the country.

Maryland is not alone in having deep-seated problems with its health marketplace. Technical issues also have plagued Oregon, Minnesota and Hawaii. But Maryland will be the first to walk away from its site, a particular embarrassment for Lt. Gov. Anthony G. Brown (D), who was placed in charged of implementing health-care reform in Maryland by Gov. Martin O’Malley (D).

Henry said the exchange has cost $125.5 million to develop and operate.

As of last Saturday, 49,293 Maryland residents had enrolled in a private plan through the exchange, far short of the state’s original goal of 150,000 enrollments and shy even of its revised estimate of 75,000 to 100,000.

http://www.washingtonpost.com/local/maryland-set-to-abandon-troubled-health-exchangeadopt-connecticuts-system/2014/03/28/ef6a3a3e-b6d2-11e3-8cc3-d4bf596577eb_story.html

March-28-2014

22:16

Everything pretty much stops anymore when the systems “go down” or “don’t work” and this is yet one more situation and folks have gone for over 3 months with no stamps or payments.  We know systems are going to fail and when you get into massive government projects like this, well I think it’s time to do what hospitals doe when their systems go down, they have a temporary “paper” back up system.  It is just that “temporary” and notimage meant to replace electronic medical records at all but it can be used in an organized formatted process when needed and data gets entered later.  What’s wrong with this?  If used this way, paper saves lives and doesn’t kill, as again it’s only temporary and folks are smart to have a back up system that can be used immediately. 

Several states including California have had issued to where the cards didn’t work when they were used at stores to buy groceries and there was a back log but I don’t seem to remember 3 months before things were taken care of for the consumer.  Xerox was the contractor that had a computer glitch in 17 states that left consumers having to abandon their groceries at the stores. 

According to this article, same old story with the “Sebelius Syndrome” here too thinking there’s miracle IT infrastructures out there and they rush out and put the system in place and operating before enough testing and other bug finding procedures can be accomplished.  With Healthcare.Gov it was folks thinking Algorithm fairies would pull them through along with a few prayers.  Code doesn’t work that way and you can pray all you want but it’s not going to help if the algorithms are not working together.  Obamacare is a mess of Killer Algorithms you could say as well as in addition to errors and not getting access, many don’t know what they have, if their policies are in place, what doctors they can see and so on. 

Obamacare - One Big “Attack of the Killer Algorithms” No Matter Which Direction You Turn, Compounded With a Lot of Government and Consumer “Algo Duping”….

Accenture is on the hook for this one with software made by a subsidiary of IBM.  Many churches have helped to supply groceries to those who could not get their food stamps.  BD 


On the 13th of every month, she has counted on seeing a $600 payment on her food-stamp debit card. But now, that payment is a month late.

Simon and thousands like her in North Carolina had enough to worry about before a computer glitch began to fray this basic part of the social safety net.

Last July, government computers across the state repeatedly crashed, preventing caseworkers from processing food stamp applications and recertifications for weeks. Eight months later, North Carolina officials are still scrambling to clear the resulting backlog.
The food stamp delays can be traced to troubles with a computer system designed by Accenture, one of the world’s largest consulting firms. The company is among a small group of politically connected technology contractors that receive government business across the country despite previous criticism of their work.

Accenture won the North Carolina contract after spending thousands of dollars on political contributions and lobbying in the state. North Carolina hired Accenture even though at least six other states -- Colorado, Florida, Wyoming, Kansas, Wisconsin and Texas -- have canceled contracts with the company in the past decade over problems with its computer systems.

But the backlog kept growing. By the end of last year, more than 30,000 families in North Carolina had waited more than a month to receive food stamps -- a violation of federal rules that require routine applications be processed within 30 days. About one third of those families had waited three months or more.

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