Category Archives: Uncategorized

Software engineering meets healthcare apps

Information technology for healthcare is not required to undergo any independent assessment of its safety and accuracy, in contrast to IT used in other hazardous industries.  See what a software engineer noticed in his inspection of a healthcare app.

Harold Thimbleby draft report


Real world absurdity and the HITECH Act

This was taken from a colleague’s post on a medical informatics listserve.  I’m reproducing it with only minor edits here because it deserves a much wider audience.  Wish I had thought of it but cannot take the credit.


Step 1) Government fails to recognize EHRs, their data, and workflow as a
public good versus a private good. Think lighthouse or highways versus a
house or car.

Step 2) The government, at private industry’s behest, decides to spend public
money indiscriminately with no provision or attempt to create public goods in
the process.

Step 3) Public money is mostly used to create more private property
(proprietary EHR software, data and workflow).

Step 4) The public money is now largely spent. Private toll booths
everywhere. Large amounts of legally protected private property exist that surprise! do not meet interoperability objectives.

Step 5) The light bulb goes on. Our leaders are shocked, shocked to find
that interoperability is not occurring despite billions spent.

Step 6) Our leaders now want to unravel or bolt something on to the legally
protected private property created with public money. The private property is
inherently not interoperable and is in fact hostile to interoperability.

Good luck.

Narratives of Absurdity

Max Weber argued over a century ago that the end result of rationalist thought would be bureaucracy — and that it would then founder on its own internal contradictions.

So, here is a place to record those contradictions, as small ‘narratives of absurdity’.  The over-specification in ICD-10 will give us a rich trove, but all other sources are welcome.  Some of my most recent favourites are:

  • Y92.72 – chicken coop as the place of occurrence of the external cause
  • V97.33XD – sucked into jet engine, subsequent encounter
  • Y92.146 – prison swimming pool as place of occurrence, subsequent encounter
  • W61.62XD – struck by duck, subsequent encounter
  • W55.29XA – other contact with cow, subsequent encounter
  • R46.1 – bizarre personal appearance
  • w61.11XA – injury from macaw
  • Y92.253 – opera house as the place of occurrence of the external cause
  • Injuries from falling spacecraft

Please add your own to the list.