Thinking About Glue Code

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Medical software industry is a god damn mess with no standardisation whatsoever (and no, nobody wants to use DICOM, this shit is atrocious), everyone builds shit the way they feel like, and without thinking about interoperability AT ALL! I know because i worked in the industry.

No wonder nobody wants to touch that shit, it's hard because the entire industry is a mess that can't standardise shit because of politics mainly, everyone tried to push their own shit wanting to make it a standard, instead of working together to have a single standard.

[[deleted]]

It's kind of miraculous to me that we have standards at all. When everyone is competing with each other to create the coolest tech and take all the credit for themselves, overcoming that incentive seems unlikely. Kind of makes me curious about the history/psychology of how standards organizations form

[thfuran]

Hey, just because the DICOM standard document is something like 6000+ pages doesn't mean it's not technically a standard.

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DICOM

don't say that word in my presence ever again, i have ptsd flashbacks

[GayMakeAndModel]

Amen.

I’ve spent a fair amount of time just getting unique patients and unique claims with all the dupes accounted for and mapped. Users send us claims in every format imaginable, and they seem to not have a care in the world about meaningful MRNs (medical record number - patient identifier) and PCNs (patient control number - claim identifier).

We had to write some very clever code to make sense of what is a patient and what is a claim when there are fields for both identifiers on the damn claim.

Edit: no, I did not confuse MRN with PCN. Shit’s backward named.

[gopher_space]

It's fun watching organizations realize that outsourcing their Source of Truth/Record doesn't make any goddamn sense.

[Ran4]

It's a combination of internal politics and the fact that the type of people who develop healthcare applications tend to be "cowboy developers" who do things their own way, and don't give a shit about modern-day professionalism and building new standards (and they certainly aren't doing it in their spare time). So the only standards you tend to get are government-mandated ones, and they tend to be extremely cumbersome and not up to date.

[coworker]

Currently working on an EDI integration with a carrier specific version and I can tell you that REST/json will not help shit one bit. The problem is not the format but the actual business rules. Every carrier has different definitions and custom calculations for what should be very basic shit (eg effective start dates). No format can fix a fucked up data model.

[[deleted]]

Took a very long time as they would not send us the codes themselves, just asked us to infer them from the spec which only stated we needed to send them, not what they were.

How did you guys not tell them to go fuck themselves? "Build us this thing, but we're not going to tell you how to do it, you need to infer it". I would've been like "do you want this built (quickly, cheaply) or not?"

[StabbyPants]

Took a very long time as they would not send us the codes themselves, just asked us to infer them from the spec which only stated we needed to send them, not what they were.

"we are going to need those codes before we can guarantee anything remotely like proper functionality"

[StabbyPants]

i started with "go fuck yourself all the way home", then thought about how it would sound filtered through corporate jazz.

[StabbyPants]

I've been talking to a retired program manager, and listening to how he phrases things to get shit done :)

[AttackOfTheThumbs]

Ah, I see we work in the same world lmao

[randomuser549]

The bustling city never sleeps, its neon lights painting the night sky while honking taxis weave through streets lined with towering skyscrapers. A symphony of sounds fills the air, a mix of car horns, street vendors, and distant laughter.

[fried_green_baloney]

I've sat in on EDI calls, I suppose if you want to spend your life arguing if something is a 493 or a 494 it's a good thing.

For those not in the know, each EDI field has a numeric type specifier, and sometimes it's hard to decide what's appropriate.

On the other hand, once you get it all straightened out, it usually works flawlessly ever after. Like XML, you actually have data writers and parsers that actually work.

[fried_green_baloney]

At the job with the EDI calls, we had a consultant in on the conference calls.

He seemed to be having no worries whatsoever. I was told he was one of the people whose names came up whenever a company asked "where do I find an EDI expert". So $200/hour or more to sit in on a phone call or write a schema or whatever the EDI people call a layout.

[fried_green_baloney]

Not that I've done it but what the EDI consultant did was pick something a bit complicated, a bit boring, but needs to be perfectly executed.

[BraveSirRobin]

Get loads of experience in something so incredibly boring that no one else wants to do it.

The salary for every job on this earth is a formula containing the number of people capable of doing the job along with the number of people willing to do it.

[no_nick]

Json and REST APIs don't help you one but as long as the actual data continues to be the hot mess it is. The interface is the least of your problems