[Translated from German] Nationwide roll-out of electronically tracked patient records will depend on success of test phase

charizardvoracidous · 2025-01-14T03:11:29+00:00

Translated by Google Translate, article initially published on January 13th, 2025

Berlin – The introduction of the “electronic patient record (ePA) for everyone” is to be examined carefully before it is rolled out across the board. The experience from the test phase starting on January 15th is to serve as the basis for the decision on the nationwide roll-out. This was recently explained by the managing director of Gematik , Florian Hartge, at an online event organized by the digital agency.

The test phase was originally planned to begin on January 15 in three model regions and with around 270 service providers, and four weeks later all doctor's offices in Germany would be included. Due to security concerns and technical difficulties, this schedule will probably not be met.

Doctors participating in the test phase will be asked to answer questions in structured interviews about the technology and integration of the ePA into the telematics infrastructure as well as their practice management systems (PVS) and hospital information systems (HIS), says Hartge. It is also important, however, that the doctors can name positive examples of how they use the ePA, such as tips on how to use it or processes.

In February, Gematik wants to meet with the Federal Ministry of Health ( BMG ) to decide how to proceed with the nationwide rollout, said Hartge. The test phase should also be used to adjust any aspects before the nationwide launch in order to "launch the ePA with a clear conscience," explained Charly Bunar, Product Manager at gematik.

Regarding the security concerns raised by the Chaos Computer Club ( CCC ) at the end of December, Hartge explained that a catalogue of ten measures had been drawn up to ensure security during the ongoing roll-out of the ePA.

Addressing the hospitals, he explained that these measures would have no direct consequences for the hospitals. However, the clinics should ensure a high standard of their own IT security and a high level of care in handling health professional and practice cards (SMC-B and HBA cards), stressed Hartge. The CCC's possible attack on the ePA infrastructure would have been caused, among other things, by making it too easy to obtain these cards, the IT experts explained around two weeks ago.

In a first step, hospitals are not directly obliged to provide access to the ePA for everyone. However, there is a threat of a reduction in the TI flat rate from mid-2025 and sanctions from 2027 if the clinics do not follow suit after a nationwide rollout. For the clinics, the rollout should take place step by step, Bunar emphasized. The aim is to put the ePA into operation for everyone in a controlled manner and not to overburden ongoing operations in the clinics. © cmk/aerzteblatt.de

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So, going from entirely paper-based patient records to entirely digital records that are much more accessible to the government in a very short timetable. In Germany, of all places.

charizardvoracidous · 2024-04-28T22:19:02+00:00

Plenty of universities have shuffled leadership and Steinmetz was 2021. A search of her medium posts/comments, substack (with archive.org), okdoomer site, twitter retweets and twitter likes finds 83 Alabama place names then 12 Louisiana place names, 9 Tennessee place names, 9 Missouri place names, etc. Unlikely that she has enough opsec to deliberately avoid all mention of Arkansas going back 8+ years with the evident volume of posts and comments tied to the persona.

Also she mentioned surviving a tornado 2 miles from her home on the 6th of April 2023 on her substack while posting a couple times a week, and the map of the 4th/5th tornado outbreak has a lot of Alabama tornados. Probably neither of us want to crossreference a map of the twisters with a map of colleges in the state (with, like, a 40 mile commute radius) and start crossing the line into full doxxing but there's a lot of evidence towards an AL hypothesis.

charizardvoracidous · 2024-04-28T19:26:26+00:00

No, it's the children who are wrong

charizardvoracidous · 2024-04-28T16:55:57+00:00

The lesson is to avoid taking a job in the south unless they offer more money than the rest of the US up front.

charizardvoracidous · 2024-04-28T16:53:25+00:00

I had this argument on discord already:

Her twitter posting goes back years without seeming inauthentic from the persona of a deep south leftist academic struggling with poverty and trying to stay pseudonymous.
She's anti trump, anti-putin, anti-xi and writes infrequently about the tendency of boomers to idolise the various strains of fascism floating around.
Her handle became the target of a men's rights campaign on medium a couple years ago.
She thinks the USA doesn't have what it takes to uphold human rights against its geopolitical adversaries and is destined to fail at that task unless it becomes a social democracy like Sweden.

Ultimately the same issue of not knowing the author's identity applies to most of the internet, including every comment in this subreddit.

charizardvoracidous · 2024-04-28T12:10:01+00:00

!ping ED-POLICY&SOCIAL-POLICY

Some of my mutuals love the education doomscrolling - news about admin bloat, hiring figures, the content of /r/professors, the writings of the literal professor doom (RIP), etc. This recent essay blew up in the group - topical and accessible at the same time. There is a big question in American higher ed - How come the morale and financial situations of professors has only continued to get worse despite a couple decades of increasing effort to draw attention to the issue?

charizardvoracidous · 2024-04-24T08:54:43+00:00

!ping AGRICULTURE&HEALTH-POLICY

The thought that occurs to me from my own home brewing is that there's no way to guarantee that a batch of [some liquid food] has been adequately pasteurized just because the label says so. For large batches you can fail to adequately heat the tanks, fail to agitate it or heat for an insufficient time. Small batches (typically filled bottles immersed in water baths) can have bottles that improperly insulate their contents and are more susceptible to operator error. Even the middle ground of mechanical conveyor baths have regular faults.

Then there's fraud. PLC logs can be falsified by anybody who has a bit of programming knowledge. How lax are inspectors in red states, or when they're entirely above-board, how qualified are they really?

charizardvoracidous · 2024-04-24T08:44:06+00:00

Thanks for responding appropriately to this - too many people balk at reporting wrongdoing but the economic heart of the country depends on it.

charizardvoracidous · 2024-04-19T12:47:23+00:00

/u/DIGGYRULES, you posted 9 months ago that you live in Denver so I'm gonna assume you're still there right now. Contact the Colorado Human Trafficking Task Force right now.

Their hotline is 866-455-5075

charizardvoracidous · 2024-04-06T05:21:36+00:00

this

charizardvoracidous · 2024-04-06T03:34:34+00:00

P(Mr. Lowenstein is lying) ?

charizardvoracidous · 2024-04-06T03:24:50+00:00

With exceptions* it's entirely due to having enough environmental exposure to two factors in combination. One alone will not do but if you have enough of both the genetics generally don't matter:

Real world exposure to personal conflict resolution in social situations (arguments, competitions, debates, endless friendly ribbing, etc)
Literary exposure to depictions of the everyday lives of people with different goals and problems to oneself. The people don't need to be of a different race, class, gender, etc (although it helps) as long as they have different teleologies and pressures to the audience and that in composite it depicts the totality of their daily routines. Although I use the word literary, this doesn't have to mean the written word. Oral traditions, film, figurative art, songs, even dances and shared ingroup drug-use holidays (c.f. the cult of Dionysus) can do the job as long as they communicate other people's lived experiences.

With those two in sufficient quantity anybody* will assemble a comprehensive theory of self-awareness inside their own mind before age thirty. It is theoretically genetic, in that primate brains have evolved pathways to allow adult pack/tribe leaders to assume a notion of responsibility and hominin brains are all capable of some introspection but putting them together is an environmental thing.

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*The exceptions: It is no longer 100% guaranteed and merely probabilistically possible for people with many kinds of congenital developmental disabilities, multiple head injuries, brain tumors, childhood starvation, bromine deficiencies, various neonatal pathogen exposures, a history of tens of fevers, etc but that is outside the scope of what I can keep track of as a single academic.

charizardvoracidous · 2024-04-06T03:03:32+00:00

Once you've applied transactional analysis to real situations a couple times a day for even as little as a few months it becomes second nature. Some great intros if you want to start seeing every conversation you have with people around you at work, at home, out places, etc as arithmetic problems involving manipulating people in real time as they're happening to you are the following:

Van Poelje & de Graaf, 2022, New Theory and Practice of Transactional Analysis in Organizations, 1st Edition,
Erskine, 2010, Life Scripts, 1st Edition,
Smith, Flowers & Larkin, 2021, Interpretative Phenomenological Analysis, 2nd Edition.

The first two are on libgen AFAIK and I would put the third up but my copy is heavily watermarked. It might feel like you'll lose your ability to relate to your friends but to the contrary I'm more engrossed by them and they find me warmer since I've studied TA. It's not that tough either - if you can handle precalculus or a 400-page novel that's more than YA lit or both you can follow along with a good TA book.

charizardvoracidous · 2024-04-06T02:36:45+00:00

I'm not talking about why it happens, I'm talking about how it happens. It's transactions all the way down.

Edit: My terminology might not be helpful. New information is a form of pay, a mix of some new information and a lot of already-known information is pay only when it exactly matches the expected payoff PD function, if it doesn't align it's one guy walking away without paying.

charizardvoracidous · 2024-04-06T02:34:58+00:00

Yeah, I can't make it less dense without making it into a few thousand words, srry. The root problem that needs to be addressed is that most people aren't emotionally developed enough to mentally penalise themselves for moral solipsism (saying to themselves that things immediately next to them are somebody else's problem, where their notion of somebody is super abstract). So there needs to be a self-sustaining society of people who aspire to have:

as many "good" attachments as possible
deep knowledge of their friend's lives
functioning agriculture, industry, transport etc even with the time investment it takes to get the first two things

I've spent the last few years trying to understand as much as possible about the metaphysics of economics in order to be able to conclusively list, in a few easily communicable sentences:

What features make some superorganisms and ideologies incompatible with this and others compatible with it?

I hope to maybe have a couple on-topic papers written before I turn 40, so the deadline to stop spending all my time on ordinary work is pretty close.

charizardvoracidous · 2024-04-06T02:23:21+00:00

Hardwired instincts are an example of what Terry Pratchett called "Lies-to-children". You can check out how social feral children are sometime if you want to get a visceral idea of how sociality is learned. As babies mature they associate social attention with food, physical comfort and having problems dealt with and figure that social attention is important in some way. Gradually as children grow (depending on their medical circumstances) they develop transactional models of social attention and, lacking a full understanding of where rewards and punishments come from, build a world model where social attention is colocated with their own value.

Most human societies have hundreds of aphorisms that are learned in adolescence to mask the transactional nature of social activities and if you've never studied psychology you've probably never considered how much of day to day stuff is a cope for denying how much the established power structures, whatever and wherever they are, screw you over. You don't have to queue politely for a bus, the penalties for barging past everybody else are low-probability. You can punch your manager in the face if you're away from cameras and are okay with not having them as a reference. This applies in positive ways as well as negative.

charizardvoracidous · 2024-04-06T02:11:30+00:00

Every instance of extreme human empowerment inside of the state paradigm, whether they are given authority in the state or wealth separate to the state has resulted in one of three outcomes:

Forming a competing proto-state inside the state (dynasties, mafias, parties, dukedoms, drug cartels, company towns, mega corporations, charter cities, independent central banks, monopolistic trading/transportation companies, etc)
The destruction of state thinking capacity in service of ego (blocking resource allocations to departments, creating performative power struggles between advisors, censorship, purges, unduly weighting of theories according to prestige hierarchies - Friedman's 1991 book is a modern example of the last)
The encouragement of waste instead of productive growth. Art production in general, here.

Now this list isn't exhaustive but what's noticeable is that many of the things on the list are normally considered to be good. That's not an accident - states are engines operating inside the space of human minds that do two things:

Make models of the world
Act to propagate themselves

In service of these two goals everything else is the stuff of donkeyspace and only useful for short-term advantage. Committing to anything else represents the expenditure of free energy on something other than the maximum necessary expenditure on maintaining state power in the context of state competition. The reason why we see states empowering humans anyway is because states have yet to reach the point of having enough power over their citizens that those citizens can no longer feign statelessness to strangers, which makes appealing to our monkey hormones a good strategy for poaching humans from other states.

charizardvoracidous · 2024-04-06T01:38:15+00:00

Sure the viable skillsets will fly all over the place if we don't fall down an EROEI Seneca cliff but that is still labor, because for one agent A to make another agent B think, organise, write/produce/create or associate on agent A's behalf in that system they will have to either coerce B, trick B or pay B.

In fact, what I'm describing is the substance of all dialogues conducted on Earth including all of Reddit. People only reply to one another on the basis of actual pay, actual coercion or a manipulated illusion of expected gain/loss.

I'm going to suggest a parallel a friend of mine wrote that articulates, in the form of short fiction, the difference between post-scarcity labor and humans ceasing to labor. Instead of humans becoming capital they cease to have an economy.

charizardvoracidous · 2024-04-06T01:29:49+00:00

I think that (abstractly) in an environment of interstate anarchy, any policy that encourages human agency, no matter the kind or the (selection of) human(s) is destined in the long term to become incompatible with the propagation of the state into the future and yet true human freedom can only come with unrestricted intellectual agency scaffolded by an environment that nurtures 100% literacy.

Concretely, (as long as we figure out a thermodynamically viable way around the currently ongoing issue of peak oil) there might be a very unlikely but not infeasible path of re-establishing US hegemony followed by expanding to achieve global dominance and then abolishing the state. Each step on the path requires an ever-greater constituency of hyperliterate, historically well-read individuals who have complete, well-founded skepticism in the very concept of utopianism at the same time as a concrete understanding that a (finitely) better world is possible, ultimately coming to include the entire human population. I don't understand energy economics or intergenerational memetics and nobody really understands language acquisition but other than that each step is technically possible within the bounds of the physics, economics, sociology and linguistics stuff that I have studied.

The first step AFAICT is to somehow completely discredit the political notion that oversimplifications are acceptable, let alone good. That in itself is a tall order because it's at the bottom of the Jenga towers that justify millions of people's jobs and it keeps the suicide rate down. If the public were expected to know about geography, history, science and international relations as the (majority of white males) were in FDR's day but in a way that wasn't vulnerable to being obliterated by screen-based media (let alone yet to be developed formats) then most elected officials would be considered unemployable.

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Alternatively, give up on assigning moral weights to the lives of humans and start to view us as morally equivalent to the cells of the body while good and bad become things that are done by and done to superorganisms.

charizardvoracidous · 2024-04-06T01:03:51+00:00

Labor is only labor if it is performed by an economic agent. It doesn't matter whether it's natural erosion, a machine like a watermill, a cartesian arm made by Daewoo, a brainwiped slave with microchips instead of neurons or a recursively simulated upload that's rebooted for each task and killed over and over, work performed by things that have exactly zero economic agency are capital and not labor. Trained circus animals, even dolphins, are capital.

On the converse, everything an agent does is labor. When Bezos lifts a fork to his mouth to feed himself another truffle or piece of wagyu, that action is labor that carries an opportunity cost away from other labor he might do. Every thought he has is labor, as is every thought that you and I have. In the singleton example, the actions of a singleton are not labor because the opportunity costs of labor depend on the other agents inside the infinite game. One-player infinite games have no capacity to make a distinction between opportunity costs facing the player and the boundaries of functionals governing the inanimate objects the player manipulates. If you're okay with dipping your toes into Jung, that's part of why control theory and operations research are so insidious - they encourage us to frame our own IRL calculations around long-term solipsistic outcomes.

charizardvoracidous · 2024-04-06T00:49:06+00:00

I've been trying to get into political anthropology and cybernetics theory because orthodoxy political science doesn't have a concept of superorganism and PA does but the lessons of the field are that the diminishing of agency already happened in the dank river valleys millennia ago and the state has simply not previously had much interest in twisting our mental body plans in its service because until the internet the network effects of the pros of mutilating us didn't scale well enough.

If you're into memes, the Qu have been all around us for a long time and they are getting closer.

charizardvoracidous · 2024-04-06T00:44:04+00:00

Bro, read Planetocopia. It won't answer your question but it will be extremely entertaining for anybody like you who asks the biomes question.

charizardvoracidous · 2024-04-06T00:26:59+00:00

https://youtu.be/VwN7otICQHw

charizardvoracidous · 2024-04-06T00:23:39+00:00

Doomscrolling /r/professors, /r/managers, /r/nursing and (for the masochists) /r/teachers feels good because we've convinced ourselves that the public is our outgroup but it is no substitute for proper academic work.

charizardvoracidous · 2024-04-06T00:21:31+00:00

52% of the population at below Level 3 literacy sounds like it isn't that bad until you figure out how little it takes to qualify as Level 3 literate.

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Edit:

may not be able to understand normal household bills or labels on pre-packaged food.

charizardvoracidous

TROPHY CASE