Sunday, October 05, 2008

It not only costs a lot and is inconvenient, it's not as good as it should be :(

A recent interview with Evan Handler (the actor) about his health care experiences
In his books "It's Only Temporary," and "Time on Fire," Handler wrote that during his months in the hospital, he was given intravenous drugs that were supposed to go to another patient, that nurses tried to give him medications his doctors had forbidden for him and that staff members refused to follow the hospital's posted hygiene precautions for immunosuppressed patients like himself.
and an October article in FastCompany
For patients, of course, getting what's been proven to work is nothing more than we expect from a Jiffy Lube. But according to a 2003 New England Journal of Medicine paper, only 55% of American patients get all the treatment that is generally accepted as necessary for their problems. To make sure the number at Geisinger is near 100%, surgeons, pre- and post-operation, face a computer screen that asks a set of questions: Is the patient on a beta blocker? A statin? Were antibiotics given at least 60 minutes before surgery and discontinued after 48 hours? A staffer sends an email query if there's no response to any of the 40 steps.
and Harold Thimbleby's article in interactions "Ignorance of Interaction Programming is Killing People" (watch the YouTube video of a medical interface) reminded me of the National Safety Council's "Odds of dying from injury" data.

What is your lifetime probability of fatality caused by "Complications of medical and surgical care and sequelae"? Take a moment to think about that. It's probably much worse than you think: 1 in 1,308. Pretty unbelievable. Although not as bad as lifetime odds for a transportation accident: 1 in 80. At NASA KSC I remember a briefing where we were told that the best guess of a fatal space shuttle accident (at that time) was about 1 in 84. More than you ever wanted to know about the PRAN (probability risk analysis number) here, and a quote:
In fact, the Shuttle’s real-world track record provides a bleaker assessment: The number of shuttle catastrophes (2) over the number of shuttle launches (114), places the statistical, historical catastrophe odds around one in 57, or 1.7%. This number is misleading, say NASA officials, because it doesn’t take into account lessons learned, and safety measures implemented to prevent similar accidents in the future
Changing the subject, computer security expert Bruce Schneier has a very interesting column on "The Seven Habits of Highly Ineffective Terrorists" in Wired:
Terrorists, he [Max Abrahms] writes, (1) attack civilians, a policy that has a lousy track record of convincing those civilians to give the terrorists what they want; (2) treat terrorism as a first resort, not a last resort, failing to embrace nonviolent alternatives like elections; (3) don't compromise with their target country, even when those compromises are in their best interest politically; (4) have protean political platforms, which regularly, and sometimes radically, change; (5) often engage in anonymous attacks, which precludes the target countries making political concessions to them; (6) regularly attack other terrorist groups with the same political platform; and (7) resist disbanding, even when they consistently fail to achieve their political objectives or when their stated political objectives have been achieved.