Chilly, cold, damp, cold, hurts the hands cold. Ice in the buckets, frost on the roofs. I know, you’re laughing at me as you shovel the walk and driveway… supposed to be cold again all day. Was 29F at midnight last night.
Spent Saturday at a fifth grade basketball game. The girls are making progress. The coaching is very aggressive. Elbows out, hands on the girl you’re guarding, setting picks, all kinds of pro league bad behaviour. And the kids still can’t pass or dribble or shoot well. D2 got two baskets and a freethrow. They still lost.
One girl in a mask. Couple of masked spectators.
Took child and did a couple of pickups. Lots of driving, more than I thought looking at the map. I got stuff for camping and for the new place, but it was a lot of driving. No masks at pickup locations. Chatted with the auctioneer and his wife at the second place, out in the country about an hour outside Houston. Both had the coof. Neither got a vax before, or after. Very aware of alt news, inflation, shortages, and the coming war. Stacking stuff, getting rid of cash dollars.
Dropped stuff off at my secondary then went by my rent house to see why the tenants were cold. I suspected a fan issue, or loose duct connection in the attic, if there was a real problem. I confirmed the problem with low air flow was a clogged up filter in the return air plenum. They said “we changed that a couple weeks ago” and “we usually change that every 3 months…” but it was black, solid, and bowed up into the duct like a salad bowl… when I removed it, there was good air flow. Problem solved.
Chatting with them, she’s preggo, and they’re looking for a house to buy. Right on schedule as far as I can tell. We may take the opportunity to swap out the water heater, or blow in some foam in the attic, or upgrade countertops in the kitchen when they find a place and move out. Spent some time chatting with them as they are pretty red pilled for being so young. They have been seeing shortages at their grocery store too, and are aware of supply chain issues. They mocked FauxXi and are boycotting the olympic coverage. They don’t see any reason for us to fight the Russian but are sure we will get involved anyway. They are racing inflation to buy a house. Pretty long and interesting talk.
Stopped and got take out sushi for dinner. Youngest loves sashimi. Not a cheap date, that one.
Wife and D1 are due back from horse camp later today, hopefully early afternoon. I’ve got housecleaning to do before then. So I’m off…
Stack the stuff you need. Seriously. It’s not getting better, it’s getting worse. And it will get worse yet. Stacks give you breathing room. They give you choices. They take the pressure off. Yes, in normal times they can have negatives associated with them, but these aren’t normal times. It’s long past time to be building up your reserves.
n
Bitterly cold here on the West side of the Brazos River. 30 F at 7am and the sun just came out. They have been running trains since 5 am, ask me how I know. 3 blocks away and I can still hear the horn in bed.
The dog and cat are outside for the second time. The dog swears that a squirrel is out there, I told her the squirrels are still in bed.
Lily is out walking the fence line in the ice grass, checking to see if she can get to the neighbors yard with all the squirrels. Man, the icey grass is cold in flipflops.
“The coaching is very aggressive. Elbows out, hands on the girl you’re guarding, setting picks, all kinds of pro league bad behaviour. And the kids still can’t pass or dribble or shoot well. ”
Ghetto ball. That kind if play and the ghetto cullottes shorts are why I quit watching basketball.
That and the cowardice of the refs that buckled to the “I’m a bit star and can take an extra step” and routinely palming the ball.
Theres a reason that basketball starts with ball handling: running is faster than dribbling, and passing is faster than running.
Sounds like one session with a real coach could double their score.
BLM's millions unaccounted for after leaders quietly jumped ship
As JEP might've said, "Wotta SOO-prise!"
Is the filter an odd size? I had 27×30 in Florida and that was a pain to find in stores there. I sometimes resorted to 25×30 and taping 1″ styrofoam pieces on each side of the cardboard frame. The filter tended to be forgotten.
You might want to go by once a year and leave them one.
The pizza box dream dies hard. At this point, I'm wondering how many civilians Tony will actually have on the satellites and not over what I believe is MVNO service, particularly in urban areas.
The $500/mo plan really makes me suspicious. Considering that the 5g carriers are allowed to dip into the unlicensed spectrum, including 2.4 and 5 GHz, to provide Baby Yoda on the go at high bandwidth video, I'd hate to be the neighbors of that "Show Ya" house.
Tony tweeted this week that the number of people they serve in a given area will be limited. I've been saying that for years. Stir that FOMO!
Again, I watched the CLEAR meltdown in the Northwest, another scheme which was arguably a front for DoD needs. The physics to serve a large number of people at high rates of speed just wasn’t there either.
Starlink also fosters development of the capability to reach low earth orbit on demand as a bonus to the comm bandwidth.
Trouble in paradise?
https://www.dailymail.co.uk/news/article-10481075/Scowling-Obama-inspects-new-multi-million-dollar-Hawaii-mansion-controversial-sea-wall.html
The sea wall is in the background of several shots of the opening credits of "Magnum PI". As the article notes, that was the location of the estate featured in exterior shots in the show as well as the beach club where Magnum and his friends hung out.
The wall was also the location of the “tidal pool” shot in the credits, but the camera is turned towards the actors with the ocean in the background. Imagine Barry and Moochelle recreating that one daily. Apologies to those of you eating breakfast right now.
https://www.youtube.com/watch?v=xIaXl7SqkBw
Today’s Daily Mail does of schaedenfreude at American expense.
In competitor media outlets, it looks like “Death In Paradise” will have to break in a new cast member before the end of the season. Friday night’s episode was a bit disappointing for fans seeking the usual escapism.
arrg. 47F and sunny but my renter's furnace won't stay on this morning. So I'm dressing and headed over.
It was running fine once I pulled the ( completely normal sized and readily available locally) filter.
Don't know what to expect, but I know the phone call to my HVAC guy is much more expensive today than yesterday.
n
Inflation isn't the problem in housing prices as much as the Fed continuing to buy the paper through the midterms to keep the markets afloat for just a little while longer.
The low interest rates and "work" from home are enabling the exodus to Texas and Florida from blue states, driving up the prices in desirable areas.
The newest member of our group at work is currently remote in Seattle. Under normal circumstances, access to the labs would be required and he would need to be here.
Sam's Club run yesterday. 2 L Coke products were thin but available.
"Limit 2" signs back in the refrigerated meat cases. The only chicken I saw were trays of legs and thighs, spread in a single layer across the three refrigerator cases that normally hold a wider variety — no whole chickens, wings, breasts, etc. Beef and pork looked similarly thin, but I didn't look closely.
Yesterday was the first day that trucks rolled in the area since Wednesday morning. Even garbage trucks didn’t roll in Austin when temperatures were still in the 50s that afternoon.
Interestingly, all the paper goods were fully stocked for a change. Anything you wanted, no limit.
Also, the store had plenty of “Baby Yoda with the Williams-Sonoma cookies” dolls. I don’t think I’ve seen one of those move.
20F in the California high desert this am, warmer than yesterdays 15F.
I was talking to my neighbor yesterday, sort of a gentleman farmer (like a number of folk around here). Apparently we are running out of hay locally.
Bales have gone in price from $8 to $26 if you can find them – a number of suppliers are just plain OUT.
He is driving to Bakersfield, 90 miles away over a mountain range, pulling a big trailer – the savings on feed pay enough to pay for the fuel at about $5\gal and about 8mpg.
He reports that talking to his long time suppliers that they’d warehoused the usual amounts, but that demand was way up.
The regular suppliers grow here in the valley, but now have trucks out themselves, roaming the small towns in Northern California, looking for more.
Interwebz meme of the day:
TRuckin Fudeau
Still in hiding.
Chris Wallace not feeling love from a Zucker-less CNN
https://radaronline.com/p/chris-wallace-meltdown-jeff-zucker-allison-gollust-scandal-jake-tapper/
Yeah, but free on KU and $4.99 to buy for Kindle. Kindles are a great deal if you read quite a bit and are more restful on the eyes than a typical tablet. There is a lot of good content that is less than paperback price or included in Kindle Unlimited. And it doesn't take up a lot of space. It's also great for travel. I used to take 8 or 9 books on a week's cruise. Now I can take hundreds with me on the plane.
Unless there are unknown loopholes in physics, both are impossible. And we've found most of the loopholes since classical physics was codified. There's not a lot of areas left to exploit.
Has either been attempted with more than 1.21 Gigawatts?
The Water Boy has always been overrated. He destroyed NBC and repeated at CNN.
Wallace isn't the brightest tool in the shed either. Another pol/celebrity with serious Daddy issues.
Back when "Must See Thursday" was on the brink, I remember Zucker passed on "Arrested Development" to give money to Whoopi to make her sitcom. That wasn’t quite the brain fart of Eisner passing on “CSI” in favor of five nights of “Who Wants to be a Millionare”, but it was one of many questionable decisions Zucker made running the network, including letting “JAG” and, subsequently, “NCIS” go to CBS as well as the Leno succession fiasco that ended “The Tonight Show” as “The Tonight Show” instead of just another 11:30 network talk program.
The high flyers usually have to auger in and destroy themselves completely before the trail of destruction in their wake can be clearly perceived by all.
I have less than no respect for the Cuomo brothers, especially Andrew the Murdering Elder. I really hope that Basement Boy spurns any settlement ("$18 million, that is soooo last week.") and insists on a lengthy hadline-filled trial to "clear his good name".
Greg Norton Said:
Yes, the Russians and the Chinese can shoot down or drag out of position a few dozen satellites in GEO. That'll be WAY harder to do to 22,000 Starlink satellites in 500KM orbits. And while Starlink service will be limited in the number of users in a given area NOW, I suspect that limit will increase with each Starlink launch.
And I strongly suspect that Musk can launch satellites faster than either Russia or China can shoot them down.
I spent the evening playin///// testing my Starlink service. Even with my terrible antenna placement (under big oak trees, and "blocked" by a trellis) the bandwidth and latency were completely stable while playing World of Warcraft.
There is only so much bandwidth available. I've always believed that, at a certain point, Musk will go up to Congress and ask for an auction of the TV and radio spectrum to the carriers providing his MVNO supplemental service, selling the concept of terrestrial broadcasting as being the final obstacle to the pizza box dream.
The beneficiaries will still be limited even if the auction takes place, another case where The Real Life Tony Stark (TM) is asking for sacrifice from all of the population to benefit, maybe, the 5% or so who can afford to buy his products.
Over The Hedge: Heated Seats
https://www.gocomics.com/overthehedge/2022/02/06
I love the heated seats in my truck. That and the remote start are the cat's meow.
Jeff Zucker had 20+ years of destruction, more than 30 if you consider that his tenure as "Today" producer was marked by the antics which ultimately cost Matt Lauer his career.
As for Wallace, Tony Snow built "Fox News Sunday" from zero in the 90s and early 2000s, and the program was an also-ran afterwards until "Meet the (De)Press(ed)" tanked when Tim Russert died suddenly in 2008, replaced by David Gregory and then, “F.” Chuck Todd as Limbaugh referred to him.
CNN is in severe cost cutting mode, possibly heading to a sale. That has been well known ever since the CNN Center was put up for sale by my former corporate masters and network HQ moved back to Techwood Drive, “the old plantation”, a former country club where Turner started the operation.
We, as humans, know a lot, but I believe we don’t even know what we don’t know. Dark matter, dark energy, and singularities being three little examples.
Unless there are unknown loopholes in physics, both are impossible. And we've found most of the loopholes since classical physics was codified. There's not a lot of areas left to exploit.
"And we've found most of the loopholes since classical physics was codified."
Are you sure about that ? Would you be willing to bet your life on that statement ?
I am convinced that we know very little about physics. We understand combustion very well, a lot of other stuff like gravity is still way out there.
Who on earth downvoted ech's 12:43 comment? Someone who's disgusted by the idea of taking hundreds of books on a plane?
Yes, the Russians and the Chinese can shoot down or drag out of position a few dozen satellites in GEO. That'll be WAY harder to do to 22,000 Starlink satellites in 500KM orbits. And while Starlink service will be limited in the number of users in a given area NOW, I suspect that limit will increase with each Starlink launch.
And I strongly suspect that Musk can launch satellites faster than either Russia or China can shoot them down.
The big question about Starlink is can it support the GPS service ? SpaceX is performing a $12 million study for DOD right now to answer this question. If not then our 31 GPS satellites are still subject to shoot down.
Oh gosh I love the trains… have always lived where I can hear them. Except when we lived on the coast. There, we heard/saw the big ships coming through the channel of Lavaca Bay, which was nice, but not as nice as the trains.
In this particular house, we hear all the neighborhood dogs howling long before the trains get close enough to blow their whistles. LOL
That's always rough. Animals gotta eat, and it gets pricey when there's no rain. People haul in hay here by the semi and park on the side of the road to sell when we are having dry summers.
Why is he having to buy hay in winter time? Did he not buy enough in the summer to get him through? He might try switching to round bales and store them under tarps. They store better. longer, than the little square bales.
During drought years, my dad has been known to drive 200 or 300 miles to places it rained to bring home 6 round bales. Since it started raining again, he tries to stay 3 years ahead. That way, if there's a winter like last year where he has to feed twice a day, the cows and horses only eat up one of the extra years' worth of hay.
I figure someone is dyslexic.
As to buying the Kindle version of any book, I'd rather have a real book. You know, like if the electricity goes out? Sometimes the used book costs less, including shipping and tax, than the Kindle version.
It's almost nice enough outside to sit shirtless in the sun. But the wind is too cold.
There's still ice/snow/sleet in the shady places. Huh. I guess a couple of nights in the mid-teens made it extra frozen.
The dogs? When it's 18F for morning potty walk? They get it done and head back to the house.
This morning at 30F? Oh, heck no. We have to wander up the driveway to the gate and wander back to the house. And bark at whatever it is they bark at. They seem happy, that's good.
Years and years ago we were going to Hawaii in March. Off season. I started working on my tan in February. It helped that the back patio faced West and the house blocked the wind. We get to Hawaii and "ow, I'm getting sunburned" and "why are you so brown?". Roll eyes….
@PC, I’ll ask, next time I see him. I’m guessing it wasn’t an issue until now.
I pirated my Kindle edition of "Atlas Shrugged" when I read it about a decade ago. The estate wanted $19.95 for the ebook at the time, and the sample I downloaded was riddled with typos.
The EPUB I ended up reading wasn't great, but it had fewer typos than the official "legal" copy.
E-ink Kindles are really good about battery life as long as you turn down the backlight or deactivate the feature. I used to charge my 2nd gen Kindle at the start of a trip and I would be good for an entire week of heavy reading.
Sadly, my 2nd gen lost the ability to download books from Amazon when AT&T deactivated their 3G network so I have a more modern Kindle. I won’t have an idea about battery performance until March.
Mr. Lynn is all about dead-tree books.
My iPad Mini not so much, but I can do more. If I'm stuck somewhere I can't charge up, that is probably the least of my worries. I'll have to try charging the Mini with my Anker solar charger sometime.
The listing on Amazon indicates a private publisher. The book may not be availble from Ingram and/or stocked in the Amazon warehouses.
I have a $49 Kindle Fire 7 with FDroid and several of the repository's apps installed as my tablet.
Total privacy sellout, but Bezos probably knows where I am if a plane ticket was involved
I stopped carrying anything on flights I would be worried about if lost or stolen.
Same thing here (well “coatless” not shirtless LOL). Pretty sunshiny day. Water still dripping off the roof and everything is wet in the sunshine, but still lots of ice and snow everyplace else, including our porches.
I went to church this morning – first time since Christmas that the local COVID cases were low for the week (had two or three weeks over 1,000). But we decided for Paul not to try it, due to the ice and snow still everywhere. Good thing: when I got there, the ramp was covered with a drift about 2" deep. The main door was clear but it has steps. This was the little Methodist church down the street. I guess we are the only ones with a wheelchair. They had a full house though, 28 regulars and 3 visitors.
My time spent on the farm we would put up around 10K bales (the square ones) each summer. A few hundred of the bales produced during the summer were delivered to a processing facility that mixed in some additives such as vitamins and other stuff with the oat hay and created feed pellets.
The bales were hauled to the facility on our truck during the winter months for processing. I would load the truck with about 50 bales, drive the truck to school (yeh, I was humiliated), then leave from school to the processing facility, return with 40 bags of pallets, unload them in the dark.
I also worked on other local farms with a couple of other guys my age hauling in their baled hay. That generally involved more hay than my farm produced. Between all the other farms, my farm, I would probably handle 50K bales of hay each summer. Did that for four years. Used custom made hay hooks that were one long arm rather than the stirrup looking things. Razor sharp point from constant wear, dangerous things if used improperly. Wore heavy leather chaps on the legs as regular Levi's wouldn't survive a day.
The bales weighed anywhere from 60 pounds to 80 pounds. One neighbor decided to try creating 100 pound bales. Big failure as no one would work on his place until he got the bales down to 75 pounds.
The big round bales at over 1,000 pounds were just being invented along with the handling equipment. The handling equipment was expensive along with the wrapping machines. Most small farmers, such as my operation, could not afford the expense so stuck with the square bales. There were bigger square bales available and those were mostly done in the Klamath Falls area, alfalfa hay. Those bales fit very well on big semi-truck flatbed trailers, generally weighed 300 pounds or so for the alfalfa hay. Mostly purchased and used by the larger operations that could afford the handling equipment.
Doesn't mean that the book is not in the Zon warehouses. My book "A Compendium of Valentine's Day Jokes" ( https://www.amazon.com/dp/B09NRK44NX?linkCode=sl1&linkId=edf699841b7915de5c22a0c68eba11f7&language=en_US&ref_=as_li_ss_tl&tag=ttgnet-20 ) is "Independently published" … because I put a publisher name (my own "Mutiny Bay Publishing" company that's a company in web site only – https://www.mutinybay.net ) when I created the KDP listing for it.
A book can be "Independently Published" and still set up a "wide" in KDP. That means that the Zon is not the only place you can purchase the book. You could also purchase it from other places (Barnes and Noble, Ingram, or wherever).
There is no way to tell from the Zon listing if it is 'wide'. You'd have to look up the book on those other sites.
Some self-published authors do the 'wide' thing. Other's don't. But it's not related to the notation of "Independently Published".
3G only? No wifi setting? How about side-loading via cable? Or does it just have a charging DC port for that?
I'm ignorant about kindles except the Fire, which is really just a proprietary locked down android tablet. Mine is wifi only. I only recently got an ipad, 10 inch, and most of what I do on it is run the kindle app. And soduku.
I bought a keyboard and a non-Apple apple pencil, and I'm trying to use the ipad for more general stuff. It's hard going for a windows guy. I'm always yelling "How do you do that on safari?" and "Where'd my bookmarks go?" and other words I can't use on a family friendly site.
"Wormhole blockchain bridge taken for more than $300 million"
https://www.scmagazine.com/analysis/cryptocurrency/wormhole-blockchain-bridge-taken-for-more-than-300-million
What a mess ! And, makes me want to invest in cryptocurrency. Not !
2nd gen Kindle. Pre-Lab126 Alexa spy regime. No Wifi. 3G modem or side loading via USB only.
Calibre still works, and most of the books on the device are … well, the legality is a grey area since I own the books but not in ebook format.
I don’t think any Kindles have Whispernet via cellular modem now, partially due to cost to Amazon but also because Amazon is quietly developing their own WiFi based mesh network to allow their devices not explicitly enabled with WiFi to “phone home”.
I love the heated seats in my truck. That and the remote start are the cat's meow.
— yes, yes and more yes. I use the remote start all the time. Heated seats less often, and I forget that I have cooled seats.
back from the rental. HVAC guy is coming tomorrow to fix whatever is wrong. I brought the tenants an extra space heater for tonight.
Unless there are unknown loopholes in physics, both are impossible. And we've found most of the loopholes since classical physics was codified.
— and yet, if aliens show up tomorrow with agrav or FTL drives, I'm convinced we'd figure it out and all our surety would be out the window.
People in the moment rarely understand the black swan that changes everything.
n
BillG famously said that no one would need more than 640k of RAM.
IIRC Microsoft had to buy an extended memory manager for DOS 5 … just like they bought DOS. Quarterdeck was really eating their lunch with QEMM for a while after Compaq hacked together the first 386 backwards compatible with the AT and MicroChannel free.
>> CNN is in severe cost cutting mode, possibly heading to a sale.
They must have high expectations as to how many Lib 'news junkies' will fork over $6/month for CNN+.
https://www.bloomberg.com/news/articles/2021-12-17/cnn-to-move-bourdain-tucci-hits-to-new-app-in-bet-on-star-power
"Forensic Files" has a big audience, but that can't carry a whole streaming service.
It isn't Baby Yoda.
>> As to buying the Kindle version of any book, I'd rather have a real book. You know, like if the electricity goes out? Sometimes the used book costs less, including shipping and tax, than the Kindle version.
Not that I'm anti First Sale Doctrine, but when it comes to books it's nice to skip the used copy so that a few cents go to the author.
I love my kindles, but also like physical books. Both have their pluses. Zoomable text and backlight make the difference for me with everyday reading though.
and according to my wife, the ipad makes an excellent kindle reader.
n
IIRC Microsoft had to buy an extended memory manager for DOS 5 … just like they bought DOS. Quarterdeck was really eating their lunch with QEMM for a while after Compaq hacked together the first 386 backwards compatible with the AT and MicroChannel free.
We own a full license of Phar Lap TNT 386 DOS Extender with complete redistribution rights. I forget what we paid for it but it was serious five figures.
https://en.wikipedia.org/wiki/Phar_Lap_(company)
I used Phar Lap with the NDP Fortran compiler to produce the first 386 / 387 version of our software. The compiler produced assembly language which you then compiled to object format. Unfortunately, about five of the subroutines generated bad assembly jump code so I had to modify those by hand and then compile to object format.
>> In 1943 Thomas Watson, chairman of IBM, said, "I think there's a world market for maybe five computers."
I guess this one didn't make the cut.
>> I love my kindles, but also like physical books. Both have their pluses. Zoomable text and backlight make the difference for me with everyday reading though.
and according to my wife, the ipad makes an excellent kindle reader.
Physical books are great, except when you have to move. My wife had a good number of books when we moved to FL and that expanded over the years. When we left FL about 80% went to the Salvation Army. Now she buys a dead-tree copy mainly when she needs to mark up the book. Otherwise she has a Kindle PaperWhite and an iPad, the latter which drives me nuts any time I try to use it. I hate iOS.
Finished the "Reacher" season 1 last night. Enjoyed it. Very close to the book as I recall it. Can't wait for further seasons.
For those that finished this season 1, did you see the quick cameo of the author (Lee Child) at the end? When I watched the scene, I thought that the guy looked familiar.
Turns out, the author cameos in all of the "Reacher" films.
And now I want some peach pie.
re: Watson and healthcare
I can speak to this from an expert viewpoint. I've done healthcare IT on electronic medical records systems for 14 years, as a reporting analyst. Between full time jobs and contract, I've worked at 7 different healthcare systems, 3 of them attached to medical schools.
Healthcare data is garbage. The best AI in the world (currently) couldn't make sense of it. Before ICD-10 coding (about 2014), the granularity of diagnosis codes sucked. After ICD-10, you had different issues.
Matching diagnosis to procedures/drugs to outcomes is just not done. Watson was supposed to thread the needle of finding diagnosis, tabulating procedures and drugs, and matching with outcomes to be predictive. But the data, as I said, is garbage.
Maybe, if you completely ignore HIPAA and do covert follow-up on every patient, the surveillance state could eventually apply Big Data or similar techniques and get there. But this isn't as simple as harvesting what you searched for in Google or what you bought from Amazon to tailor your ad profile. This is trying to out-expert the experts on what treatment may be best for you given your condition. And, not to make too fine a point of this, the expert doctors suck big-time, too.
I read a great line today: What's the difference between God and a doctor?
God doesn't think he's a doctor.
Anyway, the part of healthcare data that is NOT garbage is:
Notice that most of that deals with billable items, either labor or materials, or tracking personnel and their actions. There's a reason for that.
Outcomes once you've left the institution are not, and can not, generally be tracked. Only if you die in the hospital or your primary care doc shared the hospital's EMR and remembers to document your at-home or care facility death. I suspect that's rare.
The programmers weren't much better than the data. I had one Watson "savant" in the DIgital Logic lab section I taught in 2015, and genius boy was a major weed head, always doing completely useless work in my class, making excuses, and getting cover from my co-instructor since the student was some kind of big deal at IBM Austin. I think he works for Visa now, doing something else AI related out in their facility on 183 in Austin.
When I first arrived in town in 2014, I took an interview out at IBM Austin. The place was like a graveyard, with most of their campus property sold off and employees walking around like the opening credits of "Shaun of the Dead". The buzz about Watson always mystified me after that site visit.
https://www.youtube.com/watch?v=cnZGdC-vTCo
That was my first thought, GIGO.
n
I really enjoyed binge watching the Reacher series as recommended here. Still, the villains did some monologue-ing when they should have just fired and the only bad guy marksmanship that was any good came in the first minute of the first episode.
Disclaimer: I always liked "Hot Fuzz" better. 🙂
https://www.youtube.com/watch?v=ayTnvVpj9t4
I can corroborate lpdbw's assessment of the quality of medical data.
re ICD-10 coding, a number of practices weren't using it at least through 2018. The electronic health data systems we worked with had columns for both ICD-9 and ICD-10 and the -10 columns weren't regularly filled in until around 2020. Furthermore, there are so many ICD-10 codes that no one can keep them straight, so a few catch-all codes tend to get used more than they were intended to. Making it worse, a number of insurance companies will tell the practices to use particular codes for various ailments. This means that if John Doe and Joe Blow have the exact same problem and are seen by the same practitioner, they may be coded differently if they have different insurance companies. But maybe not, because human error rules all.
(Oddly, despite having over 100,000 codes, ICD-10 doesn't have a single one for "nurse gave the wrong medicine", "dropped by orderly", "nerve severed by incorrect surgical incision", "flesh-eating bacteria picked up during overnight hospital stay last month" or anything of that sort. Very odd. Why, it's almost like the apparent #3 cause of death in the United States doesn't exist.)
Human error rules all when it comes to data entry in medical records. One analysis I had to do was weight loss for patients of a weight loss clinic. It was not as straightforward as you might naively think because a patient's weight might be recorded on successive visits as 182, 179, 715, 172. I prepared lists of obviously bad entries for the clerks to fix but they never did. (Nor did they bother to correct A1C values of 62, a value which would have the patient's blood approximately the makeup of a stick of butter.) I wasn't able to simply drop implausible numbers or even numbers which were way off the curve. -shrug- The customer was paying for my time. I did occasionally check with the la-di-dah decision makers whether this was the most productive use of the money they were paying, and eventually they decided that it wasn't.
Oh, I almost forgot: the switching back-and-forth between male and female. One switch would be plausible with all of the transmania going around. Some patients, though, switched every other month. Either they had trouble making up their minds or some clerks were mighty clumsy with their mouse clicks. Even better, some patients' status toggled between Living and Dead more than once. Birth dates changed, too, which made certain reports a bit awkward, like "Give me a list of all empanelled patients over the age of 74 who had a hospital admission in the past two years." If a 17-year-old was shown as being 77, no real harm done. If a 77-year-old was shown as being younger, he'd be missed for whatever screening or counselling the doc wanted to do.
One of the things I set up on the previous job was looking for odd changes in the patient data as well as ridiculous values. This involved creating tables for holding the history of patient personal information (eg, date of birth, sex, deceased, empaneled practice, primary practitioner) because AllScripts, the electronic health records system used by most of our clients, didn't track history. (Or at least the version used by the client practices didn't.) Fun fun fun!
Sounds like the medical profession needs the expertise of some of the climatological data adjusters.
I'd guess that most of the practice management software was hobby coded by some smart doc way back in the day and kludged together in whatever way they could mostly get to work. And that it is still running mostly unchanged.
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WhoopiGate Just Got Worse: 'Anti-Semitic' Charity Cookbook Recipe Emerges
By Mike Miller | Feb 05, 2022 11:00 AM ET
https://redstate.com/mike_miller/2022/02/05/whoopigate-just-got-worse-anti-semitic-charity-cookbook-recipe-emerges-n517670
Let me answer the question this way:
Why should Whoopsi not be required to live with the consequences of the judgemental rules that she has spent years making up and imposing on others?
Finally. It ain't, after all, the first time she's pulled some shiite that would have gotten most conservative white folks fired before the next news cycle.
Epic is the big EMR system with over 50% of the patient records in the US. The company was founded specifically as a software company by a non physician back in the 80s.
Most doctors in private practice are constantly behind with coding due to patient load, and, as a result, it often gets done poorly. My wife is better than most, but she frequently spends another 2-3 hours at home updating records, even working for the VA with a much lower visit rate per day.
@ray
we used to buy oat hay a paltry 1/2 ton at a time. I remember how heavy and scratchy it was. Also how satisfying to see the stack and know Patches would be well fed.
Up here we mostly get double compressed bales. I buy what’s available – sometimes alfalfa, sometimes Timothy, orchard grass when I can, for the rabbits. $20 – 26/ bale. The bales are nearly as heavy however half the length of a three string oat hay bale. I appreciate the size but deplore the waste. The strands are shorter and lots of broken pieces. Fall thru the 1/2”x1” floor wiring fast. It’ll be better when I make the rabbits new hay feeders of 1/4” wire mesh.
I can get locally grown 3 string bales of hay, however I have to drive 60 miles north to pick it up. I may make a trip next weekend, if west coast is seeing hay scarcity we will see it up here also.
I modified an old rabbit cage today, affixing the nest box to a hole cut in the flooring. Kits that are accidentally drug out by doe when she’s done nursing will have a chance to roll back into the warmth of the nest. With the nest warming pad I hope this will eliminate the need to shelve kits. Litter born two+ weeks ago are fully furred, eyes open, and active. I have two juveniles to put in the freezer from last fall. That’ll free cage space for these youngsters to go outside.
I think I’ll breed their mama this week. I’d like to see if she’s a better mama and less bitey-faced in the warming weather. I like her however her bitey ways are getting old and mean daughter cannot do as much in the rabbitry as I’d like. Rabbit bites hurt.
Anchorage had a truck convoy to the next town today. Stayed home, haven’t seen local news coverage. FB accounts are impressive. Well attended with lots of American flags and enthusiasm. Every third or fourth vehicle was a semi or commercial vehicle in the videos I watched.
I would say Austin dodged a bullet this weekend, but the city proper issued a boil water alert because of someone making a process blunder at the water treatment plant a few days ago.
I'm guessing someone was wearing jammies and trying to do their job via TeamViewer on Friday when they should have been at the facility.
All of the water at local stores was gone by this evening.
re: Epic and the 1980's
It's worse than that. The original system was written in a language called MUMPS, and (as I heard it), the hospital that had the code took no steps to protect their ownership of the IP, so the entire codebase was forked to begin Epic and at least one other EMR company. Epic is what I'm trained and certified in; Hospital Billing, Professional Billing, HIM (Medical Records), and a couple of technical things.
If you are capable of looking at systems as a whole, and gain just a little insight from Epic old-timers, you can actually see the evolution of the product where they grafted module after module, database after database, onto the 80's codebase. In its original incarnation, it was Professional Billing only, then a weak EMR, then they added hospital billing, deeper EMR, Admit/Discharge/Transfer, lab, external interfaces, and more.
MUMPS no longer exists, as such, but there are a couple of completely backwards compatible databases available, both public domain and commercial products.
It got more kludgy when they went from dumb terminals (directly on the MUMPS DB) to a windows based client-server model, where each user runs a windows client speaking to the MUMPS DB, transaction by transaction. I guess like CICS, although I've never used it.
M code, as it's known now, is not a relational database, and as far as performance goes, it knocks the socks off any relational database. The trade-offs are: You don't hire M programmers, you have to build them, SQL programmers can be hired already trained and experienced, and the application/database integration has to be very tight. As a network database, certain tasks are incredibly faster than SQL, when the application aligns perfectly with the database network structure. Other tasks require searching the entire database or building expensive indexes. In general, customers don't program in M; they use another layer of tools and databases to customize the behavior and appearance of the Windows application. All the detail M code is provided by Epic.
I'll stop now because A) I doubt it's really that interesting and B) Even though I'm pretty sure I'm safe, Epic has an aggressive policy protecting their IP and I'd hate to trigger them.
Hah. Solved a very minor issue, in the grand scheme of things, but really bothersome for me.
Wife has been feeling very hot lately. Hm. Wants the indoor temp about 4 to 5 degrees cooler than we usually keep it, and it's chilly enough in my office, despite all the computer heat, that my nose is cold and my hands hurt. This is a battle I'm not going to win. LAST winter, I bought some aftermarket seat heater pads for the kinder in the back seat of my wife's van, but never used them because winter ended…
This winter I put one of the pads in the van for D2, and now I've put the other on my desk chair. MMMMmmmmm. very warm bottom and back now. Too warm until I turned down the controller in fact. Fortunately, the controller has a large range with a lot of adjustment, and not just the three levels my truck seats have.
It's only been a couple of hours but I think this will be a good solution.
It was super cheap as an auction, but I don't think the pads were crazy expensive to start with. I'm running it on a 12v wall wart with a cigarette lighter socket on it.
Toasty buns.
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One more comment about doctors being behind in their documentation.
At least half of my HIM reporting process was tracking doctors who were behind on documentation, what documentation was missing, whether they were candidates for suspension due to being behind, how many times they've been suspended over the last year, and the overall quality and ratios for on-time vs. late documentation for the system as a whole.
The HIM director is in a hard place. She was not an MD, and she had to suspend MDs, and the MDs always ran and complained to the CEO (also an MD and a pr*ck) so she had to justify each suspension to the CEO. Every month. I told her to her face I didn't want her job. She also had to talk to the CFO daily, because HIM is responsible for coding, and billing doesn't happen until coding is up to date. Literally millions of dollars held up in queues, and a lot of the coding can't happen until the docs get their documentation CORRECTLY completed.
>> I'd guess that most of the practice management software was hobby coded by some smart doc way back in the day and kludged together in whatever way they could mostly get to work. And that it is still running mostly unchanged.
Nothing like seeing a Windows 98 screensaver running on the PC in the doctor's office.