Post · Bonfire

Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Today's threads (a thread)

Inside: Epic Systems, a lethal health record monopolist; and more!

Archived at: https://pluralistic.net/2024/10/02/upcoded-to-death/

#Pluralistic

A crowded field hospital. In the foreground are massed bundles of vivid green US $100 bills; atop them stands a robed skeleton, drinking from a blood filled goblet; blood stains the skeleton's robe. In the background is a row of giant mainframes.

Image:
Flying Logos (modified)
https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0
https://creativecommons.org/licenses/by-sa/4.0/deed.en — A crowded field hospital. In the foreground are massed bundles of vivid green US $100 bills; atop them stands a robed skeleton, drinking from a blood filled goblet; blood stains the skeleton's robe. In the background is a row of giant mainframes. Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

Brian Repko @brianrepko@hachyderm.io · 2 months ago

@pluralistic Probably time to share this story. I was employee 70 or so at Epic in 1991.
Responsible for their AR system. The EMR was just getting started by my boss (Carl Dvorak, now CEO). We we’re implementing RBRVS into the system - https://en.wikipedia.org/wiki/Resource-based_relative_value_scale - and I was asked to basically implement upcoding - show close other ways to code this and the up / down. I refused. “That’s fraud” I believe came out of my mouth. We didn’t add it. Left and moved to MKE in 1992/3? Amazing to see this.

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ZombieRasputin @ZombieRasputin@fosstodon.org · 2 months ago

@pluralistic ooooh boy this is my wheelhouse, except I'm a technologist. Epic is a bloated POS that takes dozens of clicks and moving around different areas of the system to even chart simple changes (place a feeding tube in Radiology? That's 35 clicks of your mouse!)

The sad thing is, it's not even the worst. I have to use Athena now, and that system is an aggressive billing system with the thinnest veil of an EMR system attached to it.

LisaH @3x10to8mps@mastodon.social · 2 months ago

@ZombieRasputin @pluralistic I've used Epic in 3 hospital systems. It depends on how each implements it

It's a powerful toolbox that relies on getting enough physician input and the skill/talent of the IT team building it. It's harder to get right than Meditech, Cerner or Athena

University of Colorado is fabulous (for a graphical interface EMR). The hospitals in West Virginia are the worst imo- it actually gets in the way of patient care

So it's not Epic intrinsically

Space Invader @spaceinvader@social.securitytheater.net · 2 months ago

@pluralistic I nearly worked for Epic. It was a good interview experience (save for the taxi ride to the airport) overall. What stopped me accepting was learning they paid relocation costs, but you had to work for them for three years otherwise you had to repay everything. No pro-rating. And turnover at the three year mark was high.

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Tor Books has just published two new, free "Little Brother" stories: "Vigilant," about creepy surveillance in distance education:

https://reactormag.com/spill-cory-doctorow/

And "Spill," about oil pipelines and indigenous landback:

https://reactormag.com/vigilant-cory-doctorow/

JP Sugarbroad @taral@mastodon.social · 2 months ago

@pluralistic I want to read these, but I'm also afraid that they'll make me just as incandescently furious as the original Little Brother.

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/3

Epic Systems, a lethal health record monopolist: Clinical needs sacrificed to profit maximization.

https://mamot.fr/@pluralistic/113237780216406333

Image:
Flying Logos (modified)
https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0
https://creativecommons.org/licenses/by-sa/4.0/deed.en — Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/4

Hey look at this

* Inside the $621 Million Legal Battle for the ‘Soul of the Internet’ https://www.rollingstone.com/music/music-features/internet-archive-major-label-music-lawsuit-1235105273/

* Alleged Tax Dodger Says It’s a “Legitimate Snail-Farming Operation” https://www.loweringthebar.net/2024/10/alleged-tax-dodger-says-its-a-legitimate-snail-farming-operation.html

* Epic Games CEO Tim Sweeney renews blast at ‘gatekeeper’ platform owners https://venturebeat.com/games/epic-games-ceo-tim-sweeney-renews-blast-at-gatekeeper-platform-owners/ (h/t @slashdot)

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/5

#20yrsago George Soros blogs https://web.archive.org/web/20041009162245/http://georgesoros.com/index.cfm?Fuseaction=Home

#15yrsago Zombies Calling: snappy popcult zombie comic in the Scott Pilgrim mold https://memex.craphound.com/2009/10/02/zombies-calling-snappy-popcult-zombie-comic-in-the-scott-pilgrim-mold/

#10yrsago Keurig sued for anti-competitive K-cup tactics https://www.cbc.ca/news/business/keurig-coffee-sued-for-600m-by-ontario-based-club-coffee-1.2783633

#10yrsago Directors’ commentary for “In Real Life” https://web.archive.org/web/20160331041746/http://www.forbiddenplanet.co.uk/blog/2014/directors-commentary-cory-doctorow-jen-wang-talk-in-real-life/

#10yrsago David Cameron raps the Tories’ nasty party manifesto https://www.youtube.com/watch?v=0YBumQHPAeU

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/6

#10yrsago Hong Kong and America: two systems, one corruption https://web.archive.org/web/20141006033919/http://www.lessig.org/2014/10/we-should-be-protesting-too/

#10yrsago World Intellectual Property Organization in shambolic chaos https://www.keionline.org/22621

#10yrsago Why the UK middle class should be rioting in the streets https://www.telegraph.co.uk/men/thinking-man/11109845/Why-arent-the-British-middle-classes-staging-a-revolution.html

#10yrsago Human beings are the gut flora of immortal, transhuman corporations https://memex.craphound.com/2014/10/02/human-beings-are-the-gut-flora-of-immortal-transhuman-corporations/

#10yrsago Daughter of Hong Kong leader thanks “taxpayers” for diamonds on Facebook https://

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/7

timesofindia.indiatimes.com/world/china/Hong-Kong-leaders-daughter-creates-controversy-with-Facebook-post/articleshow/44115995.cms

#10yrsago Nobody wants to host the 2022 Olympics https://sports.yahoo.com/why-no-one-wants-to-host-the-2022-olympics-225450509.html?soc_src=mediacontentstory

#5yrsago IRS admits it audits poor people because auditing rich people is too expensive https://www.propublica.org/article/irs-sorry-but-its-just-easier-and-cheaper-to-audit-the-poor#168476

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/8

#5yrsago Elizabeth Warren proposes an “excessive lobbying tax” that would fund independent Congressional experts and public participation in policy https://medium.com/@teamwarren/excessive-lobbying-tax-fca7cc86a7e5

#5yrsago Apple bans an app because Hong Kong protesters might use it to avoid the murderous, out of control police https://memex.craphound.com/2019/10/02/apple-bans-an-app-because-hong-kong-protesters-might-use-it-to-avoid-the-murderous-out-of-control-police/

#5yrsago The complicated, nuanced story of how racialized French people fought to save their local McDonald’s https://www.npr.org/2019/09/05/758048712/libert-galit-and-french-fries

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/9

Yesterday's threads: Everyday homeowners are human shields for Wall Street's Internet of Shit slumlords; and more!

https://mamot.fr/@pluralistic/113232679662478149

Image:
Sam Valadi (modified)
https://www.flickr.com/photos/132084522@N05/17086570218/

Carlos Delgado (modified)
https://commons.wikimedia.org/wiki/File:Wall_Street_-_New_York_Stock_Exchange.jpg

CC BY 2.0:
https://creativecommons.org/licenses/by/2.0/ — Image: Sam Valadi (modified) https://www.flickr.com/photos/132084522@N05/17086570218/ Carlos Delgado (modified) https://commons.wikimedia.org/wiki/File:Wall_Street_-_New_York_Stock_Exchange.jpg CC BY 2.0: https://creativecommons.org/licenses/by/2.0/

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/10

My latest nationally bestselling novel is "The Bezzle," an ice-cold revenge story of high-tech finance crime starring the forensic accountant Martin Hench:

https://us.macmillan.com/books/9781250865878/thebezzle

Signed copies from Chevalier's Books:

https://www.chevaliersbooks.com/product-page/the-bezzle

My latest nonfiction book is "The Internet Con: How to Seize the Means of Computation" from Verso Books:

http://seizethemeansofcomputation.org

Signed copies available from Book Soup:

https://www.booksoup.com/book/9781804291245

Both are national bestsellers!

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/11

My ebooks and audiobooks (from Tor Books, Head of Zeus, McSweeneys, Beacon, Verso and others) are for sale all over the net, but I sell 'em too, and when you buy 'em from me, I earn twice as much and you get books with no DRM and no license "agreements."

https://craphound.com/shop/

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/12

Upcoming appearances:

* Was There Ever an Old, Good Internet? David Graeber Institute (Remote), Oct 3
https://us02web.zoom.us/meeting/register/tZUsduuprjgpG9C4SAenCK4jOsawnkxDrY_-#/registration

* “Come distruggere il capitalismo della sorveglianza” (Pisa/Remote), Oct 12
https://www.internetfestival.it/programma/come-distruggere-il-capitalismo-della-sorveglianza/

* SOSS Fusion (Atlanta), Oct 22
https://sossfusion2024.sched.com/speaker/cory_doctorow.1qm5qfgn

* TusCon (Tucson), Nov 8-10
https://tusconscificon.com/

* International Cooperative Alliance (New Delhi), Nov 24
https://icanewdelhi2024.coop/welcome/pages/Programme

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/13

Recent appearances:

* A Book Talk with Cory Doctorow and @hartzog at BU Law
https://www.youtube.com/watch?v=Gkt9dlTX-gs

* Rethink: Is the internet getting worse?
https://www.bbc.co.uk/programmes/m0022z9r

* Annie's Book Stop Of Worcester
https://www.youtube.com/watch?v=uYM3WOPOMC0

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Cory Doctorow @pluralistic@mamot.fr · 2 months ago

Long thread/14

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