The Takeaways: Week 13 of 2022

A periodic review of articles, newsletters, and podcasts that I found interesting, inspiring, or otherwise worth remembering.


Amal Trivedi, MD, MPH, Tradeoffs Research Corner. Are Vets Less Likely to Die at VA Hospitals?

It can be difficult to compare patient outcomes for VA and non-VA hospitals because many veterans are more medically high risk and more likely to have low incomes and disabilities than non-veteran populations. To get around this, the authors used data for veterans with VA and Medicare coverage who could therefore get care inside or outside the VA. The authors also limited the study to veterans living within 20 miles of a VA who went to the hospital in an ambulance because of an acute emergency.

The researchers had three key findings: * Veterans getting emergency care at a VA hospital had a 20% lower risk of death within 30 days than those at a non-VA hospital. * This lower mortality rate was much lower for Black and Hispanic veterans and veterans who had previously received care in the same VA. * Veterans getting care in the VA were sicker — they had more chronic conditions and a higher risk of death.


Tudor Girbi, feenk blog. Developers spend most of their time figuring the system out (January 27, 2021)

Reading is the most manual way to extract information out of data. It does not scale and leads to incomplete information & uncertainty.

Software is hard enough. Not knowing what the current system is like should not be an acceptable variable in the equation. A hand drawn picture about the current system is a belief. Decisions should never be based on beliefs. Not in engineering.

Once we accept that systems are data, it becomes obvious we should approach it like data, too. Data science tells us that you first start from the problem and then reason through a tool that matches the context.

Toni Morrison, accepting the 1996 Medal for Distinguished Contribution to American Letters. The Dancing Mind

The reader disabled by an absence of solitude; the writer imperiled by the absence of a hospitable community. Both stories fuse and underscore for me the seriousness of the industry whose sole purpose is the publication of writers for readers... Underneath the cut of bright and dazzling cloth, pulsing beneath the jewelry, the life of the book world is quite serious. Its real life is about creating and producing and distributing knowledge; about making it possible for the entitled as well as the dispossessed to experience one’s own mind dancing with another’s; about making sure that the environment in which this work is done is welcoming, supportive. It is making sure that no encroachment of private wealth, government control, or cultural expediency can interfere with what gets written or published. That no conglomerate or political wing uses its force to still inquiry or to reaffirm rule.

Rebecca Pifer, Healthcare Dive. Google launches new search tool for provider appointments, seeks FDA approval for Fitbit feature (March 25, 2022)

The goal of the new booking functionality is to match patients to physicians more easily and cut down on lengthy wait times for primary care appointments that can average 20 days or more, Jackie DeJesse, Google product manager for health search, told reporters on a conference call.

The tool doesn't let patients book appointments on Google's interface. Instead, it redirects them to the provider's website for the actual scheduling process. Google stressed it doesn't store any personally identifying information from providers and it will not use any data for advertising, a perennial concern as big tech giants step deeper into healthcare.

Still, the bookings functionality only shows appointments at specific practices and does not aggregate across providers, which would likely go further in pairing a patient to the closest and most near-term appointment for their needs.

Udani Samarasekera, The Lancet Digital Health. The rise of racial minority health apps (April 1, 2022)

Such co-designing of apps is key, notes Sherry Pagoto, Professor in the Department of Allied Health Sciences at the University of Connecticut and Director of the UConn Center for mHealth and Social Media, Storrs, CT, USA. “Experts from the target population should be at the design table and developers should heavily engage potential users who are members of the target population throughout the design process. If you aren't co-designing in this way, there is a good chance your app won't be of interest to an entire population of people”, she says.