The Takeaways: Week 30 of 2021

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

Closed Tab of the Week

A new addition to this type of post. I always have many tabs open. A good number of them hang around because of the mismatch between my interest in engaging with them and the time I have available for that engagement. Starting this week, I'm picking at least one to review, think about, and close out.

Katy Decorah, Improve documentation with failed searches (June 12, 2021)

Zero-result search queries give you a signal about where your application, service, or content is falling short in providing users what they need. Decorah's post digs into an even more important aspect of this (or any) data-based signal: once you set a threshold, how do you capture the signal, then assess and triage it for action?

By focusing on improving data quality, response time, and holding ourselves accountable, we are building a more meaningful solution to improving documentation with failed searches.

Having decided to solve for zero-results searches in a number of ways, Decorah's team eventually started losing ground on it. The percentage grew and grew. No fix made it better.

After stepping back, they made the following changes:

  1. Stopped relying on the search service's bare-bones analytics and instead added sophisticated logging in their APM suite.
  2. Set up a job to collect failed searches and add them to a Google Doc.
  3. Regularly reviewed the Google Doc as a team and triaged each failed search.

This put Decorah's team in a much better position: real-time reporting, visible to the entire team, for which the entire team was accountable, and expressed not simply as a percentage of events but with the number of affected users.

Great ideas, and very timely for my own work.



Tyler Cowen (host), Conversations with Tyler. Episode 128: Niall Ferguson on Why We Study History (July 28, 2021)

Keith Figlioli (host), Healthcare is Hard: A Podcast for Insiders. CommonSpirit’s Lloyd Dean and Rich Roth on Solving Inequities through Innovation (October 8, 2020)

Melissa Perri (host), Product Thinking. Episode 26: Tying Product to Go-To-Market Strategy With Ray McKenzie (July 28, 2021)

William Vincent and Carlton Gibson (hosts), Django Chat. Episode 96: Docker & Flask - Nick Janetakis (July 21, 2021)


John Cutler, The Beautiful Mess. TBM 31/52: The Weeds (July 29, 2021)

The fact that there are different definitions is important. Why? Sometimes The Weeds refers to things we want to get into! We want to focus, and not have people meddling and interrupting. Sometimes The Weeds is what we want to avoid so that we can focus elsewhere. Sometimes people are grateful for weed work. And sometimes people are dismissive. It is second class work. Overhead. The boring stuff.

Here’s something I see often. An organizations wants to “free up” product managers. But getting product managers out of the weeds to focus more on strategy and the “big picture” could go either way.

1) As a product manager, are you planning to release control over the creative process and definition? Are you empowering the team to do the creative work they are capable of doing? Are you inviting them into your work?

2) Or, are you leaving an engineering manager to deal with mind-numbing project management (and process) overhead. While you work on an island. Sayonara Jira.

Andrew Egan, Tedium. The Things That Go Bump On The Web: Explaining the power of collaborative fiction on the web—particularly the extremely compelling work of the SCP Foundation (July 30, 2021)

Ted Gioia, The Honest Broker. When the Drummers Were Women (August 1, 2021)

Redmond had identified perhaps the most significant point of rupture in music history. During a distant period in human history, drums were taken over by men—and not just by male musicians. Drumming was especially favored by military organizations, who realized that this instrument could solve so many organizational problems. Drums instilled discipline into marching soldiers. Drums made opposing troops fearful, their very sound inspiring terror. Drums could be used to send signals and coded messages, identify locations and geographical directions, and provide other informational needs.

Yet there was an earlier stage in the history of music and society, Redmond hypothesized, when drumming had been more peaceful—a distant age when women had served as the awe-inspiring custodians of drums and their powers. The role of music was much different back then. When women set the beat, drumming was about fertility, abundance, prosperity, spirituality, and service to higher powers, many of them goddesses.

Bapu Jena, MD, PhD, Tradeoffs Research Corner (July 30, 2021)

Overview of an NBER working paper by Janet Currie, Anastasia Karpova and Dan Zeltzer: "Do Urgent Care Centers Reduce Medicare Spending?"

Researchers and policymakers are always looking for alternative places for people to get medical care without needing to go to busy, costly emergency rooms (ERs) or physicians’ offices. One of the most popular potential solutions is urgent care centers (UCCs). These walk-in clinics have grown in number by more than 50% since 2013 ... But the existing evidence is mixed on whether they actually keep less-sick people from more expensive ER or doctor visits.

The research suggests a mixed outcome, at best. Modest increase in Medicare expenditures, driven in large part by increased hospitalizations. It also proved true that the number of ER visits leading to hospitalization increased. The driver here may be the increasingly close relationship between urgent care centers (UCCs) and hospitals, whether owned by or contracted with. On the basis of this study, UCCs may not be the cost-lowering win the industry had imagined.

Nikhil Krishnan, Out of Pocket. How Health Data Gets Sold: Moving From Third-Party to First-Party (July 25, 2021)

Patients, data originators, data vendors, data brokers, and data buyers.

Reuven Lerner, Better developers. Types of design patterns, and a concrete example (July 26, 2021).

Design patterns roll up to three types: creational, structural, and behavioral.

Kieran O'Hare, Superorganizers. Walking as a Productivity System: How walks create the foundation of Craig Mod's creative work (July 27, 2021)

I try to avoid what I think is the scariest part of running a membership program—having it become a gilded cage.

That can happen if, for example, you get good at publishing newsletters, but instead of continuing to write newsletters about subjects you’re interested in, you end up becoming the person who writes about how to write newsletters. You become the meta-version of yourself.

In other words, you end up not doing the stuff you set out to do at the beginning. It’s easy for that to happen, too—it tends to be more profitable (it’s a form of self-help, which is always quite profitable), and it can be easier to grow—but it’s something I’ve always been wary of.


Natasha Daly, National Geographic. What we know about the mystery bird death crisis on the East Coast (July15, 2021)

The District of Columbia and at least 12 states on the East Coast, from Connecticut to Florida to Tennessee, are in the midst of a songbird epidemic. Thousands of young birds, including blue jays, common grackles, American robins, and European starlings, have suddenly gone blind, oozing from their eyes, shaking, and dying. Lab tests have ruled out some possible causes such as West Nile virus and avian influenza, leaving scientists struggling to come up with new hypotheses.

Nicholas Florko, Damian Garde, and Adam Feuerstein, STAT. At FDA, Biogen found a key believer in its controversial Alzheimer's drug (July 27, 2021)

Bill Frist, Forbes. The Little-Known Agency That’s Trying To Boil The Ocean—A Look At CMMI’s Decade Of Trying To Change Medicare & Medicaid (July 26, 2021)

A good overview of CMMI.

Phil Galewitz, Kaiser Health News. Amid Covid Booster Debate, West Virginia to Check Immunity of Vaccinated Nursing Home Residents (July 28, 2021)

Jim Groom, Bavatuesdays. Building bavacade: Double Digits! (July 31, 2021)

The thing you learn quickly once you get into the hobby of collecting [video game] cabinets is that it’s not necessarily a savvy investment. You tend to put more time, energy and love into these artifacts than you will ever realize from a sale. What’s more, these games are of little value (at least to me) if they can’t be played, and for that to happen they will need repairs, and with that goes any hope of serenity in exchange for a whole lot of fun.

Jay Hancock, Kaiser Health News. Pfizer Court Fight Could Legalize Medicare Copays and Unleash ‘Gold Rush’ in Sales (July 29, 2021)

A close look at drug pricing, offsets to consumers, and how the judicial landscape continues to evolve in pharma-friendly ways.

Samantha Liss, Healthcare Dive. 'Pent up demand' spurs Centene Q2 net loss as more members seek care (July 27, 2021)

Dina Fine Maron, Scientific American. Science Career Ads Are Disproportionately Seen by Men (July 26, 2021)

Women see fewer advertisements about entering into science and technology professions than men do. But it’s not because companies are preferentially targeting men—rather it appears to result from the economics of ad sales.

Surprisingly, when an advertiser pays for digital ads, including postings for jobs in science, technology, engineering and mathematics (STEM), it is more expensive to get female views than male ones. As a result, ad algorithms designed to get the most bang for one’s buck consequently go for the cheaper eyeballs—men’s. New work illustrating this gap is prompting questions about how that disparity may contribute to the gender gap in science jobs.\

Hannah Norman, Kaiser Health News. The Pandemic Made Telemedicine an Instant Hit. Patients and Providers Feel the Growing Pains (July 26, 2021)

From getting everyone online, to maintaining connectivity to keep them there, to working out fallbacks and workarounds: telehealth is still pretty complicated for end users, both clinicians and patients.

Casey Ross, STAT. Epic’s AI algorithms, shielded from scrutiny by a corporate firewall, are delivering inaccurate information on seriously ill patients (July 26, 2021)

Epic may have aggressively deployed its products. But regulators have not intervened, and hospitals eager to reach for the benefits of AI have also failed to appreciate the challenges associated with putting novel technology products into clinical use.

Gopal Sarma, STAT. The first challenge for ARPA-H should be electronic health record migration (July 27, 2021)

One of the original aspirations for electronic health records was that they would launch a digital transformation of U.S. health care by laying the foundation for a deep integration of informatics into all aspects of care delivery. The reality is that they are extremely poor systems for capturing high-quality health and outcomes data and do not have adequate technical infrastructure for supporting downstream data analytics, such as advanced machine learning.

So true.

Kate Sheridan, STAT. Research into centenarians’ microbiomes reveals potential clue to longevity (July 29, 2021)

TLDR, certain anti-microbials turned up quite often. And as Sheridan points out, there is "literal survivorship bias" so interesting but no clear action.

Ernie Smith. Midrange. Valuable Keys (Issue #78) (July 27, 2021)

So now I own the Laser 2269 keyboard—the same model I used at the age of 11.

Liz Szabo, Kaiser Health News. Unraveling the Mysterious Mutations That Make Delta the Most Transmissible Covid Virus Yet (July 28, 2021)