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Comment by wpasc | Hacker News Reader

I sincerely hope IBM's failures do not deter further progress in trying to innovate in healthcare technology. I believe healthcare vitally needs GOOD/USEFUL technology and AI applications because medical progress is not advancing quickly enough by several metrics.

I hope IBM continues to fail and becomes a case study in the failure of massive bureaucracy.

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IBM will not fail, Oracle will fail first than IBM and that's unlikely to happen.

You see, they are NOT tech companies. They have something you would call "tech", they sell something that looks like "tech" but they really solve problems people with access to large amounts of money have.

In other words, they produce cushy and warm beds for C-level execs to have a good night of sleep, and everyone needs some bed to sleep every night..

Technology is a risky and volatile business and IBM has more than 100 years in business.

Spot on.

IBM really does capitalize on the adage of nobody being fired for buying IBM. Their biggest strength has been in their marketing rather than actual technology.

Note that, being a large org, they do have teams doing excellent work too. IBM research, some of the cloud, design etc. teams seem to be doing good stuff. But most of it is still overpromising and underdelivering while charging clients a lot of cash.

This is less true than it used to be. Oracle/SAP are largely recognized as multi-billion dollar technology quagmires these days; integration has become so much easier that cobbling together a bunch of SaaS solutions to replace a centralized ERP is a viable approach.

Likewise, IBM has become known as a vaporware vendor. They combine the worst parts of management consulting with an offshore / outsourced development process, so I guess it’s not a surprise they ended up like all the other companies that sell business tech solutions (Infosys, Wipro, etc). They’re often mentioned in the same breath these days.

IBM has been banned from our data center for several years. The decision was before my time, but the answer I've been told is overly expensive, unreliable, and poor support when compared to other vendors.

In my experience, IBM’s support is excellent, bordering on fanatical. It’s just that their hardware (in this case, Spectrum Scale and Power9) are preposterously overpriced. Same for their software, if not more so.

As a former IBMer I really like the POWER hardware. It is just a shame that it is made by IBM. Like you said IBM stuff is just too damn expensive.

Right, I should have pointed that out: the Power hardware is truly incredible, especially the fast I/O to GPUs. There’s a reason why the national labs and Google have gone with that architectue.

I know about it from the Raptor PC team and their Foss compatible microcode. Would you say it holds its own performance/reliablilty wise with competitors?

I think these two statements can be reconciled:

- IBM's hardware support is excellent to the point of being obsessive

- IBM's support for anything that is not a hardware problem would be better-implemented by a 5 year old eating paste

Thats why the average company on the s&p500 only survives 10 years so 75% will be whiped out in 10y. At the time ibm was founded the average company stock lifetime was +70 years. So maybe IBM won't die soon but their customers will with this attitude. Every company is a tech company today.

It almost feels like these two corporations (IBM and Oracle) and giant marketing, consulting and legal firms than technology firms.

In the startup world there is a lot of customer obsession. What is it about these big companies that let's them de-prioritize that and still thrive? Honest question.

They have customer semi-obsession, but just a selected big customers ( most SP500 and governments ) and I can't think of a company that offers what IBM does ( the full spectrum, not just a subset).

So after getting in, they don't need to be good, they just need to not be too awful.

I think there has to be tougher scrutiny for the tech we apply to healthcare. Us in the healthcare technology community have to have the guts to stand up and call out companies like theranos. If we don't, investors will come away thinking that healthcare is overly complicated and won't invest, and healthcare stakeholders will come to the conclusion that we don't actually care about their business practice or more importantly patients.

We need to prove them wrong on both these accounts.

How about easier barriers to entry with tougher reporting requirements? I personally fear the FDA is too optimized for bad headline avoidance to the detriment of allowing more experimental leeway. Not saying it should be the Wild West, just suggesting that perhaps the risk tolerance is currently too low. What if it were easier to perform more experiments, but if you hid/covered up any bad data there would be hell to pay?

I think the current system is working now, it just needs enforcement. 510(k) applications (where you need a preexisting requisite on class 2, or low/moderate risk device) certainly seem to be doing their job. Lots of healthcare startups (including those using AI algorithms) have used that path to successfully submit to the FDA for clearance.

That said, there's a lot of bunk science marketed to consumers within healthcare. Your average consumer heats microbiome and genomics and AI and thinks that the product will cure them of disease. I don't think it's the role for the FDA (until they make specific health claims), but we need to remind consumers to be smart purchases of these services. And for us in the healthcare tech space need to be careful who we want to include within our communities to ensure we share the values of positive patient.

I work at a startup that uses machine learning for medical purposes (junior position). My biased impression is that the interest in this tech is growing rapidly and not even IBM can ruin it. IBMs problems might be good in a sense if it leads hospital networks to experiment more with the offerings of up-and-coming companies with more reliable offerings.

EconTalk from last week[1] shed some light on the convoluted world of drug pricing and pharmaceutical patents. While I agree with your point that AI could help with medical progress, I would also emphasize that we're being held back by meat-space institutions as well (in this case, drug patents). One of the key takeaways was looking at the return on marginal investment in gaming the patent system vs developing new drugs. As firms achieve success, they become conservative, wishing to hold onto current profit levels. The patent system, as formulated, enables the drug company to make a meaningless change to a drug and receive an extended period of patent monopoly. This keeps out generics, raising prices, and reducing investment in drug research.

[1] http://www.econtalk.org/robin-feldman-on-drugs-money-and-sec...

All the preclinical work is actually the cheap part of pharmaceutical development. Most of the costs come from the clinical trials for the FDA. Now a lot of the reason for this is that the US spends a pretty penny (and a lot of elbow grease from grad students) on basic biomedical research that's published into journals for "free" from the perspective of the pharmaceutical corporation.

That said, if you can make clinical trial reporting data collection more efficient, there's a LOT of money to be made.

https://www.nature.com/articles/nrd3078

it is a half baked truth. pharma want you to believe trials are expensive so they inflate crazily their costs to price their drugs high. but at the end when u try to sell them software they dont look at the inflates costs of trials be sure of that

Costs don't drive prices. Demand does. I'll be the first to admit that pharmaceutical economics is not simple (lots of externalities, asymmetry of information, etc.), but in the long run costs do matter, and so does price. Best example is Solvaldi, which initially sold for ~$100,000 per treatment. It's much much down (~$65,000) once Merk came online with their hep C competitor. Prices do matter, and while the market is easily distorted, it's not immune to the laws of economics.

The week before that was even more incisive http://www.econtalk.org/jacob-stegenga-on-medical-nihilism/

AI has been applied to healthcare technology since the 1970s, like https://en.wikipedia.org/wiki/Mycin and https://en.wikipedia.org/wiki/CADUCEUS_(expert_system) .

One failure by one company, even IBM, won't stop future attempts.

There was even an Artificial Intelligence in Medicine Symposium held in 1979 -

https://blog.jacob.vi/an-80s-throwback-artificial-intelligen...

In response to the above blog - Watson's early small-scale success clearly hasn't scaled to bigger and broader applications.

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