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Comment by CompuHacker | Hacker News Reader

It is my experience that hospital(s) do not have the budget for Windows 10 across their entire network.

In that case, my proposal would be that hospital customers should be able to opt into a program that allows them to buy a thumb drive from the hospital that has their records in an encrypted file, with images exported into an open lossless standard such as PNG. What size thumb drive would most patients individual records fit onto?

I registered an account to comment because this made me laugh. One does not simply export images from medical systems. It takes a ton of effort and clicking to get patient images out of most PACS systems IF YOU ARE LUCKY. DICOM images are often high bit-depth JPEG2000 and are hard to get access to because of the way PACS systems and medical devices store data. Screen scraping DICOMs would take ages as each DICOM can have any number of slices. You don't want to lose the original bit-depth either as radiologists use contrast enhancement techniques which don't work with images encoded in 8-bits like screen scrapes. The PACS tech industry is simply painful to deal with.

That sounds challenging to deal with. What you are describing reminds me of proprietary backend banking, military systems and most internet-of-things that have custom firmware. Maybe I was hoping too much for hospitals to have pushed for more compatible standards. Do you have a theory as to why they have not evolved? Lack of vendor competition due to certification costs?

In my experience when I worked for a medical image analysis startup some major vendors such as Philips, Siemens, and GE are developing analysis tools in house as value adds for their existing customer channels and there is no reason for them to open themselves up to competition by increasing interoperability. Hospitals are happy with waiting for your next startup idea to become a feature in their next MRI purchase from the same vendor they have had a relationship with for years.

One way I can think of to disrupt this process is partnering with a new medical device company which is accelerating sales to hospitals. Last time I had this conversation the promising ones were all Chinese, wanted investment solely for development of algorithms under Chinese jurisdiction as part of terms of investment, and carried all the usual IP theft and legal risks you can imagine. Israel has some med tech startups too but they wanted to source talent from within their country and their due diligence seemed to be more of an intelligence gathering operation.

I moved on to working in finance. I don't know what ended up happening to that startup. I left after the paychecks stopped coming.

Thankyou for that explanation. I suppose that none of this should surprise me.

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