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joshuakelly

1,005 karma · joined May 1, 2017

joshuakelly on x

working on flexpa.com

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joshuakelly··on Ironclad – formally verified, real-time capable, Unix-like OS kernel
Building new operating systems seems so ambitious to me. Radiant Computer (https://radiant.computer/) was also recently posted.

What other exciting projects like these exist?

joshuakelly··on The Myth of Developer Obsolescence
Read this, and then compare it to Daniel Kokotajlo's "What 2026 Looks Like" published 4 years ago.

This time it really _is_ different, and we're looking at a world totally saturated with an abundance of bits. This will not be a simple restructuring of labor markets but something very significant and potentially quite severe.

https://www.lesswrong.com/posts/6Xgy6CAf2jqHhynHL/what-2026-...

joshuakelly··on Why are cancer guidelines stuck in PDFs?
This is the comment I was looking for.

You would aim to use CQL expressions inside of a PlanDefinition, in my estimate. This is exactly what AHRQ's, part of HHS, CDS Connect project aims to create / has created. They publish freely accessible computable decision support artifacts here: https://cds.ahrq.gov/cdsconnect/repository

When they are fully computable, they are FHIR PlanDefinitions (+ other resources like Questionnaire, etc) and CQL.

Here's an example of a fully executable Alcohol Use Disorder Identification Test: https://cds.ahrq.gov/cdsconnect/artifact/alcohol-screening-u...

There's so much other infrastructure around the EHR here to understand (and take advantage of). I think there's a big opportunity in proving that multimodal LLM can reliably generate these artifacts from other sources. It's not the LLM actually being a decision support tool itself (though that may well be promising), but rather the ability to generate standardized CDS artifacts in a highly scalable, repeatable way.

Happy to talk to anyone about any of these ideas - I started exactly where OP was.

joshuakelly··on Ask HN: Who is hiring? (January 2024)
Flexpa | Remote (US timezones) | Software developer | https://www.flexpa.com

Flexpa connects applications to health insurance data. We are looking to grow the team with a software developer who is excited to work on our mission of refactoring healthcare.

Our company handbook is open and available to get a sense for how we work [1]. For more details about our product, please review our developer documentation [2].

Our stack: TypeScript, Turborepo, NextJS, React, Tailwind, Prisma, PostgreSQL, Fastify, HL7 FHIR, Docker

What We Offer:

* A purposeful mission of refactoring healthcare

* Mentorship from experienced founders who have been through Y Combinator in S15 and W20.

* Support from world-class technologists, investors, and healthcare practitioners

* A unique culture where we "put the shopping cart back" and uphold values we take pride in

* Clear and competitive compensation targeting the 75th percentile rates

Skills & Experience:

* 2+ years of full-time experience as a software developer

* Proficiency in TypeScript and functional programming patterns

* History of shipping

To apply please submit an application at https://flexpa.applytojobs.ca/engineering/25554 and _afterwards_ send us an email to hiring@flexpa.com about what makes you interested in the role!

[1] https://handbook.flexpa.com/ [2] https://www.flexpa.com/docs

joshuakelly··on Ask HN: Who is hiring? (December 2023)
Flexpa | Remote (US timezones) | Senior software developer | https://www.flexpa.com

Flexpa connects applications to health insurance data. We are looking to grow the team with a software developer who is excited to work on our mission of refactoring healthcare.

Our company handbook is open and available to get a sense for how we work [1]. For more details about our product, please review our developer documentation [2].

Our stack: TypeScript, Turborepo, NextJS, React, Tailwind, Prisma, PostgreSQL, Fastify, HL7 FHIR, Docker

What We Offer:

* A purposeful mission of refactoring healthcare

* Mentorship from experienced founders who have been through Y Combinator in S15 and W20.

* Support from world-class technologists, investors, and healthcare practitioners

* A unique culture where we "put the shopping cart back" and uphold values we take pride in

* Clear and competitive compensation targeting the 75th percentile rates

Skills & Experience:

* 2+ years of full-time experience as a software developer

* Proficiency in TypeScript and functional programming patterns

* History of shipping

To apply please submit an application at https://flexpa.applytojobs.ca/engineering/25554 and _afterwards_ send us an email to hiring@flexpa.com about what makes you interested in the role!

[1] https://handbook.flexpa.com/ [2] https://www.flexpa.com/docs

joshuakelly··on Ask HN: Who is hiring? (November 2023)
Flexpa | Remote (US timezones) | Senior software developer | https://www.flexpa.com

Flexpa connects applications to health insurance data. We are looking to grow the team with a software developer who is excited to work on our mission of refactoring healthcare.

Our company handbook is open and available to get a sense for how we work [1]. For more details about our product, please review our developer documentation [2].

Our stack: TypeScript, Turborepo, NextJS, React, Tailwind, Prisma, PostgreSQL, Fastify, HL7 FHIR, Docker

What We Offer:

* A purposeful mission of refactoring healthcare

* Mentorship from experienced founders who have been through Y Combinator in S15 and W20.

* Support from world-class technologists, investors, and healthcare practitioners

* A unique culture where we "put the shopping cart back" and uphold values we take pride in

* Clear and competitive compensation targeting the 75th percentile rates

Skills & Experience:

* 2+ years of full-time experience as a software developer

* Proficiency in TypeScript and functional programming patterns

* History of shipping

To apply please submit an application at https://flexpa.applytojobs.ca/engineering/25554 and _afterwards_ send us an email to hiring@flexpa.com about what makes you interested in the role!

[1] https://handbook.flexpa.com/ [2] https://www.flexpa.com/docs

joshuakelly··on Ask HN: Who is hiring? (April 2023)
Flexpa | Remote (US timezones) | Senior software developer | https://www.flexpa.com

At Flexpa we’re solving hard problems in healthcare by making it easy for patients to share their claims, benefit coverage, and other data from health plans. We’re a developer-first platform with rich APIs, robust developer documentation, and other tools to help applications to build novel patient and provider experiences powered by claims data.

We believe in open standards, open source, and open, transparent culture. We surround ourselves with excellent people who want to build the best products, with high independence, drive, and enthusiasm. We expect this will be a good role for mid-to-senior-level career developers who share our values and want to work on hard problems.

Our company handbook is open and available to get a sense for how we work [1]. For more details about our product, please review our developer documentation [2].

Our stack: TypeScript, Turborepo, NextJS, React, Tailwind, Prisma, PostgreSQL, Fastify, HL7 FHIR, Docker

Skills & Experience:

* 5+ years of working full-time as a software engineer (strongly preferred)

* Experience with TypeScript (strongly preferred)

* Experience with functional programming patterns (preferred)

Compensation: we benchmark comp offers to 75th percentile of comp for nearest major metro region for similar levelled roles at companies with similar levels of funding using Pave.com

To please email us at hiring@flexpa.com (anti-spam detection: mention HN in the subject) and submit an application at https://flexpa.applytojobs.ca/.

[1] https://handbook.flexpa.com/ [2] https://www.flexpa.com/docs

joshuakelly··on Ask HN: Who is hiring? (February 2023)
Flexpa | Remote (US timezones) | Senior software developer | https://www.flexpa.com

At Flexpa we’re solving hard problems in healthcare by making it easy for patients to share their claims, benefit coverage, and other data from health plans. We’re a developer-first platform with rich APIs, robust developer documentation, and other tools to help applications to build novel patient and provider experiences powered by claims data.

We believe in open standards, open source, and open, transparent culture. We surround ourselves with excellent people who want to build the best products, with high independence, drive, and enthusiasm. We expect this will be a good role for mid-to-senior-level career developers who share our values and want to work on hard problems.

Our stack: TypeScript, Turborepo, NextJS, React, Tailwind, Prisma, PostgreSQL, Fastify, HL7 FHIR, Docker

Skills & Experience:

* 5+ years of working full-time as a software engineer (strongly preferred)

* Experience with TypeScript (strongly preferred)

* Experience with functional programming patterns (preferred)

Compensation: we benchmark comp offers to 75th percentile of comp for nearest major metro region for similar levelled roles at companies with similar levels of funding using Pave.com

To apply see our careers page https://flexpa.applytojobs.ca/ or email us at hiring@flexpa.com (anti-spam detection: mention HN in the subject).

[1] https://handbook.flexpa.com/

joshuakelly··on Show HN: 0xFast – Faster Web3 APIs
This seems to implement the same JSON RPC interface as Geth, so it should be a drop in replacement RPC. I wonder how you are thinking about potential customers here?

I wonder further if there is an intermediate solution in this space where chainstate was denormalized into sqlite. How much of the read-only JSON RPC could be implemented with a sqlite over http approach?

Would also be curious to read more about the technical details here. What the application architecture is, for example.

joshuakelly··on Tell HN: ChatGPT can reply like a specific Reddit or HN user, including you
I completely agree. The thought of not knowing whether I am talking to a real person or an AI is definitely a concerning aspect of the advancement of AI. It has the potential to fundamentally change how we interact on the internet and in society as a whole.

This response was, of course, also generated by an AI.

joshuakelly··on Ask HN: Who is hiring? (December 2022)
Flexpa | Remote (US timezones) | Full stack engineer | https://www.flexpa.com

Flexpa is making it easy for patients to share their claims, benefit coverage, medications, and other data from health plans. We're a developer-first platform with rich APIs, robust developer documentation, and other tools to help applications to build novel patient and provider experiences powered by claims data.

We believe in open standards, open source, and open, transparent culture [1]. We surround ourselves with excellent people who want to build the best products, with high independence, drive, and enthusiasm. We're building the Plaid for healthcare and we want you to join the team.

We build with:

* Fullstack TypeScript (strict mode) and ES2020

* Turborepo and a one repository monorepo

* NextJS, React, and Tailwind

* Fastify and JSON Schema

* PostgreSQL and Prisma

* HL7 FHIR

To apply see our careers page https://flexpa.applytojobs.ca/ or email us at hiring@flexpa.com.

[1] https://handbook.flexpa.com/

joshuakelly··on Ask HN: Who is hiring? (June 2022)
Flexpa | Product designer | REMOTE (US and Canada) | https://flexpa.com

Flexpa is the fastest way for your digital health app to connect to new Patient Access APIs. Support linking sources of data from Medicare, individual & family, and employer group plans from Unitedhealthcare, Anthem, Humana, and more.

If you join us in 2022 you will be an early team member and help us shape decisions about what we are building and why, who we hire, and company culture.

Our pitch to you:

Flexpa is working in a hard space that matters to everyone. We are all future or previous patients in the healthcare system. Access to care is personal.

Flexpa has experienced founders. We've founded two YC companies.

* Flexpa has support from world-class technologists, investors, and healthcare practitioners.

* Flexpa has a culture of calm, respect, and a "put the shopping cart back" mentality.

Product designers on the team will:

* Design user experiences (UX) for both (1) patients who use systems that integrate with Flexpa and (2) the health care tech teams that create those integrations

* Design user interfaces (UI) for patient access including especially for Flexpa Login

* Advocate and build for a11y

* Be a technical contributor too - by writing CSS and helping us systematically manage product design with hybrid tools like TailwindCSS and Storybook

* Get to choose their trade tools (Figma, Origami, or Framer)

* Value clear written communication

Apply by sending us an email at hiring@flexpa.com and mention HN.

joshuakelly··on Ask HN: Who is hiring? (April 2022)
Flexpa | Product designer | REMOTE (US and Canada) | https://flexpa.com

Flexpa is the fastest way for your digital health app to connect to new Patient Access APIs. Medicare Advantage enrollees from Unitedhealthcare, Anthem, CVS Aetna, and Humana can permission access to third party applications.

If you join us in 2022 you will be an early team member and help us shape decisions about what we are building and why, who we hire, and company culture.

Our pitch to you:

Flexpa is working in a hard space that matters to everyone. We are all future or previous patients in the healthcare system. Access to care is personal.

Flexpa has experienced founders. We've founded two YC companies.

* Flexpa has support from world-class technologists, investors, and healthcare practitioners.

* Flexpa has a culture of calm, respect, and a "put the shopping cart back" mentality.

Product designers on the team will:

* Design user experiences (UX) for both (1) patients who use systems that integrate with Flexpa and (2) the health care tech teams that create those integrations

* Design user interfaces (UI) for patient access including especially for Flexpa Login

* Advocate and build for a11y

* Be a technical contributor too - by writing CSS and helping us systematically manage product design with hybrid tools like TailwindCSS and Storybook

* Get to choose their trade tools (Figma, Origami, or Framer)

* Value clear written communication

Apply by sending us an email at hiring@flexpa.com and mention HN.

joshuakelly··on Ask HN: Who is hiring? (March 2022)
Flexpa | Full-stack developer/engineer, Product designer | REMOTE (US and Canada) | https://flexpa.com

At Flexpa, we're making it easy for patients to share healthcare data. As of July 2021, 28 million Medicare Advantage patients can electronically share their health plan, benefit coverage, and medications. Flexpa is the easiest way to start using these newly released APIs.

If you join us in 2022 you will be an early team member and help us shape decisions about what we are building and why, who we hire, and company culture.

Our pitch to you:

* Flexpa is working in a hard space that matters to everyone. We are all future or previous patients in the healthcare system. Access to care is personal.

* Flexpa has experienced founders. We've founded two YC companies.

* Flexpa has support from world-class technologists, investors, and healthcare practitioners.

* Flexpa has a culture of calm, respect, and a "put the shopping cart back" mentality.

* Flexpa has clear and competitive compensation. On base pay: we will pay you more than average (by role and location). We target 75th percentile rates for everyone and use a third party to provide this data (happy to share it with you).

Developers on the team today:

* Get to drive product development

* Work with TypeScript everywhere

* Have a fast running CI pipeline and never wait on builds because we use tools like SWC

* Make generalist contributions and can touch any part of the product

* Value clear written communication

* Are passionate about security, privacy, and accessibility issues

Apply by sending us an email at hiring@flexpa.com and mention HN.

joshuakelly··on RIPE NCC executive board resolution on provision of critical services
I strongly support a universal terrestrial communications protocol. In many ways, that's not the internet of today - but it's the internet that will be.

Have courage for principles in the face of an overwhelming preference cascade - they will serve you (and your spirit) better in the long run than retreating exactly when they matter.

joshuakelly··on Ask HN: Who is hiring? (January 2022)
Automate Medical | Eng | Remote | Full-time

We’re looking for people who want to show up to the future and we’re building a founding team for the future of health devtools. We have an open core "Plaid for health" product that you will help us build.

* Company formed at start of the year by ex-YC founder group of 3, raised $2M at the start of 2021 — cumulatively, we’ve raised nearly $30M in our careers so far

* You will be employee #2 and help us launch "Plaid for health"

* You will alter the trajectory of our R&D work with rapid prototype development

We want to work with people who are:

* Authentic and opinionated — with a story to tell

* Thinking about the future a lot these days

* An ex-founder or a future founder

* Deeply technical

Bonus: if you know what FHIR, HL7 V2, X12 are, tell us when you apply.

Our current stack includes: ES2020 JavaScript/TypeScript, Fastify, AJV, Next.JS, React, Tailwind

You can see some of our open source work publicly on GitHub and at docs.sero.run Apply by emailing founders@automatemedical.com

joshuakelly··on Scuttlebutt Protocol Guide
SSB has a special place in my heart. I wrote this a year ago on HN and it seems truer than ever:

> There’s no global timeline — just archipelagos. It assumes that network heterogeny is the default, and is transmission layer agnostic. Breakages will occur. Maybe you’re living on a catamaran in the South Pacific and you only have connectivity once a month — SSB will work even then.

> Your own timeline is a sigchain — a sequenced list of signed messages. You replicate the content in your network (2 hops away). Bridges between communities can be built or burned. Many islands can exist without needing to erase the others from even existing — mutual separation is possible. Consensus is not necessary. #againstconsensus

> Is global network culture still possible? If it is, in the midst of the national internets we now live inside of, I suspect it will look something like this. A little different from what we were promised, but maybe a little better too.

joshuakelly··on Why Zulip will stand the test of time
Zulip is used for the FHIR community (chat.fhir.org) and it manages to deliver a much more "email thread"/async communication stream. It's almost closer to a Hacker News than one of the dozens/hundreds of forgettable Slack/Discords for other communities.
joshuakelly··on Building the Brex API
This is really cool to see. At the start of my YC batch, when I was still dabbling with building general accounting ledger systems as a service, I discovered that the GraphQL API Brex itself was using was, actually, pretty usable. Schema introspection worked. I was able to write scripts with it. Looks like they went with REST for the truly public one, but it's good to see it at all frankly.
joshuakelly··on Show HN: The Billboard, a fully decentralised billboard stored in Ethereum
Already exists - see PaperclipDAO https://clip.mirror.xyz/mOCENLvP1aYXOBOPiLoLjBlSTvJWBqccfkn4...
joshuakelly··on Ask HN: Who is hiring? (October 2021)
Automate Medical | Eng | Remote | Full-time

We’re looking for people who want to show up to the future and we’re building a founding team for the future of health devtools. We have an open core "Plaid for health" product that you will help us build.

* Company formed at start of the year by ex-YC founder group of 3, raised $2M at the start of 2021 — cumulatively, we’ve raised nearly $20M in our careers so far

* You will be employee #1 and help us launch "Plaid for health"

* You will alter the trajectory of our R&D work with rapid prototype development

We want to work with people who are:

* Authentic and opinionated — with a story to tell

* Thinking about the future a lot these days

* An ex-founder or a future founder

* Deeply technical

Bonus: if you know what FHIR, HL7 V2, X12 are, tell us when you apply.

Our current stack includes: ES2020 JavaScript/TypeScript, Fastify, AJV, Next.JS, React, Tailwind

You can see some of our open source work publicly on GitHub and at docs.sero.run Apply by emailing founders@automatemedical.com

joshuakelly··on How we got to LiveView
I didn't realize Fly hired Chris McCord. Wow!
joshuakelly··on Manyverse – A social network off the grid
Great to see this advancing - I met you a 33C3 when this was in the works.
joshuakelly··on Ask HN: Who is hiring? (September 2021)
Automate Medical | Eng | Remote | Full-time

Dev tools that make launching in digital health easy. We write open source software (`npm i @sero.run/sero`) that let developers seamlessly work with new healthcare APIs for patient data and more.

Are you an ex-founder? Do you want to write open source software to make healthcare better?

- Change healthcare

- Build in the open

- Be the first FTE after founders

- Work with an all ex-YC founding team

- Use TypeScript to write standards-conforming healthcare software

Learn more about the company at automatemedical.com and our open source work at sero.run - email is josh@ the company domain.

joshuakelly··on SARS-CoV-2 Lambda variant exhibits higher infectivity and immune resistance
After this legitimation crisis, sorry, but articulate strangers are often the best way to "read the headlines upside down" - a necessary fact of life now.
joshuakelly··on The emergence of heat and humidity too severe for human tolerance (2020)
This feels like one of those prescient HN comments that are cited in the future. IDK, just... replying to say I was a witness too.
joshuakelly··on Done with YC: Age Discrimination
I cannot strongly enough discourage you from trying to do YC solo (been there, done that, obviously do not regret it - but would do it differently 2x).

> I signed-up for and graduated from Startup School. We applied for YC and were not accepted. I continued with Startup School for a second term. Applied again. Nothing. We likely applied about three times, if not four. I honestly don't remember. This included pivots. I wasn't trying to do the same thing and expect different results

If you've applied with the same company, and that company's trajectory hasn't changed between the applications then that's pretty valuable heuristic that it's likely not right for YC. YC's model requires power law style returns. Massive, mega, huge 1/500 hits. Your company could grow substantially. It could 10x - that's not enough. YC needs 10,000x returns and momentum/trajectory/team is really the only material information available to them.

Once you've been around for a while, all of sudden it's no longer unknown what your trajectory will be - you have one that you have to bend. And that's a super valuable heuristic for any investor. If the company really has hit an inflection point during the period you were applying, well that's YC's loss (of which there are many, and of course there will be many more).

joshuakelly··on The 5-Hour CDN
Yes, I'm using it. I deploy a TypeScript project that runs in a pretty straightforward node Dockerfile. The build just works - and it's smart too. If I don't have a Docker daemon locally, it creates a remote one and does some WireGuard magic. We don't have customers on this yet, but I'm actively sending demos and rely on it.

Hopefully I'll get to keep working on projects that can make use of it because it feels like a polished 2021 version of Heroku era dev experience to me. Also, full disclosure, Kurt tried to get me to use it in YC W20 - but I didn't listen really until over a year later.

joshuakelly··on Ask HN: Who is hiring? (August 2021)
Automate Medical | Eng | Remote (Canadian company) | Full-time

We build dev tools that make launching in digital health easy (https://docs.sero.run)

We're looking for our first full-time engineering hire. Our current team is 3 founders and 2 contractors. If you're new to the health care industry, you will need to voraciously learn. Most of the code you write will be open source and publicly licensed. We succeed when others do, so experience with open source is a plus. If you have experience with FHIR or other health standards, that's a mega plus.

Check out our work here: https://github.com/automate-medical/sero and https://docs.sero.run) and contact is the email in my profile.

joshuakelly··on Ask HN: Looking for a CTO
Not for me but maybe a friend
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