332 karma · joined December 31, 2010
It's not anything new, it's just that more people have caught on and jumped into the game.
i.e. you don't bother to spend an hour to plan a project. I don't think anyone wants to work at those kinds of places, young or old.
Judging by the NYC pension fund, I could manage 100 billion better.
http://mobile.nytimes.com/2015/04/09/nyregion/wall-street-fe...
Hack-a-thons need to change so that the objective isn't clear until you walk in so people have to create something on the spot.
1.) Regulation, HIPAA is a massive pain to deal with, the rules nebulous and require significant process that is expensive and time consuming.
2.) Violations of HIPAA lead to fines and even lawsuits from the office of civil rights. It used to be that Business Associates could hide behind the medical institutions to avoid this but with the Omnibus rules you'll face massive fines that will easily bankrupt any startup.
3.) The entire healthcare sector is extremely risk averse, slow moving and you cannot work around them you have to work with them which means you're going to move slowly too.
4.) You will HAVE to integrate with dozens of other ancient applications that medical institutions use, some of which have no documentation or publicly available source code. I hope you like searching through hundreds of pages of outdated HL7 and X12 documentation to figure out how a specific vendor screwed up their implementation.
5.) Large medtech companies regularly snuff out competition through lobbying and leveraging existing relationships in the medical community. So you've got a killer new medical app that will change the world? Big deal, your competition has three doctors who are leaders in their field(and conveniently board members). They will tell all of their buddies at the next American Cardiology Conference that your app is garbage. I hope you've got some big names associated with your startup and you can pay them handsomely.
6.) The medical field is a data hell. Some of it unstructured and non-sensical, much of it is structured but has no validation. That field you are getting from a third party API for albumin levels which was documented as g/dL, was actually entered in mg/L from the years 06/2004-12/2008, mg/dL from 09/2003-05/2004 and the proper documented g/dL for all other dates. Why was it that way? No one knows. You have to keep track of things like that for one field in one database for a single department in a medical institution with a few dozen departments that don't cooperate. Worst of all, it WILL change on you without you knowing.
1.) Whole house UPS 2.) A way to take advantage of significantly lower night time electric rates.
Little thought is given to efficiency or refactoring because the decision makers don't care about that. Everything eventually becomes about quick quarterly "wins" so that executive management can earn their bonuses. In practice this means if you can't plan, complete and show the project directly increased revenue or decreased expenses for that quarter it won't become a priority.
That is the wonderful shortsighted world of a one product company in decline :-)
This is the NYC in which these minor offenses needed to be enforced strictly. There are a number of theories regarding the decrease in crime but I'm pretty certain no one can argue that the drastic measures were necessary. Fast forward to 2014 NYC is basically disney world for adult tourists. There definitely needs to be a review of how we police the city because the tactics currently in place are from 25 years ago. Hopefully the data from this slowdown will provide the evidence necessary to create change.