skysight-inc/HackerNews huggingface dataset:
Ask HN: Why do all electronic health records suck so bad?
I go to 6 practices (counting urgent cares, non-primary care, specialists), and they all have their own system with some provider I've never heard of but sounds like any of the others.

This provider always has a hidden subdomain to access the practice's patient portal. There's no way to get to it unless you have memorized it or have a link in your email handy and strip out the end of the URL.

You could go to the homepage of the provider, and they will have a login button, but only for doctors. If you click the "Patient Login" button it either prompts you to ask your doctor, or some of them will present a login that doesn't work and I've absolutely no clue who its for.

Usually it asks for a password, when I have never made a password, and to reset the password it needs my email, but I have no idea which one.

Then, two factors dictate my fate: if the UI is pretty OR if it is a big provider like AthenaHealth (naming & shaming), it is unlikely that anything will work. Usually I have to login 50 times, create an account a bunch, call the practice 2-3 times, and then finally magically the correct sequence of the above will unlock my patient portal. Each time it fails it will, of course, tell me it can't find my account, only to also email me "did you recently try to log in?"

I then try to navigate the maze of their interface which ultimately only needs to provide me with records & let me schedule appointments but, for some reason, has a dozen widgets that appear empty and I can't configure, and prompts me constantly to add profile information. Of course this is necessary and critical, as without a profile picture, how will I use the future social networking + tiktok-copy feature?

After sacrificing my firstborn in hopes of preventing the application from crashing, I might be able to find the records (so far I am 2/4 in getting to the records, taking into account I could only login to 4/6 EHRs), but they are rendered terribly as if this was an afterthought. Some offenders like AthenaHealth actually render your single blood panel into 10 different tests that navigate to different pages (and pressing back in your browser brings you all the way back to Home).

So above, on a commercial level, I was able to use an electronic health record to access my health records (the SOLE and ONLY functionality it absolutely needs to have) a shocking 33% of the time across multiple providers.

On a larger enterprise level or government level, this is even worse. EHRs are regularly costing enterprises millions and the government $10-20MM a pop [1] and yet fail to deliver results with any consistency or stability.

What gives? Why do EHRs suck? This seems easy enough to hack together in a day and still be HIPAA compliant, and it is clearly a competitive market if there are this many providers.

[1] https://sam.gov/opp/1e345d6c414d455897ea4e6292e94b1b/view
My furnace's air handler fan pulls hundreds of watts. That's generator territory. And I'd have to re-wire it somehow to give it a male plug or better yet add a transfer switch.
Oh, last week. I missed that.

Idiotic if you ask me. He’s just like any dimwitted everyman: every single pub in the UK has at least two Joe Rogans. I was sat with my back to one in a coffee shop the other day.
Recaptcha has not been used to train any neural network to detect anything in a very long time.

In fact, visual challenges like this are a mostly solved problem, and the real magic is the classification that happens behind the scenes.
No. Never.

kcal and cal atleast is the same unit.
Realistically, it's been possible on and off for quite some time. Chrysler's UConnect system received quite a bit of flak some years back over just how easy it was to take over full control of a vehicle[0]; not just locking/unlocking doors, but full control over the climate system and wipers, all the way up to starting and stopping the engine or changing gear in the transmission.

[0]: https://jalopnik.com/chryslers-uconnect-vulnerable-to-remote...
Mind blowing! What are the odds of life there? Would there be enough energy getting there to support complex life like maybe small fish? I guess the water is kept “warm” by some internal latent heat from the moon formation?
Anyone else feel a little weird reading the section about exercise?

> You exercise because you'll live longer and you'll feel better.

It's a little depressing that despite a good diet and exercise, he had a slightly shorter than average lifespan. When I put in the effort to eat well and exercise, I know I certainly have the mindset that it will extend my life. I hope that at the least he felt strong and healthy.
If they did, a quick trip to a gas station and in less than 10 minutes they are topped up. And their gas tank doesn't permanently shrink if they fill it with gas too quickly or too full either.
So are cars and yet it's common practice among drivers to simply slow down to 5-10 mph, declare that a "stop" and proceed into the intersection.
What we do know is that this incident will be analyzed with the level of attention we would give to a plane crash. If there was any way the incident could have been avoided, the engineers will probably figure it out. It’s likely that software will be updated to implement a fix as well, and this type of accident will become much less likely across Waymo’s entire fleet. That seems like a really good result.
protectionist policies hurt the end consumer more than they protect the workers.

It's already bad to have any sector that is protected from competition (foreign or domestic), why look to expand it?
If you end up taking a drug because someone bangs you on your head everyday, it's good that it's there, but you might also want to put a stop to that.
lego, as in Minecraft? Roblox? nobody wants that.
The laws should overlap with the norms more.

It really bothers me that the laws don't reflect real life. It gives the authorities the ability to harass whoever they like for violating laws that are routinely ignored until a cop wants to start something. That's not okay.
Just take a look at this teardown video:
https://www.youtube.com/watch?v=JVJPAYwY8Us
There are like 50 captive screws and a gajillion ribbon cables in that thing

There's vast room for improvement and slimming down, and I'm not just referring to the silicon and battery!

Maybe an alternative using passthrough lightfield displays will come along eventually, but that's not going to happen for a while. Shrinking this technology is all it will take for similar devices to make workstation monitors and gaming consoles completely obsolete.
> rules as written/rules as followed

As a bicyclist in San Francisco, if I follow the rules as written, I cause traffic. Cars expect me to blow through four-way stop-sign intersections, and if I stop and wait for the cars, the drivers get confused & don't want to go (afraid of hitting me, I suspect).

In terms of right of way, the rules as followed seem to be pedestrian > bike > car.
Yeah the ways I can interpret that are

1) The cyclist entered from a cross street going straight as soon as the truck partially cleared the intersection.

2) The cyclist was following behind the truck and then turned in front of the Waymo.

3) The cyclist was following behind the truck and the Waymo turned into it.

To me "crossing into the Waymo vehicle's path" is a pretty weasel-worded way to say (3), but it is technically true.
I assume any data they can get you to give them permission to take. Assume they don't at your own peril
Logic and morality are on two separate paths. IF the driverless car decides to kill your daughter because saving a van full of refugees was for the greater good, then it wouldn't be a question of what was "better," it would be a question of what was "righteous." In this hypothetical scenario, logically it would make sense to kill your daughter and apparently you're completely comfortable with amoral constructs making this decision on your behalf.

Fortunately we don't have to ponder such philosophical dilemmas while the current iteration of so-called "driverless" vehicles are `developmentally delayed` to put it lightly. But I guess a few bruised-up bike commuters are considered "acceptable loss" along the way to real progess (which is surely coming soon, surely)
AI Infrastructure Landscape
The bloody cheek of those Norwegians!!

It's all relative - I live in a state 3x bigger than Texas and the highest point is only 1248m .. when I visited (man years ago) lot's of places in Finland looked steeper than here.
I have great experiences building webapps with Rust and HTMX.
And getting deals to get you to open the app so they can track you isn’t? It’s the same game. Offer deals through the app so they can sell your data. Subsidizing the fries. All your cookies are belong to MarTech.

How else would they offer fries for $1? Cheap transportation? lol. I built it, I know.
> So, God designed it for a reason

Or it was the result of evolution.
> Drivers of other types of vehicles shouldn't also have to remember special rules just for cyclists.

Drivers of any vehicle should learn all of the rules they need to drive safely and legally. It's not like there's a hundred different types of vehicles on the road. There's some special rules for trucks and motorcycles and bicycles and that's about it.

Plus, travel by bicycle is a net positive for society and I strongly support incentivizing it, including through preferential laws (even though I almost never do it myself).
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As a developer and Lego enthusiast, I wanted a way to come up with lego designs quickly and what better way then using AI! I decided to take a stab at it and created BrickGenerator.com. This is a novel tool that turns text into Lego models. This proof of concept uses generative AI to create Ldraw code-based Lego designs from your descriptions. It's early days, and the results are intriguingly varied – perfect for those who want to experiment with me. Try it out with simple object descriptions and let me know your thoughts. How can I make this even better going forward?
> I mean, LinkedIn has what, 20,000 employees? If you had spherical developers in a vacuum, I doubt you'd need more than 40-50 to maintain their products, but there's more to running a tech company.

This is a ridiculous take. You would need way more than that just to maintain Kafka and run ops for it, that LinkedIn heavily relies on. You are trivializing the complexity of running a platform like LinkedIn.
BULLSHIT

No treaty with Putin has ever been honored. He is attempting to rebuild the Russian Empire and "peace" agreements are merely used to get the opponents to stand down while Russia prepares aggression.

Putin and his govt have said that they have rights to the Baltics, Poland, Germany and more. They have said that Ukraine should not, indeed DOES NOT exist. The very existence of the idea of a free, and especially prosperous Ukraine is seen by them as an existential threat. And they may be right, as it certainly makes Russians wonder how those awful Ukrainians can live so well, having toilets and all.

Read Winter Is Coming by Garry Kasparov. He's a former world chess champion, former candidate for President of Russia, and deeply involved in global democracy. He knows more than you or I ever will.

No one intends to destroy Russia as a nation. It is the autocracies of Russia, Iran, NK, China, etc. who see that international law and order threaten their criminal way of life, and are working hard to destroy democracy. If you are so big on Russia, go live there and report back after a year (if you aren't conscripted and killed in one of their 'meat assaults' on Ukraine.
Only the driving software will be updated, the intersection will not be redesigned to reduce the severity of driver mistakes. It’s not the best outcome, ideally someone will analyze the case and produce the changes that needed to made to the driving software, the intersection, and biking behavior (aka the Dutch approach).
Vcpkg, Conan, and even CMake (kinda) do this. That's why I mentioned them. They're all trying to replicate pip, npm, cargo' success.

The second sentence was not clearly a second unrelated thought, but it was.
He died from an accident. Stairs can be hazardous.
No, I did say that animal intelligence has some characteristics. I think I made it clear that metacognition is more optional but I may have written less clearly.

However, I was responding to assertions made specifically about GPT, not some other or future AI.

Other AI systems may be different (I am enthusiastic about Steve Grand’s approach for example) but GPT is not “thinking” by any useful stretch of the word.

I am not placing human intelligence at the pinnacle. I am rebutting the idea that GPT is usefully thinking. It alarms me how many people are willing to strongly suggest it has magical, unknown emergent abilities, when all it can really do is surface embedded logic in the corpus of the written word.
I’m not arguing about whether or not the shooting was justified. I’m merely pointing out that she wasn’t shot in the back as you initially stated.
I daily commuted on a 1300cc sport bike for 6 years (and have owned them for much longer). Only reason I don’t now is that I work from home.

As a taller person I find I feel way safer on a big bike over a small one. Theyre more comfortable (less hunched over, better for my back), more stable, have more grip due to more weight on bigger tyres, yet have the power to punch your way out of a sticky spot or overtake someone in a split second if needed. It’s all personal preference but I’ve ridden everything from 250cc to 1300cc and way prefer the upper end of the scale.

Plus they just put a stupid grin on your face and make the commute a happy part of the day rather than a boring one.

In saying that I’m far from your typical big-cc rider. I’ve never done stupid speeds or raced anyone and just love the feeling of vehicles with some oomph.
Trump blamed California for not raking their forest, and presented it as a simple solution. Trump was not right, for three reasons. One doesn't rake the forest to solve the problem, there are reasons (political and financial) why doing a controlled burn on 1/3 of the state hasn't happened, and finally, most of that is federal land -- Trump's responsibility.

BTW, I lived in California from 1985-2003; this issue existed then, and for decades before my time, and it continues to this day. It was there when California had Republican governors, Democratic governors, Republican presidents, and Democratic presidents.

Complex issues have multiple layers, often on opposition to each other. When you claim it is a black and white issue, you (like Trump) demonstrate you don't understand the topic.
Cool idea, but pretty much impossible on iPhone safari.

Clicking the controls too fast just zooms in and out
California requires bicyclists to come to a full stop at stop signs. There's no stop-as-yield here.

Even in places that do, they still require bicyclists to yield right-of-way to any vehicle stopped at the intersection before they arrived.
Putting aside the debate on whether bicycles have to follow rules designed for cars, shouldn’t we still avoid accidents even if the bicyclist were unambiguously at fault?

But then that’s exactly why cars have stop signs. They trade high speed and carrying capacity against lethality.
Actually missed this is answered in the article!
Honestly, a little 15-20hp generator would be all thats needed for the vast majority of passenger vehicles.
AutoCAD is a transformative product and one that really helped me appreciate good software design (albeit only seeing it through AutoCAD’s commandline and AutoLISP). Autodesk has lost a legend and his legacy will live on.
>Someone else said that stop signs are legally equivalent to yield signs for bicycles in California.

California does not have the "Idaho Stop".

https://en.wikipedia.org/wiki/Idaho_stop
Actually missed this was covered in the post, thanks
I'm disappointed in all the folks immediately blaming the cyclist without further information, and I'm similarly disappointed in all the folks blaming Waymo for the same reason.

But, unless they somehow have extra information we're not privy to, I'm much more disappointed in the S.F. Supervisor quoted in the article, Shamann Walton, for immediately going online to say "so much for safety." Us internet weenies are always going to have our hot takes, but someone in charge of the city has a responsibility to at least try to be better.
It runs a desktop os and you can use your regular apps, along with a keyboard and mouse.
this strikes me as a chesterton's fence situation - "what kind of weird nonsense is this 2's complement where it's asymmetric (yuck) and you can't negate -0x8000"

i seriously doubt the folks who think this is a good idea know enough about the math and computer architecture to understand why in fact it's a terrible idea.

- programming languages are abstractions. but (old joel) leaky ones sometimes. we don't like this, but you have to live with it.

- in this case, the choice might be between reality-leaks such as "integers have limits", "the limits are asymmetric, leading to this negation pseudo-paradox" and a much worse leak such as "why does this spiffy safe integer type run 100,000 times slower than the weird C int"

- actually math itself is a series of ever complicated abstractions. first counting numbers. then ZERO. then NEGATIVE numbers. ACK! now wait until you get to Fields and Rings and Galois Fields, which are very close to the concept of 2's complement integers. i believe that if ignoring the botched C standard that makes signed integer wraparound UB, "normal" 2's complement integers (and unsigned) form a finite ring.

- so what? well even these fancy, and frankly, impenetrable math abstractions are just abstractions. they leak too and aren't "perfect" if you take into account the real universe which doesn't always match the perfect math. doesn't mean it isn't very useful.

- these concepts can be used to reason about the behavior physical things, like the behavior of an array of flip-flops representing a 64 bit number and especially how you can create circuits and simplify them to do things that implement addition, multiplication, etc.

- the problem with a sorta-1's-complement-without-two-zeros idea is it has none of these connections to grounded theoretical basis. so how do you simplify an adder? can you perform algebraic simplifications to it? what is the model for this thing?

- symmetry is in the eye of the beholder. draw a 4-bit signed 2's complement drawing using "clock diagram". it works. now do it with 1's complement or this suggestion which is even worse with an odd, sometimes prime, number of nodes.

- implementation: 2's complement is a very clever hardware technique that lets you interpret N bits as N digits of a binary number. each digit has weight 2^n: 1, 2, 4, 8, etc. except the last digit which has weight -2^n. this simple trick lets the signed and unsigned integers use the same addition, subtraction, and with minor processing, multiplication and division logic unchanged. it's very unlikely that you can implement the suggested scheme at even 1/10th the performance or cost.

- and, yes, i think C really got it wrong calling "overflow" or wraparound UB. if it was defined to wrap, at least it would be theoretically analyzable. you'd still have overflow flaws, but that's provably impossible to avoid with finite sized integers of any design.
With the hacker comment, in fairness the weakest link in a lot of orgs is often the human one. Ignoring obvious stuff like phishing links, people can be disillusioned by their employer or their government through propaganda and other campaigns run by their adversaries. The westerners who supported ISIS, etc didn’t just do so in a vacuum out of the blue.
That is like saying doom and cyberpunk 2077 are fundamentally the same thing.
https://github.com/charmbracelet/vhs/blob/main/record.go#L22

I was looking at the code, and it seems like you could put a low value for this and it would do what you want.

I did not try it though

// sleepThreshold is the time at which if there has been no activity in the
// tape file we insert a Sleep command
const sleepThreshold = 500 * time.Millisecond

EDIT:

I tested it. It actually work, but their software crash, I had to patch line 153

for lines[i] == lines[i+repeat] {
repeat++
if i+repeat == len(lines) {
break
}
}

EDIT 2:

I actually went ahead and created a pull request to fix the bug.

https://github.com/charmbracelet/vhs/pull/446
It still is. Any serious CAD user knows that there’s nothing that comes quite close to AutoCAD after all these years (even with all the pork introduced by new developers).
Not in love with axolotl but appreciate the advantages. This is an interesting approach, but you can also finetune easily on providers who wrap axolotl like Replicate [1], Modal [2], or if you want to run the infra, LLM Engine [3].

My only gripe with Helix would be that it's smaller than the above and my org would be peeved about data security. The ability to self host is cool, but too much can go wrong too quickly with plain Docker ML. Would love to see, for example, a `cog` version of the images that we can deploy distributed with more confidence/bravado.

[1] https://replicate.com/mistralai/mistral-7b-instruct-v0.2
[2] https://modal.com
[3] https://llm-engine.scale.com/
Journalists swarm all over it. Waymo engineers will take their learnings. But honest question: is there an official, scrutinous authority also coming into this that would be able to hold Waymo to account? Maybe like the NTSB?
I'm drawing the conclusion that this is a non-issue, or would be if autonomous vehicles hadn't got to be so political over the last year in San Fransisco. There are many people out for blood, they want a follow-up to the Cruise scandal.

One fact of the matter is that the cyclist wasn't seriously hurt, and Waymo has had many minor contact events in its 10 million+ miles of driving on public roads. We're hearing about this event because politics.
Solar net metering is a weird subsidy. The solar panel owners are not paid for the full value of the electricity they provide. The utility is not paid for the full value of the electricity distribution they provide (you can pull 240V x 200A on demand).

Net metering can only form a small part of the retail market before the fixed costs of distribution get concentrated on remaining customers in a death spiral. A population that is generally less able to take advantage of tax credits (because their tax liability is not high enough), and has less access to capital in the form of homeownership or financing for the solar system.

This is analogous to the "problem" of fuel efficient car owners paying less fuel tax. Some states have added higher registration fees on hybrids and EVs to offset the "lost" revenue. Another similar situation is water utilities that encouraged efficiency through higher rates. Customers saved water and then the utility had to increase per unit rates to maintain enough baseline revenue to cover fixed expenses of maintaining the distribution network to every home.
> How did we get here? Crisis of ideology? Counter-reaction to relative social liberalization?

Well yeah. The alternatives we tried didn't exactly go so great did they.
This is too boring as you can drop a straight line every time that minimally changes anything. The game is extremely repetitive and doesn't require any thinking. It's like tetris but you always get the line piece and the speed ramps very slowly.
generally it's the motorists who are dangerous to the cyclists... when's the last time someone in a car was injured by a bicycle?
It supports grammar and that's more than enough in practice.
What are you talking about?

All road users do have different rules for using the road: peds, cycles, scooters, motorcycles, cars, cargo trucks, buses, trams, etc. all have specific rules applying to them.
Show HN: Promptcast – Podcast Summaries with ChatGPT