Blog Odyssée

Crossway

January 31st, 2018

Nous sommes le 30/01/2018, et le logiciel hospitalier Crossway est toujours utilisé afin de retarder la prise en charge des patients tout en augmentant le risque d’erreurs.

#FierDeRienDuTout

Mais je vous sens dubitatifs. Je sens même que certains se disent que c’est de la méchanceté gratuite. Alors voilà des exemples :

Vous savez ce qui se passe dans Crossway si je prescris 480 comprimés de paracétamol toutes des deux heures ?

Rien. Il accepte.

Vous savez ce qui se passe si je prescris de l’héparine et des AVK pour un relais ?

Il hurle à la mort.

Vous savez comment je peux faire pour prescrire un traitement d’après une observation où est noté l’ordonnance du médecin traitant ?

Et bien je peux pas. Je dois la recopier à mon tour pour la re rentrer ensuite dans un autre écran.

Vous savez comment je peux envoyer un courrier au médecin traitant à partir de Crossway ?

Je peux pas non plus.

Mais vous vous dites peut-être que pour le patient c’est mieux car on peut surveiller ses constantes vitales ?

Pas de bol. Crossway ne montre par défaut que ce qu’il y a à faire, donc si je veux voir le passé il faut se perdre dans les menus.

Évidemment vous rebondissez en vous disant qu’au moins comme ça on est sur de rien oublier si Crossway montre tout ce qu’il y a à faire !

Encore raté.

Bon bref, Crossway est directement responsable d’une surcharge mentale de malade sur les médecins et infirmières, sans que son concept n’en ait rien, mais alors rien à taper.

Là encore je vous sens dubitatifs. Mais savez-vous comment on peut faire évoluer Crossway ? En s’inscrivant à un club des utilisateurs. Et savez-vous comment on s’inscrit à ce club ? EN PAYANT ! Oui oui, on paye pour donner son avis.

Et là les plus blasés vont dire : bah si c’est si dangereux, pourquoi vous portez pas plainte ? Ben parce qu’on peut pas.
Parce que la responsabilité de la qualité de la prescription c’est celle des médecins, et celle de l’administration, celle des IDE.

Davos

January 27th, 2018

Where People Go To Get Better

January 22nd, 2018

"Where people go to get better" could be the best definition ever for the Ligne de vie… and it is pretty good news that it is obviously still missing ;-)

Picture by Panh Rithy (RPanh)

Quia hortulanus esset

January 21st, 2018

Je suis l’ouvrier du silence,
L’au-delà des gestes humains,
L’obole qui contrebalance
L’or des Césars entre vos mains.

Je suis l’innocence de l’aube
Et l’œuf fragile au fond du nid ;
Les replis usés de ma robe
Ont la largeur de l’infini.

Je suis plus vendu qu’un esclave,
Et, plus qu’un pauvre, abandonné ;
Je suis l’eau céleste qui lave
Le sang que pour vous j’ai donné.

Les lys et les agneaux, mes frères,
Sont comme moi sans défenseur ;
Je revêt tous ceux qui pleurèrent
D’une cuirasse de douceur.

Peu m’importe que l’on me nie ;
Je suis l’obscur et l’insulté
Semant sa sueur d’agonie
Aux sillons du futur été.

Je suis la neige qui prépare
La lente éclosion des fleurs ;
Deux bras ouverts, vivante barre,
Diamètre de vos douleurs.

La rose à mes côtés relève
Son visage innocent et beau ;
Le bois mort s’humecte de sève ;
Et la Madeleine au tombeau,

Moite encor des larmes versées,
Reconnaît, dieu qui sanglota,
Le jardinier aux mains percées
Sous l’arbre noir du Golgotha.


Marguerite Yourcenar
1931-1933
Les Charités d’Alcippe

L’expression "quia hortulanus esset" apparaît au chapitre 20 de l’Évangile selon Jean, versets 11 à 18

  1. «  Maria autem stabat ad monumentum foris, plorans. Dum ergo fleret, inclinavit se, et prospexit in monumentum » :
    Marie se tenait près du tombeau, au-dehors, tout en pleurs. Or, tout en pleurant, elle se pencha vers l’intérieur du tombeau
  2. «  et vidit duos angelos in albis sedentes, unum ad caput, et unum ad pedes, ubi positum fuerat corpus Jesu. » :
    et elle voit deux anges, en vêtements blancs, assis là où avait reposé le corps de Jésus, l’un à la tête et l’autre aux pieds.
  3. «  Dicunt ei illi : Mulier, quid ploras ? Dicit eis&nbsp: Quia tulerunt Dominum meum : et nescio ubi posuerunt eum. » :
    Ceux-ci lui disent : « Femme, pourquoi pleures-tu ? » Elle leur dit : « Parce qu’on a enlevé mon Seigneur, et je ne sais pas où on l’a mis. »
  4. «  Hæc cum dixisset, conversa est retrorsum, et vidit Jesum stantem : et non sciebat quia Jesus est. » :
    Ayant dit cela, elle se retourna, et elle voit Jésus qui se tenait là, mais elle ne savait pas que c’était Jésus.
  5. «  Dicit ei Jesus : Mulier, quid ploras ? quem quæris ? Illa existimans quia hortulanus esset, dicit ei : Domine, si tu sustulisti eum, dicito mihi ubi posuisti eum, et ego eum tollam.“ :
    Jésus lui dit : « Femme, pourquoi pleures-tu ? Qui cherches-tu ? » Le prenant pour le jardinier, elle lui dit : « Seigneur, si c’est toi qui l’as emporté, dis-moi où tu l’as mis, et je l’enlèverai. »
  6. «  Dicit ei Jesus : Maria. Conversa illa, dicit ei : Rabboni (quod dicitur Magister). » :
    Jésus lui dit : « Marie ! » Se retournant, elle lui dit en hébreu : « Rabbouni ! » – ce qui veut dire : « Maître ».
  7. «  Dicit ei Jesus : Noli me tangere, nondum enim ascendi ad Patrem meum : vade autem ad fratres meos, et dic eis : Ascendo ad Patrem meum, et Patrem vestrum, Deum meum, et Deum vestrum. » :
    Jésus lui dit : « Ne me touche pas, car je ne suis pas encore monté vers le Père. Mais va trouver mes frères et dis-leur : “je monte vers mon Père et votre Père, vers mon Dieu et votre Dieu”. »
  8. «  Venit Maria Magdalene annuntians discipulis : Quia vidi Dominum, et hæc dixit mihi. » :
    Vient Marie de Magdala, qui annonce aux disciples : « J’ai vu le Seigneur et voilà ce qu’il m’a dit. »

Austin Brexit

January 16th, 2018

Social Decay

January 14th, 2018

In his Social Decay opus, Andrei Lacatusu illustrates a world where the fading lustre of social media companies only results in beat-up advertising material.

The Blockchain Bandwagon

January 7th, 2018

Comic by Tom Fishburne (@tomfishburne)

Eleonore

January 6th, 2018

Superbe image de la tempête Eleonore prise à Saint-Quay-Portrieux par nico_nilo

We Were All Humans

December 31st, 2017

François Gabart : 42 jours autour du monde

December 18th, 2017

© François Gabart/Macif

Be Happy

December 2nd, 2017

Maybe it is as simple as listed by Monica Sheehan… maybe such behavior is necessary but not sufficient. At least worth considering as a "fresh piece of advices" since the usual words (as "success", "fortune", "greatness", etc) don’t read here.

  • Have a sense of wonder
  • Stay inspired
  • Help others
  • Do things you’re good at
  • Read books
  • Limit television
  • Love your work
  • Exercise
  • Face your fears
  • Believe in yourself
  • Stay close to friends and family
  • Let your heart be your guide

The unfair advantage

December 2nd, 2017

Yet another great post by Seth Godin (@ThisIsSethsBlog)


Here’s a sign I’ve never seen hanging in a corporate office, a mechanic’s garage or a politician’s headquarters:

WE HAVE AN UNFAIR ADVANTAGE:

We care more.


It’s easy to promise and difficult to do. But if you did it, it would work. More than any other skill or attitude, this is what keeps me (and people like me) coming back.

De l’informatique médicale…

November 23rd, 2017

dites, @WedaOfficiel, ça va bien ? On savait déjà que vous cherchiez à facturer systématiquement toute option en plus du logiciel qu’on vous paie déjà 120 euros par mois par médecin (y compris moi qui travaille 2 jours par semaine au cabinet, pas de jaloux) 1/7

Puis, @WedaOfficiel, on apprend que vous voulez facturer une option qui sera en fait obligatoire pour bosser correctement (on a besoin de ROSP et compagnie, nouveaux types de rémunération pour bosser, et on n’a pas encore assez d’administratifs loin de là) 2/7

et là, en fait, on comprend que vous souhaitez juste vous payer grassement sur la-dite ROSP, puisque vous voulez surfacturer 280 euros par an par médecin pour le passage au DMP #SerpentDeMerMonSerpentDeMer Pour la mise en place bien sûr ? 3/7

Noooon, pas pour la mise en place @WedaOfficiel. Vous voulez facturer 280 euros par médecin ET PAR AN. Pour une option d’un logiciel que chacun d’entre nous paie déjà 1440 euros par an. Et dont on sait que vous allez chercher à nous surfacturer toutes les options. 4/7

On est plusieurs médecins par structure. Ca chiffre vite l’investissement dans votre logiciel @WedaOfficiel 5/7

Un exemple, pour que tout le monde comprenne bien. Pour faire apparaître un bouton à un endroit prévu à cet effet pour un scanner qu’on ne peut pas raccorder tout seuls (ou que notre informaticien habituel ne peut pas raccorder), bim, 80 euros. 6/7

Alors si j’ai mal compris, je veux bien qu’on me réexplique. Je ne demande que ça, même. Et puis j’aimerais avoir l’esprit tranquille pour m’occuper des gens sans avoir à me demander tout le temps si mon "entreprise libérale" tient le coup financièrement 7/7

Should You Use Blockchain?

November 22nd, 2017

Almost everything on computers is perceptually slower than it was in 1983

November 9th, 2017

A tweeted argument by @gravislizard on November 6, 2017

Almost everything on computers is perceptually slower than it was in 1983

Amber-screen library computer in 1998: type in two words and hit F3. search results appear instantly.
Now: type in two words, wait for an AJAX popup. get a throbber for five seconds. oops you pressed a key, your results are erased
One of the things that makes me steaming mad is how the entire field of web apps ignores 100% of learned lessons from desktop apps

Data in webpages in 2017 is distressingly fragile. go to google maps and try and find an action that *doesn’t* erase what you’re doing
Drag the map even a pixel? it erases all your results and closes the infobox you were looking at.

You have a list of interesting locations on the screen but you want to figure out how far they are from the center of town? you can’t.
You can open a new tab, do the search there, then flip back and forth manually in the browser. there’s no other way.
That is to say, once the data’s up on the screen, you *can’t add to it*. which is one of the core functions of computers, generally.
One of the primary reasons computers were *created* was to cross reference data. that is nearly impossible in most software now.

Maps are a particularly hot item for this. christ, what about looking at a map ISN’T about cross ref’ing data? it’s the WHOLE POINT
You have a start and a finish and need to integrate that with geography and roads. and gmaps, bing, etc. are all the worst choice for this.
You are, literally, better off taking a screenshot of the map, dropping it in ms paint and manually plotting there.
Gmaps wildly thrashes the map around every time you do anything. Any time you search, almost any time you click on anything it’s a bewildering whirl of colors and shapes that has gotten worse every six months for 15 years and in doing so it has made humans worse and worse and worse at doing things that computers were created to replace and improve
In 1998 if you were planning a trip you might have gotten out a paper road map and put marks on it for interesting locations along the way
With online maps you CAN do that, but the entire process is built assuming you already know everywhere you’re going
It APPEARS to be what you want – you can keep putting in locations and it’ll keep plotting them – but in truth it’s not at all
The process you WANT: pick your start and end. now start searching for places in between. Your start and end are saved.
When you find someplace interesting, add it to your list. Keep doing that, keep searching and adding.
Search far and wide. Search for cities and then click around inside them. Read reviews. Do street view.
When you’re all done, you go back to your plotted trip and start laying out the chosen locations and optimizing your path.
You can do this with a paper map. You can’t do this with gmaps. So you just don’t do it.
You do something halfass and unsatisfying instead, using multiple tabs or a text file you save addresses in or some shit

You don’t even realize why the process is frustrating because it’s just The Way It Is.
And everything on computers is like this. It’s just How It Is now. You can’t fail quickly and iterate.
On the library computer in 1998 I could retry searches over and over and over until I found what I was looking for because it was quick
Now I have to wait for a huge page to load, wait while the page elements shift all over, GOD FORBID i click on anything while its loading
how many times have i typed in a search box, seen what i wanted pop up as i was typing, go to click on it, then have it disappear

I make no secret of hating the mouse. I think it’s a crime. I think it’s stifling humanitys progress, a gimmick we can’t get over.
The mouse is the CueCat except it didn’t get ridiculed and reviled as it should have been. It’s inappropriate for almost everything we do.
There’s no reason for Twitter to use a mouse. There’s nothing mousey about this website, not a damn thing
Mice are for rapidly navigating through a complex and unstructured set of objects, like an app with dozens of options and input types

The Elephant In The Room

October 6th, 2017

This "Elephant in the room" is the perfect model to explain why the hierarchy is a wrong answer to complex issues. Imagine that all these "experts" will go and make their report to a minister who, while not having been confronted with field realities, will have to build a synthesis, then make a decision for the whole community.

AI Myths

September 24th, 2017

The coded messenger

September 21st, 2017

"Look," I sighed, fidgeting with the rear-view mirror. "Boss says I’ve gotta give this talk to everyone. If you have the gene drive, it’s in your blood. It doesn’t matter if the Ash has started affecting you, if your skin has started to go all white and crumbly or not. It won’t be any better for you on the other side."

"I promise we are not GMs," the dark-haired woman said. "Please. Keep driving."

She winced as we hit a bump, clutching her slung-up arm. Her eyes screamed desperation. She had no right to be looking at me like that. What with the Genome Authority drones flying around projecting her image on rubble all day. A scientist from a bioweapons lab, wasn’t it? Well, money was money. If that little girl with her wasn’t really her daughter, if she wanted to spread some of her knowledge outside the Wall, more power to her.

Ash lashed the windows, for all the world like the snow storms I hadn’t seen since I was a kid. They weren’t dressed for the journey. Not like it was easy to find winter coats nowadays. But you needed something to slog through the last stretch to the breach. No luggage either. Only stacks and stacks of red-covered notebooks. The little girl clutched one like a teddy bear.

"What’s your name?" she asked.

"JJ."

"You gonna escape over the Wall with us, Jayjay?"

I shook my head.

"Why?"

"People out there are afraid of people like me," I said.

"Why?"

"That’s enough honey," the scientist shushed her. "Try to get some sleep now."

My sensor beeped and I jerked the wheel, pulling over to the side of the road. A herd of mammoths passed in the distance. Even through the Ash, I could make out their shaggy forms, the red helix on the backs of their gun-toting riders. The Genome Authority. I remembered when the Wall first went up. Most of us went willingly. After all, we understood that we couldn’t breed with normal humans. It made sense. It made sense, but when they sealed the gates, I couldn’t help but think of Jade, left behind in one of their labs. The mammoths would disintegrate too, I thought. They would turn to Ash that floated like snowflakes on the wind. Like us, it was meant to happen before we reproduced. There was only supposed to be one generation of us.

"We’re going to make it," I said, as if we hadn’t been stop-and-go, pinned by patrols on all sides for hours. "We just have to wait for the Ash to clear. They won’t find us."

We could just see the mass of the Wall on the horizon, so near and so damn far.

"You were a soldier?" the scientist asked.

The girl slept in her lap. I adjusted my sleeve over my white-streaked skin and nodded.

"I’m sorry. You see, I’m one of the people whose research was used to make the technology — that made you what you are."

More free sci-fi stories from Futures

It was the same with all these do-gooders who locked themselves behind the Wall with us and decided they wanted out now. I’d heard it all. It was a war. Our parents made tough choices for us. Better for your super-powered kid to fight and come back than get smashed in the claws of a mech on their first day, at 18. They didn’t know about the Ash. The safeguard disease in our genomes, which would disintegrate us piece by piece if we lived past reproduction age.

"You think I give a damn that you’re sorry?"

"No. I don’t expect to be forgiven. But I want you to know my group has been working on a reverse drive — a cure — these 20 years behind the Wall. In 5 more, we could’ve. But the Genome Authority found us."

She unbuckled her seat belt and grabbed an armful of notebooks.

"The hell are you doing?"

"I’ll tell them it was too dangerous. That I insisted on walking the rest of the way and you turned back. Please. Take care of her. Make sure she gets to the other side."

When the little girl woke, the sun had risen. I bundled her up the best I could in my jacket and carried her outside. We found the scientist like a beacon in the Ash, her notebooks fluttering around her, her hand clutching the already dried bullet wound in her chest. This one dignity would be afforded to her — that she wouldn’t dissolve like the rest of us, at least.

"Jayjay, don’t cry," the little girl said. "It’s going to be okay."

"How can you say that it’s okay?"

The most important part of me had crumbled. I realized that the Genome Authority was crap. My Jade — my daughter — had been gone for a long time now.

"Your mother is dead," I finished.

"No." The little girl shook her head. "Mama is inside of me. Half of her DNA. Her notebooks too. She took out the extra parts of my genome that didn’t mean anything and wrote a message there instead."

"I don’t know what that means!"

She slipped her hand into mine.

"As long as I live, the cure will too," she said. "That’s what Mama told me. The same technology that caused this can be used to make something beautiful too."

I clung to it. Even though I didn’t have any right to, I know. To fill the gaping hole in my chest, both physically and mentally. But I was selfish. I still grasped at it. Because I’d never got a chance to say good-bye to the people who mattered, you know?

"What’s your name?" I asked.

"It’s Hope."


A short piece by Andrea Kriz published in Nature


I got the idea for this story after reading a recent Nature article in which researchers describe encoding a movie into a bacterial genome (Nature 547, 345–349; 2017). Late night in lab, the thought popped into my head — how much information could be encoded in the human genome using similar technology? What kind of state would the world have to be in to make it even remotely acceptable to use genome editing in that way? And what could lead a scientist to use another human, rather than synthetic DNA or bacteria, for this purpose?


Probably everyone who uses CRISPR in their research has thought of a similar slippery slope at one point or another. Gene-editing technology has already been used to correct devastating genetic diseases in embryos. The world is understandably hesitant about taking the next step, making edits to ‘improve’ human traits. But what happens if someone does it first? And, after a few years, if it looks like the kids are okay, even outperforming non-genetically modified children? If one country embraces the technology, others may follow out of fear that their next generation will fall behind if they don’t. Add an on-going world war on top of this, and it becomes an arms race. Eventually, the changes to the genome become so experimental and extreme that it could be disadvantageous to let them spread to the general population. In the United States, a governing authority arises and oversees the implementation of a safeguard (a ‘gene drive’) in the genomes of genetically modified soldiers to prevent this from happening.


Of course the scenario remains firmly science fiction. Currently, many technical issues limit even the theoretical use of genome-editing technology in humans (for example, most human traits are not the result of one gene but incredibly complex gene networks as well as environmental factors). But even if these could somehow be overcome, I don’t think that genome-editing technology should be feared. Instead I believe it should seen for its potential to improve the lives of everyone on Earth — if used in a compassionate and ethical way. Hopefully that’s the story all of us are writing with our research now :)

A Story of Nine Probes

September 20th, 2017

The New Scientist (@newscientist) just released a poster of the nine probes that have reached the outer solar system, with their trajectories and current location.

Compete with Intelligence and Agility

September 10th, 2017

In a recent article, Justin Bariso (@JustinJBariso) published a mail Elon Musk (@elonmusk) sent to Tesla employees a few years ago.

Subject: Communication Within Tesla

There are two schools of thought about how information should flow within companies. By far the most common way is chain of command, which means that you always flow communication through your manager. The problem with this approach is that, while it serves to enhance the power of the manager, it fails to serve the company.

Instead of a problem getting solved quickly, where a person in one dept talks to a person in another dept and makes the right thing happen, people are forced to talk to their manager who talks to their manager who talks to the manager in the other dept who talks to someone on his team. Then the info has to flow back the other way again. This is incredibly dumb. Any manager who allows this to happen, let alone encourages it, will soon find themselves working at another company. No kidding.

Anyone at Tesla can and should email/talk to anyone else according to what they think is the fastest way to solve a problem for the benefit of the whole company. You can talk to your manager’s manager without his permission, you can talk directly to a VP in another dept, you can talk to me, you can talk to anyone without anyone else’s permission. Moreover, you should consider yourself obligated to do so until the right thing happens. The point here is not random chitchat, but rather ensuring that we execute ultra-fast and well. We obviously cannot compete with the big car companies in size, so we must do so with intelligence and agility.

One final point is that managers should work hard to ensure that they are not creating silos within the company that create an us vs. them mentality or impede communication in any way. This is unfortunately a natural tendency and needs to be actively fought. How can it possibly help Tesla for depts to erect barriers between themselves or see their success as relative within the company instead of collective? We are all in the same boat. Always view yourself as working for the good of the company and never your dept.

Thanks,
Elon


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