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Dinkclump Linkdump
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I'm on tour with my new novel The Bezzle! Catch me TONIGHT in LA (Saturday night, with Adam Conover), Seattle (Monday, with Neal Stephenson), then Portland, Phoenix and more!
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Some Saturday mornings, I look at the week's blogging and realize I have a lot more links saved up than I managed to write about this week, and then I do a linkdump. There've been 14 of these, and this is number 15:
https://pluralistic.net/tag/linkdump/
Attentive readers will note that this isn't Saturday. You're right. But I'm on a book tour and every day is shatterday, because damn, it's grueling and I'm not the spry manchild who took Little Brother on the road in 2008 – I'm a 52 year old with two artificial hips. Hence: an out-of-cycle linkdump. Come see me on tour and marvel at my verticality!
https://pluralistic.net/2024/02/16/narrative-capitalism/#bezzle-tour
Best thing I read this week, hands down, was Ryan Broderick's Garbage Day piece, "AI search is a doomsday cult":
https://www.garbageday.email/p/ai-search-doomsday-cult
Broderick makes so many excellent points in this piece. First among them: AI search sucks, but that's OK, because no one is asking for AI search. This only got more true later in the week when everyone's favorite spicy autocomplete accidentally loaded the James Joyce module:
https://arstechnica.com/information-technology/2024/02/chatgpt-alarms-users-by-spitting-out-shakespearean-nonsense-and-rambling/
(As Matt Webb noted, Chatbots have slid rapidly from Star Trek (computers give you useful information in a timely fashion) to Douglas Adams (computers spout hostile, impenetrable nonsense at you):
https://interconnected.org/home/2024/02/21/adams
But beyond the unsuitability of AI for search results and beyond the public's yawning indifference to AI-infused search, Broderick makes a more important point: AI search is about summarizing web results so you don't have to click links and read the pages yourself.
If that's the future of the web, who the fuck is going to write those pages that the summarizer summarizes? What is the incentive, the business-model, the rational explanation for predicting a world in which millions of us go on writing web-pages, when the gatekeepers to the web have promised to rig the game so that no one will ever visit those pages, or read what we've written there, or even know it was us who wrote the underlying material the summarizer just summarized?
If we stop writing the web, AIs will have to summarize each other, forming an inhuman centipede of botshit-ingestion. This is bad news, because there's pretty solid mathematical evidence that training a bot on botshit makes it absolutely useless. Or, as the authors of the paper – including the eminent cryptographer Ross Anderson – put it, "using model-generated content in training causes irreversible defects":
https://arxiv.org/abs/2305.17493
This is the mathematical evidence for Jathan Sadowski's "Hapsburg AI," or, as the mathematicians call it, "The Curse of Recursion" (new band-name just dropped).
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But if you really have your heart set on living in a ruined dystopia dominated by hostile artificial life-forms, have no fear. As Hamilton Nolan writes in "Radical Capital," a rogues gallery of worker-maiming corporations have asked a court to rule that the NLRB can't punish them for violating labor law:
https://www.hamiltonnolan.com/p/radical-capital
Trader Joe’s, Amazon, Starbucks and SpaceX have all made this argument to various courts. If they prevail, then there will be no one in charge of enforcing federal labor law. Yes, this will let these companies go on ruining their workers' lives, but more importantly, it will give carte blanche to every other employer in the land. At one end of this process is a boss who doesn't want to recognize a union – and at the other end are farmers dying of heat-stroke.
The right wing coalition that has put this demand before the court has all sorts of demands, from forced birth to (I kid you not), the end of recreational sex:
https://www.lawyersgunsmoneyblog.com/2024/02/getting-rid-of-birth-control-is-a-key-gop-agenda-item-for-the-second-trump-term
That coalition is backed by ultra-rich monopolists who want wreck the nation that their rank-and-file useful idiots want to wreck your body. These are the monopoly cheerleaders who gave us the abomination that is the Pharmacy Benefit Manager – a useless intermediary that gets to screw patients and pharmacists – and then let PBMs consolidate and merge with pharmacy monopolists.
One such inbred colossus is Change Healthcare, a giant PBM that is, in turn, a mere tendril of United Healthcare, which merged the company with Optum. The resulting system – held together with spit and wishful thinking – has access to the health records of a third of Americans and processes 15 billion prescriptions per day.
Or rather, it did process that amount – until the all-your-eggs-in-one-badly-maintained basket strategy failed on Wednesday, and Change's systems went down due to an unspecified "cybersecurity incident." In the short term, this meant that tens of millions of Americans who tried to refill their prescriptions were told to either pay cash or come back later (if you don't die first). That was the first shoe dropping. The second shoe is the medical records of a third of the country.
Don't worry, I'm sure those records are fine. After all, nothing says security like "merging several disparate legacy IT systems together while simultaneously laying off half your IT staff as surplus to requirements and an impediment to extracting a special dividend for the private equity owners who are, of course, widely recognized as the world's greatest information security practitioners."
Look, not everything is terrible. Some computers are actually getting better. Framework's user-serviceable, super-rugged, easy-to-repair, powerful laptops are the most exciting computers I've ever owned – or broken:
https://pluralistic.net/2022/11/13/graceful-failure/#frame
Now you can get one for $500!
https://frame.work/blog/first-framework-laptop-16-shipments-and-a-499-framework
And the next generation is turning our surprisingly well, despite all our worst efforts. My kid – now 16! – and I just launched our latest joint project, "The Sushi Chronicles," a small website recording our idiosyncratic scores for nearly every sushi restaurant in Burbank, Glendale, Studio City and North Hollywood:
https://sushichronicles.org/
This is the record of two years' worth of Daughter-Daddy sushi nights that started as a way to get my picky eater to try new things and has turned into the highlight of my week. If you're in the area and looking for a nice piece of fish, give it a spin (also, we belatedly realized that we've never reviewed our favorite place, Kuru Kuru in the CVS Plaza on North Hollywood Way – we'll be rectifying that soon).
And yes, we have a lavishly corrupt Supreme Court, but at least now everyone knows it. Glenn Haumann's even set up a Gofundme to raise money to bribe Clarence Thomas (now deleted, alas):
https://www.gofundme.com/f/pzhj4q-the-clarence-thomas-signing-bonus-fund-give-now
The funds are intended as a "signing bonus" in the event that Thomas takes up John Oliver on his offer of a $2.4m luxury RV and $1m/year for life if he'll resign from the court:
https://www.youtube.com/watch?v=GE-VJrdHMug
This is truly one of Oliver's greatest bits, showcasing his mastery over the increasingly vital art of turning abstruse technical issues into entertainment that negates the performative complexity used by today's greatest villains to hide their misdeeds behind a Shield of Boringness (h/t Dana Clare).
The Bezzle is my contribution to turning abstruse scams into a high-impact technothriller that pierces that Shield of Boringness. The key to this is to master exposition, ignoring the (vastly overrated) rule that one must "show, not tell." Good exposition is hard to do, but when it works, it's amazing (as anyone who's read Neal Stephenson's 1,600-word explanation of how to eat Cap'n Crunch cereal in Cryptonomicon can attest). I wrote about this for Mary Robinette Kowal's "My Favorite Bit" this week:
https://maryrobinettekowal.com/journal/my-favorite-bit/my-favorite-bit-cory-doctorow-talks-about-the-bezzle/
Of course, an undisputed master of this form is Adam Conover, whose Adam Ruins Everything show helped invent it. Adam is joining me on stage in LA tomorrow night at Vroman's at 5:30PM, to host me in a book-tour event for my novel The Bezzle:
https://www.vromansbookstore.com/Cory-Doctorow-discusses-The-Bezzle
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If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:
https://pluralistic.net/2024/02/23/gazeteer/#out-of-cycle
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Image: Peter Craven (modified) https://commons.wikimedia.org/wiki/File:Aggregate_output_%287637833962%29.jpg
CC BY 2.0 https://creativecommons.org/licenses/by/2.0/deed.en
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jcmarketresearch · 5 months
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drnic1 · 10 months
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Transparency and Personalized Health Care
This week I am talking to Jennifer Danielson, Chief Growth Officer at Collective Health an integrated third-party administration and navigation company delivering health benefits. Jennifer describes herself as a recovering attorney who has ‘followed the money in healthcare to understand the workings of healthcare and bring about some positive change. By now I think most of us have some sense that…
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spectrumpsp · 1 year
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How Does Hospice PBM Work?
Introduction
Hospice PBM is an innovative approach to healthcare that aims to improve end-of-life care for terminally ill patients. Hospice care provides a holistic and compassionate approach to healthcare that addresses not just physical needs but also emotional and spiritual needs. In this article, we'll look at how hospice PBM works and what it entails.
What is Hospice PBM?
Hospice PBM is an abbreviation for hospice pharmacy benefit management. Hospice PBM combines the principles of hospice care with the benefits of a pharmacy benefit management program. The goal of hospice PBM is to provide patients with the right care at the right time and to help them manage the cost of their care.
How Does Hospice PBM Work?
Hospice PBM works by utilizing a team of healthcare professionals who are knowledgeable in hospice care. This team works together to develop a comprehensive plan of care for each patient, taking into account their individual needs, preferences, and medical history.
The hospice team consists of a physician, nurse, social worker, and chaplain, who work together to manage the patient's care. This team also works with the patient's family and other healthcare providers to provide the best possible care.
The hospice PBM program also includes a pharmacy benefit management component. This component helps patients manage the cost of their care by negotiating with pharmacies and insurance companies to get the best possible prices on medications and other treatments.
Benefits of Hospice PBM:
Comprehensive care: Hospice PBM provides a comprehensive approach to care that addresses the physical, emotional, and spiritual needs of patients.
Cost savings: Hospice PBM can help reduce the cost of care by negotiating with pharmacies and insurance companies for the best prices on medications and treatments.
Improved quality of life: Hospice PBM helps improve the quality of life for patients by providing care that is tailored to their individual needs.
Support for families: Hospice PBM provides support and resources to help families care for their loved ones during the end-of-life stage.
Conclusion:
Hospice PBM is an innovative approach to healthcare that combines the principles of hospice care with the benefits of a pharmacy benefit management program. By utilizing a team of healthcare professionals and negotiating with pharmacies and insurance companies, hospice PBM provides patients with comprehensive care that addresses their individual needs and helps manage the cost of their care.
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slowgravity · 7 months
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TROYE SIVAN Something To Give Each Other (2023)
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bmj-arts · 7 months
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birthday boy 🎂
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idk if its official but whatever, I wanna do something wholesome
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dannidorina · 9 months
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@ultearmilkobitch commented a meme on my fic the bottom meme and I'm not immune to drawing a good meme. LMAO THANK U!!
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cheezyratz · 10 months
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Peter B: Miguel, MJ, you know how you both love me so very much and I, Peter B Parker, love you both with my whole entire heart?
MJ: Did you let the raccoons in again?
Peter B: yes…
Miguel: and did you put little hats on them? Again?
Peter B: … also yes.
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miguelobsession · 10 months
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My most favourite part of spiderparents is Miguel falling in love hard equally with both people
I think Peter is a given in this fandom but Miguel just being soft and in love for MJ makes me cry with happiness
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penaltyboxmaster · 7 days
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hii!! could you draw juice and/or georgie to help me manifest good things for our goalies?? <3
i’ve been doing these in order, but things go well when i draw the goalies before games. go avs go
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titikookieslyth · 23 days
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I just finished tsats and I love this Book so so much. The messages, the pacing, the characters, the dynamics are just so good and well made.
It's a Book of healing. For those who can't see the light and are stuck in the Darkness they find within themselves. There's an alternative, a choice you Can make. Being safe and creating around you help you in Times of need m. But do not choose loneliness, sadness, isolation and misery just because they are familiar. You are just hurting yourself and others.
Your Darkness are not to be vanquished or conquered. WE just have to learn to live with them, so our loved ones Can accept and love them too.
I'm so happy Nico is having his happy ending. Like Hades said, he deserves everything.
A special shoutout to Will Solace, my coup de cœur in this Book. I've learned to know him more and he's so human, kind and loving, a litteral Ray of sunshine.
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blackfawn · 19 days
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tickly-tufts · 9 months
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Date Night
in which mj bullies miguel with thigh tickles cuz i have brainrot and wanted to treat myself
Unsurprisingly, it was Peter’s fault.
“I am… so sorry.”
Muffled through a palm that barely hid a grin, the apology was entirely unconvincing.
“Yeah, I can tell you’re just wracked with guilt,” Miguel deadpanned, feeling dead inside. He would’ve rubbed his temple if he’d been able, but neither arm was stuck close enough to his head. His next move might’ve been to use his claws, if he’d had the range of motion for it. Unfortunately, there was little one could do when they were half-encased in webbing.
It was the end result of a series of mishaps, comical for Peter, miserable for Miguel. In short, there’d been a Spiderman experimenting with new web fluid, high-strength to the point that it’d jammed their web-shooter. Much to everyone’s surprise, they’d turned to Peter B. Parker for help. Flattered, he’d promised to take a look at the web-shooter… then promptly misplaced it in Miguel’s lair.
And then, because the only thing worse than Parker luck was O’Hara luck, Miguel had been the one to find it.
On the floor.
By stepping on it.
“Wow, you’re super stuck on there, huh?” Peter tugged at the webbing on Miguel’s chest. It wrapped across his entire torso, too thick to simply pull apart. In contrast, Miguel’s lower body had nearly been spared, bearing only a handful of web clumps. Unfortunately, that still proved enough to bind his legs, trapping him in an odd lean against the wall.
“I can whip up a solvent in the lab, but it’ll take time,” Peter warned, getting serious. Then he exhaled ruefully. “Of course this happened on date night… MJ’s gonna be bummed.”
Honestly, Miguel was disappointed, too. He’d been looking forward to his evening with the Parkers. However, before he could consider admitting it, Peter suddenly brightened and lifted his watch.
“I just had the best idea.”
MJ had visited Nueva York before, but the portals were still a novelty to her. Stepping from her sunny living room into Miguel’s shaded sanctum resulted in some stumbling as her eyes adjusted.
“¡Cuidado!” Miguel hissed out in alarm when she nearly ran into a shelf. Quickly course-correcting, MJ followed his voice, eventually locating the correct corner.
“Oh, Migs,” she sighed when she saw him, reaching out to cradle his face. Instinctively, Miguel leaned forward, though he couldn’t actually get any closer.
“How much did Peter tell you?” Miguel asked while her thumb brushed soothingly against his cheek.
“Enough to know our dinner plans won’t be happening, but I can still keep you company while Peter fixes this mess.” MJ then paused, realizing something. “Is Lyla not with you? I thought she lived here.”
Miguel shrugged, or at least tried to. “She’s assigned to monitoring the multiverse tonight.” He scowled a bit. “I got her to call Peter, but that’s as far as she needs to be involved in this.”
MJ’s lips quirked up in amusement. “Because she’ll make fun of you?”
“…She already did.”
Miguel pouted, and unable to resist, MJ kissed him, nice and slow. “You poor thing,” she murmured when they parted, pleased to see him looking slightly dazed. “Anything I can do to make you feel better?”
Miguel raised an eyebrow at her tone. “Not that I don’t appreciate the offer, but what can you do while I’m webbed up like this?”
MJ looked down, and Miguel followed her gaze, realizing then that she stood between his legs. There was some space separating their bodies, but it couldn't have been more than an inch. “Depends on how much you can feel through the suit,” she practically purred, giving his left thigh a squeeze. MJ had meant for it to be flirtatious... only to jump when Miguel jolted violently.
“Miguel?!” she cried out in concern, then registered that he'd also made a sound. Not one of pain, nor pleasure like she'd aimed for, but- “Wait a second, are you…? Here?”
Miguel froze as MJ reassessed him, eyes roaming curiously across his legs. Hyperaware of where her thoughts were leading, he barely suppressed the urge to shiver. He did shiver when she grabbed herself a seat, scooting in right between his knees. Placing a hand on top of each thigh, she smiled up at him... then started kneading.
“SHOCK!” Miguel screeched before he crumbled, cackling without any restraint. Both MJ and Peter had tickled him before, but no one had gone for the thighs since… well, Xina. It was even worse than he remembered, and he'd remembered it being pretty embarrassing. His ex had never let him live it down, and evidently, it was back to haunt him.
“How did we not know about this?” MJ marveled, alternating between legs. She massaged upwards from his knees, which might’ve been relaxing for anyone else. Miguel writhed within the cluster of webbing, eyes squeezed shut as tightly as possible. They shot back open when MJ moved inwards, pinching along his inner thighs.
“¡Mierda!” escaped him more like a whine than a curse, as he flung his head back, giggling uncontrollably. MJ only did this for a minute before withdrawing in astonishment.
“So that’s all it takes to get the fangs out, huh?” She could not have been more delighted. “Aww, no, don’t be shy!” she protested when Miguel rushed to hide them. Thinking fast, she switched to scratching, honing in on the thickest part of his thighs. Miguel promptly lost his mind, fangs flashing openly as he wailed with mirth.
Scratching eventually eased into grazing, granting Miguel a break, though not enough to stop smiling. He allowed his fangs to peek out from his mouth, if only to garner more mercy from MJ.
“Such a cute smile,” MJ cooed, smirking when Miguel turned his head away, flustered. She and Peter had realized quite early on that direct praise worked wonders on him. Speaking of which- “Peter’s really missing out… We’ll definitely have to fill him in later.”
Miguel tried not to think too hard about all the things Peter might do with that knowledge.
As soon as Miguel was reasonably recovered, MJ resumed her exploration with the backs of his thighs. Miguel’s legs trembled as MJ’s fingers climbed them, but that wasn’t the part that got him giggling again.
“Oh my god.” MJ couldn’t stop grinning when she finally noticed where her hand had wandered. “Seriously? Your ass is ticklish? Peter is gonna love this so much.” She was very tempted to linger there herself, but Miguel's position just wasn't ideal for it. Sitting back, she examined him again, contemplating her other options.
“Will I regret asking what you’re thinking?” Miguel questioned cautiously.
MJ looked pensive, then mischievous.
“There's just one more thing I have to try.”
The solvent was done sooner than he’d expected. Future tech really never ceased to amaze. Peter swung his way back to Miguel’s lair in record time, fully prepared to announce himself, until-
“¡POR DIOS, ERES UNA SÁDICA!”
The exclamation made him rear back. It had obviously come from Miguel, but what the hell was making him sound like that?
Peter’s spider-sense wasn’t going off at all, but just to be safe, he crept forward in stealth mode. He nearly abandoned it to charge in when he heard what sounded like a sob. Experience kept him grounded, though. If something bad was happening, he needed the upper hand. Then he finally rounded the corner, and apprehension made way for awe.
He’d seen MJ tickle Miguel before, poking playfully at his sides, or even nibbling at his neck. Peter and MJ had both picked up on the fact he never genuinely tried to stop her. It was one of Peter’s favorite discoveries about Miguel, even if Miguel rarely made it that easy for him. With all that in mind, though, Peter still wasn’t ready to find MJ tickling Miguel to tears.
“Nonono- ¡No puedo más!” Miguel was babbling between hysterics. Meanwhile, Peter’s very lovely wife was digging into the crease of his thighs. The webs holding Miguel showed off their strength, hardly letting him thrash, much less escape. Miguel’s desperation only intensified as MJ’s fingers migrated inward.
Mary Jane could be a menace. Peter had known that for years. He was pretty sure that after this, Miguel would never forget it either. With MJ scribbling right between his thighs, he broke down within seconds.
“¡No más! Please! Stohohop, plehease!” Miguel begged breathlessly, hitting his limit.
And because MJ was mean but never cruel, she pulled back without any hesitation.
Peter waited another minute for Miguel to calm down, while MJ gently brushed tears from his eyes. He couldn’t make out whatever she was whispering, but he could guess from the way Miguel nuzzled her palm. “Hope I’m not ruining a tender moment,” Peter piped up then, revealing himself. All attention snapped to him, and in greeting, he pulled out the solvent.
“…How long were you watching?” Miguel asked once he'd been fully freed from the wall.
“Pretty sure I heard you call my wife a sadist,” Peter answered cheerfully.
Miguel flushed. MJ laughed. Peter was incredibly in love with them both.
He did wish he'd gotten a turn, though... Maybe they could pencil it in next date night.
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spectrumpsp · 2 years
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What is the main difference between Electronic Medical Records and Electronic Health Records in PBM?
Some people use the terms "electronic health record" and "electronic health record" interchangeably. However, at the Office of the National Coordinator of Health Information Technology (ONC), you will find that we use Electronic Health Records (EHRs) almost exclusively.
Although it may seem trivial at first glance, the distinction between the two phrases is quite substantial. The term EMR appeared first, and the first EMRs were truly "medical". They were primarily intended for diagnostic and therapeutic use by professionals.
In contrast, “health” refers to “the state of being healthy in body, mind, and spirit; especially… the absence of physical disease or pain… the general condition of the body. The term “health” encompasses much more than “medical”. And EHRs are far superior to EMRs.
How are they different?
Electronic medical records (EMRs) are the digital equivalent of paper medical records in a doctor's office. Medical and treatment histories of patients in a practice are stored in an EMR. EMRs are superior to paper records. EMRs, for example, allows physicians to:
Track data over time
Easily identify patients who need screening or preventive exams.
Check how your patients are doing on specific factors, like blood pressure measurements and vaccinations.
Monitor and improve the overall quality of care of the practice.
However, the information contained in EMRs does not come easily out of practice. It may be necessary to print and send the patient's file to specialists and other members of the care team. In this regard, electronic medical records are inferior to paper records.
Electronic health records (EHRs) perform all of the functions listed above and more. EHRs focus on the overall health of the patient. Go beyond traditional clinical data collected in the provider office and provide a more comprehensive view of patient care. EHRs are intended to extend beyond the initial healthcare organization that collected and compiled the information.
They are designed to exchange information with other health care providers, such as laboratories and specialists, and therefore contain information from all professionals involved in the treatment of hospitalized patients. According to the National Alliance for Health Information Technology, "EHR data may be developed, maintained, and accessed by licensed physicians and personnel from various health care organizations."
Patient information is transferred to the nearest specialist, hospital, nursing home, state or even across the country.
Analytics said, looking at the differences between log formats. That "the EHR represents the ability to easily transmit medical information between stakeholders and to follow a patient's information through the many treatment modalities that the individual receives."
EHRs are intended to be made available to all parties involved in the treatment of a patient, including the patient. In fact, this is an explicitly stated requirement in the Stage 1 definition of “meaningful use” of EHRs.
And this is the decisive factor. Because information becomes more powerful when it is shared securely. Health care is a team effort supported by the exchange of information.
After all, a significant part of the value of the health care delivery system comes from the effective exchange of information from one party to another and, ultimately, the ability of many parties to engage in interactive communication of information. .
Benefits of EHRs
With fully functional EHRs, all team members have immediate access to the latest information, enabling more coordinated and patient-focused treatment. Use of electronic health records,
Even if the patient is unconscious, care may be modified based on the patient's life-threatening allergy communicated by the attending physician to the emergency department physician.
The ability for a patient to log into their chart and see the trend of their lab results over the past year can encourage them to continue taking their medications and maintain the lifestyle adjustments that have leads to improved numbers.
Last week's lab results are already on file. Therefore, no additional tests are necessary to provide the specialist with the information he needs.
Physician's notes regarding the patient's hospitalization can help inform discharge instructions and follow-up care. Facilitate patient transition between care settings.
Yes, there is a one-word distinction between "electronic medical records" and "electronic medical records". But this term contains a universe of distinction.
The EMR provides digital patient records for a single practice. But the EHR allows physicians to quickly share records with other healthcare professionals, regardless of their geographic location. Keeping the terms "medical" and "health" in mind will help you remember which ones.
In other words, the EMR provides a more limited view of a patient's medical history. While the EHR provides a more comprehensive report on a patient's health.
Consider an EHR similar to an EMR, but with additional tools and capabilities to provide a more comprehensive view of a patient's medical history than the often more limited EMR. The EHR generally offers a more comprehensive view of a patient's medical history than an EMR.
The EMR allows for the entry of patient care information, including test results and prescription medications. This type of software can issue repeat prescriptions, schedule patient appointments, and bill patients.
In addition to facilitating electronic prescribing, EHR software provides communication tools that allow healthcare providers from different organizations to collaborate on patient care. For more information, visit https://www.spectrumpsp.com/.
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slowgravity · 14 days
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TROYE SIVAN 2024 | via his Instagram story (April 13)
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battlships · 10 months
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Peter B x Miguel x MJ should have a ship name called Peanut Butter M&Ms or PB M&MS
Anon I am holding your face so lovingly rn that's perfect
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