Secure email is nearly always implemented as a portal-based system in practice. It’s also typically only used for one-off exchanges. It’s not our first-line method of communication, but it gets used within the facility literally every day.

HIE portals are more commonly used for provider-to-provider exchange that doesn’t justify full data integration.

At any rate, the fundamental point stands: regulatory compliance has absolutely nothing to do with why faxes are still in use in the industry.

To be clear, this is specifically what I was calling incorrect:

An email, even an encrypted one, is not.

Faxes are one compliant means of electronic communication. They’re just not the only one. Secure email is fine.

That’s likely a peculiarity of the niche you’re in. HL7/FIHR are the norm for enterprise-level systems. Hospitals couldn’t function without it and at any given time we typically have multiple HL7 integration projects rolling just as a mid-size regional.

Definitely less defined in the small-practice and patient-side space. Though, like I said, the big problem there ends up being data normalization anyway.

There’s no one standard…except for faxes.

HL7 and FHIR have been around for decades. Exchanging data is actually the easy part.

The problem is typically more on the business logic side of things. Good example is the fact that matching a patient to a particular record between facilities is a much harder problem than people realize because there are so many ways to implement patient identifiers differently and for whoever inputs a record to screw up entry. Another is the fact that sex/gender codes can be implemented wildly differently between facilities. Matching data between systems is the really hard part.

(I used to do HL7 integration, but have since moved more to the systems side of things).

Such a company has little motivation to completely change to something new, since they’d have to retain this for anyone that hasn’t switched.

They’ve had motivation since the HITECH Act passed in 2009. Medicare/Medicaid compensation is increasingly directly tied to real adoption of modern electronic records, availability, and interoperability. Most healthcare orgs rely heavily on Medicare/Medicaid revenue, so that’s a big, big deal.

You’re dealing with it first hand, so you know what’s involved.

I do. Which is why I’m actively and aggressively removing fax machines from our environment. Efaxing (e.g., fax-to-email gateways) will stick around for back-compatibility purposes with outside organizations, but the overall industry trend is to do everything you can to minimize the footprint of fax machines because they’ve traditionally been used in ways that will cost the company serious revenue if they cause you to miss CMS measures.

Speaking as someone who works directly in the field: this is just plain factually incorrect. Encrypted email is compliant with patient privacy regulations in the US.

The issue is entirely cultural. Faxes are embedded in many workflows across the industry and people are resistant to change in general. They use faxes because it’s what they’re used to. Faxes are worse in nearly every way than other regulatory-compliant means of communication outside of “this is what we’re used to and already setup to do.”

I am actively working on projects that involve taking fax machines away from clinicians and backend administrators. There are literally zero technical or regulatory hurdles; the difficulty is entirely political.

lol and this is exactly why that decision was so baffling.

The game has absolutely nothing to do with the 3D Realms Prey game. It’s truer to System Shock than the Bioshock series ever was. It routinely goes on sale for next to nothing – highly recommended if you’re a fan of SS2.

This is ridiculously well trod ground, but Prey also wasn’t at all helped by Bethesda’s marketing.

They had what is probably the truest successor to System Shock 2 that’s been made on their hands and Bethesda made Arkane use the title of a 15 year old portal based shooter that had absolutely no relation to the game and didn’t do particularly well because they owned the IP.

The entire Bethesda-Arkane relationship has been pretty thoroughly mismanaged.

Wattage = V x A.

They’re pointing out that it’s impossible to hold both wattage and voltage constant while changing the amperage.

The old FourSevens Quarks used to rotate the tailcap the switch between modes. I’ve got one of the older QT2L-Xs that’s probably my favorite light ever for that reason. That and it’s the perfect size for pocket carry while still being decently bright. The newer models since they got bought out ditched it which sucks because it was such a simple interface.

I got a couple of Fenix lights recently that I don’t hate. They still do the “cycle through modes with a button” thing, but it’s at least a dedicated button separate from the tailcap switch.

I really enjoyed Weird West. It mashed up immersive sim elements with Divinity-inspired isometric sandbox combat. Lots of really cool world building.

Rough around the edges in a few places and probably a little ambitious in scope for the size of their team, but overall a pretty solid and fun title for a new indie studio.

tl;dr definitely interested in seeing what they do next.

The Sovjets came at the invitation of the current government of that time.

“The current government of that time” was a communist regime that seized power after multiple successive coups and was deeply unpopular in much of the country. While your statement is technically true, it leaves out a massive amount of context.

I would argue all colonial powers are of similiar blame in repeatedly fucking Afghanistan over.

That does get to the underlying point I was hinting at: imperialism is generally net harmful in all its flavors, whether that’s capitalist imperialism or communist imperialism.

The Soviets moreso than the US in the case of Afghanistan.

The country actually received substantial modernization aid from both, but eventually went through a series of coups that culminated in the Soviet invasion of the country and the rise of the mujaheddin.

https://en.wikipedia.org/wiki/Afghanistan#Barakzai_dynasty_and_British_wars

The US isn’t blameless in how the country turned out, but it’s a much less direct line than it is with Iran.

Afghanistan in the 1970s was similarly culturally ascendent and relatively progressive.

See, e.g.,:

https://www.gettyimages.com/photos/afghanistan-in-the-1970s

80%+ of severe injury and death on a bicycle is caused by motor vehicles, or complications of motor vehicle involvement.

Which would mean ~1 in 5 have absolutely nothing to do with a motor vehicle. That’s significant.

There is considerable evidence that everyone wearing a helmet in a car would save vastly more lives and prevent severe head injury

Then that should be an easy [citation needed] for you because my searches are coming up blank for actual studies. Lots of assertions of it, but I’m not finding anything in terms of actual data.

It’s very easy, on the other hand, to find comprehensive meta analyses on the efficacy of helmet use.

It’s also worth noting that the introduction makes a point of calling out another common online assertion that you repeated – that helmets make people engage in more risk-taking behavior – as false:

There has already been an extensive peer-reviewed literature review conducted by Esmaeilikia et al.5, which found little to no support for increased risk-taking when cyclists use helmets and if anything, they cycled with more caution.

I don’t feel those people should be called stupid for their choice.

I don’t think they’re stupid. I think they’re bad at risk analysis. That’s a pretty inherent feature of humans. It’s the reason I want to see actual data.

A helmet is only needed if you intend to spend significant time in traffic.

The worst wreck I’ve ever had on a bike was without a single car in sight. Pinch flat while carrying speed through a steep downhill curve. I split an expensive MIPS helmet in two and still hit hard enough that I had a minor concussion, road rash up one side of my body, and cracked the face of a week old watch just to pour salt in the (metaphorical) wound. I mostly landed on my head and that helmet is the reason I didn’t have drastically more severe head injuries.

Helmets aren’t just for traffic.

When I was a teenager in the early 2000s, typical retail price for a game was $50.

That’s equivalent to about $85 today.

The vast majority of the games I buy today are well under $50.

Like how Ferrari cars are designed for 20 year olds but only 80 year olds can afford to buy them.

I mean, making the comparison to motorsports just emphasizes how cheap gaming is as a hobby.

Autocross is as entry level as you can get and a typical ~$50 entry fee gets you maybe 10 minutes of seat time and it’s typical to need to drive 2-3 hours each way for an event. That’s before you start adding in things like the fact that a $1500 set of tires will last you a season or two at most, suspension and brake upgrades easily running a couple of thousand dollars, etc.

Start dipping into actual track time and fees jump to more like $250-750 plus around that much again for track insurance per event. And the upgrades needed for the car to hold up on track are even more expensive still. And this is all ignoring the purchase price of the car and potentially needing to trailer a dedicated track car.

I’ve almost certainly spent far less on PC gaming in the last 5 years combined than I have on motorsports in the past 3 months. I’m on the upper end of spending for most gamers and a dabbler at best when it comes to the cars.

The insanity of the GPU market since covid has put some upward pressure on things but A. the proliferation of great indie titles means you can get incredible value without breaking bank on the highest end equipment and B. even then, the money I spent literally tonight ordering just brake pads and rotors would buy you a 4070 all day long. And I went cheaper than I could have.

Gaming dollars go a long, long way. It’s a hobby that was affordable even when I was younger and broke. It’s still relatively affordable compared to many, many other hobbies.

it would require a constitutional amendment

Senate, yes. House, no.

The House used to regularly increase in size and has only been at 435 seats since 1911 and capped at that size since 1929. This is changeable through normal law making.

https://fivethirtyeight.com/features/how-the-house-got-stuck-at-435-seats/

One thing this overlooks is that the rigid mounted bed of the V2 causes thermal expansion issues. There’s a lot of really bad lore that gets repeated in the community re: bed heater power because the V2 tends to want to taco the bed if it’s heated too quickly.

The WhoppingOrchard kinematic mounts are a solid option for addressing the issue.