[olieidel]

I had the same thought. But I think it's more complex than that.

Always consider the alternative. This could be a hospital in a remote part of a third-world country. Maybe they're understaffed. How are they currently handling the task of gathering information from monitoring devices and reacting to alarms?

Maybe, their nursing staff has to run from bed to bed to check patient's vital signs and device alarms. Emergencies would frequently be missed because they are understaffed and checking is irregular. Now, you could introduce software which provides centralized monitoring. If it's introduced on top of the existing activities (i.e., running from bed to bed), it leads to a net benefit - you catch emergencies earlier and consequences of malfunctions are less severe. But if it's introduced to replace the existing activities, it may lead to patient harm.

Sure, it's self-coded, browser-based and buggy - but you always need to weigh risks with benefits, and those depend on usage context.

Of course, in most western countries, this would be completely illegal. But these are also the countries in which medical software looks like it's from the 90s, with catastrophic usability and missing features.

We need to ask ourselves: Right now, we heavily prioritize patient safety over innovation - but have we got that balance right? What are patients missing out on if we could just bring a few more of the latest advances in technology to their bedside?

You know, not machine learning, the blockchain or the internet of things. Rather things like browser-based applications which "just work" and have great usability.

Note: I'm a physician, software developer and consultant for medical software certification :)

[DanBC]

> Maybe, their nursing staff has to run from bed to bed to check patient's vital signs and device alarms.

It feels to me like the management has misunderstood the cost of the software vs not having the software. It feels like they're saying "this software is expensive, and doing nothing is free" when they should be saying "having all these healthcare professionals spending time putting on and taking off PPE the check patients is costing us this much per year".

As you probably know, an ICU will go through 30 sets of PPE per patient per day. That's a lot of time putting stuff on and taking it off.

[im_down_w_otp]

Sure, but there are plenty of technologies that are applicable to safety-critical systems or are safety-critical adjacent which are freely available. There are MCUs, application boards, RTOSs, programming languages, compiler toolchains, network stacks, parsers, etc. available which are the same-a or close-to those which would be commonly sourced and deployed in a safety-critical context.

So, why not use those to build the "something is better than nothing" solution?

[p_l]

Availability.

Just availability.

This was a quick and dirty hack to improve access to patient data done with what was on-hand, for a constrained deployment using specific known devices. They didn't have anyone with knowledge on using any of the tech you mentioned, some of which requires spending months setting up unless you have practical experience in delivering on the platforms. Just getting a more safety-minded setup for a MCU using free software can be a harrowing experience.

And they don't have the money to just contract it out or pay for the commercial grade stuff.

They did what they could with what they had, with explicit mention that it's not good on safety and security - but it brings some benefit now.

Here in Poland, a few weeks into lockdown, nobody asked for certifications on volunteer made PPE parts anymore. Because a shoddy PPE with no certification was still better than none.