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Weekly Byte: Changing the World, For Better or For Worse
I've been watching the HBO series Silicon Valley and it has reminded me of all the great, and terrible, and just-plain-weird things about the software industry.

The starry-eyed idealism is accurate. For example, the "What is Hooli?" promotional video by a software mega-corp features African children, a CEO holding a baby goat, and the saccharine line "We can't achieve greatness... without first achieving goodness." Like much of the show, this is over the top, but it's also eerily accurate - as though cobbled together from the cutting room floors during the production of every large software company's morale videos, combined with bullet points from a Forbes article listing 17 ways to attract millennials to your workforce. See also the startup founder who earnestly pitches, "We're making the world a better place... through paxos algorithms for consensus protocols." Big companies, startups, venture capitalists... everyone in Silicon Valley is making the world a better place. Everyone is changing the world.

But when you change the world, you don't necessarily make it better. Sometimes you just change it. There's no going back, but in return for ubiquitous, unlimited access to information, we've revealed the most intimate details of our lives to corporations whose only real purpose is to monetize that data. In return for instantaneous communication and increased productivity, we've created a culture where it's difficult to ever truly be away from our work. And in return for being connected digitally at all times with far-flung friends and family, we've spawned cyber-bullying and FOMO and social media addiction. Any software engineer who's paying attention must eventually come to terms with their own responsibility for the consequences - both positive and negative - of the change that they're creating.

There are ways to stay grounded, to understand the effects and side-effects of your software, and to adjust your approach to make sure you're really "achieving goodness." But it requires having users - which is a catch-22 for most newly-minted startups - and making the effort, especially as an engineer, to stay extremely close to those users. It requires a long-term commitment to what you're doing - in an industry where the leading companies have an average employee tenure between 1 year (Amazon) and 1.1 years (Google)*. And it requires working at a company with the discipline, control over its own destiny, and the financial independence to chart its own course rather than chasing trends, making shady deals, or finding ever-more-creative ways to monetize its users.

I just celebrated my ninth anniversary at pMD, and it's been an amazing journey. It's never easy to do the right thing in the right way, and we've chosen to turn down a lot of opportunities, investors, and partners along the way because they would have compromised our control over our destiny, or distracted us from our core mission to make doctors happy - which has never changed. Watching Silicon Valley has been a great reminder about the power of software to change the world - and how poorly situated most software companies are to do so in a responsible way.

*Source
ACA Account Management ACI Advancing Care Information AHCA AHRQ AI Alternative Payment Model Android API Apple Artificial Intelligence Audit BCRA Best Place to Work Big Data bootcamp BPCI BPTW Bundled Payments Care Communities care coordination Care Navigation Care Team Career Fair CDC Charge Capture Charge Capture App Charge Capture Software Charge Capture Solution Charge Capture Statistics Charge Lag CHIP CIO Clinical Communication Clinical Data Registry Clinically integrated network CMS Communication Company Culture Conferences Connected Health Record culture custom reports Customer Interaction customer success customer support Customers cybersecurity Developer DHHS Dialysis discharge instructions EHR Electronic Charge Capture Encryption epidemic Expansion FDA FHIR Flu fundamentals GI GI Outlook Goals Health Care Health Care Technology Health Care Web Health Information Exchange Health Record Healthcare HIE HIPAA hipaa compliant communication hipaa compliant communication platform HIPAA-Compliant HL7 Home dialysis Hospital Census Hospital Communication IA ICD-10 ICD-11 Implementation Improvement Activities interoperability iOS iOS 8 iOS7 iPad iPhone iPhone 6 Lead Generation length of stay MACRA Medical Billing Medical Errors Medical Software Medicare Mentorship Messaging Messaging with Patients MGMA MIPS MIPS Registry mobile Mobile App Mobile Charge Capture Mobile EHR Mobile Health Mobile Messaging Mobile security Mobile Technology Modern Healthcare Native App news NIH OCM onboarding Oncology Care Model opioid crisis Patient Patient App Patient Care Patient Chat Patient Communication Patient Engagement Patient Generated Health Data Patient Handoff Software Patient Information Patient Safety Patient Visits Patient-Centric pmd pMD Team population health Population Health Management PQRS Product Development Productivity Promoting Interoperability QCDR Quality Scoring Recruiting Recruitment Reimbursement Remote Work reports Residents Responsibility ROI Sales Secure Data Secure Messaging Secure Messaging Video Secure Text Messaging Security Audit SF Biz Times SOC 2 success support TCM Teamwork technology telehealth Telemedicine Text Messaging texting training Travel Upgrades VA Value-based care Video Calling Video chat video communication video conferencing Wearable Device wearing many hats Web App Work From Home