Thread

1. progmetaldev · 1790115104 · focus · HN ↗

   I worked with a physician's office in 2006, and the lead physician had cobbled together a system for patient tracking using Visual FoxPro. It was a monstrosity, and using it over a network drive gave all sorts of file locks and issues with multiple people changing the same record (usually the physician and front of house staff when checking the patient out).

   I finally got the physician to switch to a proper client/server architecture using .NET WinForms and ASP.NET RPC calls. All issues went away, and I was even able to allow staff members to edit the interface to set what mattered to them most at the top of the application, by building the lab testing form in XML so they could move the X/Y coordinates to where they wanted them. It wasn't even a feature I had thought of, just a physician looking through the technology and figuring out how it worked (luckily the business and security logic were on the server, so a bad actor could only have destroyed their own local copy of the app).

   1. nradov · 1790119350 · focus · HN ↗

      When networked PCs and rapid application development platforms became popular there was a "Cambrian explosion" of custom electronic health record and practice management applications built by doctor hackers who knew exactly what they wanted, and had just barely enough technical skill to sort of make it partially work. Those have gradually died off because commercial products kept improving, and the cost of complying with security and interoperability requirements kept escalating. But I predict that the cycle will now repeat because the combination of AI coding tools plus headless EHR platforms (built in security, storage, and APIs) has made it easier to build a custom EHR that actually works.

      1. wjholden · 1790120848 · focus · HN ↗

         Yes, I am seeing exactly this at my own workplace. Two things have happened close together: low code and LLMs. I don't personally like using low code solutions (such as PowerBI and Power Automate), but for many knowledge workers this is all they have. Now you can just ask your favorite LLM how to do stuff and it can help you. It's not exactly vibe coding because these people really understand what they have and what they want, they just don't know the syntax to get there.

         1. cm2187 · 1790152170 · focus · HN ↗

            Low code solution have a fairly steep learning curve, and when someone got into it in anger, the complex electrical diagrams that result are even more impenetrable than spaghetti code.

            In a large enterprise environment I have seen business users getting burned by vibe coding already, as they often don't even read the comments and warnings that the LLM gives them. But I think it is inevitable and should enable software to automate the millions of manual processes that are too bespoke to pay an IT team to automate.

            For a solo entrepreneur, it should enable to get so much done before having to hire the first employee. Hence less risk to go bust, easier to take risks, pure value added.

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