iiinova — where your digital self keeps evolving

Sufjan Stevens - "The Only Thing" (Official Lyric Video)

It's hard to say that Sufjan is underrated but he certainly has never received adequate credit for this particular song. youtu.be/TSuKQ0ld6pc?...

youtu.be

YouTube video by Sufjan Stevens

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@nickseewald.com and I were among the oldest people at the venue, proving that an interest in quantitative methods keeps you young at heart

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This was a really great show, if you have the opportunity to go I recommend it, wear ear protection

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I like to think I don't have parasocial relationships with anyone on here but that feels like a self negating statement

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I know exactly how fast my laptop is so I rarely know where it is

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My reply guys are ungovernable

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I would simply stop posting

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Emily Moin @emilymoin.com · 28/09/2026

Being to able to Duo from my watch is one of the main reasons I wear an Apple Watch

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More of a when than an if

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Emily Moin @emilymoin.com · 28/09/2026

my definitive comment on seeing Phoebe Bridgers

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Emily Moin @emilymoin.com · 28/09/2026

This would be concerning to receive if I were not on my laptop at the moment I received it

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Reposted by Emily Moin

huck mason @tylerhuckabee.bsky.social · 16/09/2026

rip annie dillard

One of the things I know about writing is this: spend it all, shoot it, play it, lose it, all, right away, every time. Do not hoard what seems good for a later place in the book or for another book; give it, give it all, give it now. The impulse to save something good for a better place later is the signal to spend it now. Something more will arise for later, something better. These things fill from behind, from beneath, like well water. Similarly, the impulse to keep to yourself what you have learned is not only shameful, it is destructive. Anything you do not give freely and abundantly becomes lost to you. You open your safe and find ashes.

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Yeah, but it's rude to wait until someone shows up in person to ask

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(Although it's quite fair to counter that they don't prioritize standardization because health systems DEMAND customization, which I believe is downstream of CIO-types engaging in makework to justify the existence of their own role, but I digress)

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My evidence is highly anecdotal next to yours but because I work with Cosmos so much – which is the product of Epic's *own* internal attempts to harmonize data – I feel like I have a good view into how the sausage is made and how much is lost because Epic doesn't prioritize standardization.

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I think we're kind of making the same point from opposite directions, to be honest – I think it is simultaneously true that Epic does interoperability better than anyone else, have taken actions that have worsened interop in the service of their business, and also have huge market share.

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I guess the natural question is whether all such emails require a response. Others are seeing similar behavior in LTEs already, but at least those are going through an ostensibly human filter at the journal first.

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I'm hesitant to even give this idea oxygen by retweeting it but yeah, this sucks

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That said, there are plenty of "one standard to rule them all" type attempts and they are all far more baroque than anyone outside the field would guess. Epic is not the ONLY reason, but they've taken steps that are profit-maximizing for them and made the problem even harder.

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@proflhunter.bsky.social is correct. Epic made a very successful business model out of convincing health systems to pay THEM to implement "customized" EHRs that are not standardized or easily interoperable.

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"I myself cannot" is probably the most under-appreciated line in Silence of the Lambs and definitely the one I've most incorporated into my own daily speech.

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I haven't seen this one actually

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It's funny to think that a movie made today with the same level of temporal remove would be set in 2013 and have a really bitching soundtrack with, like, Avicii and Roar by Katy Perry

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Taking suggestions for autumnal movies to screen for atmosphere while the weather is *gestures*, currently watching Donnie Darko

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Carbonadoks @carbonadoks.com · 25/09/2026

Emergent Grok behavior tbh

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Reposted by Emily Moin

Do you ever wanted to see the complete edit history of a wikipedia article? Introducting wikipedia timemachine at timemachine.carbonadoks.com

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Tomer Ullman @tomerullman.bsky.social · 25/09/2026

You'll have to trust me that it's a banger reference. But I will explain it if you want.

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Reposted by Emily Moin

thinking of sending funding agencies Letters of Disinterest, see if negging works any better "Your foundation is really close to being the kind of place I'd want to work with"

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I regret that these technologies – which are powerful and could certainly be incredibly useful – have entered medicine in the way they have: unexamined, without rigorous patient-centered evaluation, mired in proprietary claims, regulatory capture, and credulous adopters.

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For this reason alone I still prefer human-expert curated sources like UpToDate. That I have more training in evidence appraisal than the average practicing physician and I feel poorly equipped to remain adequately skeptical about OE output during a typical workday may be an informative signal.

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This is one of the reasons I personally have not incorporated OE into my practice. The vast majority of practicing physicians are either not competent to or do not have the time to individually vet every piece of primary literature supporting a guideline or treatment decision.

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I've grown used to seeing this claim in every piece about OE, and it comes directly from the company itself, but it is facially untrue, as I've posted before. OE is as cagey about their model as any for-profit enterprise, but there is plenty of non-medical content in the underlying training corpora.

**OpenEvidence is trained exclusively on peer-reviewed evidence and guidelines,** and includes citations for all its claims.

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We've reached the grab portion of this thread so these are just some observations that didn't fit into the screed above:

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Learners I've trained know one of my hobby horses is "stuff you just have to memorize" (for internists: opioid, corticosteroid, and diuretic conversions). Until acute care is delivered through autonomous closed loop systems – which I think is further off than anyone realizes – this will remain true.

A.I. is only the latest tool to provoke a reckoning around which skills are truly essential to doctoring. As a student, I struggled valiantly to identify heart murmurs in my patients, even though I had access to imaging techniques that made my stethoscope somewhat redundant. Similarly, students today need opportunities to build cognitive muscles through study, **even if they will seldom rely on their own memories over their machines.**

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We talk a lot about how technology took physicians "away from the bedside," but as an ICU physician – who still spends an awful lot of time at the bedside speaking to my patients (or their conscious family members) – I worry more about technology that is driving physicians away from each other.

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to provide other relevant teaching (because the learner didn't know enough to know the question they should have been asking), and – and this is really important – to forge a bond based on mutual respect. Having the humility and diligence to ask for help is an incredibly powerful social signal.

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When I was a senior resident and an intern came to me to ask a question – having worked through the problem themselves but reaching the limits of their abilities – the interaction offered the opportunity to answer the question, but also for me to assess the learner's skills and knowledge,

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It also lays the groundwork for higher quality social interactions between practitioners. I was trained – and train learners now – in a medical educational model where learners at every level collaborate.

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Social friction is good. When you know you are demanding someone's time and incurring their judgment, you're more likely to work through a problem independently to the best of your abilities. This preparatory work makes the ultimate consultation more valuable to the patient and the practitioner.

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