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SPM member Fred Trotter is a member of the open source / innovator community that knows “hacker” as a noble word – people who disregard how something was intended to be used (by its designers) and rearrange the parts to suit their needs. Today on the O’Reilly Radar blog he post a truly great introduction to e-patient-hood: “e-Patients: The Hackers of the Healthcare World:  A quick reference for becoming an empowered patient.”

If you’re not familiar with this original meaning of “hacker,” see this description of the “hacker ethic” from the Wikipedia article on Steven Levy’s 1984 book Hackers: Heroes of the Computer Revolution:

  1. Access to computers—and anything which might teach you something about the way the world works—should be unlimited and total. Always yield to the Hands-on Imperative!
  2. All information should be free.
  3. Mistrust authority—promote decentralization.
  4. Hackers should be judged by their hacking, not bogus criteria such as degrees, age, race or position.
  5. You can create art and beauty on a computer.
  6. Computers can change your life for the better.

Not coincidentally, those principles exactly describe the “Hard Hats” (docs programming for themselves) who created the VistA system at the VA. Long ago I blogged about them while reading the excellent Best Care Anywhere.

p.s. As far as I know, the term originated in the MIT Model Railroad Club in the 1950s, in which members would get under the table and “hack” the wires to make things happen in ways beyond what the piece-makers intended. According to legends I’ve heard (which must be authoritative), this extended to “hacking into” a distant Coke machine down the hall and running a long wire to the club’s room, to let members know when the machine was empty and avoid pointless Coke runs.


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