Ok I was planning to write a few word about this, actually more than few, but I realized that I won’t have the time for a long post for a few weeks, so here it is: a few points about PHR. Personal Health Record is a concept which is not generally pronounced as much as EHR, at least not in my usual environment. However, PHR has some very interesting opportunities, which deserve another post on its own. What I want to point out is that, Microsoft seems to be investing in the idea with HealthVault . It is not only Microsoft however, according to this article American Heart Association, Johnson & Johnson LifeScan, NewYork-Presbyterian Hospital, the Mayo Clinic and others are joining the initiative with Microsoft. Now when you have such big boys in a game, that’s a good one to have a look at. ...

Ok, I have to admit that I have been waiting for the new Ruby/Rails development environment from CodeGear (they are the development tools division of Borland), and finally it is released. At the moment my primary rails development environment is Netbeans 6 beta 1, and being an Eclipse fan, I really wanted to see some action in Eclipse front. My expectations got higher while I was downloading the trial version of 3rd Rails, since the feature matrix had some very nice remarks. First of all, please to all other teams building developer tools for rails: a better console would be nice! Just pressing the up arrow can repeat the last command, can’t it??? ...

Ruby on Rails is nice. It’s really nice. For most of my web development, I would not hesitate to use it. There are some aspects of it that I really like, and you can read a lot of things written by many others, explaining why rails is nice. The major problem is about scalability, and the way people see rails. It’s a young technology, and for those of us who have projects with certain demands, there is not much to do when it comes to choosing technology. For a large scale healthcare project that will use millions of records, I’d really like to use rails, but I know that it would be an adventure to talk about this in a meeting where there are people who will pay the money. Probably (actually most of the time. these days ) they will not be aware of ruby or rails, and when they hear that the project for which they will be paying will be built on a technology that they have never heard of, they will not be happy. The problem is not always about the technology, but also about the maturity of it, the brand of the technology. When you say Java or .NET, people do not usually object. Both of these technologies, especially Java has been a dependable, mature solution for quite some time. ...

Ruby on Rails is nice. It’s really nice. For most of my web development, I would not hesitate to use it. There are some aspects of it that I really like, and you can read a lot of things written by many others, explaining why rails is nice. The major problem is about scalability, and the way people see rails. It’s a young technology, and for those of us who have projects with certain demands, there is not much to do when it comes to choosing technology. For a large scale healthcare project that will use millions of records, I’d really like to use rails, but I know that it would be an adventure to talk about this in a meeting where there are people who will pay the money. Probably (actually most of the time. these days ) they will not be aware of ruby or rails, and when they hear that the project for which they will be paying will be built on a technology that they have never heard of, they will not be happy. The problem is not always about the technology, but also about the maturity of it, the brand of the technology. When you say Java or .NET, people do not usually object. Both of these technologies, especially Java has been a dependable, mature solution for quite some time. ...

Please ask yourself what is the holy grail of healthcare information systems? Your answer might not be same as everybody else’s but you can be sure that quite many people will name “interoperability”. Interoperability has been one if the most demanding, challenging demands of healthcare, and to be honest despite all the work, the problem still remains. However, at least we have standards like HL7 which has been alive for the last 20 years, we have initiatives like OpenEHR, EN 13606 etc. You can spend a lifetime on these subjects, and I actually know people who have done so, but for the moment let’s try to dream of that sweet future where we have no interoperability problems. ...

User interface design in health related software is a big problem. On one hand, you have a set of technical people who have a set of skills and produce results based on those skills, and on the other hand you have medical people who demand various functionality. The problem is, the skills and approach of technical people produce outcomes which does not always satisfy the users. In fact medical people rarely seem to be satisfied with user interfaces provided to them. I can’t remember how many times I have heard the following sentence from a doctor, when asked what he/she would like to see on the screen: “I want to see everything”. From a developer perspective fitting everything on screen has two basic issues: first, providing a lot of information on the screen does not mean that it can be easily used. Second: a lot information related to various factors in care process (current medication, prior treatments etc..) means collecting data from a lot of sources. Even if they are found in the same system, it is not easy for developer to put them on the same screen. The fundamental problem with developers is: we are continuously conditioned to think in terms of sub systems, clearly isolated from each other. Call it modules if you want, or frameworks, or libraries. “Divide and Conquer” is our motto. We do it for better performance of subsystems, and for better maintaining code later. Unfortunately, doctors are not interested in our technical success in managing a large chunk of code, they want “Unite and Conquer” for information when it comes to managing care process. ...

Well, I have been thinking about this for a long time, and I have managed to do it finally. I have a few domain names, for which I always have some thoughts, and of course I never have the time to work on those thoughts. This time I have made a change and bought myself a nice warm slice from slicehost. I have a linux server on my own now, and it is much more fun than any other shared hosting service you might have. One thing though : it is not easy to set it up! Still, after quite a bit of work, I have managed to put together all my domain names on one box, and so far, I am very happy with what I have. More to come on this, just wanted to say from my new home.

Ok, this was not expected, but it appears that Netbeans is about to present the best Ruby on Rails ide to the market. I have been using Netbeans for about 5 years now, and for the last 2 years I have only set it up for J2ME development. It appears that Netbeans team has been working very hard, since what I saw in Netbeans 6 Milestone 10 is very, very promising ...

Just like every other software developer who constantly dreams of having a tool that will fix at least some the usual problems of software development, I am really interested in new tools and languages Ruby on Rails has been gathering a lot of attention for quite some time, and I have been considering giving it a try. One of the things that I have learned in the past is that you need a purpose to actually use a tool. Other than that, you’ll usually be taking a look at it, you’ll have a broad idea of what it does, but you’ll never really understand why it is good or bad. ...

No matter how hard you work on your code, at some point you’ll have to use a debugger. For rails, the most painful part of all the development process is debugging. Well it was up until now, but thanks to ruby-debug and its integration with aptana, I can debug my code just as fast as any other development environment. Before I used ruby-debug, it was simply not possible to use the debuggers that comes with aptana or komodo ide. They are so slow that you find yourself pulling your hair. I have seen many posts saying that you don’t need a debugger so often when using rails, but I can’t say I agree. I want my debugger! All I had to do was to type gem install ruby-debug-ide and change a configuration in aptana. Now I have debugging at a speed that does not make me think about suicide. And to make it work in ubuntu (if you get errors during ruby-debug-ide installation), use : sudo apt-get install ruby1.8-dev