Earnest Engineer

In watching advances in medical devices, it's obvious the trend is pushing devices out into patients hands. This allows diagnostic tests to happen when they are needed during the patients normal life, rather than simply at the point of care. This allows right time diagnostics.  For other patients isn't the necessity of catching a problem at the right time, but getting the diagnostic devices to where the patient is, rather than the patient coming to the diagnostics. This allow devices to be in the right place. This is enabled by the ubiquity of smartphones - capable computers which disguise themselves as consumer communications devices. In this arena, there is a recently introduced ECG device from Sanatmetal called WIWE . It communicates via Bluetooth to the users smartphone, which provides the visual output and feedback as well as communications back to the clinicians who will use the data collected. This is a good example of creating a "Right Time" diagnostic to

To maintain secure computer systems, in the past the basics have been tasks like keep systems updated, run anti-virus software, use a properly configured firewall,use a filtering proxy for access to the internet. The advice on basics has been mechanistic in the past - make the machinery protect itself was the ideal and most hoped-for outcome. The new Basics include the old things and add: Establish a Security Culture Maintain Good Computer Habits  Plan for the Unexpected Control Access to Protected Health Information (from  Top 10 Tips for Cybersecurity in Health Care ) What's interesting about the new Basics is the additional items all have something in common: People. Each item focuses on how people interact with the systems, what they should expect and look for in terms of benefits, risks and dangers, and the fact the use of computers and computerized machinery must always remember the human elements for mistake, misuse and out-right abuse. Why Is Cybersecurit

Doing some security reading, I came across a post from Bruce Schneier about voting and technology. It is part of a continuing thread in his blog and is quite timely. Securing Elections . As a software engineer, I agree with Schneier and I think that working on secure, distributed, open and widely implemented voting registration system and tabulation systems would be interesting - both technically and socially. I have up-close experience (as a candidate in small city) with the tabulation process and I was surprised by the apparent lack of tools to expedite, verify, validate and secure the process. This piqued my curiosity further, to no particular end. Given that, I started searching the web for open voter registration and I found the Voting Technology Toolkit . An online sample of voter registration can be found at Trust the Vote demo project (Virginia) . or even better at Rock the Vote . Another system is Civitas , a NSF funded project from Cornell which is interesting for it

Right from the get-go, I was intrigued by this post which used the phrase "Data Liquidity" since this term is new to me, but I grasp a meaning for it right away. The post points out the importance of interoperability for care continuity and how this impacts value and quality driven care. As a technologist, ideas and concepts like this always interest me and it represents an area I've dealt with as a software engineer responsible for tying systems together into a coherent whole. I understand the need for continuing technology improvements in this area. But an even more frustrating and worrisome impediment to data liquidity are institutional barriers . I have often run into mazes of siloed data, groundless HIPPA fear-reactions, lack of data management infrastructures, turf wars and other strictly institutional impediments . I understand that hospitals and healthcare systems are large and complex organizations. But I find that often the data management policies in bu

Here is a glossary of terms useful in Healthcare and Health Informatics ACO (Accountable Care Organization) MEDICARE’s outcomes-based contracting approach Arden Syntax an approach to specifying medical knowledge and clinical decision support rules in a form that is independent of any EHR and thus sharable across hospitals ARRA (American Recovery and Reconstruction Act) the Obama administration’s 2009 economic stimulus bill Blue Button an ASCII text based standard for heath information sharing first introduced by the Veteran’s Administration to facilitate access to records stored in VistA by their patients. The newer Blue Button + format provides both human and machine readable formats. CCD (Continuity of Care Document) an XML-based patient summary based on the CDA architecture CCOW (Clinical Context Object Workshop) an HL7 standard for synchronizing and coordinating applications to automatically follow the patient, user (and other) contexts to allow the clinical u

There is a discussion draft  of a house bill called the ‘‘Active Cyber Defense Certainty Act’’. This would relieve a victim of "persistent unauthorized intrusion of the individual entity’s computer" from the risk of prosecution for using active defense measures against the intruder. This is an interesting new ground it seems. I think efforts like this, "hacking back" were often considered cowboy moves, discussed on in sotto voce, since it was not an "authorized" strategy. This article on the proposal  discusses the potential hazards of the law and using hacking back as a tool for cyber defense. While it is good to see attention being paid to cybersecurity in law, there needs to be an intelligent debate and a resulting well-crafted law which helps to define sensible boundaries. Think of areas where "hacking back" could simply be used as a defense for what was actually an offensive maneuver for instance. If you have experience and knowledge applica

I have been caught at odds when asked about some of the key differences between Object Oriented Programming and Functional Programming. In fact I’ve felt somewhat like a fraud, in that I regularly work in both paradigms. I often keep in mind the many of the precepts of functional design in the methods of objects I am creating. So, I was looking to see what others had to say on FOOP (Functional Object Oriented Programming - or perhaps POOF “Programming Object Oriented Functionally”?) and I came across a post on Lambda the Ultimate which let me know I am not alone. This lead me on to further investigations on the questions I was pondering such as where the different types of programming work - and when they don’t. A good synopsis of this started on Stack Exchange of course... These readings exposed me to a key nub of the problem - concisely stated, which has the name of “The Expression Problem”. The expression problem is well stated in the best answer in the stack exchange po