Healthcare delivery systems : Win apps or Web apps ?

A couple of weeks back, while I was contemplating on the health-care software delivery to a wide variety of users, I was inclined to realize that not one mode of delivery (either window-form based or web-form based) was suited to all with the same rate of acceptance. To help understand better, the users of the products/portals we develop include

  • Site administrators
  • Departmental administrators/supervisors
  • Physicians
  • Nurse(s), hospital/clinic staff
  • Brokers
  • Plan administrators
  • Company representatives (for small/large groups)
  • Underwriters
  • Medical underwriters
  • Account managers
  • Data-entry personnel
  • Support personnel
  • ….amongst others who are specific to the health insurance company we are working with.

With such a diverse population involved, the need for a web/win application depend on the frequency of usage of the system, and the amount of rich functionality that they require.

For example, a member (like you or me who are getting insurance from a company), will use the application for registering self and family, answering the medical questionnaire that describes the conditions me/my family might have, and a bunch of agreements along with the rates that the insurance company may want to offer. After this, a member’s interaction with the system is mostly for routine stuff like

  • Change the Primary Care Provider (PCP)
  • Change his address (so long as he/she is under the insurance coverage)
  • Change his contact details
  • Check out the claims submitted/approved/rejected (depending on how much the insurance company wants you to see)

A member is a perfect example of designing a member portal as a regular web-application on any browser.

However, when the staff members, underwriters, administrators, physicians want to use the same system, they are certain to have much more richer functionality than a web-application can seem to offer. Even with the latest advancements in web technology, the gap between rich client applications and rich Internet applications is still there. With such a requirement to meet to cater the needs of diverse sects in the intended population, there needs to be a hybrid approach or maybe a completely new revolutionary approach.

  • Sandboxing : This is the process of customizing the intended browser to make it more distraction-free, and clutter free. One approach to do this would be to strip the browser of everything and just keep the shell with a status bar that hopefully will be used as a regular one along with taking care of the settings for the shell. As I learnt today, Mozilla is coming up with something very similar in theory, and it has been christened as “Prism“. Though their concept is similar to mine, there remains an imminent issue of making it absolutely generic to support all kinds of clients, many an issue can come up thanks to the varied style of handling JS, CSS and the programming language of choice. However, in all honesty, I don’t think this would be an issue by the time they get it out to the public.
  • Always-connected : This approach would simply ask one to develop both windows applications and web-applications. Agreed that this is kind of a nightmare for small companies, but take the case of MS Money suite, and the newly released MS Healthvault. The idea of having a windows-app and a web-app at the same time is giving the end-user the choice of picking his/her comfort level, and catering his/her needs the same way irrespective of his/her choice. Unless there comes a time when the slowest internet-connection available has upload/download speeds at a minimum of 4Mbps/4Mbps respectively. Google gears also does a good job of this with Google Gears, but the technology has a long way to go to be mature and widely accepted. Trust in the storage provider is a major hurdle in this approach. How many of you would trust your health-information to any one other than yourself and your doctor. Heck, we don’t even have an option to opt out of “web-access” to the insurance company portals showing everything about you and your family’s health.
  • Web-desktop : There are a few approaches in this direction, however none are competent enough to provoke a shift in healthcare delivery.

In conclusion, depending on the size of the health-care company, one would choose either Sandboxing or Always-Connected approach. However, unless the web app technologies comes up with some ground-breaking advancements, this is what the future of healthcare delivery will be.

9 notions of innovation

  1. Ideas come from everywhere.
  2. Share everything you can. (Every idea, every project, every deadline – all accessible to everyone on the internet)
  3. Intelligence over experience
  4. Spend one day per week pursuing your own dreams.
  5. Innovation, not instant perfection.
  6. Don’t politic, use data
  7. Creativity loves restraint.
  8. Worry about usage and users, not money.
  9. Don’t kill projects, morph them


Source attribution : Found this on some business site….about Google.

7 secrets of successful programmers

1. Code for human consumption

It is one of the most pervasive misunderstandings in computing that the source code is for the computer’s consumption. Computers work with low-level binary code, a series of impenetrable 1’s and 0’s or hexadecimal numbers, not the structured high level languages we code in. The reason that these languages were developed was to help the programmer.

In practice, coding for human consumption means coding for clarity first, over efficiency and speed second.

2. Comment often and comment well

The comment is the extreme example of a language element for human consumption. Most compilers will strip the comments from the executable program. The purpose of the comment is to tell you (and any future developer) what the program is intended to do. Write comments with this in mind – and avoid simply restating the code.

Good comment: Disable button to prevent its activation Bad comment: Set cmd = False

A good indication that you have got the level of comment right: could someone understand what your program does if all but the comments were removed?

3. Layout code to increase legibility

Just as it is important for an author to split a book into chapters and paragraphs that aid reading so it is important for the developer to consider the layout of the code and how that can aid readability of the code. In particular any code branch (an IF..THEN…ELSE construction) and any code repetition (a WHILE…END WHILE construction) should be indented so that it is easy to see where they start and end.

4. Expect the unexpected and deal with it

Before you open a file, make sure that the file is present. Before you set focus to a control, make sure that the control is visible and enabled. Try to work out what conditions could cause your code to fail and test for them before they cause the program to fall over.

5. Name your variables to aid readability

There are a number of strategies to variable naming. The key is to be consistent and to be as informative as possible. If you name a variable nMonth, you give the programmer extra information as to what that variable is expected to contain. I personally prefer the Hungarian notation style – but whichever style you use, consistency is the key.

6. Keep your functions and subroutines simple

A function or subroutine should ideally only do one thing. One of the greatest sources of misunderstandings, in my experience, is a subroutine that does a number of different operations. This should be split into separate functions for each different thing it is doing so that these in turn are easy to reuse, and the scope of a code change is easy to understand.

7. Scope functions and variables appropriately

Functions and variables that are only used in one module should not be visible outside that module. Variables that are only used in a function or subroutine should not be visible outside that function or subroutine. This prevents any use of a variable or function outside of where it makes sense to use it.

There are many other hints and tips which can help you become a better programmer, which will make you more efficient and the programs you write more maintainable, but the seven secrets listed above will serve as a good foundation – however high you build upon them.

2007 : Predictions


All video-sites (you-tube[google video], yahoo video, aol videos) will face a tough time…with lawsuits. Simply said, they are going to be the video version of what the old napster used to be. Heck, I can see full-length movies on these sites without even having to get a DVD myself. Eventually the DRM guys and the RIAA will end up trying to show their holy round ass and stick it up to all these companies.

Too many of “Loading” / “Waiting” screens.

The web is going to be a bit more slower. Newer technologies are going to make more richer internet applications…and they are going to concentrate on marketting with the “replacing your desktop applications”. This will end up becoming a fad someday soon. Though the telecom guys are doing their job of trying to give us faster ethernet connection speeds, lets face it …. not all can really afford it…not for the next few years for sure.

Websites = Website Services

Most of the portals and the tech celebrity websites are going to have their own API’s and web-services published for other’s to consume. This will lead to all the lesser known tech bloggers/site-owners to start consuming their services and place them on their own site, there by having a continous supply of content for their own website. People can get more creative and do a mix-n-match, to best suit the site-visitor’s needs. Sad part about this is there are multiple points of failure.

Example : If I have Scooble’s feed also coming onto my website/blog. And lets say…considering Scooble’s. Everything works fine…so..great. Suddenly Scooble’s decides to take his blog down, and go to the mountains, trying to understand the true meaning of life, thereby abandoning everything techie. Now, thanks to Scooble’s decision, soo many other websites are gonna go down. This is a naive example, but soo many people loose their domain names, thanks to procastination, domain-name-stalking,etc. With over a 100 million domain names already in existance, and soo many bloggers desparate to drive traffic to their site, multiple points of failure are bound to pop-up, and it will all eventually come crashing down.

Google’s honeymoon.

Microsoft’s Bill Gates called it Google’s honeymoon, but the amount of disk-space that Google is currently handling and the gradual increase in the services it offers, looks like unless there is growth in its adSense program’s revenue, it could make it a paid-service. And if Google starts making its offerings as paid-services, chances are Google’s honeymoon is going to end. And also take into consideration the thought in everyone’e head that Google is a better version of Yahoo…but bottom line…its just another Yahoo.

Towards a better mark-up language.

Based on the amount of work required to make web-sites, chances are there will be some kind of baby-steps that will be taken towards the creation of a newer mark-up language. Advantages of this would be more comprehensive html for starters, then richer support for multimedia, extensive wiki style of layout.


With IE 7 taking its first step towards standard CSS compliance, chances are Microsoft will look towards standardizing other stuff like multi-media delivery on the web to desktops, mobile phones, etc.


Doctors will continue to get expensive, but the healthcare premiums will see a lesser jump in their standard yearly increase. This may not quite be reflected this year, but there will be steps towards it. With the so-called “digitization” of healthcare records all-over, and companies claim to reduce the operating costs for healthplans by as much as 40% (ikaSystems, IBM, etc), we will see more advances in healthcare management over the net. This also includes richer versions of WebMD, with more healthplans taking similar approach. This will be one more boom, but will take a while for this bubble to bust.

Web 2.0

More and more companies will try to invest in their look and feel, not simply coz they want to, but they will have to…simply to stay abreast with their comptetion, and yeah..their way of saying it that they are always “Working for you“.

Syllabii upgrade

Considering the way the industry is heading, chances are that the university syllabus for Computer Science guys is bound to change to incorporate more specific technologies  in addition to their standard basics.

2006 : What did I learn?

Just when I was going through Instigator’s blog, I came across a call for group-writing where he asks the question of the year-end….”What did I learn?

And here are my thoughts.


  1. The importance of patience in every situation.
  2. The strength of silence.
  3. The beauty of simplicity in code and design.
  4. The art of winning an argument.
  5. The science of convincing anyone.
  6. The pain of seeing someone you love shed a tear.
  7. The joy of simple pleasures.
  8. The ecstasy in being recognized
  9. The humbleness in being referred to.
  10. The responsibilities involved in taking care of your loved one.
  11. The passion in a developing relationship.
  12. The sense of maturity that comes during the final stages of bachelorhood.
  13. The knowledge of knowing a little more of how stupid I am/can be.
  14. The wisdom of learning from my mistakes…and making newer ones.
  15. That technology is just a tool….newer ones keep coming…but the job still remains the same

When God created father’s…

When the good lord was creating fathers, he started with a tall frame. A female angel nearby said,” What kind of father is that? If you are going to make children so close to the ground, why have you put fathers up so high? He won’t be able to shoot marbles without kneeling, tuck a child into bed without bending, or even kiss a child without a lot of stooping”. And God smiled and said, “Yes, but if I make him child size, who would children have to look up to?”

And when god made a father’s hands, they were large and sinewy. The angel shook her head sadly and said,” Large hands are clumsy. They can’t manage diaper pins, small buttons, rubber bands on pony tails or even remove splinters caused by baseball bats”. And God smiled and said,” I know, but they’re large enough to hold everything a small boy empties from his pockets at the end of the day, yet small enough to cup a child’s face.”

And then God molded long, slim legs and broad shoulders. The angel nearly had a heartattack. “Boy, this is the end of the week all right,” she clicked. “ Do you realize you just made a father without a lap? How is he going to pull a child close to him without the kid falling between his legs?”. And God smiled and said, “A mother needs a lap. A father needs strong shoulders to pull a sled, balance a boy on a bicycle or hold a sleepy head on the way home from a circus.”

God was in the middle of creating two of the largest feet anyone had ever seen when the angel could contain herself no longer. “That’s not fair. Do you honestly think those large boats are going to dig out of bed early when the baby cries? Or walk through a small birthday party without crushing atleast three of the guests?” And God smiled and said, “they’ll work. You’ll see. They will support a small child who wants to ride a horse to Ban bury cross or scare off mice at the summer cabin or display shoes that will be a challenge to fill.”

God worked throughout the night, giving the father a few words but a firm, authoritative voice and eyes that saw everything but remained calm and tolerant. Finally, almost as an afterthought, he added tears. Then he turned to the angel and said,”Now, are you satisfied that he can love as much as a mother?”

– Erma Bombeck

When God created Mother’s…

By the time lord made mother’s, he was into the sixth day of working overtime. The angel appeared and said, “Why are you spending so much time on this one?”. And the good lord answered and said, ”Have you read the spec sheet on her? She has to be completely washable, but not plastic; have 200 movable parts, all replaceable; run on black coffee and leftovers; have a lap that can hold three children at one time and that disappears when she stands up; have a kiss that can cure anything from a scrape knee to a broken heart; and have six pairs of hands.”

The angel was astounded at the requirements for this one…”Six pairs of hands ! No way !” said the angel.

The lord replied,”Oh, it’s not the hands that are a problem. It’s the three pairs of eyes that mother’s must have !”

“And that’s on the standard model?”, the angel asked. The lord nodded in agreement, “Yepp, one pair of eyes are to see through the closed door as she asks her children what they are doing even though she already knows. Another pair in the back of her head, are to see what she needs to know even though no one thinks she can. And the third pair are here in the front of her head. They are for looking at an errant child and saying that she understands and loves him or her without even saying a single word.”

The angel tried to stop the lord “This is too much work for one day. Wait until tomorrow to finish.”

“But I cant !, “ the lord protested , “I am so close to finishing this creation that is so close to my own heart. She already heals herself when she is sick and can feed a family of six on a pound of hamburger and can make a nine year old stand in the shower.”

The angel moved closer and touched the woman, “But you have made her so soft,Lord”. “ She is soft”, the lord agreed, “but I have also made her tough. You have no idea what she can endure or accomplish.”

“Will she be able to think?” asked the angel. The lord replied, “Not only will she be able to think, she will also be able to reason, and negotiate.”

The angel then noticed something and reached out and touched the woman’s cheek. “Oops, it looks like you have a leak with this model. I told you that you were trying to out too much into this one.”

“That’s not a leak…” the lord objected. “That’s a tear !”

“What’s the tear for?” the angel asked.

The lord said, “the tear is her way of expressing her joy, her sorrow, her disappointment, her pain, her loneliness, her grief, and her pride.”

The angel was impressed. “You are a genius, lord. You thought of everything for this one.You even created the tear. !”

The lord looked at the angel and smiled and said, “I’m afraid you are wrong again my friend, I created the woman, but she created the tear. !”