Future of Health IT: Trends and Scenarios

SERENDIPITY: Older Wiser Wired

While looking at the Guidelines Sorting Tool, a cool feature of the US DHHS's usability.gov guidelines tome, I stumbled across the AARP's subsite on computer use by adults over 50 - Older Wiser Wired - Adults over 50 Online, Life and Living - AARP. 

This is a great find for those of us interested in making our Websites usable to persons other than college sophomores and baristas, who in any case spend most of their time on MySpace, YouTube, Second Life, World of Warcraft, and Google Everything rather than visiting the sites and applications we build and the blogs we write.

Agent Architectures - the next paradigm for software engineering?

Just about the time I got back from my vacation, HISTalk posted a very interesting interview with Novo Innovations CEO Robert Connely. In it, they discuss in some depth the way Novo's EMR synchronization solutions work. They have had what appear to be some remarkable successes integrating hospitals and labs with community clinics, not just one-offs but across what sound like some mid-sized health systems (check out the Company News items on the right side of their Website) and a one-pager about their implementation at Atlanta's Northside Hospital [pdf], a 455-bed community hospital with 1450+ physicians on staff.

What caught my eye is that they are using an agent-oriented distributed architecture. This is one of the architectures that I believe will dominate the future of healthcare informatics, as I predicted in my 2001 scenario planning paper on application architectures. But - such architectures present challenges in terms of performance and security, and can be awfully hard to debug when things go bad.  Still, Novo's example is worth studying if you are responsible for designing large-scale systems, particularly in the healthcare arena.

A Toy Story - Patrick Baudisch's projects

Some people definitely have jobs that are more fun than mine. Take a look at Patrick Baudisch's projects and you'll see what I mean - his job is probably more fun than yours is too. Patrick works for Microsoft Research, one of the great sources of innovative ideas, even if its parent organization is the Borg. Whatever. This post is about toys, not commerce or politics.

I got turned on to his work through a recent article in IEEE Computer that I finally got to read over lunch today. The article was called Interacting With Large Displays, and it describes some of his work regarding the pains that accompany the joy of having a wall-size display "monitor" for your computer. His solutions for these problems are truly fascinating.

More on the Linux Wearable Computer

(Click to enlarge)

Yesterday I put up a quickie about a post in The Positive Technology Journal regarding a wearable Linux computer targeted at the healthcare market. I took a look last night at the Web page describing this new toy, the Zypad WL 1000 from Parvus Corporation. I have mixed feelings about it - I love new gadgets as much as anyone, am enjoying learning to hack Linux, but feel like this may be a bit ahead of its time, at least in the healthcare market.

A better way to browse the Web: Google Notebook

I often wish for a better way to browse the Web than what I have had up to now. The way I work, like many people, is as Marcia Bates described in her invention of the berrypicking metaphor for search - I wander here and there, following a train of thought; I get diverted onto a side path; I pick up bits and pieces here and there, like berries in a berry-patch. You can read her 1989 paper, the Design of Browsing and Berrypicking Techniques, at http://www.gseis.ucla.edu/faculty/bates/berrypicking.html.

Delicious (http://del.icio.us) has been the best tool for this up to now, at least the best I've found. But Delicious breaks my chain of thought by taking me off to another Web page every time I want to record something for later.

Now, though, there's what looks to be a better tool, from the folks at Google Labs: Google Notebook. I haven't played with it much, so I'll be sure to report on it more later. It's a browser plug-in, for IE only so far, that lets you gather text and images and save them for later, without leaving the page you're on. You select text or an image and right-click on it. If you haven't selected anything, it captures the URL and the page title. This may be the best tool yet for online search and browsing.

The Clinical Trials Management System Marketplace

I recently re-visited a report issued by IDC a year and a half ago, which you can still find on Oracle's Website (http://www.oracle.com/industries/life_sciences/IDC_CTMS.pdf).  In retrospect, given what I know now about the future direction of clinical research, what's most interesting is not what's there, but what's missing.

Quickie: Software Development: Google's GWT Example: Interactive FIFA 2006 World Cup Application

There is a great blog post and sample application showing off Google's recently-announced Google Web toolkit or GWT. The post is at Jose Sandoval - Software Developer - Software Development: Google's GWT Example: Interactive FIFA 2006 World Cup Application.

Here's a quote to give you a taste of what's there:

The key feature of this API is that developers never code JavaScript to control the UI. Everything is coded in Java, and the provided compiler generates all the functionality in a language (HTML and JavaScript) that is understood by different web browsers.

The application works fine in IE6 on Windows XP, but some of the comments indicate that FireFox 1.5 isn't working.

Write Java, compile to a thin-client Web app: what could be tighter than this?

EDS' Next Big Thing Blog: Models with Alternative Vocabularies

I often look to the EDS Fellows' Next Big Thing Blog for ideas about the future of technology. Although a bit more uneven and cursory than some of the quality blogs by mavens at Microsoft and IBM, the EDS Fellows can be counted on to be at or near the cutting edge of the IT world. A recent entry entitled EDS' Next Big Thing Blog : Models with Alternative Vocabularies is a great example, and one with tremendous practical implications for those of us in health IT and clinical research informatics.

The Healthcare IT Guy - XML data models are viable alternatives to relational data models in healthcare systems

Healthcare IT Guy blog. the post, entitled XML data models are viable alternatives to relational data models in healthcare systems, resonates with my experience and made me think hard about my own assumptions and preconceptions in these topics.

UPDATED: Towards 2020 Science

UPDATE 3/31/06: A colleague pointed out to me that this site reports the same research described in the Nature Web Focus site I mentioned in my earlier post entitled Quickie: 2020 Vision @ nature.com. I haven't delved into either enough to know if I'm being redundant here - apologies if I am. I only have a life where I can read at leisure on the weekends, and both items are in the queue, both of things to read and things about which I hope to say something intelligent sometime in the future.

Many of the blogs that popped up today on one of my trolling searches (Dr. Web's Domain and Psychology and the Singularity, to name a couple) are bombarding me with pointers to Microsoft Research's new site called  2020 Science that encapsulates the results of their "Towards 2020 Science" effort. The description in the opening page's meta tag is this:

2020 Science sets out the challenges and opportunities arising from the increasing synthesis of computing and the sciences. It seeks to identify the requirements for technology to accelerate a decade of scientific advances, particularly those driven by computational sciences and the new kinds of science the synthesis of computing and the sciences is creating. Already this synthesis has led to new fields and advances spanning genomics and proteomics, earth sciences and climatology, nanomaterials, chemistry and physics.

I have just begun to delve into this, but it seems to be the deep-ocean equivalent of the little frog-pond in which I have been immersed, trying to get my colleagues focused on taking the future potentialities seriously.