I like the two-factor authentication feature of myOpenID powered by CallVerifID. The two-factor authentication works like so. You determine that a website offers compelling features and are ready to authenticate yourself (think stackoverflow.com). Provide your user id (userid.myopenid.com). You will be redirected to myOpenId.com. You enter your password. And wait. Within 15 seconds your phone rings and only after you verify over the phone, will the authentication proceed to the next step. I use this to logon to my HealthVault.

Great! Has always worked like a charm for me. But…

This month I am in Bangalore. Although CallVerifID is available in 30 countries, it’s not available in India, yet. So, for the entire month of July, I can’t authenticate on any website that offers openID authentication. For HealthVault, I can use my Windows Live ID as a backup but I suspect that I have two accounts on HealthVault, one tied to my myOpenId ID and the other tied to the Windows Live one. I can’t disable CallVerifID on myOpenId because myOpenId uses CallVerifID to logon to my myOpenID account. For now dead in the water. I am not ready to give up on the CallVerifID feature. I like it. Very much. Just need to figure out a way to make it globally portable even if CallVerifID is not available in the country I travel to. I guess the one piece of critical link in the chain is the ability to receive a phone call.

Given my passion for Health Care IT, it is only natural that I give Microsoft HealthVault a try. I have already downloaded the SDK and am waiting for our product rolls at work to be done to start playing with the SDK and creating my own application.

I plan to chronicle my experience using HealthVault here. And after I have explored it, I’ll move to Google Health and contrast my experiences with that application.

The first thing you do to get into your HealthVault is to navigate to the HealthVault website.

The home page for HealthVault looks like a typical marketing web page. The design is simple, clean, and unobtrusive. I like it. The sign-in option is at the top left corner, but in my opinion should be a bigger font. Very easy to miss and it’s blue on very light blue. Make it a little more prominent, and it will be easy to find. Click it and you are taken to the login screen.

You are presented with couple of options. You can enter your email address or sign in using OpenID. Ah! This is great. I have setup my open id with myopenid.com and I have set it up so that every time I logon using my open id, I get a call on my cell phone from myopenid.com verifying that I indeed did try authenticating on some website. This is great and especially important on a cloud application that promises to hold all kinds of health information imported from all providers. So I click on the OpenID link, enter my open id. In the screenshot below, I have xxed out my open id, but here is what I get when trying to use open ID

Communications problem! What? I can’t sign in using my open ID? What kind of communications problem are we talking about here? And this has been going on for quite sometime. I have been trying to login using my openID since I created my account. Yes, I know HealthVault still sports the BETA tag, but implementing an openID authentication scheme should not be that hard. stackoverflow.com does it. Not impressed, yet.

However what impressed me is the responsiveness of the HealthVault team. I tweeted my issue and a few hours later, @HealthVault responded to my tweet and I got an email from a HealthVault team member requesting additional repro information and an assurance that the team will look into it. Great job folks!

Update: I figured out the bug. Here is what is happening. If you type in https://name.myopenid.com and click Sign In, you will redirected to the openID provider’s (myOpenId.com) site where you can authenticate. However, if you type in https://firstname.lastname.myopenid.com, you will receive the error shown in the screen shot above. My guess is, https://firstname.lastname.myopenid.com is being parsed and the extracted provider ID is lastname.myopenid.com and not myopenid.com and therefore results in a communication error because there no provider called lastname.myopenid.com. A simple parsing bug. Hope the HealthVault folks can fix it soon.

So the only alternative, at least for me, is to use Windows Live ID. My issue was, I had a weak password for my Windows Live account because I use it only to view MSDN Live meeting screen casts. The first order of business was to strengthen my Windows Live ID password. Once you successfully login, your home page will look like so

There a host of tasks that can be completed. I’ll delve into each of the available tabs in future posts and also share my opinion. HealthVault is being billed as a consumer focused and consumer centric application. Let’s see if it truly holds up to the promise. Stay tuned.

Thanks to Cesar Torres (@HIMSS), I got a VIP invitation to the HiMSS Virtual Conference and Expo. If I were to use one word to describe the experience, it would be – AWESOME.

I have been to many conferences, mainly hosted by Microsoft, but this is my first time attending a Virtual Conference. And it was completely beyond expectations. This is what the main screen looks like. You can mouse over various venues and click to enter, say the Exhibit Hall, which hosted a few familiar and a few not so familiar vendors.

Although I did not get a chance to attend any live presentation during the day because of work, I did “wander” around a few vendor booths and register for giveaways. These vendor booths are just like the physical booths at real conferences. You have the vendor staff on hand to answer any questions, you can browse the available literature, or participate in an open chat. Just like in the physical world, when you “walk-up-to” a booth someone will greet you. I was surprised not to see Microsoft or Google. Both are trying to market their consumer Health Records Management systems. Microsoft, probably, is getting ready for the Connected Health Conference. Next year?

The navigation links at the top guide you to the various sections and you can wander around to check out the action. Another neat feature is the Tote Bag. This is a one-stop collection of all “conference goodies”, articles, information brochures, white papers, podcasts and a host of things. All these can be downloaded.

The lounge is an interesting place. You can strike up conversations via the chat and expand your network. You can look up who is online using the Who’s Here link. Click on a name and you can drill down into additional information. Cool feature – Send VCard.

Overall, I am very impressed by the sophistication of the event. I wish there were more vendors. Can’t wait for day 2. I hope I can find some time to attend a few live sessions I am interested in.

Unit Testing ASP.NET? ASP.NET unit testing has never been this easy.

Typemock is launching a new product for ASP.NET developers – the ASP.NET Bundle – and for the launch will be giving out FREE licenses to bloggers and their readers.

The ASP.NET Bundle is the ultimate ASP.NET unit testing solution, and offers both Typemock Isolator, a unit test tool and Ivonna, the Isolator add-on for ASP.NET unit testing, for a bargain price.

Typemock Isolator is a leading .NET unit testing tool (C# and VB.NET) for many ‘hard to test’ technologies such as SharePoint, ASP.NET, MVC, WCF, WPF, Silverlight and more. Note that for unit testing Silverlight there is an open source Isolator add-on called SilverUnit.

The first 60 bloggers who will blog this text in their blog and tell us about it, will get a Free Isolator ASP.NET Bundle license (Typemock Isolator + Ivonna). If you post this in an ASP.NET dedicated blog, you’ll get a license automatically (even if more than 60 submit) during the first week of this announcement.

Also 8 bloggers will get an additional 2 licenses (each) to give away to their readers / friends.

Go ahead, click the following link for more information on how to get your free license.

I am a fan of John Halamka, Mr.Healthcare CTO and hope to be able to become like him. In his recent blog post, Mr. Halamka talks about cloud computing and how cheap computers deriving their power from the cloud can help cut costs in the healthcare industry. In my previous blog post on Accelerating the adoption of EHRs (Electronic Health Records), I was kind of alluding to leveraging the power of “the cloud app” to speed up the adoption of EHRs. I wondered why a 3rd party vendor cannot build an interface to either Google Health or Microsoft HealthVault and give away such an application to primary care facilities. As was pointed out in the comment, McKesson’s Relay Health division, in fact, has been closely working with Microsoft in developing such an interface which will allow easy import of health records into HealthVault. This is a great first step. However what I proposed is something different.

Consider the diagram below. I have drawn it on a real napkin to emphasize the fact that this is a rough, grossly simplified draft of my understanding of the healthcare setup based on my interactions with various touch points.

The typical “actors” here are, the individual, the primary care doc’s office, the dentist’s office, the big insurance companies and of course the Internet which connects everything. HealthVault is the new kid on the block.

You visit a doc for the first time and you have to fill out couple of sheets of paperwork with the same set of standard questions. If you move to a new practice, you do this all over again. Just remember not to write your SSN. The doc’s office does not need SSN. They are not paying you social security. All the information you handed over goes into a “system”. Each primary care facility or practice may have a proprietary system which hopefully is developed to a set of standards. I know we have HIPPA and other regulations pertaining to medical records, but my point is that, your information is fragmented among various systems.

The current set of solutions provided by Microsoft HealthVault or Google Health involve the following steps:

1. You, the individual, have to create an account (free) on HealthVault.

2. You have to fill in the standard set of questions and submit your information to the system. DISCLAIMER: I have not created an account on either system so I don’t know the exact set of questions/forms you need to answer or fill out.

3. You will have to authorize the pulling (or downloading) of your health records from various providers. Your insurance company, your primary care facility, and any other healthcare providers that you may have interfaced with.

And step 3 is where I see a problem and unless we redesign the workflow we will never be able to achieve the goal of EHRs for the majority of the population. The very fact that you the individual has to create an account on HealthVault or Google Health assumes that you have access to a computer and are fairly competent in the use of one. That is a whole lot less number of people than there are in the country. Of all the computer savvy folks only those who want to take control of their data will be able to pull information into HealthVault.

Although this is a great first step, I think, we should turn the idea around and sell HealthVault as a free data repository solution to primary healthcare centers where most of the data collection happens. The folks at these primary healthcare centers, have no choice but to maintain the data collected in some form. So why not just store all that information in HealthVault? Granted the health records are *your* records and *you* should be responsible for them, but currently you have no control or easy access to this data anyway. Shifting the responsibility of moving the data into the cloud from individuals to those who already are engaged in the activity will greatly accelerate the move toward EHRs. Imagine the cost savings. The various providers will not have to maintain proprietary systems. They can better deploy such funds toward developing competitive advantages and providing better services to beneficiaries. And your records will be in a central repository.

I know I have grossly simplified the processes but we have to start somewhere and let this, the shifting the responsibility of moving data into HealthVault, be the first step toward a giant leap in Healthcare reform. Just ping me if I can help in any way

I picked up the book “The Future of Medicine Megatrends in Healthcare” by Stephen C. Schimpff from our local library, by chance. I can read too much into the coincidence given my interest in Healthcare in general and Healthcare IT in particular or just enjoy the fact that I relish reading anything and everything Healthcare. Let’s move on.

Healthcare as a system is a complex beast and most times players forget about the most important actor in this system. The patient. The human whose “issue” needs to be resolved. We have providers, insurers, benefits, plans, employers, lawyers, and law makers (and breakers). Most of these are working toward covering their behind. And in this complex dance, often times the beneficiary is forgotten or relegated to the back. This post is not about that.

Recently the Federal Health Architecture released the Connect system, an open-source scalable solution to help organizations tie Health IT Systems to NHIN (National Health Information Network). One of the key pushes of the current US administration is digitizing medical records so we can realize the dream of electronic health records (EHRs). Also, a while back, both  Google (Google Health)  and Microsoft (Health Vault) released their versions of consumer grade one stop Health records management system. I am not sure if this has hit widespread adoption. We are skeptical and are concerned about security and privacy issues.

And here is where, I think, a third independent player, say, McKesson, can come in and help move the adoption of electronic health records. How you ask. Where is the data collection happening? I would say, most, about 70% of the information, is collected at the primary care facilities that people go to for their routine illnesses and wellness checkups. So, instead of relying on the patient or people to put their data in the “cloud” (either Goggle Health or Microsoft Health Vault), McKesson can work with the primary care facilities and, give them a system that interfaces with both Google Health and Microsoft Health Vault and stores the data in both clouds. A double entry system. I said give. Yes give, like give away, free. Google Health and Microsoft Health Vault, I am sure, have API’s (Application Programming Interfaces) that lend themselves amenable to creating applications that encapsulate workflows of a typical primary care facility. So, McKesson can put together a high performance team to develop a software system, preferably a web application that can be installed on a single server. With McKesson’s reach in the Healthcare space (McKesson is *everywhere* in Healthcare), they can influence large numbers of these primary healthcare facilities to adopt their system. Throw in some free data migration consulting work too. What do the facilities have to lose? If a company like McKesson is giving your facility a complete system, why wouldn’t you take it?

What is McKesson gaining from all this? Remember McKesson is everywhere in Healthcare. They then make their big budget systems (say, Horizon HMS – Hospital Management System) consume the data from Google Health and Microsoft Health Vault clouds. Which could then be a leverage in the sale of such systems to the hospitals. Hey hospital, this many primary care facilities and doctor’s offices in your community use our other system which seamlessly interfaces with the HMS so you can concentrate on taking care of the patients and not worry about data import tasks. I say that is a big win.

I know I am making this sound simple. But, we have to start somewhere. Like the Micofinance movement to help alleviate poverty, an open source, free, patient healthcare records management system can drive the push toward electronic health records, lowering the healthcare costs significantly. Digitizing health records is a big first step and I think giving away free systems that leverage Google and Microsoft’s clouds is the way to go. Currently you and I don’t have any control over what software system, if any, a doctor’s office uses. We don’t even know if they have proper data security policies. I don’t think any doctor’s office will let you logon to system to check your records. If the Google and Microsoft clouds are used, we would have a ready made system in place for patients to check their records. What I am proposing is we shift the responsibility of feeding the system from the patient to the folks at the doc’s office who are already doing the work, except on numerous proprietary systems that may or may not talk to each other.

Anyone listening? Well, maybe I should get started on the project. Hey where are the API docs?

Quick tip:

If you are trying out the tweetsharp .Net C# API for twitter, remember that you will need to add the following using statements to your code to get the sample code working

using Dimebrain.TweetSharp.Core;
using Dimebrain.TweetSharp.Fluent;
using Dimebrain.TweetSharp.Extensions;
using Dimebrain.TweetSharp.Model;
using Newtonsoft.Json;

tweet away!

Writing unit tests is not something we are very good at on our team. Some of us truly believe and practice the principles of TDD to the extent possible and, others simply “don’t have time”.

We did impress upon our co-workers the importance of practicing the art of writing unit tests. Off they went to write their first set of tests. D came back with questions and our conversation went something like this

D: I wrote this unit test to test this method on the data repository class that calls this other thing. So what is my unit test doing?

I: It is testing the method on the repository class.

D: So AM I good here.

I: Well here is the thing. Your unit test is testing the method foo on the repository class. But foo is calling bar on the other class. When the test fails we don’t really know if the failure is in foo or bar.

D: Ah, I see. So what good is this test?

I: The test is good. Unfortunately we have to refactor the class so we can inject into the repository this other “provider” of bar.

D: Why would I do that?

I: That will allow us to use a mock object to mock up the provider, add some “known” expectations and exclusively test foo and only foo. Any test failure tells us that something is wrong with foo.

D: Ah Ha. The unit test exposed a flaw in our design.

I: B I N G O!! Another light goes on.

Here we go again. Hopefully, third time is a charm or it could turn out to be a third strike. And I am out. After failing not once, but twice, I am going to try again. This time, it’s yet another favorite community leader, Jeff Atwood of Coding Horror fame. Jeff and Joel Spolsky, co-founded stackoverflow.com, a go-to site for anything and everything computer programming. They also record a weekly podcast which is nothing but conversations on IT and is hosted on IT Conversations by The Conversations Network.

On behalf of all the programmers who have benefited from stackoverflow.com, I am organizing a fundraiser to raise money to sponsor an episode of the stackoverflow podcast. I got in touch with the folks at The Conversations Network and gathered that it costs about $500 to host and produce one episode of the stackoverflow podcast.

Fellow developers, let’s come together and raise money to sponsor an episode. I suggest a donation of not more than $10. With 550 pledges, we will have enough to cover the cost of an episode after fundable.com has taken its cut.

Let’s do it. Click here to go to the fundraiser page.

TIA

A HUGE thank you to everyone involved in putting together the fifth Atlanta Code Camp (March 14 2009). I attended a few useful sessions. Although I could not stay for the entire day, I gathered enough information that can be put to immediate use. Like tomorrow.

Having been involved, along with The Blogus Maximus (aka Chris Williams) and, Lou Vega, in putting together the very first code camp hosted by Greater Charleston .net User Group (GCNUG), I know what it takes to host such an event.

A huge shout out to Matt Ranlett (@mranlett), Brendon Schwartz (@brendonschwartz), The King of Linq (aka Jim Wooley) and others , for working tirelessly to make the code camp yet another memorable event. Thanks are also due to Glen Gordon, Developer Evangelist (Microsoft) for his continued support of all .Net user groups and their activities. Microsoft in Atlanta has been very supportive and has been lending their facilities in Alpharetta for user group activities.

I attended 3 sessions. Restful-WCF presented by James Ashley, ASP.net and jQuery – A Match made in Heaven by Glen Gordon and Entity Framework by Sven Aelterman. Except for the Entity Framework session, I can put things I learnt at the other 2 sessions to immediate use. Beware, here I come with a set of new hammers.

The Georgia Gwinnett  College facility is great. And it is a new facility. The main auditorium where we had the welcome talk is well built. I don’t think every one was wearing a mic, but I could hear them all loud and clear. Good acoustics.

I do have a complaint, if you call that, regarding the code camp. 9 tracks, in my opinion, is too many. 6 would have been ideal. But with 9, a *LOT* of topics were covered. How about two code camps per year? Atlanta can handle that. Maybe my complaint should be about not being able to attend ALL the sessions. At  least the good ones. I had to give up one too many. Short of breaking Heisenberg’s uncertainty principle, it is NOT possible to attend all the sessions you want to. That is sad. Well, there are the user group meetings. Some of the code camp sessions will be presented again at these meetings.

Overall, it was a short but fun day. Let’s do it again. And hats off to all of you who worked hard toward making the fifth code camp a great event. Thanks guys.