My Medical Records

Medical records need disrupting. I’ve made little quips here and there on Twitter about this. I should own my medical records and they should be shared with physicians and their facilities as needed.

Why? In the words of Joe Biden “None of your business.” Seriously though, why should our medical records be locked in a system we cannot access? We can learn something from Twitter, Facebook, and Google. We should own our medical records — via an open standard — and allow doctors and hospitals to ask our permission to see them. Much like friending someone on a social network. The doctor looks me up, asks if they can see my records, I get a message saying the doctor would like access to my records, and I choose to let them or not. My choice, my records.

Case in point. I have a problem with one of my knees. In 2004 I had surgery to remove cartilage, a bone spur, and some arthritis from that knee. It was a fantastic decision. It made my day to day life much better. Fast forward to 2017 and that knee has become an issue. It hurts — constantly, it swells, on occasion it fails causing me to stumble, and it’s unstable. I don’t trust it and I’m tired of the constant pain it causes.

Getting to the point. I made an appointment with my family doctor to discuss the problem. Before going I tried to locate the doctor that did the surgery back in 2004, but she’s moved on. I contacted her old group to see if they had my records. Nope. All they have are records dating back to 2006. Ok, no proof of the surgery and more importantly I don’t have a record of what was done to the knee. Swell.

I visit my doctor last week. Tell her what’s going on. She puts the knee through some tests and understands there is something going on. Great. I explain there is a history here but I cannot tell her exactly what was done. My only explanation is I had surgery in 2004 to do X, Y, and Z. But I don’t know the exact terms nor do I know where the cartilage was removed or how much.

She orders and x-ray and while she’s doing this she explains she’d like to do an MRI but the Insurance company requires she order an x-ray and order physical therapy before doing the MRI. What?

She knows it’s wrong but her hands are tied. She can’t see what’s already been done to the knee and to top it off the insurance company has it’s checklist she has to fulfill before she can order what she really needs.

Now I get to go through — what I imagine will be quite uncomfortable — physical therapy because my records are lost.

I have to believe if a service existed, based on open standards, I’d be able to share these records with my doctor so she could see exactly what was done in 2004 and the insurance company would also have evidence physical therapy didn’t work back then so why not go right to the MRI and avoid the expense of the x-ray and physical therapy.

This is broken.

I know the EHR is only a tiny fraction of our dated system but I’d like to have a complete medical history. It’s my history.

To fix this will take eons. Medicine is so far behind when it comes to technology. Look at systems like Epic. It is seen as a leader in its field, but it’s a closed system. How does that benefit anyone but Epic? It doesn’t.

We need an Open API with services offered by many providers that are patient driven. Allow data to move between systems. Don’t make your money by holding patient data hostage. Make your money by building the better service.

Hopefully, someday, we’ll have a Single Payer System in America. As part of that system it’s my sincere hope good patient outcomes becomes the center of attention and data is allowed to flow between systems at, at least, national level.

Someone please disrupt this industry with an open system.

Apple Park Design

The Wall Street Journal: “A section of workspace in the circular, Norman Foster–designed building is finally move-in-ready: sliding-glass doors on the soundproof offices, a giant European white oak collaboration table, adjustable-height desks, and floors with aluminum-covered hinged panels, hiding cables and wires, and brushed-steel grating for air diffusion.”

Like so many people I couldn’t wait to see the inside of the new Apple Park building. From the outside it’s absolutely amazing. But the inside appears to be stark, cold. Of course this is my opinion and I haven’t actually been inside the building, which could change my mind because experiencing something for yourself can make a world of difference.

I hope you like white, stark, and cold?

I happen to have some recent experience moving into new digs. Agrian just completed construction on our new building and we moved in a couple months ago. By contrast our building is inviting, not stark. It has a design I’ve never experienced and I love it. Our building is basically split down the middle by common space. The main entrance is in the middle of the building, which is a rectangle, not a circle. That main entrance opens to a long hallway which ends in The Hub. It’s the heart of the building. It’s a reconfigurable space with a great kitchen on one side. The wall opposite the kitchen holds giant monitors stitched together. Yes you could play games on it, watch your favorite TV show, or whatever! It’s a great feature. Most of the time The Hub is configured with tables and booths so we have a place to eat together.

“Desks in the open-plan workspaces can be raised to standing level at the push of a button.”

Open workspaces? Ack.

Another feature of the new Apple Park space I’m not a fan of is open workspaces. I’ve worked at companies with open spaces and private offices, I prefer private offices. That allows me to make the space mine. The new Agrian building has a great layout, with private offices, fully adjustable desks, and big displays. Perfect.

I really need to take some pictures and share them. Another design choice I appreciate in our space is the use of texture throughout.

The only picture I’ve taken is of our exposed Server Room. It’s super easy for a server room to become messy. An exposed server room is a great way to embarrass folks into keeping it clean.

Our new server room. Nice and clean.

I’ve found over the years my environment affects my mood. I’d love to see Apple Park in person. It may be absolutely perfect, but from the article it doesn’t look like a place I’d fall in love with.

Does anyone else think it’s strange a design focused company like Apple didn’t locate in the middle of a city? I am. I don’t know why, but I am. Their new space is beautiful but was entirely too small for the company before it left the architects office. It only houses 12,000 people. For some reason I think Tony Stark when I think Apple. The Stark building in the Avengers seems Apple-like to me —with the exception of the big Stark lettering and it should be in San Francisco, not New York.

I could see the Apple logo in place of the Stark name.

I wonder if they’ll have tours at Apple Park? I’d like to check it out and see if my opinion changes.

Wearing Pants poll results

73% of respondents agree wearing pants does not make you a better Software Developer.

The only puzzling thing to me about this poll is the 27% that voted Yes. Must be management types?

MacBook Reviews

Joe Cieplinski: “Here’s the thing about this MacBook: I’m drawn to it. I don’t know if it’s the small size of the thing that just makes it more lovable, but I’m already finding more excuses to use this machine than I ever did with my 13-inch MacBook Pro.”

Casey Liss: “I haven’t regularly handled a full-size iPad since the iPad 3, but the MacBook feels to be roughly the same size in-hand. In actuality, the MacBook is 150% the weight of the iPad 3, but the fact that I’m even making that comparison should indicate how light it feels.”

For these two it pretty much boils down to size. It’s the laptop version of the iPad. Compact, light, easy to carry anywhere. That convenience comes at a small price — it’s not a powerhouse.

If you code for a living and can only afford to purchase one computer make sure you consider a MacBook Pro before pulling the trigger on the MacBook. Read Casey’s piece. He uses this device as a kind of iPad replacement. It’s not meant for serious development work, at least for him.

I’ve heard the MacBook called the ManagerBook. That seems, based on these reviews, to be fairly accurate. It’s a super usable, fun, portable computer that could be a great choice if you have the luxury of owning more than one device.

I could see purchasing one of these for my wife. She’s a full-time iPad Pro 9.7 user and on rare occasion she pulls out her ancient MacBook to do something like rip music to her collection. She doesn’t need a full computer often but the need does arise.

On the flip side of all this praise for the MacBook I have a good friend recently return his MacBook and pick up an older MacBook Air because he couldn’t get past the key travel on the new MacBook keyboard.

You win some, you lose some.

Blog for Love

Dave Winer: “Now I’d like to take you back to a discsussion that was had many years ago that resulted in this conclusion. You don’t make money from this work, but it leads to opportunities where you can make money. Ideas and information make their way to you and if you are so-inclined you can make money by investing in those ideas. No sure things, but some bloggers have made billions, and others have made millions. And others have made a decent living. Not from their blog but because they blog.”

I’ve talked about blogging to people a lot over the past 16 plus years. Some folks don’t understand what it is after you’re done explaining it, others feel they don’t have anything to say, and still others say they don’t know how to make money at it.

Rocking Chair

I always have to stop people that make that last statement. Blogging doesn’t have to be about money. I’ve been doing this since February 2001 and haven’t made any money directly from writing. I’ve described my blog as my front porch on the internet.

I think the most important point to make is this: Own your content. What you write is yours and yours alone. Giving your words to Facebook only helps them. Make sure you own your work.

See also, Why We Blog. I’d also recommend following Dave Rogers if you don’t. I think he’s a great writer.

Movie Line of the Week

Cut, cut, cut!Good morning!

Here’s a classic. I’d be surprised if you can’t guess it.

You keep using that word. I do not think it means what you think it means.

Ok, quick, what movie! Send your guesses here.

Rob’s 2017 Summer Blockbuster Must See List

Well, here we are on the verge of Summer Blockbuster season. It always seems to sneak up on me.

Here’s my list for 2017. Enjoy.

Guardians of the Galaxy Vol 2 May 05
Snatched May 12
The Wall May 12
Alien: Covenant May 19
Pirates of the Caribbean: Dead Men Tell No Tales May 26
Wonder Woman June 02
The Mummy June 09
It Comes at Night June 09
The Hero June 09
Wakefield June 15
Cars 3 June 16
The Book of Henry June 16
Amityville: The Awakening June 30
Spider-Man: Homecoming July 07
War for the Planet of the Apes July 14
Valerian and the City of a Thousand Planets July 21
Dunkirk July 21
The Dark Tower July 28
Atomic Blonde July 28
Detroit August 04
Baby Driver August 11
Annabelle 2 August 11
It September 08

This Blockbuster season looks pretty darned good to my eye. Stephen King has two film adaptations of his books this summer, that’s awesome, but I’m really looking forward to It in September.

As always I’ll have to pick and choose which films to see because I can’t catch them all in theaters. Here’s my short list.

Guardians of the Galaxy Vol 2, Alien: CovenantPirates of the Caribbean: Dead Men Tell No TalesWonder WomanCars 3Atomic Blonde, and It.

See you at the movies! Remember to get popcorn with extra butter and an extra large soda!

Past Must See Lists, plus 2009 from my original weblog.

Scripting iOS

Last week Apple acquired automation workflow application Workflow. Of course there was a nice buzz around it and it was a big topic of conversation on various podcasts and websites.

This, of course, got me thinking about automation. I’ve always been a fan of open API’s and the ability to automate applications. We’ve also seen recently that Omni Group is opening up OmniGraffle to automation via JavaScript.

Back in 2010 x-callback-url was created as a way to allow applications to call into each other and return results so you could chain together calls to build custom workflows. Apps like Launch Center Pro and Workflow took advantage of x-callback-url to let you build those workflows and execute them. Now we have a bonafide standard, without a standard. The app ecosystem found a way to support automation without Apple’s help.

I’ve used Launch Center Pro but until recently I’d never used Workflow, and it’s pretty amazing. The Workflow guys did an amazing job creating a drag and drop UI for building what amounts to a program. Well worth a look.

So, this brings me to what I’ve been thinking about over the past few days. Given x-callback-url and App URL schemes in general it would be extremely cool to use those to create object hierarchies using JavaScript. Why JavaScript? Well, it’s native to iOS and applications can use the runtime. Given the advances made by the Workflow team why not take it one step further?

Allow applications to specify a  Scripting Dictionary or Type Library as part of the application bundle, this should allow runtime creation of objects. I know this isn’t rocket science and it’s been done many times over.

Short of adding support to the OS it would be pretty sweet if an App like Workflow, Launch Center Pro, or Pythonista would standardize on a way to parse a URL Scheme into an Object Hierarchy.

I’m going to use Evernote, Bear, Overcast, and Arrgly as examples.

What do you mean by Object Hierarchy?

That’s a good question. Here’s what I’m thinking. Since the Apps mentioned above all support URL Schemes we can derive an Object Hierarchy from them. Basically the beginning of a URI begins with a scheme. The scheme is the name. In the case of Evernote it’s evernote. Pretty simple, right?

Given the scheme name we follow that with a path. In the case of x-callback-url based URL schemes we will skip over that part and move to the second item in the path. This will be the action, or function, or the object we’re going to execute.

evernote://x-callback-url/new-note?type=text&title=EC%203

The above URL will tell Evernote to create a new note of type text with a title of “EC 3”. If we had a way to parse that in a runtime application we could present the user with an Object that has methods that take arguments, like this.

evernote.new-note(type, title)

Let’s do a couple for Bear. First the URL Scheme.

bear://x-callback-url/create?title=My%20Note%20Title&text=First%20line&tags=home,groceries

Now translated into code

bear.create(title, text, tags)

Overcast URL Scheme.

overcast://x-callback-url/add?url=

Code

overcast.add(url)

And finally, my favorite, Arrgly URL Scheme.

arrgly://shorten?url=

Arrgly Code

arrgly.shorten(url)

Pretty simple to turn all of those into objects. When I say you can create a hierarchy it means you could, by convention, lump groups of actions into objects, or like the above examples have a set of actions that all live on a single object.

Here’s what a object might look like as a URL Scheme.

thing://x-callback-url/document/add?title=
thing://x-callback-url/document/delete?id=

That would result in using it like this

thing.document.add(title)
thing.document.delete(id)

Of course this need more fleshing out and it would require app developers to decide on a well known convention to make it work as expected, but it could be done with a bit time and effort. It could be these become an extension of the x-callback-url specification?