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Comment Re:WinRT corrections (Score 1) 474

Thx again for the clarifications, it really helps. We have a lot to go through, and I'm crossing my fingers that most of it will transition ok. It sounds like, from all the stuff out tonight, that most of "old" windows is still there so I'm hoping it's a straightforward process, or that its at least manageable while we make any changes. Now I just need a clean workstation to test it all out on...I wonder who's on vacation? hehe :D

Comment Re:WinRT corrections (Score 1) 474

Ok cool, so the next question is happens to design patterns like MVVM under this shiny new wrapper? It sounds like a native code implementation takes a lot of the roundabout out by merging the View and Model together to allow for direct access via HTML5 as opposed to XAML (for the view). If that is true, it's going to suck for folks like us who tied in viewmodels and now have to go back and put the logic into a single structure instead. Yuck, that's a lot of work.

Comment Re:WinRT corrections (Score 1) 474

Someone Mod this up plz, this is kind of post that keeps /. special. Thx for the corrections/clarifications Shutdown. I was wondering if they truly threw MDI/Dialogs out the window, but it sounds like it works a bit like Popup objects in WPF where multiple forms just have to live within the app boundaries (?). I'll get the tech preview off MSDN in the morning and check it out... something tells me tomorrow is going to be long and filled with tequila and tears by the end. Thanks again for the post.

Comment Re:Warning: Excessive buzzwords can be fatal (Score 1) 474

I have to agree with LordLimecat's humor post here. These COULD have been significant announcements, but weren't. Instead, its a way for the MS marketing department to wallpaper the fact that the "cloud" vision of theirs is invasive and mostly useless. I don't want to have to stay connected to the internet all the time to make ANY software work, unless its specifically made to that end, such as a browser. SQL failover has been around forever by the way, so that's just pissing on me and calling it rain showing a "new and Improved" version that does the same damn thing that's been around since the 90s (yeah, I'm old, and did over 10 years with SQL Server as a DBA going back to the Sybase days, and then another 5 years as an Oracle/Solaris DBA as well). NIC binding is NOT new, and has been used forever to both provide redundant connections and to amplify bandwidth such that if one fails it's seamless to a query user. This has always been the main point of database clusters in the first place. Right now, as a commercial WPF developer, I'm just about pissed off enough to go back to zero with our current .NET product iteration and start over in Linux or IOS, just to get out from under this kind of idiocy. What really makes this whole process shitty is that they pushed everyone towards silverlight, .NET, and WPF all the way up through now, waited until the shit actually started to work right for once, then threw everyone under the bus the first time something shiny ran by (HTML5). This crap with the BUILD Visual Studio demo where some jackass "changes 2 lines of code and it runs" on stage is just more marketing fluff, and I don't believe for a second that it will work like that in the real world. Hell, they still haven't fixed VS2010 yet, and it's FULL of bugs a year after release, so what makes you think this time it's different? Like it or not, software takes a long time to develop, and when a toolware company like MS arbitrarily tosses out 20 years of other people's working code they can expect a backlash. Conversion will be painful, expensive, and it genuinely gains almost nothing in this case. What's really amazing is how much of their own IP they are cannabilizing along the way to keep their sales people happy. Finally, I'm not alone among .NET devs in getting mad about all this. The debate on silverlight has been raging all summer on the MS dev forums, and people are NOT happy with them over their HTML5/bandwagon decisions. The last time I looked, there were tens of thousands of protest postings just from the Silverlight folk, and thousands more for WPF. Ballmer can say whatever he likes, and everybody wants to have a good time at BUILD and not get all bitchy, but in the end this whole idea is a mistake. They're trying to combine tablets and desktops, and they are just different. To summarize, Limecat's post is actually pretty funny, and I think he nailed MS to a tee, and its unfair to pick on him about something MS is doing to themselves. Marketing, like this windows 8 bs-fest, is fucking this industry up badly.

Comment Re:Good for insurance (Score 1) 380

Say WHAT?!?!? I don't know ANY doctors who don't have at least a CPT reference to work from. Most have one of the plethora of iphone apps for coding lookup for sale if they don't have up to date EMR software (see CCHIT certification for more about what that is). What we do is try to make interfaces that allow a doctor to type in "turtle" (nod to top level author) to get filtered list of possibilities, rather than having to memorize codes. Coding is really an antique process, so as programmers its our job to make it a plain english experience for doctors. What you are missing is that billing codes and diagnostic codes are two interrelated things though, and that the bill (while important) is really only a part of the picture. A good for instance is people with drug allergies. A good EMR system has to cross reference any pending Rx requests to make sure that something you (as a patient) are given doesn't not have an allergic affect on you. This has nothing to do with billing, but everything to do with health, and should happen in realtime, not at the front desk. To me, a good programmer sees automation of complex processes like this as opportunity (and indeed, it can be a very lucrative one, even in these trying times) instead of something to be ignored and borne. In fact... who's your doctor again? J/K :D

Comment Re:Good for insurance (Score 1) 380

So much this! I'm no big fan of insurance companies, but they only care about what procedure(s) are performed and what materials were used. Observations (ie - A patient note of a "cough" when seeing a patient for med refills) end up getting wrapped up into ANONYMOUS reports, which consequently go back to places like CDC. From this, hopefully one day, we can start to track trends of things like Bird Flu before they become widespread epidemics. Right now, specifically because of consumer paranoia about privacy and insurance, there can be a lot of lag time in reporting social problems which may, in fact, affect us all. Just food for thought there.

Comment Re:One big number? Is there an app for that? (Score 1) 380

Exactly! The whole of the coding system actually uses Vocabularies to determines the state (such as mood codes) of the patient so that the actual coding can be scoped down to represent informed use. Concepts (CUI) lead to atomic use (AUI) based on the context of the patient or subject (entity) so that by a subject symantic type you can translate the actions within a patient encounter to a VERY granular level. Consequently, regarding the top level post, it's not that people are obsessed with coding, its that its the process which drives the billing cycle in pretty much every hospital, and every insurance company, and has for over 20 years. The UMLS used to drive me nuts, until I realized that it makes more sense when you start from the HL7-RIM (Reference Info Model) first and work down from there to give the framework coherence.

Comment Big datasets are fun :) (Score 1) 380

We do this, specifically I program and design PACS (Radiology) and EMR systems that use various coded sets. What's really interesting about the "water skis" thing people caught on NPR is that in reality there are 61 specific codes involving 'skis' alone, and that's just in English. Within the full subset of the Metathesaurus we use, there are in excess of 4M interacting concepts, and with the entire set there are over 400M interacting concepts. To make things even more complex, CPT, ICD-10, SNOMED-CT, and others all have to be made relational such that an injury related to "water skis on fire" has subrelational codes for the skis (material), what the patient was doing (observational), and what a role (doctor) does about it (procedural) before it can be billed to insurance, a process that (even electronically) takes up to 30 days and 20 revised submissions. This is PER BILLING STATEMENT. You have to be a special kind of warped to get into this (I, for instance, started as a DBA...). All this said, the whole of the codesets actually can describe pretty much anything in reality, starting with the semantics of the subject and trickling down to the price of each material and service consumed. It's pretty complex, but it's truly challenging, and beats the hell out of coding drudgery based projects by a long shot.

Comment This is so cool! (Score 2) 94

I think this kind of shit gives me hope that the internet isn't just for porn and poker anymore. What a great and smart way to exponentially increase the resources of the project. Stuff like this, and folding@home, and other crowd-sourced projects are an amazing phenomenon. Whoever is in charge knows how to sell it too, with the whole "read it while you translate it" concept, which kind of turns the whole thing into a video game. Nice work by the Oxford folk.

Comment Re:Unfunded mandate? (Score 1) 254

Hmm this isn't really true now is it? For the record, NOBODY knew what the actual final standard for US healthcare would be until Sept 2010 (although the preliminary final ruling was July 2010, but still...). While ICD9 to 10 may have taken ten years, there was no reason to believe it was going to float to the top of the coding systems expected for use until it was written into the federal register last year. And its not like there's a ton of options or anything that could have replaced it, making early adoption risky and potentially pointless or anything.

Comment This isn't just ICD-9/10, its the rest... (Score 1) 254

What I think TFA is trying to express is NOT limited to ICD. That's a "low hanging fruit" which doesn't include the other coding enhancements required for EHR conformance. ICD is a way of expressing complains and maladies via a coded system so that everyone can understand it if it appears as a part of your public medical record. In other words, everyone has to say code xxxx1 = "breast cancer" so that when you show up in an ER 6 months after a diagnosis, they can tell what's going on. The elephant in the room isn't the malady descriptions, its the coding of procedural treatment (SNOMED-CT), laboratory procedures (LOINC), RX allocations (RXNORM and the NDF), and how its billed back to insurance (CPT), and more importantly how they interconnect.

We make EMR systems targeted towards radiology, and I can say with conviction that the whole CCHIT process has thrown GE and Siemens (and their ilk) into absolute chaos. They are, today, faced with fixing their old systems to be modern/conformant, and then trying to keep them updated going forward on a MUCH more aggressive maintenance schedule than they are used to. Oh, and every month that they can't do it, their customers will see as lost revenue from govt. reimbursements. Unenviable is an understatement, it will be a financial disaster for GE if they start losing people en masse to Epic and other new players.

As someone who makes "meaningful use" based systems, I can tell you its no joke to implement. CCHIT certification alone encompasses 25k pages of standards that have to be followed to the letter and proven via testing for qualification.

In a way, it's a strange twist that the big players (GE/Siemens/Merge) lobbied to make the qualifications as hard as they currently are in order to limit new competition, and are now sinking into the pit they themselves dug. Sick, but hilarious simultaneously.

Comment Re:Annnnnd it's a big nothing. (Score 1) 662

Trolling, LOL.

Every computer made has more than a TB, including the new windows tablets (which we happen to have prototypes of, since we are a development shop). And I deal with big data every day (medical images, among other things). So just to recap, I'm sitting in front of a windows tablet with a 1.5TB drive in it right now.

Oh, and it has audio in, not to mention my mixer has wireless support (granted, most people would plug their tables into a sound card, but that's not the point here).

So, again, Apple is selling last year as new, except they get to control its use?

Again, how about no.

Comment Re:Annnnnd it's a big nothing. (Score 1) 662

The summary is very light on details, so I can understand you misinterpreting this. iCloud isn't the only place your data is stored, it is actually stored on the iPad, iPhone, iPod, and Mac. It is just that all files are seamlessly shared between your different devices. Buy a song on iTunes on your Mac, and it is automatically available from your iPad. Take a picture on your iPhone, and it is automatically in iPhoto on your Mac.

You are right to an extent - this is nothing new from a tech perspective. What is new though is how Apple is presenting this to the user. They don't tell the user "map this drive to this location...", it all just happens automatically. That is this trick of the iCloud - the user doesn't explicitly interact with iCloud. Rather, files are just always available. The user doesn't have to understand what the cloud is or how to access it. The cloud is the means, not the end.

Ok yeah that's cool and all, but it already exists. Last night, I was watching Top Gear on a phone, then I went inside and picked right back up in the middle of the episode on a PS3 using Netflix. It's not really The Cloud(TM), but it might as well be and works just as well. And it's hardly a revolution worth crowing about. It's kind of neat but they ain't the first to get there. Not even hardly.


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