Category Archives: Technology

For now, it is iPhone over Android

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I currently carry a Samsung Infuse  Android phone. It is an AT&T phone that I have had for about a year. I am ready to replace it and I have been wrestling between the new Samsung Galaxy SIII and an iPhone.

The reviews of the SIII are tempting. The specs are impressive (quad core graphics, super high resolution screen). I want to love the Android platform, because I am predominately a user of the Google platform and I like setting up my phone with a single login. But, I think I am going to join the rest of my family in carrying an iPhone. My Infuse has been buggy (screen lockups, slow response to screen touches), although I am not convinced that a year-old iPhone would be better. Here is why I am going to the iPhone:

  • Apple forces the carriers to behave. I did not get one upgrade for my Infuse. They are available, but AT&T won’t push out the updates. Forget Ice Cream Sandwich, I just want to go from 2.2 to 2.3. Sheesh.
  • There are too many Android phones to make sure everything is universally compatible. Today I went to download the Microsoft Lync app and the Google Play Store told me that it was not compatible with my year old device. With an iPhone that would never happen where the number of devices are limited and the iOS upgrades are backwards compatible for at least 2 years back. I have had apps that would not install on an iOS device, but the device was more than 3 years old.

By the way, we are rolling out Good as a way for smartphone users to connect to our Exchange Server. This was a good move, no pun intended. I can’t see a future where BlackBerry thrives. I am just one customer – but for us that ship appears to have sailed.

eMail Stats for Our Health Care System

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Over the last 3 years the number of email users at the organizations I serve (Ministry Health Care and Affinity Health System) has increased 17%. In 2008 we had 15,900 mailboxes. Today we have 18,578 mailboxes.

Over that same period our total email storage has increased from 1.5 Terabytes to 5.6 Terabytes. That is a 273% increase.

Interestingly, the top 7% of the mailboxes (1,300) account for 55% of the total storage. My mailbox is the 88th largest (5.3 Gb), this includes deleted and sent items, which I cling to.

These cool stats are courtesy of our Data Center Manager, Dave Roggenbauer and Pete Leonard, System Administrator.

Bring Your Own Device in Healthcare?

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The NY Times has a good article on the increasing popularity of Bring Your Own Device (BYOD) policies. This is appealing to many employees, and interesting to me. I want to further empower our tech savvy employees. But, I don’t think it won’t work in our environment at this time.

It is probably no mistake that the company cited in the article is Citrix Systems. I am sure that they have had a corporate IT purchasing policy for years that restricted purchased applications to those that work well in their Citrix environment. I think an environment where are applications are served via Citrix is a key requirement for a BYOD policy. All that is required is the IT to make sure that the Citrix client is running on the employee’s device. This leads me to…

Reason #1 that BYOD doesn’t work in a typical healthcare environment: Most applications don’t run well on a Citrix.

At Ministry Health Care and Affinity Health System we have literally hundreds of apps that we cannot deliver on Citrix. In fact so many, that we don’t try to deliver apps via thin client technologies unless there is a specific need to do so. Because most of our client applications run locally on the employee’s PC, we need to tightly control that environment to avoid conflicts and other things that keep people from doing their job.

It is probably reasonable to assume that the employees at Citrix Systems are more technologically savvy than the average employee base. Consequently the IT department at Citrix Systems doesn’t have to worry about the devices being in a usable state. That is not the case for our employee base, while we have many IT savvy employees many others, especially our caregivers, spend more time thinking patient care than computers. Many need a lot of help with basic PC support.

Reason #2 that BYOD doesn’t work in a typical healthcare environment: Many of our users require a lot of support from IT just to make sure their computers are in a working condition. IT cannot efficiently support hundreds of different device models.

I have seen it all, from browsers with a dozen installed toolbars to deleted system files. I would love to allow users to install their own software and customize their computers, but history has proven that there are far too many disruptions to the work environment when a liberal desktop management approach is used.

The story also quotes that Citrix Systems has reduced its device cost by 20%. But I am sure that doesn’t include the multi-year investment in Citrix software and servers required to deliver the applications to the desktops. That is hundreds of thousands of dollars and a significant new support requirement for organizations like ours.

In the future we might be able to offer such a policy to a certain group of users (managers and analysts). But there would be a lot of work in developing a plan to move that model and right now there this does not arise to the level of the most strategically important issue for Ministry to tackle. Needs like improved clinical information systems come first.

Thoughts About The Cloud

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There is a lot of buzz about “the cloud,” as there should be. Still, it is amazing to me how the hype, especially IT company advertising, seems to miss the mark. Here is an example, the Microsoft commercial with the couple stuck in the airport.

They are able to use “the cloud” to remote into their home PC to watch a video. I think this commercial sucks for the following reasons:

  • In my opinion, this is not using the cloud. I will explain my definition below.
  • Watching video over a remote connection is like taking a shower with your clothes on. It sort of works, but the experience is awful.
  • Few people use Microsoft technologies to record TV. It would have been more realistic (and more cloud-like) if they downloaded TV using iTunes, or Amazon.
  • If you want me to empathize with this beautiful couple, don’t have them watch “Celebrity probation.” I have my share of guilty pleasures, but still…

Worst of all, this ad obfuscates what the cloud means. I suspect Microsoft’s only goal is to associate their name with the cloud. What the couple is actually doing may be irrelevant to Microsoft marketing types.

Nothing Microsoft does in this commercial helps us better understand “the cloud” and why is it noteworthy.

Everyone has their own definition of the cloud and typically they are written in a way that justifies their interests. To me The Cloud is a means to deliver an application as an IT service, where:

1. the service is hosted on servers and storage that are not on our private network
2. those servers and storage are connected to our private network via the Internet
3. the application is accessed by the user using a standard browser without any plug-ins, active-x controls or java requirements. Just HTML5.

I don’t believe in private clouds, or other variations. That strikes me as market-speak that organizations use to make their products and services seem like they are part of the hype. The cloud is not about watching bad TV with a massive latency and audio synch problems while we are sitting on airport carpet.

The cloud is about buying IT as a service to shift time and focus away from:

  • deploying and managing data centers; and
  • installing and troubleshooting desktop software.

Spending less time on these technical things should allow a business to focus on leveraging IT to drive even greater business value.

Is Enterprise-class WiFi an Oxymoron?

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I have never launched a point of care application on wireless devices that has not had immediate and ongoing problems.  Usually the problems are enough to be annoying but not severe enough to scrap the initiative.  Even the highly paid outside network engineers can’t seem to provide me the flawless wireless connectivity that the vendors and trade journals lead me to believe is possible.

Recently I spoke to a group of hospitals on behalf of a consulting friend of mine.  As part of that favor I reviewed a short assessment of each of the 4 hospitals.  All of them had three things in common with our 14 hospitals:

  1. They all cited medication scanning at the point of administration as their top clinical priority.  Our three Affinity hospitals in the Fox valley have implemented this and the others want to join them.
  2. They all cited frustrations with their Carts on Wheels (aka COWs).  I too have yet to find the perfect choice.
  3. They all cited frustrations with wifi reliability in their clinical areas.

I suppose misery loves company.  How did we all buy-in to this enterprise wireless disappointment?

What is your experience?  Does anyone have the secret code?