Money Boost for HealthCare IT

The stimulus package signed into law by President Obama injects about 20 billion dollars into the US Health Care industry.  The bulk of the money, 17 billion, are incentive contracts to help process Medicare and Medicaid reimbursements.

I have consulted with several Healthcare IT companies and their productivity and quality rates are higher than the IT industry overall.  Yet these same health care companies struggle with silo processing because information is not easily shared between software applications.  In other words, the software applications do not play nice together.    Another problem are those required to use the software applications are frustrated because many of the applications are difficult to use.  As one nurse told  me, “I feel like I need a degree in Computer Science to use some of the hospitals software applications.”

The real issue with Healthcare IT is not a lack of technical knowledge, but a lack of understanding how hospitals work and especially how doctors, nurses, and administrators do their jobs.   Software developers would benefit from following healthcare professionals during their normal workdays and watching just how they do their jobs.  Then software applications could be designed around the user instead of forcing users to adopt to some obscure  unrelated software design.  Software applications need to be designed around normal workflow patterns.

Hopefully some of this government money can be used by developers, so they can study healthcare professionals and how they do their jobs.

Published in: on March 30, 2009 at 14:02  Leave a Comment  
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Reboot! Some Metrics

Since publishing my online book  Reboot! Rethinking and Restarting Software Development in earlier February 2009 there has been 35,000 pages read by 4,000 different visitors in 101 different countries.

The USA and India had the most visitors with about 1,000 visitors each followed by United Kingdom (250) and Canada (153).  What I find interesting are not the number of readers from countries known for software development, but the readers from countries such as Nepal, Moldova, or Zambia.   There were even a few readers from the Cayman Islands.  They need to step away from the laptop and get back to the beach!


Published in: on March 24, 2009 at 23:01  Leave a Comment  
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How do you write great user manual, you don’t.

A user manual is created to provide step-by-step instructions on how to use a product. The product can be a lawn mower, iphone or a software application. Software applications that are designed well do not require any user manual. Instead the software application is designed to be intuitive.

To design something that is intuitive requires a great understanding of how the product fits into the natural flow of things. This means the person or group of people that will use the software application have to be studied.  Too many software applications require the user to adapt instead of developing a software application to the user’s natural environment.

It does not matter if we are talking about people or gorillas. It is best to study people in their natural habitat instead of dragging them into a conference room and asking, “What do you want?” It is always best to go to the jungle and study your customer.  Ethnological analysis, going to the jungle, is alien in software development.  Most software developers have little or no contact with an actual user.

If you don’t understand how a person does his or her daily tasks or the natural workflow, then you can’t design software applications that are intuitive. Let me guess – you don’t have time to go to the jungle because you are busy writing user manuals and other documentation.


My mobile phone rings, so I give a typical, “hello, this is David Longstreet.” There is no “good morning, my name is…, how are you”, but the voice gets right to the point. The voice on the other end asks, “What is the average cost to develop software?” Without hesitation I respond,”42!”

There is a long pause and the voice asks, “42 what?”

I say, “42 whatever you want, you fill in the units.”

The voice, “What do you mean?”

I respond, “42 hours, 42, 000 dollars, 4,200 euros, 42 million whatever works best for you.”

The voice, “Wow, I like this. I think I will go with 42,000 hours.”

I say, “Sounds good to me.” There is a long pause, so I assume the voice is thinking.

The voice asks, “how many people?”

Quickly I respond, “42”

The voice, “How many months?”

In a rapid fire fashion I say, “42”

The voices says, “42,000 hours, 42 people, 42 months.”

I say, “I think you got it!”

The voice says, “I really want to thank you for helping me out on this.”

I gleefully respond, “No problem.”

The voice just hangs up. There is no typical good bye, just silence on the other end of the phone. I think to myself, “42, it is really the answer to all the questions of the universe.”

Specialization: Focus on the patient

Those IT professionals that specialize along  industry lines have productivity and quality rates orders of magnitude higher than generalists.   This is especially true in the health care industry.    The idea of specialization is nothing new to the health care industry, but it is a new idea to the IT industry.

The following are some links to blogs written by individuals that understand the value of specializing in IT as it relates to health care.   One thing you will notice on their blogs is they do not spend much time explaining the latest and greatest coding techniques.   They spend most of their time writing about Health Care IT and especially patient care.   If I am not mistaken, I think that patient care is the objective of Health Care IT.

A Nurse that knows about IT versus an IT guy that knows a nurse
How about  this crazy idea, a registered nurse with nearly 20 years of technology experience!  Her blog is Healthcare & Technology:  Innovation at the intersection

The HealthCare IT Guy
Here is a a technology consultant that has specialized in health care. He describes himself as a “Consultant/speaker that specializes in healthcare IT”

The Geek Doctor
Who is more valuable to a hospital  a CIO who is also a MD or a CIO that was working at a bank last month?  (

For those IT professionals working in the health care field, please step away from the code! and learn about the health care industry – please.   My life could depend on it.   One of these days I may find myself at a hospital and I would like to think the software systems were designed by people  that know something about health care and especially patient care.

Published in: on March 2, 2009 at 13:40  Leave a Comment  
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What Software Component Gets Built First?

Abbott: Well Costello, the CIO has given me a promotion, project manager of our new software application.

Costello: If you’re the project manager, you must know the order of how the software application will be built?

Abbott: I certainly do. Well, let’s see, the order we plan on building software components is, What’s is first…

Costello: That’s what I want to find out.

Abbott: I said, What gets built first, Who gets built second, I Don’t Know’s gets built last.

Costello: Are you the project manager?

Abbott: Yes.

Costello: And you don’t know the order of how things are going to get built.

Abbott: I do.

Costello: Well then what gets built first?

Abbott: Yes.

Costello: I mean the components name.

Abbott: What.

Costello: The component that gets built first.


Abbott: What.

Costello: The first component.

Abbott: What.

Costello: The first component.

Abbott: What is built first!!

Costello: I’m asking what is built first.

Abbott: What

Costello: What’s the component’s name?

Abbott: Yes.

Costello: Well go ahead and tell me what get’s built first.

Abbott: That’s it.

Costello: That’s what?

Abbott: Yes.


Costello: Look, you gotta build something first, then second, then third?

Abbott: Certainly.

Costello: What’s built first?

Abbott: That’s right.

Costello: When you record your time, what component gets charged?

Abbott: Yes

Costello: All I’m trying to find out is the component built first.

Abbott: What


Costello: Let me try something different, you have three components, what component get’s built last?

Abbott: No, what gets built first.

Costello: Ok, finish this sentence the last component built is…?

Abbott: I don’t know.

Costello: I don’t know.

Abbott: Yes?

Costello: What?

Abbott: No what get’s built first.


Costello: You know I just don’t give a darn.

Abbott: That is the name of our methodology.

Costello: What’s the name of your methodology?

Abbott: No, what’s built first?

Costello: Your methodology is….

Abbott: I don’t give a darn.

Costello: Neither do I.

Published in: on March 1, 2009 at 14:22  Comments (2)  
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