New site, new organization

I have not had much time to update this blog recently.  Work has been busy.  I have also been working on a new way of organizing my blogging entries.

One of the things I am doing is migrating off wordpress.com to a hosted wordpress.org instance.  There might be hitches and problems as I get going with this.  As of today, you can see the old postings on health IT or healthcare IT under http://svfruitstand.com/healthit. I hope to add more posts to it soon.

I also have not abandoned commenting on what’s new in IT and trends in social media and software.  Those blogs have been migrated over to http://svfruitstand.com/swblog.

The future of CCHIT

During the year of 2009, when the HITECH act allocated stimulus funds and assigned the responsibility for specifying the criteria for physicians to qualify for these funds, people in the Healthcare IT business have been wondering what would happen to CCHIT (The Certification Commission for Health IT) which is a non-profit consortium made up of among others the traditional large EMR vendors.  If the government wanted to make HIT easier, cheaper and more effective, it could not just adopt the CCHIT methodology which hadn’t been very effective in promoting EMR adoption.

From the start, it was clear that the requirement for Meaningful Use would not fit neatly into the CCHIT requirements, so the relevance of the organization was in doubt.  Centers for Medicare & Medicaid Services (CMS)’s Notice of Proposed Rule Making (NPRM) on January 13, 2010 made it clear that the government wanted to be vendor neutral in its requirements.  Thus, CCHIT had to do something to play a role in this new development in the EHR marketplace.

This article from InformationWeek reports the first steps being taken by CCHIT since the January 13 rules (which were actually released on Dec 30, 2009).  Basically they have introduced a scaled down version of their “Comprehensive” certification program called the “Modular” program.  They also offer to certify for ARRA stimulus those vendors who have already spent a huge amount of money to pass their Comprehensive program.  Of course, such certification program does not really exist yet because the rules for certification have not yet been finalized.

To make this situation even more interesting is the perspective from Practice Fusion.  You probably already realize that nobody speaks without self-interest in this muddy puddle we call Healthcare IT.   As an upstart in the EMR/EHR space, Practice Fusion obviously enjoys watching the established vendors in the CCHIT organization squirm.  The fact that the National Institute of Standards and Technology has contracted with Booz Allen Hamilton to develop testing methods and process of certification of EHR will keep the squirming going a while longer.

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Yodlee, a shrewd platform strategy or missed opportunities?

For those not in the business of financial software, Yodlee might not be a familiar name.  However, if you use online bill pay or one of the popular online personal financial management software, you probably have been using Yodlee without knowing it.  The issue I want to explore in this post is whether Yodlee has missed a great opportunity to provide vertically integrated solutions that end users use or that they have been smart to stay away from the trench warfare in the end consumer products space.

Yodlee has spent over over 10 years to build out its business relationships, technological capability and dominance in the financial data aggregation space.  It makes little sense now for anybody building personal financial software to go sign individual agreements with each of the likes of Citibank, Fidelity and Chase.  As the go-to platform, Yodlee now earns a platform tax from every Personal Financial Management software provider that needs to integrate with banks, credit card companies and investment firms.

At the same time, one cannot help but wonder what would have happened if Yodlee’s end user facing business was a lot more successful and most people actually subscribe to Yodlee to do their bill and financial management, as opposed to doing it through their banks or using services like Mint.com.  Given the number of new product launch and M&A activities across the US, UK and India in the news, Mint.com, Artha Money, Kublax and MoneyDashboard, DebtGoal are just a few of them, there must be significant opportunities to be realized.  However, it appears that Yodlee will not become a dominant player for end users.

Yodlee is in every one of these Personal Financial Management software but it is staying in the background.  That might well be a very comfortable commercial position.  However,  this article from bankingtech.com, Where’s the money in Personal Finance? indicates that Microsoft (after killing its MS Money software) is teaming up with Citi to build a vertically integrated solution to rival Mint/Intuit called Bundle.  If they are successful, they will have a platform that competes with Yodlee as well.  I said earlier that it made little sense for anybody to replicate Yodlee, but then Microsoft is not anybody.  It has cash and it needs growth stories.

This just goes to show no matter where you are, you cannot stay still with a successful product.  What do you think?

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Database as a Service – from Force.com to Amazon RDS and SQL Azure

These days, those who are building internet applications have many choices for database.  Traditionally (i.e. up to the last few years), you have the usual commercial and open source solutions such as Oracle, Microsoft SQL Server, MySQL, PostgresSQL to store user and application data.  Usually, these databases run in the company’s own data centers or a co-lo facility managed by AT&T, Verizon or the like.  However, offerings from Force.com (from Salesforce.com), Amazon Web Services and Windows Azure are changing this landscape.  In fact, in some cases, they start to converge despite their differences.

I started thinking about database as a service not because I was building one or looking for a DBaaS solution.  In fact, I was building a full stack internet application based on open source technology.  However, the offering from Force.com was rather intriguing as they claim to offer faster development time, easy to use language and secured infrastructure as this InformationWeek article indicates.

However, when you dig a little deeper, you will find that if you do not want your UI to look like the Salesforce.com form based interface and instead you want a rich interactive user experience, Force.com offers limited options.  The reason is because Force.com only offers a database driven form application UI or a heavy client written in Adobe AIR and Flex.  The former is reminiscent of web application from the late 1990s and the latter requires significant processing power on the client desktop.

Now you may say Force.com supports Java, Ruby and every other language under the sun.  That is indeed true though it is also where Force.com veers from a Platform as a Service provider into a Database as a Service provider.   If you want to use Java, Ruby, PHP or another language to build your application logic and client interface, you essentially have to host that code yourself.  You would be using the Force.com infrastructure for database and maybe stored procedures.  Sure you can host your application code at AWS or even Azure cloud but does it really make sense to have multiple vendors hosting different tiers of your technology stack?  It is tough enough to satisfy your SLA for applications that you run fully in-house.

In short, if you see a need to contract with multiple hosting vendors for the database, application and client technologies, you may well start looking at Force.com, Amazon RDS and SQL Azure as similar solutions.  Each has its strengths and drawbacks.  Here is an article comparing RDS and SQL Azure that you can start with.

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The slow revolution in Healthcare IT

For years, healthcare IT has been dominated by big players and arcane system architecture that resembled the ERP market in the 1990s.  Playing into this is the vendor dominated CCHIT certification process, which required everything under the sky to pass, but did little to ensure the software support a better care delivery or even integration with the disparate systems used by different physicians.  However, there are reasons to be optimistic as 2009 comes to a close, as written in this blog.

Looking at healthcare IT, I see a lot of parallels to how the enterprise IT space has evolved over the last 15 years.  There were many promises and much money spent, but little to show in the form of tangible quality improvements or cost savings.  Sure the marketplace will eventually sort out winners and losers, but I postulate that government stimulus money will make the outcome of this evolution different.

Granted, what needs to happen in this space isn’t limited to just moving the power from traditional HIT vendors.  The interoperability in HIT in general is abysmal.  Even new vendors aren’t much better at allowing physicians and patients share data.  However, there are reasons to be optimistic that people building HIT software would consider a multi-tenant system or a data sharing platform a fundamental requirement instead of an afterthought.

What do you think?  I am especially interested in hearing from those who are involved in healthcare delivery.  After all, I am peddling wares just like everybody else.  You the user should have the final say.

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Managing debt with Web 2.0

I took some time off from blogging to get started on a new project.  I am still far from fully ramped up in this new space.  However, that’s a story for another day.

This entry is about managing personal debt, especially the credit card kind.  I think we can agree that the American society is on average not very savvy financially.  Add that to the credit card companies and banks that chased profit without any ethical compunction, we have brought on ourselves a global financial crisis.

Regardless of what the government is doing around better disclosure by credit card companies, people really should know what kind of impact their credit card debt and other loans will have on their financial health long term.  For this, I think DebtGoal.com is a valuable resource and worth checking out.  As Newsweek pointed out in an article, you’ve got to Bail Yourself Out.

Some of the interesting facts that they might not have shared on their website:

  • These guys are not software engineers.  Rather they are former bankers who decided that there is a business opportunity in helping people save money.
  • They have not really spent their money on marketing.  Instead, this is really guerrilla marketing at its best.  You can see it by simply typing DebtGoal into your favorite search engine.

Given the recent acquisition of Mint.com by Intuit, I wonder if there are further web property consolidation in the personal finance space.  Obviously the credit card companies can generate some good will with congress by purchasing such technology.  At the same time, providing this kind of utility would reduce their profit since they have always count on you not knowing how much those cash advances and coffee are costing you.  A knowledgeable consumer is an unprofitable customer.

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Simplicity is Usability

Simple Product Design versus ???

Simple and Functional

So classic!  Thank you to my friend Aloke of iXiGo.com for twittering this.

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