The Information Technology Forum

Linux on the Cloud { even from Microsoft }

2012-01-03T10:35:00.008-05:00

A number of vendors known for supporting Linux have made this operating system available on the Cloud. And some Cloud vendors are offering other operating systems in addition to offering Linux. Amazon, for example, offers the ability to run both Linux and Windows on its EC2 infrastructure-as-a-service platform.

Now, surprisingly, Microsoft is preparing to launch a new persistent virtual machine feature on its Azure cloud platform, enabling customers to host Linux, SharePoint and SQL Server there. However, it will be up to customers to provide uploads of their own Linux images.

Click here for a brief overview of Microsoft Azure

Click here for a brief overview of Amazon EC2

Click here for a brief overview of [Linux] Cloud computing with Ubuntu

Click here for a brief overview of [Linux] Cloud computing with Red Hat

Click here for a brief overview of [Solaris] Cloud computing with Oracle

The Personal Computer Is Dead ?

2011-12-06T14:17:00.006-05:00

Saying that the personal computer is dead may or may not be premature. However, I just read an article that makes this assertion, and I'd like to suggest that you read it too.

Click here to read The personal computer is dead by Jonathan Zitttrain. He says in conclusion,

"A flowering of innovation and communication was ignited by the rise of the PC and the Web and their generative characteristics. Software was installed one machine at a time, a relationship among myriad software makers and users. Sites could appear anywhere on the Web, a relationship among myriad webmasters and surfers. Now activity is clumping around a handful of portals: two or three OS makers that are in a position to manage all apps (and content within them) in an ongoing way, and a diminishing set of cloud hosting providers like Amazon that can provide the denial-of-service resistant places to put up a website or blog."

For users of iPhones, Blackberries, Androids and/or Skype

2011-12-03T08:22:00.008-05:00

We live in an age that's nothing short of Orwellian.

There's a new industry that secretly vacuums up your data and preserves it forever on high-end servers that hold many petabytes (a million gigabytes) of information.

WikiLeaks has just released the Spy Files – a trove of almost 300 documents from these companies that shine a light into this industry.

One, a brochure from SS8 of Milpitas, California, touts its Intellego product that allows its owner to see (in real time, if it wants) such things as your draft-only emails, attached files, pictures and videos.

State agencies have expanded their data-collecting to include data on water and sewage billing, visitor logs from parks and recreation facilities and much more.

To read more about this subject, click here for Wikileaks: The Spy Files 2011-12-01

NB: Several posts to this blog have been on the subject of security. I feel that The Spy Files need to be part of any consideration of this subject.

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It turns out that spyware is running on hundreds of millions of smartphones and tablets.

The carriers explain their use of this spyware program in a way that makes it sound harmless. However, it only sounds harmless until you see, among other things, that it is capturing your every key stroke.

With iPhones, which have the program in them, turning off the spyware program is sometimes easy.

If you’re running iOS 5.x, just head to:

Settings > General > About > Diagnostics & Usage

and click “Don’t Send” on.

If you’re running iOS3 or 4, however, I don’t know of any current way to disable the service.

With Android phones, it’s much trickier, but it can be done. The story on BlackBerries is a bit murky.

Hopefully, because this practice has received a lot of attention recently, the carriers will soon make it simple to disable this spyware for those of you who don’t want to share everything you do on your phones with your phone companies.

Search Engines and The Data Explosion

2011-11-15T07:44:00.006-05:00

Throughout all of human history up until 2003, we created 5 exabytes of data (five billion gigabytes). We now create that much every day. In 2011, we’ll create 1.8 zettabytes of data (a zettabyte is a 1000 exabytes). That’s up from 1.2 zettabytes in 2010, and some have predicted that we’ll be creating over 20 times that by 2020.

In trying to scale to meet this data explosion, our search engines are getting creaky.

While Google has been busy working on building Google+ as its social tool, Microsoft has quietly gone out and cut partnership deals with Facebook and Twitter and started integrating their social data into Bing search results. For example, if you do a search on Bing and you’re logged into Facebook in the same browser then the search results will show which of your friends have liked a certain page. See the example below:

Bing may have a leg up on Google in social today because of the Microsoft deals with Facebook and Twitter, but you also have to keep in mind that Google is going to have more control over its social-search destiny by building its own product. It won’t have to worry about partnership deals going bad or having to ask its social partners for additional API access. Google can just make it happen.

An Open Standard - HTML5, Yes; Flash, No

2011-11-09T14:36:00.014-05:00

Adobe says it will pull Flash, its software for Web video and software, from the Web browsers of mobile devices. Flash will still work on mobile apps and on computers' Web browsers.

It's a win for Apple Inc., which has famously banned Flash from working on the iPhone and the iPad.

The mobile era is about low power devices, touch interfaces and open web standards - all areas where Flash falls short.

HTML5’s video chief rival, Adobe Flash, appears to be throwing in the towel.

HTML5 is now universally supported on major mobile devices, in some cases exclusively.

This makes HTML5 the best solution for creating and deploying content in the browser across mobile platforms.

The writing may be on the wall. While Adobe programmers will be able to use their same Adobe software development tools, the end-product is clearly going to be HTML5 video. Flash may now be a legacy format.

Silverlight? Microsoft’s one time rival to Flash? It may be toast. The day of non-standard video formats seems to be coming to an end.

Note 1: Adobe is working on Flash Player 12 and a new round of features which they expect to again advance what is possible for delivering high definition entertainment experiences … to the desktop, not to mobile devices.

Note 2: Flash is not an open standard — it is controlled by Adobe Systems — whereas HTML5 is largely controlled by a committee made up of three companies, one of them being Apple.

Click here for an 11/11/11 Wall Street Journal front-page article on HTML5.

Developers now have to consider three development environments to address desktop and mobile device access: 1). traditional Websites using Flash for desktop and laptop access, 2) mobile-optimized Websites using HTML5 for mobile-device Web access, and 3) mobile-application development that may interact with Web resources on the back end.

Adobe is now focusing its mobile developer solutions on Adobe Integrated Runtime (AIR) that helps developers use Flash technology and develop apps that will run across multiple mobile platforms such as iOS, Android, BlackBerry and Windows Phone.

Webkit-Based Development Revisited

2011-09-19T10:56:00.014-04:00

I've made references to Webkit-based technologies in prior posts to this blog and in some early articles. For example,

Click here (2011) and here (2008).

I've also been referring to HTML5 of late. For example,

Click here and here

And way back, I've referred to A/B testing. For example,

Click here (2009)

For a presentation from NetFlix that pulls together these and other related topics,

Click here. The download of this 7 MB pdf file may take awhile if you have a slow connection.

Comment: While you may not be working on a project exactly like the one the authors discuss, you may find its information interesting nonetheless. I did.

As the default browser for both iPhone and Android, WebKit has become a major player in the mobile arena, offering a wider array of HTML5 and CSS3 support than any other major engine. For a soon-to-be-available book, see

This book gets you started with WebKit and shows you how to maximize HTML5 and CSS3 features in WebKit, and it addresses ways to optimize your web site for mobile devices and enhance the mobile user experience.

Speech Recognition With General and Medical Vocabularies Revisited II

2011-09-08T15:09:00.012-04:00

A Google search on “mba md programs” brings back over 12 million results, many of which are the particulars of the hundreds of MD/MBA programs now offered by leading universities.

This means that medical practices are now incorporating modern business models and that, in turn, means that practice managers and their accountants are not only looking for ways to cut costs as they have in the past but are now also looking for ways to establish new profit centers. Many times, speech-to-text tools like Dragon Medical Practice Edition provide the solution to one or both.

Nuance will this month release Dragon Medical Practice Edition, an upgrade to its medical speech recognition tool for small offices that should even further reduce transcription costs by making it easierier to enter data into an EHR.

Dragon Medical Practice Edition is similar to Nuance's existing Dragon speech recognition options for health care in that it allows health care workers to create medical notes directly in an EHR system in real time.

The new version has a number of time-saving features: for example, it alerts the user and offers advice when a poor audio input caused by incorrect microphone connection or background noise is detected. And that’s just the beginning.

Existing and new users can click here for the results of a YouTube search on “Dragon Medical Practice Edition”

These voice-translation videos fall roughly into the following three categories:

• Technical topics such as profile optimization

• Nuance and other tutorials

• Case studies narrated by practicing physicians

These YouTube videos and my prior posts on speech-to-text translation offer a pretty comprehensive introduction to speech recognition software in general and Dragon Medical software in particular. Check them out.

Speech Recognition With General and Medical Vocabularies Revisited

2011-08-30T09:57:00.024-04:00

A while ago, back on May 10, 2009, I posted an article that discussed speech recognition software in general and Dragon Medical 10 in particular. Click here to navigate to that post. In the two years plus since then, the field of speech-to-text translation (and the hardware available for speech-to-text translation software to execute on) has advance. This can be seen in the research reports published at the Special Interest Sites that you can navigate to from the links at the top of the right-hand column of this blog.

Reflecting these advances, Vendors, Nuance Communications Inc., the maker of Dragon NaturallySpeaking and Dragon Medical Practice Edition, in particular, have been able to release improved versions of their products: The next version of Dragon Medical will be called “Dragon Medical Practice Edition” and will feature the Dragon NaturallySpeaking 11.5 Speech Engine. I have found it to be faster and more accurate than any previous version of Dragon. (The most recent versions utilize new hardware features such as multithreading and multicore CPUs, and they double the sampling rate and more).

That said, it's still important that you use any speech-to-text translation product with a good sound card and a good microphone.

Click here for a downloadable Product Sheet

Click here for a Feature and Specs Sheet

As is my wont, I recently installed a pre-release copy of Dragon Medical Practice Edition hurriedly: that is, I wasn’t very careful when I built a profile (trained Dragon) and then gave Dragon an initial test run by speaking into a 10-year-old, $5.95 microphone that happened to be connected to my sound card at the time. The idea was simply to familiarize myself with this new edition a little before using it seriously later. To my astonishment, even with this primitive set up, Dragon Medical Practice Edition converted my speech to text without a single error throughout a 5-minute run (using the General vocabulary).

There's an awful lot of information about this new version to sift through. Nuance's site (click here) is a good place to start.

{ Click on the image above for a larger view }

As a footnote, I want to add that systems that convert spoken words to text are not just of value to professional practices. I have an acquaintance who has used this software for over a year as he has had a stroke and finds it difficult to type. He speaks well of it.

Security Requirements for Electronic Health Records Redux

2011-08-19T09:50:00.007-04:00

Click here for a commercial white paper on the title subject from the vendor Symantec. Although much of its content appears in earlier posts to this blog, this white paper presents a good summary of today's conventional wisdom on the subject.

Counter views abound, however. For example, many believe that there is no such thing as cybersecurity. That’s because no system can be 100% secure. There is no uncrackable code.

Google+ ... The next big thing ?

2011-08-17T12:32:00.004-04:00

The following numbers are impressive, given that Google+ marketing hasn't yet begun.

It will be fascinating to see whether Facebook, which has a very big head start and hundreds of millions of satisfied users, or Google+, now only a few weeks old, which, once you get a free Google+ account, has a spot on the new, nearly ubiquitous, black Google toolbar, reaches a billion users first. Note: Each time you connect with any of the Google services (a billion people do each month), you see this new toolbar across the top of your browser.

Stay tuned ….

And/or click here for more overview.

The Changing Landscape For HTLM5 Design

2011-08-05T12:26:00.019-04:00

Motion and Interaction Design for HTML5

Adobe Edge Preview is a new Web motion and interaction design tool that allows designers to bring animated content to websites, using web standards like HTML5, JavaScript, and CSS3.

The initial version of Edge focuses primarily on adding rich motion design to new or existing HTML projects, that runs beautifully on devices and desktops.

Click here to download your own copy of this free beta and examine the samples for yourself. With them, you can be up and running in only a few minutes, or click here to see an image of one of these samples that I've run on my desktop, or click here for one video that shows Edge in use and/or here for another.

{ Click on the image above for a larger view }

As much as we can give Apple credit for getting the HTML5 ball rolling, Adobe's decision to offer an HTML5 design tool is unlikely the result of Adobe giving in to Apple. It is a reasonable business decision that answers to a global trend - a decision that is driven rather by opportunity than surrender.

Few of us paid attention to this new format before Apple said it would deny Flash access to its iOS platform for performance, security and power consumption reasons (while others claim it is really the closed platform approach that killed Flash on iOS).

Within two years, HTML5 has evolved from an Apple thought process to a global movement with the conviction that HTML5 will be the future standard of how Web applications will be developed. It is a conviction that is shared by those who follow corporate interests as well as those who have the open Web in mind, such as Mozilla. Whether we like it or not, HTML5 will become a powerful application layer for the Internet within a few years - the first application layer that will enable Internet applications and services that will look and feel like desktop applications today.

Adobe sees Edge as a tool designers can use along with its Creative Suite applications such as Photoshop and Dreamweaver (discussed on a few of my earlier posts to this blog), although direct import support isn’t available yet. Adobe does, however, have plans to add import support as development continues.

Edge-created content is viewable on any HTML5-aware browser, such as Safari, Firefox and Chrome, and works on mobile devices such as the iPhone, iPad, HP’s WebOS, and Android-based smartphones.

The beta is still in its early stages, so it isn’t feature complete yet, and Adobe plans to use feedback from customers in the development process.

If you look at the market share for browsers, you will find that less than half the browsers in use are HTML5 compatible at this point. That percentage is certain to rise rapidly over the next couple of years, but a substantial share of the browser market will require an alternative to HTML5 for the foreseeable future. Companies will still need to be backwards compatible for older browsers at a minimum and will employ Flash for this.

In addition to raw browser support, HTML5 lacks a number of features that Flash offers. Most notably, Flash includes digital rights management (DRM) features, while in HTML5, users can quickly save videos to their own machines. That may not sound like such a bad thing for users, but for developers and content owners, it's a serious problem. A number of DRM schemes are currently under consideration for HTML5, but the issue is far from resolved. The best-fitting software depends on your use case. Many projects will benefit from technologies like Flash that are not browser controlled, for some time to come.

Adobe to Capitalize on The Rise of HTML5

While Flash has been the dominant technology used to create interactive, animated content, its market share has been decreasing as HTML5 gains ground. Apple refused to support Flash on the iPhone and the iPad citing performance issues (as noted above), which led many developers to move to adopt HTML5.

With PC sales dropping and tablet sales showing tremendous growth, many developers will eventually move on to HTML5 to create content as it is compatible with most platforms and doesn’t need any special plugins.

With Adobe Edge, Adobe plans to capitalize on this shift to HTML5. With Edge, Adobe can recapture some of its lost market share and improve sales of its Creative Suite software bundle, which currently has more than a 40% share of the global market.

Briton's EHR System - IT and Politics

2011-08-03T08:48:00.005-04:00

Briton has been trying to create a single network that would allow NHS staff across England to access any patients’ details. A new report, however, says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems.

Critics claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

Click here for more.

I found the comment there that includes the following:

"One of the most basic mistakes in the public sector is to assign "IT experts" to these types of projects. That, however, is not what is needed at all - we, as suppliers and designers, have all the IT expertise required. What we need on the customer side is somebody who can write and develop correct specifications - what exactly is required, and how is it supposed to work? Specifically, we don't need young ambitious people that want to jump start a career but don't understand the KISS principle..."

I encourage the reading of the comments following the article cited in the link above.

Tracking technology is getting smarter and more intrusive

2011-07-30T12:39:00.018-04:00

An Online Tracking Service That Can’t Be Dodged:

Researchers at U.C. Berkeley have discovered that some of the net’s most popular sites are using a tracking service that can’t be evaded -- even when users block cookies, turn off storage in Flash, or use browsers’ “incognito” functions.

The service, called KISSmetrics, is used by sites to track the number of visitors, what the visitors do on the site, and where they come to the site from -- and KISSmetrics says it does a more comprehensive job than its competitors such as Google Analytics.

The research was published Friday, July 29, 2011 by a team UC Berkeley privacy researchers that includes veteran privacy lawyer Chris Hoofnagle and noted privacy researcher Ashkan Soltani.

It is possible, the researchers say, for any two sites using KISSmetrics to compare their databases and ask things like “Hey, what do you know about user 345627?” and the other site could say “his name is John Smith and his email address is this@somefakedomainname.com and he likes these kinds of things.”

Click here to down the research paper (2 MB pdf file) of the Berkeley researchers, read it and see what you think!

For additional insight into the tracking ecosystem, see the article "The Web's New Gold Mine: Your Secrets" in The Wall Street Journal" of July 30, 2011.

{ Click on the image above for a larger view }

And, of course, if you’re using a GPS enabled smartphone, they can add where you are now and where you’ve been to the info about you that they’re collecting . . . including where you live.

Nobody is immune to cyberattack

2011-06-11T12:59:00.020-04:00

Around the world, computer networks are getting more vulnerable even as they grow more sophisticated. They are being penetrated and looted by digital intruders.

The personal records of 100 million people were stolen in an attack on Sony Corp.’s video game networks. Up to 210,000 unemployed Massachusetts residents were put at risk by data theft software that infected computers at the state’s Executive Office of Labor and Workforce Development. And, in March, as mentioned in an earlier post, criminals stole vital information from data protection company RSA Security, a division of storage giant EMC Corp. The stolen RSA data was later used in a hacker raid on defense contractor Lockheed Martin Corp., an RSA client. The list of data breaches grows almost daily, and while consumers and businesses can take steps to reduce the risk of losing sensitive information, security analysts say that making our computer networks truly secure is virtually impossible.

Antivirus and other commercial security software products may be adequate against the kind of amateur hackers who vandalized websites in the Internet’s early days, but they often fail to detect the custom-made attack programs, or “malware,’’ created by today’s organized crime gangs and foreign intelligence agencies. Cybercrime by governments will probably be even tougher to fend off. In late 2009, computers at the search engine giant Google Inc. came under a severe attack aimed at getting access to the company’s software codes. A host of other companies, including Adobe Systems Inc. and Juniper Networks Inc., were also hit. In January 2010, Google attributed the attack to hackers working from within China, a claim the Chinese government rejected.

The International Monetary Fund was hit recently by what computer experts describe as a large and sophisticated cyberattack whose dimensions are still unknown. The fund said that it did not believe that the intrusion into its systems was related to a sophisticated digital break-in at RSA Security that took place in March, which compromised some information that companies and governments use to control access to their most sensitive computer systems. After that attack, the World Bank briefly shut down external access to its most sensitive systems, for fear that the stolen information could make it a target. But it quickly resumed its normal operations and says it has seen no evidence of any attacks.

Companies and public institutions are often hesitant to describe publicly the nature or success of attacks on their computer systems, partly for fear of providing information that would be useful to the individuals or countries mounting the efforts. Even so, Google has recently been aggressive in announcing attacks and, in one recent case, as mentioned above, of declaring that its origin was China, an accusation the Chinese government quickly denied.

But in the case of the I.M.F., officials declined to say where they believe the attack originated — a delicate subject because most nations are members of the fund. The attacks were likely to have been made possible by a technique known as “spear phishing,” in which an individual is fooled into clicking on a malicious Web link or running a program that allows open access to the recipient’s network. It is also possible that the attack was less specific, a case in which an intruder was testing the system merely to see what was available.

Caveat emptor.

HTML5 is now playing in the big leagues

2011-06-08T07:35:00.015-04:00

The Financial Times (London) yesterday introduced a mobile Web application aimed at luring readers away from Apple’s iTunes App Store, throwing down the gauntlet over new business conditions that Apple is set to impose on publishers who sell digital subscriptions via iTunes.

A number of publishers have expressed their displeasure with Apple’s plan to retain 30 percent of the revenue from subscriptions sold on iTunes, and to keep customer data from such sales, beginning at the end of June. At the same time, mobile applications are a fast-growing source of new readers and revenue, so publishers have been reluctant to pull their applications from the iTunes store.

The Financial Times, the British daily, has tried to get around this problem by designing a new app that includes much of the functionality of an iPad or iPhone application, while residing on the open Web. It employs a new Web technology standard called HTML5, which allows programmers to create a single application that can run on a variety of devices, including Apple’s iPhone and iPad, Google’s Android system and the BlackBerry PlayBook, although the new app does not work on some versions of the devices.

The Financial Times said it would encourage users of its iPad and iPhone applications to migrate to the new app. It said it did not plan to comply with Apple’s proposed conditions, even if that meant Apple removed the existing applications from iTunes.

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Update on my earlier posts on SecurID tokens

RSA Security has offered to replace the SecurID tokens used by enterprises and government agencies to secure their networks after attackers attempted to hack a defense contractor’s network in May.

The SecurID two-factor authentication technology relies on a pseudo-random number that is generated every 30 to 60 seconds. Users have to enter their own username, self-selected password and the code displayed on the token. The authentication server knows what number was generated. Attackers also now know how to figure out what number is being generated, and it is easy to steal usernames and passwords using phishing or keyloggers.

There are an estimated 40 million SecurID tokens currently in use.

Click here for an open letter to RSA SecurID customers.

Chromebook and The Google Chrome OS

2011-05-18T09:45:00.007-04:00

Most of the IT professionals I know scoff or snicker when I bring up the topic of Google Chrome OS. But, just as IT pros used to roundly dismiss the idea of cloud computing — and many of them are now climbing over each other to tout their cloud and virtualization expertise — it might not be long before IT also warms up to Chrome OS, out of necessity.

Over a three-year rental period, a business would pay $1008 for a Chromebook, plus another $150 for Google Apps. That’s roughly about the same cost most businesses would pay Microsoft for a seat of Windows, Microsoft Office, and a CAL for Microsoft servers (as part of an Enterprise Agreement with Microsoft). However, with the Google deal, the company also gets desktop hardware and it can eliminate or at least greatly reduce most of the expensive server hardware and backend Microsoft software. For many businesses, that kind of equation would be very lucrative and way too tempting to ignore.

Click here for YouTube video.

Using The jQuery Mobile Framework - Write Once, Publish Anywhere

2011-05-17T08:02:00.008-04:00

As described in earlier posts, the emphasis in Dreamweaver CS5.5 is firmly on mobile development and designing for multiple screens. A big part of this capability comes from its inclusion of jQuery Mobile, a sophisticated JavaScript and CSS framework designed to work consistently in all major mobile platforms.

•Apple iPhone/iPod Touch
•Google Android
•RIM BlackBerry/Playbook OS
•Nokia Symbian (retired, but still with over 1 billion users worldwide)
•HP/Palm WebOS
•Microsoft Window Phone 7

Built upon the popular jQuery JavaScript framework, jQuery Mobile lets Web designers and developers build mobile application interfaces quickly and consistently. Dreamweaver CS5.5's jQuery’s mobile strategy can be summarized simply: Delivering top-of-the-line JavaScript in a unified User Interface that works across the most-used smartphone web browsers and tablet form factors.

Click here for an introduction to jQuery from Adobe.

Click here for an introduction to jQuery Mobile from Adobe.

Click here for the jQuery Project site

Click here for the jQuery Mobile Project site

Building Mobile / Phone Apps with Dreamweaver CS5.5 and PhoneGap

2011-05-06T15:33:00.023-04:00

As Web browsing becomes available on an ever-growing number of smartphones and tablets, you need solid support for the “write once–publish anywhere” development model. To streamline your projects, the PhoneGap framework is now integrated as an extension in Dreamweaver CS5.5. Using PhoneGap, you can build native Android and iOS apps directly from Dreamweaver CS5.5 projects.

Seamless integration of the PhoneGap and Android SDKs into Dreamweaver CS5.5

PhoneGap emulator with my app (The one with the red check)

My Dreamweaver CS5.5 mobile app running in the PhoneGap emulator

With PhoneGap, you can write a mobile app using standards-based technologies (HTML, CSS, and JavaScript). You can add device-specific functionality, such as multitouch, geolocation, and accelerometer features. To finish up, Dreamweaver assists you in compiling and packaging the app for direct delivery to the device or to vendor-specific online app stores.

The PhoneGap emulator phone

{ Click on any of the images for larger view }

Using jQuery. HTML5, PhoneGap And More In The New Multiscreen World

2011-04-29T09:59:00.020-04:00

The soon-to-be-released Adobe Dreamweaver CS5.5 (part of Creative Suite 5.5) helps you create content with HTML5, CSS3 and the JQuery mobile framework (among other things) and target multiple platforms including Android operating systems, iOS, and Adobe AIR. As seen in the images below, Dreamweaver CS5.5 reflects the new and growing presence of not only the desktop computer, but the smart phone and tablet as well.

{ Click on any of the images for larger view }

With the Dreamweaver CS5.5 Media Queries dialog box, you can attach or create CSS files for different screen sizes and force devices to report their actual widths.

PhoneGap

With the Mobile Applications feature and the SDK for Android (shown above) or iOS, you can emulate and create a native mobile application from your Dreamweaver CS5.5 site files.

PhoneGap is an HTML5 app platform that allows you to author native applications with Web technologies and get access to APIs and app stores.

To streamline your projects, the PhoneGap framework is now integrated as an extension in Dreamweaver CS5.5. So, using PhoneGap, you can build native Android and iOS apps directly from Dreamweaver CS5.5 projects.

Adobe has proven that it can work intimately with a vendor, such as with Research in Motion, whose application development strategy for the PlayBook at launch is 100 percent dependent on Adobe’s AIR and Flash technologies (and will be so until other native QNX SDKs and “Players” are released). Today, the PlayBook demonstrates excellent performance with the Flash and AIR runtimes as both stand-alone tablet apps and embedded into a Mobile browser.

Click here for a look of the Blackberry PlayBook runing video using Flash and HTML5. Video on the PlayBook is superb, with crisp resolution. Video arguably looks better on the PlayBook than on its iPad 2 and Motorola Xoom rivals.

At the same time, on the iOS platform, users aren't feeling any lack of Flash. Virtually every Web site imaginable has moved to HTML5 H.264-based encoding of embedded video. YouTube itself has also fully optimized itself for Mobile Safari and iOS. So, as I've been pointing out, to compensate for this shift, Adobe has introduced HTML5 support into its tools.

More to follow. Stay tuned.

Developing Rich Web Apps On A Network With Many Platforms (JQuery Mobile)

2011-04-16T08:41:00.024-04:00

We live in a networked world filled with smartphones, tablets, Internet-enabled televisions and, yes, desktop computers. So, it's no surprise that application development tools like the soon-to-be-released Adobe Creative Suite CS5.5 Web Premium reflect this evolution of the network by targeting multiple platforms including, but not limited to, Google's Android operating systems, Apple's iOS, RIM's Blackberry in addition to Adobe AIR by facilitating the authoring of rich content with HTML5, CSS3 and JQuery mobile to name a few. I've written about HTML5 and CSS3 in earlier posts to this blog and will have something to say about JQuery in an upcoming one. For now, please note that the

jQuery mobile framework takes the "write less, do more" mantra to the next level: Instead of writing unique apps for each mobile device or OS, the jQuery mobile framework will allow you to design a single highly branded and customized web application that will work on all popular smartphone and tablet platforms. Click here for more.

Basic features of jQuery Mobile include:

General simplicity
The framework is simple to use. You can develop pages mainly using markup driven with minimal or no JavaScript.

Progressive enhancement and graceful degradation
While jQuery Mobile leverages the latest HTML5, CSS3, and JavaScript, not all mobile devices provide such support. jQuery Mobile philosophy is to support both high-end and less capable devices, such as those without JavaScript support, and still provide the best possible experience.

Accessibility
jQuery Mobile is designed with accessibility in mind. It has support for Accessible Rich Internet Applications (WAI-ARIA) to help make web pages accessible for visitors with disabilities using assistive technologies.

Small size
The overall size of the jQuery Mobile framework is relatively small at 12KB for the JavaScript library, 6KB for the CSS, plus some icons.

Theming
The framework also provides a theme system that allows you to provide your own application styling.

Some jQuery Mobile UI elements

But getting back to Adobe Creative Suite 5.5 Web Premium: with it, you can:

Manage content for different screen sizes.
Develop apps for virtually any mobile device.
Ensure design integrity across the entire web.

For a look at this new flexibility, click here to watch Adobe's Dreamweaver CS 5.5 creating a rich app for Apple's iPad.

Stay tuned!

HTTPS, Certificates and Web Security Reconsidered

2011-04-13T09:41:00.009-04:00

The Comodo Group, an Internet security company, has been attacked in the last month by a talkative and professed patriotic Iranian hacker who infiltrated several of the company’s partners and used them to threaten the security of myriad big-name Web sites.

But the case is not a problem for only Comodo, which initially believed the attack was the work of the Iranian government. It has also cast a spotlight on the global system that supposedly secures communications and commerce on the Web.

The encryption used by many Web sites to prevent eavesdropping on their interactions with visitors is not very secure. This technology is in use when Web addresses start with “https” (in which “s” stands for secure) and a closed lock icon appears on Web browsers. These sites rely on third-party organizations, like Comodo, to provide “certificates” that guarantee sites’ authenticity to Web browsers.

But many security experts say the problems start with the proliferation of organizations permitted to issue certificates. Browser makers like Microsoft, Mozilla, Google and Apple have authorized a large and growing number of entities around the world — both private companies and government bodies — to create them. Many private “certificate authorities” have, in turn, worked with resellers and deputized other unknown companies to issue certificates in a “chain of trust” that now involves many hundreds of players, any of which may in fact be a weak link.

The Electronic Frontier Foundation, an online civil liberties group, has explored the Internet in an attempt to map this nebulous system. As of December, 676 organizations were signing certificates, it found. Other security experts suspect that the scan missed many and that the number is much higher.

Making matters worse, entities that issue certificates, though required to seek authorization from site owners, can technically issue certificates for any Web site. This means that governments that control certificate authorities and hackers who break into their systems can issue certificates for any site at will.

Experts say that both the certificate system and the technology it employs have long been in need of an overhaul, but that the technology industry has not been able to muster the will to do it. “It hasn’t been perceived to be a big enough problem that needs to be fixed,” said Stephen Schultze, associate director of the Center for Information Technology Policy at Princeton. “This is a wake-up call. This is a small leak that is evidence of a much more fundamental structural problem.”

In the Comodo case, the hacker infiltrated an Italian computer reseller and used its access to Comodo’s systems to automatically create certificates for Web sites operated by Google, Yahoo, Microsoft, Skype and Mozilla. With the certificates, the hacker could set up servers that appear to work for those sites and try to view the unscrambled e-mail of millions of people, experts say. Comodo says it has suspended the Italian reseller and a second European reseller that the hacker also infiltrated.

In a series of online messages teeming with bravado, the hacker described himself as a software-engineering student and cryptography expert and said he worked alone. He suggested he was avenging the Stuxnex computer worm, which was directed at Iranian nuclear installations last year. And he indicated that he intended to use the certificates he created to snoop on opponents of the Iranian regime. “As I live, you don’t have privacy in Internet, you don’t have security in digital world,” he warned.

The certificate system was created at the dawn of e-commerce in the early 1990s before security was a major issue. Security experts say the system is not up to the challenge of today’s immense, commercial and much-attacked Internet. It was designed primarily to let businesses take credit card payments online, and less to confirm the authenticity of Web sites.

The crucial tool available to Comodo and the browser makers — revocation — is ineffective, security experts say. After the Comodo case, Google, Mozilla and Microsoft rushed out patches so their browsers would recognize and reject the bad certificates. But this solution requires many millions of Internet users to update their browser software, which many people never do.

Moreover, because certificate authorities’ servers are seen as unreliable, most browser makers allow users to proceed to an alternative site, and hackers can exploit this weakness, security experts say.

Browser makers have another problem: Faced with a suspicious certificate authority, there is little they can do shy of rescinding it. But if they did that, millions of Web users might encounter troubling error warnings when they visited sites with certificates from that company, causing a cascade of problems for users and site owners. Cutting out a large player like Comodo, which controls at least 95,100 active certificates, could effectively “break the Web,” said Dan Kaminsky, chief scientist at the security firm DKH.

They are effectively “too big to fail,” said Christopher Soghoian, a former Federal Trade Commission technologist who is now a graduate fellow at the Center for Applied Cybersecurity Research at Indiana University. “The problem is that the browser vendors don’t have a small stick, they only have a big stick." He said he could not recall a single instance in which the browser vendors had rejected a certificate authority.

Microsoft and Mozilla said that they would consider removing certificate authority if it was in the best interest of Internet users, and that they remained in talks with Comodo about its security practices. “Participation in Mozilla’s root program is a privilege, not a right,” the company, the nonprofit maker of Firefox, said. Apple, maker of the Safari browser, declined to comment. (Google’s Chrome browser defers to the choices of operating system makers like Microsoft and Apple about which certificate authorities are accepted.)

Mozilla, Microsoft and Google said they would work together and with certificate authorities and the security community on improvements to the system. One approach proposed by Comodo and Google engineers in January would allow Web site owners to specify which certificate authorities may issue certificates for their sites.

An initiative preferred by security experts would overhaul the system more radically. It would give Web sites similar control while securing their certificates within a new encrypted version of the domain name system, the central directory of the Web, making it the de facto central certificate authority through which Web sites could generate their own certificates.

Security Breach Anouncement @ RSA

2011-03-23T13:56:00.003-04:00

As you may have heard, last Friday RSA announced that a security breach had resulted in the disclosure of information "specifically related to RSA's SecurID two-factor authentication products." RSA states that "this information could potentially be used to reduce the effectiveness of a current two-factor authentication implementation." While RSA has released little information about the extent of the breach, there’s a great article from Dell that provides an objective view of the potential impacts and recommended actions RSA SecurID customers can take today. If you’re currently using SecurID, I encourage you to read over the article at http://www.secureworks.com/research/threats/rsacompromise/ { click on link }

Also, you could click here for the two-factor authentication page (3) of my 2006 article "Secure Mobile Web Service Applications: The BlackBerry Enterprise Solution."

IBM's Watson and Nuance's Dragon Medical

2011-02-19T11:12:00.004-05:00

Earlier this week, after the Watson computer defeated human champions in a three-day match on the popular TV show Jeopardy, its creators and a Massachusetts software company prepared to sell a medical version of the smart machine.

IBM has an agreement with Nuance Communications Inc. of Burlington to sell Watson-based products to health care providers. Nuance already offers voice-recognition software for a variety of applications. The companies are pitching forthcoming technology that will, among other things, allow medical providers to describe symptoms orally and get diagnostic information in return.

Watson technology will enable Nuance to add artificial intelligence to its offerings. And that's where this blog comes in. I've been talking about these two topics, albeit separately, for some time now.

Watson's ability to analyze the meaning and context of human language, and quickly process information to find precise answers can assist decision makers, such as physicians and nurses, unlock important knowledge and facts buried within huge volumes of information, and offer answers they may not have considered to help validate their own ideas or hypotheses.

For example, a doctor considering a patient’s diagnosis could use Watson’s analytics technology, in conjunction with Nuance’s voice and clinical language understanding solutions, to rapidly consider all the related texts, reference materials, prior cases, and latest knowledge in journals and medical literature to gain evidence from many more potential sources than previously possible, thereby helping the medical professional to confidently determine the most likely diagnosis and treatment options.

For more information about the Watson computing system and the Jeopardy! challenge, click here.

On earlier posts to this blog, I discussed the semantic Web, ontologies, and speech recognition software from Nuance (and Adobe):

See, for example, my November 7, 2009 post "Vagueness, Logic and Ontology: Fuzzy Ontologies"

In traditional ontology theory, concepts and roles are crisp sets. However, there is a great deal of fuzziness in the real world.

For example, one may be interested in finding “a very strong flavored red wine” or in reasoning with concepts such as “a cold place”, “an expensive item”, “a fast motorcycle”, etc.

A possible solution to handling uncertain data is to incorporate fuzzy logic into ontologies. Unfortunately, these fuzzy ontologies have shortcomings – reasoners for fuzzy ontologies are not yet so polished as those for crisp (aka traditional) ontologies.

See, for example, my May 30, 2009 post on "Speech Recognition Software"

The trivial example of one-to-one translation given there can be extended to one-to-many translation: That is, in a matter of seconds, you could “program” Dragon Medical to type out a whole sentence in response to your speaking just a single word or code into the microphone. And, vice versa: you could “program” Dragon Medical to type out just a single word or code in response to your speaking a whole sentence into the microphone.

Wikileaks and EHR Security

2011-02-07T13:53:00.004-05:00

As far as the leaked US cables are concerned, the fury of the US administration and of certain US politicians was, for a time, positively comical. It stopped being funny when they began talking about prosecuting Julian Assange for "espionage", given the draconian penalties that a conviction would carry. But the State Department's indignation over the leaks of allegedly valuable secrets was, and remains, preposterous.

Why? Because there is absolutely no way that a huge database containing 250,000 "secret" documents that can be lawfully accessed by more than a million officials can ever be secure. Any security engineer will tell you that it cannot be done: if you want to keep things secret online then the only way to do it is by compartmentalizing the system. Huge, monolithic computer systems are intrinsically insecure.

So, I believe that what is true of Wikileaks is true of Electronic Health Records (EHR) in so far as security (confidentiality) is concerned. Actually, as any reader of his or her hometown newspaper or local TV news knows, all computer systems are potentially insecure. Caveat emptor.

HTML5, WebGL and Google Body Browser

2010-12-28T11:58:00.021-05:00

Google has recently demoed an interesting WebGL application called Body Browser, which lets you explore the human body just like you can explore the world in Google Earth. Now you can try Google Body Browser before it's added to Google Labs, assuming that you have a WebGL-enabled browser:

* WebGL is available, but not enabled by default in Chrome 8 (the latest stable version).

* WebGL is enabled by default in Chrome 9 Beta, Chrome 9 Dev Channel, Chrome Canary Build and Firefox 4 beta.

Google Body is a detailed 3D model of the human body. You can peel back anatomical layers, zoom in, and click to identify anatomy, or search for muscles, organs, bones and more. You can also share the exact scene you are viewing by copying and pasting the URL.

The application doesn't require a plugin. Unlike many other web-based medical applications, no Flash, Java, or other plugins are needed. This application will run on any WebGL-supported browser.

WebGL is based on OpenGL ES 2.0 and provides a programmatic interface for 3D graphics. It uses the HTML5 canvas element and is accessed using Document Object Model interfaces. Automatic memory management is provided as part of the JavaScript language. HTML5 was discussed in some of my earlier posts.

Click here for Getting a WebGL Implementation

Click here for An Introduction to HTML5

Comment: Years ago, matrices (and tensors) were taught only to graduate students. After some time, these subject(s) were taught to undergraduates too. Today, even a few elite secondary schools teach these subject(s). Similarly, anatomy references were once available only to medical students at institutions like the Harvard and Johns Hopkins Medical Schools. Today, anyone with a high-speed internet connection can access such an application.

For a 1-minute video on Google Body Browser, click here.

For a 7-minute video on Google Body Browser, click here.

Strategies for Closed-loop Radiology Workflow with Speech-Driven Documentation and Communication

2010-11-12T09:12:00.020-05:00

Commercially-available Clinical Radiology Support

Nationally, it is estimated that 20 to 30 percent of currently performed High Tech Diagnostic Imaging (HTDI) exams are medically unnecessary or inappropriate.

This is due, in part, because many HTDI exams are currently scheduled without the benefit of a standardized, evidence-based, decision support tool.

After a yearlong pilot program, in which more than 2,300 physicians from five Minnesota medical groups, five health plans, and the Minnesota Department of Human Services used e-Ordering (defined later) to order high-tech diagnostic imaging exams, it was found that the exams ordered with evidence-based decision-support technology had an increase in medical appropriateness versus orders initiated without it. The pilot also showed that using decision-support appropriateness criteria (defined later) in the physician’s office reduced patient exposure to unnecessary radiation, and contributed to a 0 percent increase in HTDI scans ordered in 2007 (following an 8 percent increase in Minnesota in 2006). N.B. During the time of the pilot, an estimated $28 million in healthcare cost savings was reported.

Going forward, Nuance’s RadPort, an electronic, evidence-based, decision-support (e-Ordering) solution is going to be used to support a statewide initiative to help ensure Minnesotans only receive medically appropriate high-tech (MRI, CT, PET and nuclear cardiology) diagnostic imaging (HTDI) tests.

Derived from the American College of Radiology (ACR) Appropriateness Criteria, and designed in conjunction with Massachusetts General Hospital, RadPort’s scoring methodology is continuously reviewed and updated by a panel of clinical and radiology experts.

RadPort combines the clinical information provided by the referring physician at the time of ordering with patient demographics to produce a “utility score” for the examination requested.

Click here for a discussion of appropriateness criteria and utility scores.

A high score indicates that the information provided strongly supports the use of the requested imaging test. A low score indicates that the request may not be appropriate. As a result, RadPort displays alternate procedure choices with corresponding utility scores of other relevant and appropriate exams.

In the event of a low score, RadPort provides clinical reference material designed to educate the referring physician so as to ensure appropriate ordering in the future.

Nuance Healthcare manages radiology as a single, end-to-end or closed-loop process. This approach gives radiologists and administrators a continuous view of the order from diagnosis through results process, which allows for analysis that can drive improvements at each stage.

The benefits of closed-loop radiology are evident: saving time, money, and resources, improving patient safety and care, and better clinical documentation.

Click here for an overview.

Click here for info on RadCube, a comprehensive, yet flexible, data warehouse for multi-dimensional business analysis and visualization tool. RadCube is another key application in the Nuance portfolio of imaging documentation and communication software.

RadCube merges OLAP and web architecture. This radiology-centric solution allows its users to perform highly complex clinical and detailed business analysis on your data in mere seconds using a simple drop-and-drag interface. By integrating advanced On-Line Analytical Processing (OLAP) techniques and Natural Language Processing (NLP) with one's unique institutional data, RadCube provides ways to visualize, analyze and optimize healthcare delivery to each patient. With RadCube, you can explore information from various business, clinical and research perspectives or identify trends, opportunities and potential issues quickly with familiar visualization techniques. You can analyze all operational aspects of your business including: Business Productivity, Quality Assurance, Utilization Management, Throughput Analysis, Communication Management, Evidence-Based Radiology, Advanced Data Mining Techniques, Trending and Forecasting, and Benchmarking.

{ click on image to see larger view }

Click here for info on applying “Six Sigma” principles to the radiology process.

Click here for an early article of mine on “Six Sigma”

A link to this article is also available near the top of "My [partial] bibliography" at the bottom of this blog.

Finally, click here for a brief introduction to i2b2, an open-source calable informatics framework that enables clinical researchers to use existing clinical data for discovery research and, when combined with IRB-approved genomic data, facilitate the design of targeted therapies for individual patients with diseases having genetic origins.

HTML5 and Adobe Redux

2010-10-26T10:24:00.009-04:00

With the rise of HTML5, Adobe's Flash has been positioned as the antagonist of the open standard. Increasingly, HTML5 is used to serve online videos though the matter is far from resolved.

Adobe has just released an embeddable video player that plays HTML5 native video in browsers that support it, and falls back to Flash in browsers that don't. It's cross-browser and cross-platform, so it works on iPhones, iPads and other devices that don't support Flash. Using Adobe's new player, these devices can show videos in web pages without the Flash plug-in. The shift takes place regardless of the screen -- from phone to monitor to TV.

This means that Adobe wasn't kidding when they said they were riding the HTML5 bandwagon as hard as anybody right now.

The HTML5 Video Player widget, now available through the Adobe Widget Browser, works with or without Dreamweaver CS5. Code generated from the widget plays video in the best possible player for the requested platform using a range of video codecs. Based on the Kaltura open source library, the HTML5 Video Player widget is fully cross-browser compatible with support for Internet Explorer, Firefox, Safari, Chrome, and Opera. Moreover, the player is completely customizable with industry standard CSS techniques.

You can run the Adobe Widget Browser directly from within Dreamweaver and, once you’ve set it up, insert the generated code and files for the HTML5 Video Player widget with point-and-click simplicity. But if you’re not a Dreamweaver user, you can also download the Widget Browser independently. (You’ll need to install Adobe AIR first.)

Click here for links to several new tutorials on HTML5.

Click here for my post on the Dreamweaver CS5 HTML5 Pack

HTML5 And Risks To Privacy On The Front Page Of The Non-Techinal Press

2010-10-11T08:41:00.011-04:00

I have a couple of posts on HTML5 below. Nonetheless, I was a little surprised to see this topic (in the context of "risks to privacy") discussed on the front page of this morning's edition of the New York Times (and elsewhere):

From this morning’s front page:

Most Web users are familiar with so-called cookies, which make it possible, for example, to log on to Web sites without having to retype user names and passwords, or to keep track of items placed in virtual shopping carts before they are bought.

The new Web language (HTML5) and its additional features present more tracking opportunities because the technology uses a process in which large amounts of data can be collected and stored on the user’s hard drive while online. Because of that process, advertisers and others could, experts say, see weeks or even months of personal data. That could include a user’s location, time zone, photographs, text from blogs, shopping cart contents, e-mails and a history of the Web pages visited.

Click here for more.

Cost/Benefit and ROI aspects of Health Information Technology (HIT)

2010-10-07T13:51:00.012-04:00

Whether or not EHR and other HIT systems benefits exceed costs is a question being discussed in many quarters today. A 2006 report { click here } based on research conducted by the Southern California Evidence-based Practice Center provides what I consider a good framework for a priori and a posteriori examination of the cost/benefit and ROI aspects of this question.

Despite the heterogeneity in the analytic methods used, all cost-benefit analyses predicted substantial savings from EHR (and health care information exchange and interoperability) implementation: The quantifiable benefits are projected to outweigh the investment costs. However, the predicted time needed to break even varied from three to as many as 13 years.

Many of the studies concerned HIT systems developed and evaluated by academic and institutional leaders in HIT.

Regenstrief Institute in Indianapolis, IN
Partners/Brigham and Women’s Hospital in Boston, MA
Intermountain Health in Salt Lake City, UT
Kaiser Permanente health care system
Vanderbilt University in Nashville, TN
U.S. Department of Veterans Affairs (VA) health care

As asserted above, you need to ask when a particular system will reach the break even point. You also need to examine any potential for a mismatch between who pays for and who accrues cost savings from HIT use. Private organizations deciding whether to invest in HIT must weigh the costs and benefits of doing so. Although the primary goal of nonprofit healthcare organizations may be to provide high-quality care, these organizations still need to watch the bottom line to survive, which includes understanding the costs of measures designed to improve quality. Such private return-on-investment (ROI) calculations can provide results that are quite different from those of societal cost-benefit analysis, which are often reported in clinical journals. For example, one study showed that a hospital that installed a computerized reminder system to alert providers when patients were not up-to-date on their immunizations increased pneumococcal vaccine orders by 8 percent. Another study showed that, among the elderly, each $12 vaccination averts $20.27 in hospital costs and increases life expectancy an average of 1.2 days. From society’s point of view, the reminder system saves money and improves health, so it is a win-win program. However, from a financial perspective, the hospital has spent money on a system that had no effect on the costs or revenues of current stays because the pneumococcal vaccine is not delivered in the hospital. To benefit from this intervention, the hospital must make a reputation for higher quality and convert it into profits. This is one example of the potential for a mismatch between who pays for and who accrues cost savings from HIT use. A more extreme example would be a hospital’s implementation of a HIT intervention that averts future hospitalization. In this case, HIT implementation both costs the hospital money and decreases hospital revenues, even if the HIT implementation has a net cost-savings from a societal (or Medicare) perspective.

For more, click here, here and here.

HTML5 - its support in Dreamweaver CS5, Internet Explorer 9 and elsewhere - Part II

2010-08-12T10:41:00.039-04:00

There's been a lot of discussion lately about whether or not the HTML5 video tag is going to replace Flash Player for video distribution on the Web.

Consensus: While the video tag is a big step forward for open standards, the Adobe Flash Platform will continue to play a critical role in video distribution.

Click here for a discussion of this topic in the YouTube context (a pretty significant one).

HTML5 (and CSS3) are works in progress. While some parts of these specs are finished or stable, other parts are still under development or have no current browser support.

Nonetheless, leading development tools, e.g., Adobe's Dreamweaver, have begun to support these technologies. To wit, specs that are stable or that have some level of browser implementation are now seen in the new Dreamweaver CS5 HTML5 Pack. Select the Product Details tab.

While the official specifications are still not yet complete, they are now supported to varying degrees by a number of different desktop browsers – and more importantly by all smartphones using Webkit-based browsers (e.g. iPhone, Android, Nokia WRT, Blackberry OS). Given the recent surge of interest around HTML5, Dreamweaver CS5’s compatibility with HTML5 and CSS3 was updated so you can begin exploring their potential today.

Epocrates Mobile Electronic Health Record

2010-07-13T10:27:00.017-04:00

Health care delivery is now moving away from a specific location and into a virtual care space, where patient medical records and real-time clinical data will reside.

There has also been a revolution in access to clinical reference material, and physicians and other care providers are moving core scientific knowledge from books to apps. Today’s doctors are no longer what they can memorize.

Throughout this blog, I've been discussing many of the components of Electronic Health Record (EHR) systems that will likely be used in the larger systems installed throughout entire hospitals and regions. However, 50 percent of physicians in the US work in small or solo practices.

The Epocrates EHR is specifically targeting the solo practitioner and the small physician groups, which have different needs from the larger enterprise care facilities that so many EHR providers are pursuing. To that end, Epocrates says that it has "teamed up with a very well known” but still undisclosed practice manager partner, whose software will be integrated into the Epocrates EHR for calendaring, scheduling, appointments, billing and more.

The as-yet-not-released Epocrates EHR app will include the company's drug and safety content and will, they say, meet “meaningful use” and HIPAA compliance requirements.

There are offerings from other vendors such as Microsoft and Symantec too, but I've decided to look at Epocrates Mobile EHR because Epocrates was the first company to introduce a medical app for the iPhone. Furthermore, as seen in the image below, their app is now available for many of the popular hand-held smart devices.

Their fully functioning mobile EHR app will work both when connected and disconnected. It’s not enough to just have a mobile EHR, of course, and it is also a fully featured, web-enabled desktop application, too.

The mobile and desktop versions may have the same functionalities, but the different form factors will likely lead to certain applications being favored on each.

There is a functional parity between their mobile and web interface. The information will be delivered differently and the iPhone version will be used for some use cases more often than the desktop version and vice versa. These two platforms are complementary, so Epocrates is not necessarily "leading" with mobile.

Unlike some mobile “portals” to EHR systems, Epocrates offering is a native app with patient data stored in it.

One differentiator between the Epocrates mobile EHR app and some others is that theirs will be a native app and it will store patient data on the device. Users will interact with the EHR differently from a mobile device vs. a desktop client. The iPhone interface is not ideal for text entry, so they are looking for other ways to get information into the device. The iPhone interface will be used more for things like dictation, while the desktop interface won’t be used for that as much. From a task perspective, though, they are not looking to hobble the handheld interface in any way.

Click here to see new apps from Epocrates

Click here to see the Dragon speech-to-text application on a hand-held device

Epocrates is launching an EHR offering now because of the increase in EHR adoption because of the ARRA deadlines for stimulus fund incentives payments. These external deadlines are encouraging physicians to adopt EHR, making it an ideal time to enter the market.

There are also drivers from the technology perspective as well. It’s a good time to enter the market with a mobile EHR because more clinics have a high penetration of smartphone users. Also, 3G wireless networks now have higher bandwidth – enough to support these kinds of applications. Physicians rarely take note of [mobile] Internet connectivity issues anymore. Note: I've also talked a little about the less-ubiquitous 4G (WiMax) networks in earlier posts.

Epocrates plans to integrate the features of the iPhone, such as the camera, as well as dictation directly into the app, an interesting feature especially in light of the recent announcement by Nuance that they will be shipping a medical transcription application for the iPhone.

Epocrates will also utilize the iPhone’s Push Notification Service to alert doctors of important or timely information (and hopefully not overuse it). Given Epocrates’ depth of knowledge of pharmaceutical formularies, e-prescribing will be built in.

Although the mobile application will synchronize with the web application, it will continue working even when there is no internet connection. Data will be stored on the handheld device in a secure, encrypted manner and synchronize when a connection is available, a real issue for hospitals where there are many “dead” zones. And, there will be condition-based templates for easy entry of clinical information.

There will also be integration with a revenue-cycle platform so physicians can charge and submit codes, through a partnership with a “known” company. Epocrates anticipates they will achieve Certification Commission for Health Information Technology (CCHIT) certification by the time of release. The EHR will be delivered as a software-as-a-service (SAAS) model, meaning the physician will effectively lease, not purchase it.

This could be an attractive low-cost product for solo or small group physicians who do not have complex office staff EHR integration needs. In particular, for the physician who already uses their smart phone for many work activities, the potentially painless transition to using it as the primary interface into their office EHR may be very appealing.

Stay tuned.

Click here to see Epocrates executives at HIMSS 2010

Click here to see Andy Wiesenethal, Kaiser Permanente at HIMSS 2010

As an aside, I'd like to note that when Epocrates Online can be accessed with a browser on which Google's (or other) translation app has been installed, as shown in the image below.

Contemporary Speech Analysis and Systems - A Palimpsest

2010-06-25T07:37:00.004-04:00

Computers are making strides in recognizing speech, as reported in earlier posts to this blog. Beyond that, a host of companies — AT&T, Microsoft, Google and startups — are investing in services that hint at the concept of machines that can act on spoken commands. They go well beyond voice-enabled Internet search.

Click here for a comprehensive review article on all this. My links Spoken Language Systems and Audio, Speech, and Language at the top of the right-hand column are very good sources for up-to-date information on these subjects.

Finally, to see a contemporary system at work, click here for Medical Bayesian Kiosk, a voice-based system designed to ask patients about their symptoms and to respond with empathy. (Microsoft Research)

The Promise of Information Technology in Electronic Health Records

2010-06-22T11:58:00.007-04:00

This blog is written by and largely viewed by IT professionals, 5,217 visits from 106 countries according to Google Analytics at last count. While the [technical] subject matter herein applies to many fields, its application to electronic heath records (EHR) has been a large part of my focus.

So, to add balance to this blog, I've provided below several links to material written by medical professionals within the healthcare industry who are concerned with these same subjects.

The Promise of Information Technology in Electronic Health Records (EHR)

Information Technology Tools to Support Best Practices in Health Care

Microsoft HealthVault Platform

Electronic Medical Records (EMR) and The Prospect of Real-Time Evidence Development

Executive Summary

Evidence-Based Medicine and the Changing Nature of Healthcare

HTML5 - its support in Dreamweaver CS5, Internet Explorer 9 and elsewhere

2010-05-25T13:42:00.033-04:00

With HTML5, an open Web standard, the browser becomes a first class RIA citizen.

HTML5 is being developed as the next major revision of HTML (HyperText Markup Language), the core markup language of the World Wide Web. HTML5 is the proposed next standard for HTML 4.01, XHTML 1.0 and DOM Level 2 HTML. It aims to reduce the need for proprietary plug-in-based rich internet application (RIA) technologies such as Adobe Flash and Microsoft Silverlight.

The HTML5 video tag is a markup language tag, introduced in the HTML5 draft specification, that adds support for embedding video in an HTML page.

The Adobe Flash Player has been and continues to be widely used to embed video on web sites such as YouTube, since the majority of web browsers have Adobe's Flash Player installed (with controversial exceptions such as the browser on the Apple iPhone and iPad). Now, however, HTML5 video is intended by its creators to become the new standard way to show video online, but has been hampered by lack of agreement as to which video formats should be supported in the video tag.

Rather than relying on the browser plug-in Flash, Apple has adopted HTML5, CSS and JavaScript – all open standards. Apple’s mobile devices now ship with high performance, low power implementations of these open standards.

Not to be left out, Adobe has recently added HTML5 support to Dreamweaver CS5. This move should not be viewed only in light of the company's war of words with Apple regarding Flash, but in the other reality that HTML5 is reaching critical mass as evidenced by long-time holdout Microsoft adding HTML5 support to Internet Explorer 9 and a slew of HTML5 books being published by leading houses this summer. I've pictured the covers of a few of them at the end of this post.

These developments come despite the fact that HTML5 is still a work in progress. Even so, HTML5 in Dreamweaver CS5 makes for a mighty application development tool, as shown in the video http://www.youtube.com/watch?v=OEXrd8CR5AY

The HTML5 compatibility pack for Dreamweaver CS5 lets you author CSS3 and HTML5 compatible Web pages for modern browsers. And, of course, it supports the audio and video tags.

Note: The HTML5 extension will work only with Dreamweaver CS5 and not with any of the previous versions.

For more on this new Dreamweaver HTML5 support, check out labs.adobe.com and the following videos:

HTML5 Fundamentals with Dreamweaver CS5 - Semantic Structural Tags - Part 1

HTML5 Fundamentals with Dreamweaver CS5 - Semantic Structural Tags - Part 2

Readers of this blog who are interested in the Semantic Web may find the Part 2 video of particular interest.

HTML5 Fundamentals with Dreamweaver CS5 - Using the Video Tag

Finally, Microsoft will support HTML5 and CSS3 in Internet Explorer 9.0. A developer preview of their next browser can be downloaded from

http://ie.microsoft.com/testdrive/

and click here for a discussion of I.E. 9's support for video content.

Note: There has been a lot of interest and debate about HTML5 and its support for video tags. This release of Internet Explorer provides such support, with tags available for H.264/MPEG4 and MP3/AAC codecs, leaving out support for the open source Ogg Vorbis and Ogg Theora video codecs.

A final note: HTML5 is not likely to displace Adobe Flash videos any time soon. As evidence of this, consider the latest news from Dell: Dell Inc. yesterday unveiled plans for a computer tablet based on Google Inc.’s Android operating system.

Called Streak, the tablet will have a 5-inch screen, Wi-Fi, Bluetooth, and work on a 3G network. Users can download music; interact with social-networking sites; send e-mail, text and instant messages; and make phone calls. It has turn-by-turn navigation with Google Maps, a 5-megapixel camera with flash, and a removable battery.

Streak will have 2 gigabytes of internal storage. Memory can be expanded up to 32 gigabytes allowing it to store as many as 42 movies or 16,000 songs.

Later in the year, the tablet will support Adobe Flash 10.1 — something Apple Inc.’s iPhone, iPad, and iPod Touch devices do not. Flash is widely used for online video.

The Streak is designed to be larger than a smartphone but more portable than a laptop. It is 6 inches wide, nearly 3 inches high, and half an inch thick.

Tim O'Reilly on State of the Internet Operating System

2010-05-20T09:33:00.001-04:00

Click on the image below to watch a talk given by Tim O'Reilly at Web 2.0 Expo San Francisco 2010.

"The fox knows many things, but the hedgehog knows one big thing." -Archilochus

Note: Tim graduated from Harvard College in 1975 with a B.A. in Classics. His honors thesis explored the tension between mysticism and logic in Plato's dialogues.

Adobe's Extensible Metadata Platform (XMP) as used with DICOM images - Photoshop, MathWorks and Oracle Multimedia

2010-05-15T08:56:00.019-04:00

Healthcare-related images (e.g., those that conform to the DICOM standard) can be moved from place-to-place within a local organization over a network and, with help from HL7, moved from place-to-place globally (and interoperably).

DICOM and HL7 are about program to program communication between computers, not a standard file format, and not information retrieval for use by humans.

• The DICOM Upper Layer protocol (DUL) is the language used to make connections, compose, send, receive and decode messages.

• DICOM Services are the operations DICOM programs can do, e.g., send, store, look up information.

• DICOM Objects are the data that programs can send and receive, e.g., patient data, CT, MR and other images, radiation beams, anatomic structure contours.

This post will be concerned with the last of these: i.e., DICOM Objects.

These images can be imported into Adobe Photoshop for a great deal of manipulation and, from there, accessed by Mathlab, which has powerful image analysis capabilities, and finally stored and managed (with search and much else) in Oracle Multimedia. Throughout, Adobe's Extensible Metadata Platform (XMP) - a labeling technology that allows you to embed data about a file, known as metadata, into the file itself - plays an important role.

Click here for more information on XMP.

Click here for an example of medical image processing with Photoshop

Click here for an introduction to medical image processing with MathWorks

Click here for an overview of Oracle Multimedia

and here for the first of several in-depth pages on Mutimedia DICOM

The figure below illustrates the architecture of typical DICOM Web application. Shown only as "Third-Party Media Processors" are Adobe Photoshop and MathLab Medical Imaging.

Click here for an example of a Photoshop and Mathlab collaboration before the advent of XMP

and here for how Mathlab can read XMP metadata today.

Click here for info on work with metadata (Dicom, XMP, etc.) in Photoshop

Finally, click here for another introduction to using Photoshop for processing DICOM files.

Speech transcription with Adobe Soundbooth CS5 and Dragon Naturally Speaking 10

2010-05-07T15:03:00.026-04:00

Nuance Communications’ voice recognition software – Dragon Naturally Speaking 10 – is the industry-leading speech recognition software. In the healthcare space, the software eliminates physicians’ need to rely on typing, clicking and scrolling, something that a high percent of doctors surveyed cited as a usability concern. Using Dragon Medical 10 gives physicians more time to allocate toward patient care instead of reporting. And, because most doctors speak three times faster than they type, Dragon Medical speech recognition software can improve productivity by up to 25%. For more on this product, see my May 30, 2009 and May 1, 2009 posts below.

Meanwhile, Adobe Soundbooth CS5 is normally used in entirely different environments. For example, you can jump directly into Soundbooth from within other Adobe Creative Suite components to create, clean up, or enhance your audio. The nondestructive ASND file format shares audio files easily with Flash Professional, Adobe Premiere Pro, or After Effects, and the ability to export cue markers as FLV or XML files makes coordinating sound to your project easier than ever. Click here for more on the Soundbooth CS5 application.

Nonetheless, Naturally Speaking and Soundbooth have this in common: both can perform speech-to-text translation and then synchronize the playing audio file and its transcript during deferred playback, thus enabling a third party to correct errors easily. To demonstrate this, I had them both perform a speech-to-text transformation on a single, randomly-selected mp3 file named Checkers.mp3. This audio file and its transcriptions by Naturally Speaking and Soundbooth are downloadable:

Click here for Checkers.mp3

Click here for CheckersDragon.txt

Click here for CheckersSoundbooth.txt

What follows is not a scientific (i.e., statistically rigorous) analysis. It's simply a quick look at how the two products performed at end-to-end transcription during an elementary test. As a matter of fact, I examined only part of a single sentence. Here are the results:

An excerpt from the actual speech (see Dragon.mp3): "- charges are made against you is to -"

An excerpt from the Dragon Medical 10's transcription (see CheckersDragon.txt): "- charges were made against is to -"

An excerpt from the Soundbooth CS5's transcription (see CheckersSoundbooth.txt): "- charges are made against him is to -"

As you can see, Dragon dropped the word "you" entirely and Soundbooth got the word "you" wrong. But, Soundbooth got the verb "are" correct while Dragon did not.

Keeping score is not the point here. The point is that they both (like all speech-to-text engines) make mistakes that have to be corrected. So, they both provide for error correction. I made no effort to optimize either tool. The results outlined above were produced after doing nothing more than installing the two products side-by-side on the same 32-bit PC and loading the same mp3 source into each product. Note: Both products have 64-bit versions but only Soundbooth runs on a Mac.

The figure below shows Sooundbooth CS5 simultaneously playing the audio and highlighting the text -- word-by-word -- as the speech progresses. The play/stop button allows you to stop the progression at any point and to edit the text before continuing. Dragon has similar functionality.

{click on image above for a larger view}

Again, these are not competing products. They each serve different populations. However, there are organizations in which Soundbooth is available and Dragon is not, where a Mac is available and a PC is not, etc. In these cases, one should consider the sometimes much less expensive Soundbooth for the automatic transcribing of audio into text.

Click here for a video that demonstrates turning spoken dialogue into searchable metadata with Soundbooth CS5.

The searching of metadata for a specific word is also shown in the following figure.

{click on image above for a larger view}

I want to conclude by noting that Dragon Medical 10 is the industry-leading speech recognition software in the healthcare space because, for among other reasons, it includes medical vocabularies covering nearly 80 medical specialties and subspecialties, as well as the tools to further customize vocabularies for a specific medical practice, which Soundbooth does not. But, Soundbooth has unique integration with the Adobe suite of applications, which Dragon Naturally Speaking does not. So, in a way, I've been comparing apples with oranges.

The Lens Correction Filter in Adobe Photoshop CS5

2010-05-01T09:11:00.008-04:00

If you take a photograph with a digital camera and load your picture into Photoshop CS5, its lens correction filter can automatically detect the manufacturer, model and lens settings that you had used, using the image file’s EXIF data.

When it doesn't have the additional information needed to correct any changes your camera and settings might introduce, Photoshop CS5 presents a button that lets you search the Web for this information in a trouble-free way. In either case, it automatically corrects lens distortions and fixes chromatic aberration and vignetting.

However, there are other scenarios: In another blog, The North Country Chronicles, I posted the photograph (jpg file) that is shown in the figure below.

This image was created by scanning a century-old picture that had very obvious distortions. Just take a look at the flagpole and the corners of the main building.

So, I spent about 10 seconds to manually straighten the flag pole and corners of the main building by dragging the Vertical Perspective slider in the Lens Correction Filter of Photoshop CS5 a little to the left as shown in the figure below.

{click on image above for a larger view}

and was immediately presented with the compensated – to a visually acceptable level - image shown in the next figure.

This manual intervention was required because no digital photography was available in 1917, when this particular photograph was taken with the Kodak Junior, Model A camera shown below, nor was digital photography used in any of the steps taken in my correcting of this photograph.

Note: The North Country Chronicles post where the original photograph appears is about the early 20th century. So, I chose to leave the original – that is, uncorrected - scanned image there.

The final figure below presents an overview of the flagpole (and other objects) correction process for the case where a digital camera is involved.

While I’m stopping here, I encourage you to watch the following easy-to-understand videos that demonstrate a good deal of additional functionality provided in this extremely handy Photoshop CS5 tool.

Click here for Video 1
Click here for Video 2
Click here for Video 3

Apple’s SDK brouhaha explained for non-developers

2010-04-15T13:32:00.006-04:00

So what’s up with Apple this week? In short, they are now the dominant platform in a space, and they intend to maintain that dominant position for as long as possible by preventing the ability to write an application once and run it anywhere. Apple’s tactics for maintaining their dominance are: bullying and complexity. They’re the same tactics use by every computer platform dominator (e.g., IBM, AT&T, and Microsoft) before them. All of this has happened before, and it will happen again. Click here for Brent Noorda's take on Apple’s SDK brouhaha.

An update (5/4/2010):

The Federal Trade Commission and the Department of Justice are exploring whether to open an antitrust inquiry into Apple over its recent actions restricting developers writing apps for its iPhone operating system.

The basis for a potential antitrust probe stems from Apple’s recent changes to its iPhone software developer kit. The changes, which were quietly rolled out during the announcement of the company’s new iPhone 4.0 operating system, made it clear that Apple would no longer allow apps into the iTunes iPhone and iPad store that are built using third-party programs.

The sudden changes to Apple’s rules came just days before Adobe was set to showcase its newest software update to its Flash authoring tools. The feature, called Packager for iPhone, would make it easy for developers to produce iPhone applications using Adobe’s software.

Decision Makers Are Not Always "Insiders"

2010-04-13T09:04:00.005-04:00

Over the past year or so, this blog has bandied about terms like interoperability, open-source, disambiguation, security and databases. All of this has been from the points of view shared by most "insiders" concerned with the introduction of electronic health records (EHR) systems into their local, regional or even national computer networks. I'm talking about individuals (including me) who typically follow other blogs like http://i2b2-zak.blogspot.com and http://geekdoctor.blogspot.com.

However, there are many more individuals who follow (and whose thinking is influenced by) publications like The Wall Street Journal and The New York Times. What they read is reports like "In a paper published last year, Alessandro Acquisti and Ralph Gross (two researchers from Carnegie Mellon University) reported that they could accurately predict the full, nine-digit Social Security numbers for 8.5 percent of the people born in the United States between 1989 and 2003 — nearly five million individuals." that I believe are sometimes more likely to influence their thinking than are the reports that you and I read in the blogs (and other publications) written by "insiders." So, with this last thought in mind, I place the following links to a few recent articles read by many of the decision makers out there.

http://www.nytimes.com/2009/11/16/business/16records.html?_r=1&scp=4&sq=electronic%20health%20records&st=cse

http://www.nytimes.com/2010/03/17/technology/17privacy.html

http://www.nytimes.com/2010/04/13/opinion/l13privacy.html

http://online.wsj.com/article/SB10001424052748704259304575043572008622004.html

http://online.wsj.com/article/SB10001424052748703625304575116512173339800.html

http://online.wsj.com/article/SB10001424052748703580904575132111888664060.html?KEYWORDS=electronic+health+records

This is not meant to be a representative sample. Just a reminder that you and I may or may not be speaking the same language as the general public, which counts among its numbers many high-ranking decision makers. So, what else is new?

How Green Is My iPad? & Who Were The Luddites?

2010-04-04T09:33:00.007-04:00

How Green Is My iPad?

Click here for a discussion which ends with the assertion "All in all, the most ecologically virtuous way to read a book starts by walking to your local library."

Who Were The Luddites?

Machine smashers of the 19th century or members of a fascinating social movement with visionary insights into the unfolding drama of industrialization?

The impact of today's technologies on social relations and the planet itself is becoming an intriguing field of inquiry. However so far the discussion of nuclear power, biotechnology, deforestation, automobiles or computers is pretty much dominated by industry and government who want us to take all this for granted.

In this context it is inspiring to remember the Luddites who questioned industrial civilization at its very beginning in England during the introduction of mechanized textile mills. They knew that the power-looms that they selectively destroyed were not just a technology but would create a whole new set of relations: Factory work, child labor, and the demise of artisan and skilled labor. They anticipated that the new machines, that they themselves had helped build, were not the promised tool to help them in their work but would eventually become part of a machine culture with power over human life and even human consciousness.

Click on the links below for a two part talk given by Iain Boal, an independent scholar and historian of technology. He taught a course on the Luddites at Stanford University.

Note: During the introduction, you'll hear the term Time of Useful Consciousness. This is an aeronautical term. It's the time between the onset of oxygen deficiency and the loss of consciousness, the brief moments in which a pilot may save the plane.

Part 1: http://WaldenITech.com/Luddites1.mp3

Part 2: http://WaldenITech.com/Luddites2.mp3

Note: The download of these audio files could take several minutes, depending on the speed of your connection and other resources.

Does the Semantic Web need Ontologies?

2010-03-23T18:57:00.006-04:00

The answer to the question "Does the Semantic Web need Ontologies?" is "yes" according to most but "no" according to some. For a discussion of this question, click here for the view of one individual who is convinced that ontologies are a luxury, not a necessity, plus the comments of others.

Business Process Management and Service Oriented Architecture

2010-02-24T11:35:00.004-05:00

Business Process Management (BPM) is used to model, simulate, automate, manage, and monitor processes, in order to coordinate operations with dynamic business priorities.

With BPM, workflows (both human and automated) are determined in real-time by events and/or outcomes within the process, and effective knowledge transfer is made possible as processes become well-documented business artifacts on which staff members can be trained.

To enjoy the full benefits of BPM, processes must integrate with existing applications and systems (e.g., hospital EHR and EMR, to name a couple of areas currently being funded by the Obama administration in the U.S.). This is where Service Oriented Architecture (SOA) - the subject of earlier posts - comes in. BPM and SOA are a natural match. There are links to a few of my early articles on SOA, in the bibliography at the bottom of this blog.

In preparation for my next post to this blog, I'd like to cite the following book:

This book shows the reader how to fill the semantic gap between the process model and the applications:

Modeling business processes for SOA and developing end-to-end IT support has become one of the top IT priorities. The SOA approach is based on services and on processes. Processes are focused on composition of services and in that sense services become process activities.

Experience has shown that the implementation and optimization of processes are the most important factors in the success of SOA projects. SOA is so valuable to businesses because it enables process optimization. In order to optimize processes, we need to know which processes are relevant and we have to understand them – something that cannot be done without business process modeling. There is a major problem with this approach – a semantic gap between the process model and the applications.

This book will show you how to fill this gap. It describes a pragmatic approach to business process modeling using the Business Process Modeling Notation (BPMN) and the automatic mapping of BPMN to the Business Process Execution Language (BPEL), which is the de-facto standard for executing business processes in SOA. The book will also cover related technologies like Business Rules Management and Business Activity Monitoring which play a pivotal role in achieving closed loop Business Process Management.

From http://www.packtpub.com/business-process-driven-SOA-using-BPMN-and-BPEL/book

Interoperability Between Oracle and Microsoft Technologies, Using RESTful Web Services - BPEL

2010-02-10T08:55:00.008-05:00

A guide to developing REST Web services using the Jersey framework and Oracle JDeveloper 11g follows.

RESTful Web services are the latest revolution in the development of Web applications and distributed programming for integrating a great number of enterprise applications running on different platforms. Representational state transfer (REST) is the architectural principle for defining and addressing Web resources without using the heavy SOAP stack of protocols (WS-* stack). From the REST perspective, every Web application is a service; thus it's very easy to develop Web services with basic Web technologies such as HTTP, the URI naming standard, and XML and JSON parsers.

For a detailed account of how to create RESTful Web services by using Oracle technologies such as Oracle JDeveloper 11g, the Jersey framework (the reference implementation of the JAX-RS [JSR 311] specification), and Oracle WebLogic Server as well as how to consume the Web service by using Microsoft technologies such as Visual Studio .NET 2008 and the .NET 3.5 framework, click here.

Building a Web Services Network with BPEL - Caveat Emptor

Buoyed by maturing Web service standards, more and more organizations are using Web services in a collaborative environment. BPEL is fast becoming the platform for orchestrating these Web services for inter-enterprise collaboration. As discussed in earlier posts in this blog, BPEL offers the compelling benefits of a standards-based approach and loosely-coupled process integration to companies building an online marketplace or collaborative network.

Yet the exciting new capabilities offered by Web services carry some risk. In many cases, partner relationships break down or integration costs skyrocket if certain technical and administrative challenges are not addressed at design time:

* Partners must agree well in advance to conduct business according to specific criteria. Transport protocol, purpose of the interaction, message format, and business constraints have to be communicated clearly.

* Joining the network has to be an easy process; collaborative networks become successful mainly through growth.

* Users must easily find business services at runtime, or the promise of services-oriented architecture (SOA) is largely lost. (Service repositories are useful for this purpose.) If developers cannot readily find and reuse services, the services essentially don't exist.

* Partners should have the ability to monitor Web services in real-time. End users should be able to track the progress of a specific order, and trading partners diagnose a specific bottleneck within a business process.

These challenges are exacerbated when a collaborative network operates in a hosted environment. In that model, partners expose the functionality provided by their legacy applications into a Web service. This Web service is published into a centralized repository. The host is responsible for orchestrating the complex business processes, which in turn, leverage partner Web services.

Front-end Web Application for use in the Human Workflow used to Disambiguate IDs in an Electronic Healthcare Record (or other) Automated System

2010-02-01T10:46:00.015-05:00

From December 14, 2009 post:

Disambiguation is a process through which multiple potential identification matches are further parsed until the patient can be matched with his or her data with sufficient certainty to allow for the delivery of a health service with reasonable confidence. The complexity of disambiguation varies according to factors such as the number of potential matches and the type of information available for further analyses. When sufficient digital data are not available to further differentiate potential matches, automated disambiguation may not be possible and may require human involvement.

Disambiguation entails implementing significant new workflows and may require substantial time and resources. When human involvement is required, many of the potential benefits of automation are lost. For example, at the point of care, disambiguation is often done by asking the patient further questions regarding personal characteristics and/or health care history. In some situation, disambiguation may not be possible, as when the patient is not present and information needed to further facilitate matching may not be accessible.

From December 7, 2009 post:

Disambiguation of IDs is the process of resolving multiple potential matches into a match with the correct person. In general, statistical matching algorithms are likely to require substantially more-frequent disambiguation compared to that required by a system that uses theoretically perfect universal IDs; often, disambiguation is done by human intervention. Such disambiguation imposes significant costs and operational inefficiencies, particularly if, for example, a physician must resolve the ambiguities.

Note 1: Many of the efficiency and safety benefits theoretically possible with health information technology (HIT) systems depend on eliminating such human involvement and its concomitant slowness, expense, and propensity for error.

Note 2: What follows applies to IDs in general, even though I’ve chosen the healthcare industry for much of this discussion.

When the business process can’t be completed by automation alone, the business process incorporates human workflow. Manual disambiguation of an uncertain ID is one such human task. The form shown in the figure below illustrates a Web app created with Visual Studio 2010 [Beta 2] that a user employs to carry out part of a human workflow.

Please note: This post is presented in early draft form.

Communication between the client (user interface shown in the figure above) and the application services is performed by using proxy classes that run in the client and that represent the application service. In practice, a Web reference is a generated proxy class that locally represents the exposed functionality of an XML Web service. The proxy class defines methods that represent the actual methods exposed by an XML Web service. When your application creates an instance of the proxy class, your application can call the XML Web service methods as if the XML Web service were a locally available component.

At design time, the proxy class enables you to use statement completion for the XML Web service methods. At run time, a call to a method of the proxy object is processed and encoded as a SOAP request message. If the XML Web service does not support SOAP, the proxy class uses HTTP GET and POST. The message is then sent to the target Web Service for processing. If the service description defines a response message, the proxy object processes this message and returns a response to your application.

Note: To make XML Web services outside a firewall available to the Web browser, when creating the Web reference in Visual Studio, you must explicitly specify the address and port of your network's proxy server.

{ click the figures for a larger view }

Click here for more on Microsoft Visual Studio 2010

Click here for more on Oracle BPEL and Human Workflow

Note: If patients cannot be unambiguously identified via a computer-based process, machine-level interoperability will be hampered significantly.

Human Workflow -- Business Processes -- Service Component Architecture -- SOA -- EHR

2010-01-16T10:56:00.024-05:00

The immediate goal of this blog is to suggest a solution for the building of state-of-the-art electronic healthcare record (EHR) systems suitable for both organizations that have already invested in a computerized infrastructure and those that have not. There are many vendors proving tools for such endeavors. Here, I have chosen one of the market leaders - Oracle - to illustrate a solution. Since the Oracle tools that I show below are standards based, the concepts will carry over to the tools provided by many of the other vendors. I'll discuss the design of a system that automates business processes when that makes sense, hands off tasks to humans where they can do the job better (according to some criterion) and that can interoperate with heterogeneous systems (local and remote) efficiently and securely. While the language that I use will sometimes be that found in the EHR literature, the solutions discussed will be widely applicable. Please note: This post is still presented in draft form.

Service Component Architecture within SOA Composite Applications

Service Component Architecture (SCA) provides a model for assembling distributed groups of service components into an application, enabling you to describe the details of a service and how services and service components interact. Composite applications are used to group service components and wires are used to connect service components. SCA helps to remove middleware concerns from the programming code by applying infrastructure declaratively to composites, including security and transactions.

An SOA composite is an assembly of services, service components, and references designed and deployed in a single application. Wiring between the services, service components, and references enable message communication. The details for a composite are stored in the composite.xml file.

Services (shown at left in figure below), such as a web services or JCA adapters, providing an entry point to the SOA composite application.

References (shown at right in figure below) send messages to external services in the outside world, such as web services and JCA adapters.

The figure below provides an example of a composite that includes an inbound service binding component, a BPEL process service component, a business rules service component, and two outbound reference binding components.

You can invoke other deployed SOA composite applications from your SOA composite application. The other applications must be deployed.

The component palette shown to the right in figure below provides the various resources that you can use in a SOA composite. It contains the following service components and adapters:

Service components

Displays the BPEL Process, business rule, human task, and mediator service that can be dragged and dropped into the designer.

Service adapters

Displays the JCA adapter (AQ, file, FTP, Database, JMS, MQ, Oracle Applications, Oracle BAM, and EJB Service), B2B binding component, SDO binding component, and web service binding component that can be dragged into the left or right swimlanes.

You add a service binding component to act as the entry point (ep) to the SOA composite application from the outside world.

You can also automatically create a service binding component by selecting "Expose as a SOAP Service" when you create a service component.

However, you cannot invoke a representational state transfer (REST) service from the SOA Composite Editor.

Activities (in the figure below) are the building blocks of a BPEL process service component. Oracle BPEL Designer includes a set of activities that you drag into a BPEL process service component. You then double-click an activity to define its attributes (property values). Activities enable you to perform specific tasks within a BPEL process service component.

A partner link (in the figure below) enables you to define the external services with which the BPEL process service component is to interact. You can define partner links as services or references (for example, through a JCA adapter) in the SOA Composite Editor or within a BPEL process service component in Oracle BPEL Designer.

The method by which you create partner links within the BPEL process in Oracle BPEL Designer impacts how the partner link displays (above) in the SOA Composite Editor. The WSDL file can be on the local operating system or hosted remotely (in which case you need a URL for the WSDL).

Adapters enable you to integrate the BPEL process service component (and, therefore, the SOA composite application as a whole) with access to file systems, FTP servers, database tables, database queues, sockets, Java Message Services (JMS), MQ, and Oracle E-Business Suite.

You can configure BPEL process monitors in Oracle BPEL Designer by selecting Monitor from the dropdown list above the Designer window. BPEL process monitors can send data to Oracle BAM for analysis and graphical display through the Oracle BAM adapter (shown in the Service Adapters section at the right of the figure below).

Oracle User Messaging Service

Oracle User Messaging Service provides a common service responsible for sending out messages from applications to devices. It also routes incoming messages from devices to applications.

You can easily send outgoing notifications from a BPEL process flow or invoke outgoing and incoming messages for tasks assigned to users from a human task.

{ Click on any of these images for a larger view }

Counter-Intuitive Considerations -- When You're Automating a Business Process That Includes A Human Workflow

2010-01-07T13:14:00.010-05:00

This blog is currently addressing business processes, human workflows, etc. However, at the very bottom of this page appears my bibliography [partial] with prior articles on topics like cost benefit analysis, six sigma, service level agreements, etc

To reconcile these two, sometimes opposed approaches to system design, I recommend the following talk (in a one-hour video) by John Seddon, an occupational psychologist. Just click on the image below to watch his January 03, 2010 presentation.

In the course of his talk, Seddon refers to the 2008 Wiley book

Customer service, often a human task, they assert, is only needed when an organization does something wrong -- eliminating the need for service is the best way to satisfy customers. To be successful, organizations need to treat service as a data point of dysfunction and figure what they need to do to eliminate the demand.

You decide!

Security Problems on Flash Drives

2010-01-06T16:44:00.003-05:00

Kingston, known as one of the giants in portable memory, has recently confirmed a security problem with some of their DataTraveler series. The problem centers on the fact that even if encryption is used, it is possible to gain access to the data on the device.

In a statement, a company spokesperson said that someone with physical access to the flash drive could access the encrypted data, given the will to do so and the skill needed. The spokesperson went on to mention that the encryption used is sound, only that “there is a small loophole regarding the processing of the password.”

While the data on the drive is indeed encrypted using 256-bit AES encryption, there’s a huge failure in the authentication program. When the correct password is supplied by the user, the authentication program always send the same character string to the drive to decrypt the data no matter what the password used. This character string is the same for not only Kingston USB flash drives but those of SanDisk and Verbatim as well.

Cracking the drives is therefore quite an easy process. The folks at the security firm SySS wrote an application that always sent the appropriate string to the drive, irrespective of the password entered, and therefore gained immediate access to all the data on the drive.

These drives are sold as meeting security standards making them suitable for use with sensitive US Government data (unclassified rating) and have a FIPS 140-2 Level 2 certificate issued by the US National Institute of Standards and Technology (NIST) and companies like CapMed (Newtown, Pa.) -- to name one -- are putting personal health records on USB drives.

If you're using one of these USB stick from Kingston, SanDisk or Verbatim, you may want to get in touch with them.

An Update on the BPEL4People & WS-Human Task Standards

2009-12-31T11:14:00.004-05:00

The BPEL specification focuses on business processes, the activities of which are assumed to be interactions with Web services with no additional prerequisite behavior. But the spectrum of activities that make up general purpose business processes is much broader. People often participate in the execution of business processes introducing new aspects, such as human interaction patterns. Workflow tools already cater for the orchestration of user interactions.

User interactions range from simple scenarios, such as manual approval, to complex scenarios where data is entered by the user. Imagine a bank’s personal loan process. This process is made available on the internet site of the bank using a web interface. Customers can use this interface to enter the data for their loan approval request and to start the approval process. The process performs some checks, and eventually informs the customer whether his or her personal loan request has been approved or rejected. Processing is often automatic and does not require any human involvement. However, there are cases that require bank staff to be involved. An example of such a case is if the online check of a customer’s creditworthiness returns an ambiguous result. In this case, instead of declining the request automatically, a bank clerk could check the request and determine whether to approve or decline it. Another example would be if a request exceeds the amount of money that can be approved automatically. In this case, a manual approval step is required, in which a member of the “approvers” group either approves or declines the request.

User interactions in business processes are not limited to approval steps. They also may involve data. An example of a user interaction that involves data is when an e-mail from an employer is manually attached to the process instance, or when the summary of an interview with an applicant is keyed into the process via a simple form or custom-built application.

To support a broad range of scenarios that involve people within business processes, a BPEL extension is required.

BPEL4People is defined in a way that it is layered on top of the BPEL language so that its features can be composed with the BPEL core features whenever needed. We envisage that additional BPEL extensions may be introduced which may use the BPEL4People extension introduced here.

BPEL4People is the WS-BPEL Extension for People as proposed in a joint white paper by IBM and SAP in July 2005.

In June 2007, Active Endpoints, Adobe, BEA, IBM, Oracle and SAP published the BPEL4People and WS-HumanTask specifications as a follow-up to the whitepaper, describing how human interaction in BPEL processes can be performed.

The OASIS WS-BPEL Extension for People (BPEL4People) Tecnical Committee is working on standardizing the BPEL4People and WS-HumanTask specifications.

Click here for a very engaging podcast that describes the inner workings of Technical Committee’s (something you usually don’t hear much about), describes the work the OASIS TC has recently accomplished and articulates the grand vision for business process management (BPM) and workflow that the committee has been working on.

I strongly encourage you to listen to this podcast. You’ll hear how some the of most important thought-leaders in the IT world, including IBM, SAP, Oracle, Microsoft, TIBCO and Active Endpoints are discussing BPEL and BPEL4People.

SOA, Web Services, BPEL, Human Workflow, User Interaction and Healthcare Systems

2009-12-30T11:48:00.013-05:00

Lack of integration among legacy healthcare systems and applications means a continued reliance on manual processes that can introduce high risk errors into critical medical data. And isolated systems can compromise a provider's ability to follow an individual patient's care seamlessly from intake to treatment to aftercare.

While healthcare providers recognize that integration can help them achieve better service levels, many have been reluctant to proceed because of the critical nature of healthcare systems. But the approach to integration need not be a radical one of system rip and replace, nor does it have to precede through the development of system-by-system integration solutions.

Service Oriented Architecture (SOA) is a standards-based approach to integrating IT resources that can enable you to leverage existing assets, while at the same time building an infrastructure that can rapidly respond to new organizational challenges and deliver new dynamic applications. The SOA approach can help free application functionality from its underlying IT architecture and make existing and new services available for consumption over the network.

To derive a new value from existing services and go beyond simple point-to-point integration, you will need to combine and orchestrate these services in a business process. You will want to connect them in a coordinated manner, for example, have the result(s) from one service be the input to another service and have branching logic based on the outcome. Of course, you can use Java, C#, or another programming environment to call the services and manage the processes and data, but there is an easier, declarative way.

BPEL

An important standard in the SOA world is BPEL, or Business Process Execution Language, which serves as the glue to tie SOA-based services (Web services) together into business processes -- at least the portions that can be automated. The resulting BPEL process can itself be exposed as a Web service, and therefore, be included in other business processes.

The BPEL standard says nothing about how people interact with it, but BPEL in the Oracle Inc. BPEL Process Manager (to be discussed in my next post) includes a Human Workflow component (shown in the figure below) that provides support for human interaction with processes.

BPEL and User Interaction

I began an introduction to BPEL and human workflow towards the bottom of my December 14 post. Click here for a good deal more on this topic.

Humans can be involved in business processes as a special kind of implementation of an activity. To facilitate this, a new BPEL activity type called human task is required. From the point of view of the BPEL business process, a human task is a basic activity, which is not implemented by a piece of software, but realized by an action performed by a human being. In the drag-and-drop design pallet shown in the figure above, the actor of a human activity can be introduced into a BPEL process by using your mouse. A human activity can be associated with different groups of people, one for each generic human role.

People dealing with business processes do so by using a user interface. When human activities are used, the input data and output data must be rendered in a way that the user can interpret. More on this in upcoming posts.

Human resolution or disambiguation -- Integrating human workflow in BPEL processes -- Errors in statistical matching of attributes to an individual

2009-12-14T12:39:00.014-05:00

To locate health records, statistical matching attempts to string together enough identifying information about an individual to substitute for a unique personal identifier. It involves matching attributes, such as last name, first name, birth date, address or zip code, and gender, and it may use medical-record numbers and all or part of the Social Security number.

The problem with personal attribute keys such as name and address is that they are usually not unique to the individual, change over time, and are often entered into different systems in different formats. And data-entry errors, such as misspellings, add to the difficulties with this type of key. Repeated collection, distribution, storage, and use of these data also represent an important identity-theft risk.

Statistical matching can attempt to correct for some of these changes and errors: The most straightforward process is to tag all of the near matches for human resolution, or disambiguation. Such disambiguation imposes significant costs and operational inefficiencies, particularly if the physician must resolve the ambiguities. Advanced approaches “score” matches on “closeness” to the input set. Those with a high score may be accepted as a match. However, all such efforts are subject to the probabilistic errors inherent in statistical matching systems.

As discussed in earlier posts, there are two types of errors - false positives, in which two different persons’ records are declared to be a match, which can lead to such errors as the wrong patient’s health data being obtained; and false negatives, in which two records for the same person are thought to relate to different people, leading to such consequences as some of the patient’s data being excluded. Both of these errors can lead to serious medical errors, waste (e.g., repeats of tests or the wrong tests), and considerable deviation from the promises of continuity and quality of care postulated for a connected digital health care system.

Disambiguation is a process through which multiple potential identification matches are further parsed until the patient can be matched with his or her data with sufficient certainty to allow for the delivery of a health service with reasonable confidence. The complexity of disambiguation varies according to factors such as the number of potential matches and the type of information available for further analyses. When sufficient digital data are not available to further differentiate potential matches, automated disambiguation may not be possible and may require human involvement. This last case will be the focus of the rest of this post and my next post.

Disambiguation entails implementing significant new workflows and may require substantial time and resources. When human involvement is required, many of the potential benefits of automation are lost. For example, at the point of care, disambiguation is often done by asking the patient further questions regarding personal characteristics and/or health care history. In some situation, disambiguation may not be possible, as when the patient is not present and information needed to further facilitate matching may not be accessible.

I will show how one vendor, Oracle, implements human tasks that can provide workflows such as those identified above. However, these Oracle services can be accessed by applications created with development tools from other vendors (my discussion will use Microsoft Visual Studio).

Introduction to BPEL and Human Workflow

Business Process Execution Language (BPEL), one of the key technologies for Service Oriented Architecture (SOA), has become the accepted mechanism for defining and executing business processes in a common vendor-neutral way. Apropos of this discussion, business processes often require human interactions as well.

User Interaction in Business Processes

BPEL business processes are defined as collections of activities that invoke services. BPEL doesn't make a distinction between services provided by applications and other interactions, such as human interactions. And that's important since real-world business processes often integrate not only systems and services but also users. User interactions in business processes can be simple, such as approving certain tasks or decisions, or complex, such as delegation, renewal, escalation, nomination, or chained execution . . . and matching an ID with an individual.

Task approval is the simplest and probably the most common user interaction. In a business process for opening a new account, a user interaction might be required to decide whether the user is allowed to open the account. If the situation is more complex, a business process might require several users to make approvals, either in sequence or in parallel. In sequential scenarios, the next user often wants to see the decision made by the previous user. Sometimes, particularly in parallel user interactions, users aren't allowed to see the other users' decisions. This improves the decision potential. Sometimes one user doesn't even know which other users are involved - or whether any other users are involved at all.

A common scenario for involving more than one user is workflow with escalation. Escalation is typically used in situations where an activity doesn't fulfill a time constraint. In such a case, a notification is sent to one or more users. Escalations can be chained, going first to the first-line employees and advancing to senior staff if the activity isn't fulfilled.

Sometimes it's difficult or impossible to define in advance which user should perform an interaction. In this case, a supervisor might manually nominate the task to other employees; the nomination can also be made by a group of users or by a decision-support system.

In other scenarios, a business process may require a single user to perform several steps that can be defined in advance or during the execution of the process instance. Even more complex processes might require that one workflow is continued with another workflow.

User interactions aren't limited to approvals; they can also include data entries or process management issues, such as process initiation, suspension, and exception management. This is particularly true in long-running business processes, where, for example, user exception handling can prevent costly process termination and related compensation for those activities that have already been successfully completed.

As a best practice for human workflows, it's usually not wise to associate human interactions directly with specific users; it's better to connect tasks to roles and then associate those roles with individual users. This gives business processes greater flexibility, letting any user with a certain role interact with the process and enabling changes to users and roles to be made dynamically.

BPEL and User Interaction

So far we've seen that user interaction in business processes can get quite complex. Several vendors today have created workflow services that leverage the rich BPEL support for asynchronous services. In this fashion, people and manual tasks become just another asynchronous service from the perspective of the orchestrating process and the BPEL processes stay 100% standard.

In my next post, I’ll talk about some of the specifics of how you might implement a BPEL process that includes human workflow/tasks for disambiguation using tools such as Oracles JDeveloper and Microsoft Visual Studio. The next two figures are meant to give you a preview of that discussion.

{ click the figures for a larger view }

Click here for more on Microsoft Visual Studio 2010

Click here for more on Oracle BPEL and Human Workflow

EHR, interoperability, etc. -- Informatics set to music

2009-12-12T11:02:00.007-05:00

Human Resolution or Disambiguation -- False Positive and False Negative Identification: Heath Care and Information Technology Perspectives

2009-12-07T10:27:00.010-05:00

Disambiguation of IDs is the process of resolving multiple potential matches into a match with the correct person. In general, statistical matching algorithms are likely to require substantially more-frequent disambiguation compared to that required by a system that uses theoretically perfect universal IDs; often, disambiguation is done by human intervention. Such disambiguation imposes significant costs and operational inefficiencies, particularly if, for example, a physician must resolve the ambiguities.

Note 1: Many of the efficiency and safety benefits theoretically possible with health information technology (HIT) systems depend on eliminating such human involvement and its concomitant slowness, expense, and propensity for error.

Note 2: What follows applies to IDs in general, even though I’ve chosen the healthcare industry for much of this discussion.

Disambiguation sometimes entails implementing significant new workflows that may require substantial time and resources. When human involvement is required, many of the potential benefits of automation are lost. For example, at the point of care, disambiguation is often done by asking the patient further questions regarding personal characteristics and/or health care history.

The potential for error in the statistical matching methods (see my December 1 post on unique patient IDs) has important safety implications, which are a chief concern for many in the health care profession. Two types of errors are involved in statistical matching: false positives, in which there is a link to the wrong patient’s records, and false negatives, in which not all of a patient’s records are found. A graphic representation of these types of errors and of how they relate to the probabilities and threshold for matching is shown in the figure below.

The horizontal scale shows the score of a particular match. As more and more attributes match and as the match is weighted by its score, or value, the higher is the probability that the patient is correctly matched to that record. A low score indicates a low probability of match (and a high probability that it does not match). It is possible to use a threshold above which the record is assumed to match and below which it is not assumed to match, which leads to the shaded areas above and below the threshold.

The area shaded to the right of the threshold is the region corresponding to false positives, or picking up the wrong patient’s records. The shaded area to the left of the threshold is the region of false negatives, or the records of the patient that are not picked up because of some non-matching personal attributes. Setting a balance between the two types of errors involves tuning.

Another approach illustrated in this figure is to define a region of ambiguity within which possible matches are tagged for human resolution, or disambiguation. Whether matching uses a single threshold or two thresholds, it is not possible to avoid encountering false-positive and false-negative matches. Adjusting the threshold or thresholds can result in a different proportion of false-positive and false-negative errors, but cannot be used to eliminate them because they result from the inherent characteristics of the population that lead to the two S-shaped curves.

As stated above, many end-to-end business processes require human interactions with the process.

Task Assignment and Routing

Human workflow supports declarative assignment and routing of tasks. In the simplest case, a task is assigned to a single participant (user or group). However, there are many situations in which more detailed task assignment and routing is necessary (for example, when a task must be approved by a management chain or worked and voted on by a set of people in parallel, as shown in the figure below). I’ve chosen tools in the Oracle SOA Suite to illustrate (in the figures below) human workflow that can provide declarative pattern-based support for such scenarios.

I’ll briefly elaborate here with an introduction to human workflow and continue the discussion in my next post, where I'll talk about how you might implement such a system.

Participant Type

In simple cases, a participant maps to a user, group, or role. However, workflow supports declarative patterns for common routing scenarios such as management chain and group vote. The following participant types are available:

Single approver

This is the simple case where a participant maps to a user, group, or role. Since at least one human being is involved, much more than his or her looking at a monitor screen and clicking with a mouse is involved.

For example, a vacation request is assigned to a manager. The manager must act on the request task three days before the vacation starts. If the manager formally approves or rejects the request, the employee is notified with the decision. If the manager does not act on the task, the request is treated as rejected. Notification actions similar to the formal rejection are taken.

Parallel

This participant indicates that a set of people must work in parallel. This pattern is commonly used for voting.

For example, multiple users in a hiring situation must vote to hire or reject an applicant. You specify the voting percentage that is needed for the outcome to take effect, such as a majority vote or a unanimous vote.

Serial

This participant indicates that a set of users must work in sequence. While working in sequence can be specified in the routing policy by using multiple participants in sequence, this pattern is useful when the set of people is dynamic. The most common scenario for this is management chain escalation, which is done by specifying that the list is based on a management chain within the specification of this pattern. More on routing later.

FYI (For Your Information)

This participant also maps to a single user, group, or role, just as in single approver. However, this pattern indicates that the participant just receives a notification task and the business process does not wait for the participant's response. FYI participants cannot directly impact the outcome of a task, but in some cases can provide comments or add attachments.

Readers who are interested in learning more about the subject of human resolution or disambiguation in an otherwise automated system might look at the following two books, while waiting for my next post.

Costs and Benefits of a Unique Patient Identifier for The U.S. Health Care System

2009-12-01T10:51:00.009-05:00

In the healthcare industry, misidentification errors are not restricted to diagnostics and therapeutics but also may affect documentation. So, my earlier posts on semantics, ontologies, interoperability and the like notwithstanding, all is for naught when a given document doesn't provide information about a given patient. A chain is only as strong as its weakest link and patient identification is usually the first link in the healthcare chain.

Complicating the issue, not everybody can participate to the same degree or in the same way in the process of identifying a patient uniquely. Neonatal and senile patients are two groups where health providers and technology are on their own, when it comes to identifying the patient. Naturally, readers of this post fall into neither of these groups.

See, for example, Patient Misidentification in the Neonatal Intensive Care Unit: Quantification of Risk at

http://pediatrics.aappublications.org/cgi/reprint/117/1/e43.pdf

which provides a rather thorough study of errors in the first of these three groups.

The information that is used routinely for patient identification is frequently similar but often not recognizably unique.

In my November 20, 2009 post, Biometric and Other Identification Technologies, I discuss some leading technologies.

Although widely touted as “great” in security circles, all biometric devices (i.e., fingerprint, palm outline, iris, retina, et al) used for unique identification produce false positives and false negatives.

For example, an episode of Fox's "24" last season showed a White House visitor placing her thumb on a fingerprint scanner, a type of screening that is not typically used at the White House.

Fingerprint: false positives or negatives with scars, calluses, cracks in the skin, dirt, household cleaners and other variables.

Retina scan: susceptible to diseases such as glaucoma.

At the same time, non-biometric technologies have their own sources of error.

For a widely discussed examination of the costs and benefits of a unique patient identifier for the U.S. health care system, see

http://www.rand.org/pubs/monographs/2008/RAND_MG753.pdf

This recent study says using unique patient identification numbers for U.S. citizens would reduce medical errors, make electronic health records simpler and protect privacy.

The study says that despite a potential cost of $11 billion to create unique patient ID numbers, the effort "would likely return even more in benefits to the nation's health care system."

Most health care systems use statistical matching to find EHRs, according to the study by RAND Health, a research division of the RAND Corp. Statistical matching looks for demographic information, including names, birth dates and all or part of Social Security numbers.

See my November 17, 2009 post, Unique Patient Identification Numbers, Electronic Heath Records (EHR), Electronic Medical Records (EMR), and Social Security Numbers (SSN).

RAND researchers, who reviewed past studies, said that method causes errors or incomplete results about 8% of the time and leaves patients more exposed to privacy breaches.

"Assuming every health care system would have these [ID] numbers, then you'd be more likely to pick up all of the person's information," said Richard Hillestad, PhD, the study's lead author. "It would certainly make a lot of things easier."Using demographic information to locate EHRs causes errors or incomplete results about 8% of the time.

But critics expressed concerns.

"It's an absolutely terrible idea," said Deborah Peel, MD, a psychiatrist and chair of the Patient Privacy Rights Foundation, a watchdog group based in Austin, Texas. "Any database that has these numbers is bound to be a treasure trove for identity thieves."

The study was funded by a group of health information technology and IT companies, but Hillestad said that didn't influence the outcome. Dr. Peel is skeptical. "The combination [of data] is really deadly," she said. "That's why I say this is a data miner's dream."

The American Medical Association advocates prohibiting the sale and exchange of personally identifiable health information for commercial purposes without a patient's consent. The AMA also advocated in 1999 in favor of legislative action to repeal the portion of the Health Insurance Portability and Accountability Act of 1996 that mandated use of a unique patient identifier.

Hillestad said privacy is a big issue, but touted the ID numbers as a security boost.

"You're not sending all of the name and demographic information through the line to get connected," he said. "[Privacy] would depend on how much you protect the numbers."

Ontology-Based Software Application Development -- Java and .NET

2009-11-25T09:40:00.007-05:00

Consider the following scenario: A programmer needs to read data from a database via the JDBC interface. The system administrator of the organization provides user name and password, which obviously need to be used in the process. Then, the programmer

1. Searches the entire API for a method call (or calls), which takes a database user name as an input parameter.

2. Has to understand how various API calls should be sequenced in order to go from the connection information all the way to actually receiving data from the database.

If the APIs are not semantically rich (i.e., they contain only syntactic information, which the programmers have to read and interpret), understanding, learning and using an API can be a very time consuming task.

For a discussion of how the application of ideas from the areas of "Knowledge Management" and "Knowledge Representation" -- The enrichment of purely syntactic information of APIs with semantic information -- will allow the computer to perform certain tasks that normally the human programmer has to perform, see

http://www.aifb.uni-karlsruhe.de/WBS/aeb/smartapi/smartapi.pdf

A similar semantification of Web services (Ontology-enabled Services) is being widely discussed and implemented today.

See, for example,

http://www.cs.vu.nl/~maksym/pap/Onto-SOA-WAI.pdf

and

http://www.computer.org/portal/web/csdl/doi/10.1109/AICT-ICIW.2006.141

A number of my earlier post have been about Protégé , the popular ontology development tool, and OWL, one of the main ontology languages. To continue that discussion, see

http://www.sandsoft.com/edoc2004/KnublauchMDSW2004.pdf

which discusses a realistic application scenario -- some initial thoughts on a software architecture and a development methodology for Web services and agents for the Semantic Web. Their architecture is driven by formal domain models (ontologies).

Central to their design is Jena, a Java framework for building Semantic Web applications. It provides a programmatic environment for RDF, RDFS and OWL, SPARQL and includes a rule-based inference engine.

Jena is open source and grown out of work with the HP Labs Semantic Web Programme.

For more on Jena, see

http://jena.sourceforge.net/documentation.html

Jena is a programming toolkit that uses the Java programming language. While there are a few command-line tools to help you perform some key tasks using Jena, mostly you use Jena by writing Java programs.

But, .NET developers have similar resources. See, for example

http://www.ic.uff.br/~esteban/files/sbgames09_Alex.pdf

for a development environment using Microsoft Visual Studio, the base language C#, and the graphical library XNA. Protégé has been used for designing the ontology, and the application uses the OwlDotNetApi library.

This 2009 work demonstrates a step-by-step implementation, from the definition of an ontological knowledge base to the implementation of the main classes of a strategy game. It aims at serving as a basic reference for developers interested in starting .NET development of ontology-based applications.

Biometric and Other Identification Technologies

2009-11-20T09:45:00.009-05:00

In my November 17 post, I began a discussion of the [proposed] unique patient identification numbers by looking at a de facto proxy, the Social Security number (SSN). In the present post, I will continue with a look at a few of the technologies available for getting information such as someone's identification into or out of a computerized system such as, but not limited to, those used to implement electronic health records (EHR).

Biometric Applications

Biometric verification is a technology which uses unique characteristic features of an individual to automatically identify a person. There are several biometric technologies including fingerprint, hand geometry, and retinal scan. Each of these verification techniques claims to provide positive identification of individuals. What's more, these forms of ID cannot be transferred, forgotten or lost. Anywhere personal identification is required (such as PIN numbers at financial institutions), biometric verification can be used.

The hardware needed for biometric verification is frequently installed at the entrance of a building or secured area and are the "keys" for entry. Fingerprint verifiers, for example, generally allow any finger on either hand to be used for positive identification. Usually an alternate finger is also chosen as a backup in case of injury (cut, scrape, etc.) to the first. Multiple fingerprint templates can be stored locally inside the fingerprint terminal or through a network on a host computer (e.g., in a database). Most vendors also include software that supports common security access features such as unauthorized overtime or early clocking in. In addition, many of these systems can be integrated with existing software packages. Therefore, usually, separate systems do not have to be maintained in order to record and restrict access.

Biometric applications are highly specialized and costly to install when compared to card recognition and other access systems. In addition, if a biometric unit such as a terminal goes down, the manufacturer is often the only source for replacement or repair. With other technologies, such as magnetic stripe, input devices are readily available and can be purchased from a variety of vendors. Biometric Identification, however, does have its benefit. When ultimate security is vital, biometric identification is sometimes proven to be the best solution. But, caveat emptor: as shown later in this post, errors do occur.

Voice Recognition

Although technically, voice recognition is part of biometric verification, its widest application is to convert speech into text and not principally for security or access control. Voice recognition has many advantages, most notably allowing people to keep their eyes and hands free while "voicing instructions" to the computer. Voice recognition is used in many professional fields including healthcare.

For a discussion of using the human voice for verification, see my article "Speech Authentication Strategies, Risk Mitigation, and Business Metrics" in the bibliography at the bottom of this blog.

http://www.developer.com/security/article.php/3684921/Speech-Authentication-Strategies-Risk-Mitigation-and-Business-Metrics.htm

For readers with a background in mathematics and statistics, see the papers

"Comparing Human and Automatic Face Recognition Performance" at

http://myslu.stlawu.edu/~msch/biometrics/papers/adler-schuckers-Human-Automatic-FR.pdf

and

"Statistical Evaluation and Estimation of Biometric-based Classification" at

http://myslu.stlawu.edu/~msch/biometrics/papers/SchuckersTIFSCorrelationStructurev3.pdf

Among the topics discussed here are

(1) false accept rate
(2) false reject rate
(3) false match rate
(4) false non-match rate
(5) biometric authentication,
(6) effective sample size
(7) confidence intervals

Note 1: A video in the right-hand column of this blog presents a brief introduction to confidence intervals.

Note 2: If 99.9% were good enough

• There would be a major plane crash every 3 days
• 12 babies would be given to the wrong parents each day
• There would be 37,000 ATM errors every hour

Nonetheless, technology-based systems in use today do yield the expected outcome less than 100% of the time.

So, it's important that you understand that, like their human counterparts, technologically-based methods are error prone. At the same time, it's also important that you know the cost of these errors to you (and those you serve) in the methodology you choose to use.

Optical laser Cards

These cutting-edge cards transform CD-ROM technology into a credit card form, capable of securely storing megabytes of personal information. For example, a patient ID card could hold an image, health care history, vaccination record, X-rays and more.

Card Based Access System

Controlling entry security to your facility (or computer system) is of vital importance, whether your facility is a high security area such as a hospital, airport, or bank, or even if it is an everyday situation such as an insurance office, school, or department store.

Visual Identification

The simplest access control systems use portrait ID or membership cards, which rely on a receptionist or colleagues at work to recognize interlopers by the absence of a valid, matching portrait card. Such systems require the printing of clear, easily visible, portrait cards. Unfortunately however, that alone is not enough, because with current PC and scanner technology, creating fake or counterfeit cards is all too easy.

Even simple door entry control systems need to use an anti-counterfeiting system which provides an overall security "watermark" feature which is proof against all attempts to copy it.
This type of access control is extremely cost-effective, and it may be all that many facilities need to achieve the security level they require.

Swipe Card Door Access Control Systems

If you need controlled access without relying on the presence of guards or reception staff, you may need to add swipe card readers and electronic locks to your controlled entrances. A higher level of security can be achieved by using mag-stripe readers.

Proximity Cards / Prox Card Access Control Systems

Proximity Cards, or "Prox" as they are often called, are standard size plastic ID cards which contain a coil antenna and a pre-programmed micro chip containing a unique code. When the prox card is within a foot or so of the Prox reader, the radio signal from the reader is picked up by the card antenna and used to power-up the micro chip which then replies with its own unique code.

The reader and its associated processor compare the code with a list of authorized entrants, and if it's OK, the door is opened and a record of entry is logged.

Prox cards must always be "personalized" with a portrait ID to eliminate the misuse of "loaned" or stolen cards.

Reference Books

For a good summary of the sources of problems (errors) and biometric performance, see

This book includes very readable material on

(1) Legal aspects of biometric technologies
(2) Selected technology error rates
(3) Resistance of the system to forgeries
(4) RFID applications
(5) Economics

and much else.

For a comprehensive introduction to RFID, see

Click here for a preview look at this book.

RFID and Bar Codes

For a discussion of the pros and cons of using RFID and bar codes for the identification of patients, staff and medications, in different use cases, see

http://geekdoctor.blogspot.com/2007/11/bar-codes-rfid-and-patient-safety.html

You will find there a summary of early work at Beth Israel Deaconess Medical Center in Boston to establish positive patient identification:

"For identification of most patients, we believe linear and two dimensional bar codes on wrist bands is robust, cost effective and standardized. For staff badges, linear bar codes work well. For NICU babies passive RFID enables scanning of swaddled infants without disturbing them.

For identification of medications, we believe linear bar codes of NDC numbers on heat sealable plastic bags provides a practical means to positively identification medications.

For identification of equipment, specifically for tracking location in real time, active RFID works well. Because of the size and expense of tags, we do not believe active RFID should be used for patient identification at this time.

Thus, a combination of bar codes, passive RFID and active RFID is working well in our various pilots. No one technology meets the needs of all use cases. Although we favor bar codes over passive RFID in the short term, we do expect to eventually replace bar codes with RFID once the technology is more robust, standardized and cost effective."

Unique Patient Identification Numbers, Electronic Heath Records (EHR), Electronic Medical Records (EMR), and Social Security Numbers (SSN)

2009-11-17T10:20:00.007-05:00

Creating a unique patient identification number for every person in the United States would help reduce medical errors, simplify the use of electronic medical records, increase overall efficiency, and protect patient privacy, according to a recent RAND Corp. study.

Creating such an ID system could cost as much as $11 billion, but the effort would likely return even more in benefits to the nation's healthcare system, said researchers from RAND Health, a nonprofit research organization.

As adoption of health IT expands nationally and more patient records are computerized, there have been increasing calls to create a system that would include such an ID.

So, as segue to an upcoming post here on the challenges presented by an electronic health records system based on a unique patient identification number, let’s take a brief look at the closest thing to it in the U.S.: The Social Security Number.

Introduction

The Social Security Number (SSN) was created in 1936 as a nine-digit account number assigned by the Secretary of Health and Human Services for the purpose of administering the Social Security laws. SSNs were first intended for use exclusively by the federal government as a means of tracking earnings to determine the amount of Social Security taxes to credit to each worker's account. Over time, however, SSNs were permitted to be used for purposes unrelated to the administration of the Social Security system. For example, in 1961 Congress authorized the Internal Revenue Service to use SSNs as taxpayer identification numbers.

In response to growing concerns over the accumulation of massive amounts of personal information, Congress passed the Privacy Act of 1974. Among other things, this Act makes it unlawful for a governmental agency to deny a right, benefit, or privilege merely because the individual refuses to disclose his SSN.

Section 7 of the Privacy Act further provides that any agency requesting an individual to disclose his SSN must "inform that individual whether that disclosure is mandatory or voluntary, by what statutory authority such number is solicited, and what uses will be made of it." At the time of its enactment, Congress recognized the dangers of widespread use of SSNs as universal identifiers. In its report supporting the adoption of this provision, the Senate Committee stated that the widespread use of SSNs as universal identifiers in the public and private sectors is "one of the most serious manifestations of privacy concerns in the Nation." Short of prohibiting the use of the SSN outright, the provision in the Privacy Act attempts to limit the use of the number to only those purposes where there is clear legal authority to collect the SSN. It was hoped that citizens, fully informed where the disclosure was not required by law and facing no loss of opportunity in failing to provide the SSN, would be unlikely to provide an SSN and institutions would not pursue the SSN as a form of identification.

Large amounts of personal information, including tax information, credit information, school records, and medical records, is keyed to your Social Security Number. Because this data is often sensitive, you should keep it private.

The Structure of the SSN

The SSN is not entirely randomly-generated. Although the procedures for issuing SSNs have changed over the years, a SSN can reveal an individual's relative age and place of origin. The first three numbers (area number) are keyed to the state in which the number was issued. The next two (group numbers) indicate the order in which the SSN was issued in each area. The last four (serial numbers) are randomly generated.

The SSN and Privacy

Today, the Social Security Number plays an unparalleled role in identification, authentication, and tracking of Americans. Because the identifier is used for many purposes, it is valuable to those who wish to acquire credit, commit crimes, or masquerade as another person.

The SSN has been increasingly used in the private sector. The SSN is the record locator for many private-sector profilers, credit bureaus, and credit card companies. It is also used extensively outside the financial services sector. And, while some businesses use the SSN to identify individuals, others use the SSN as a password. This means that the SSN is widely used both as an identifier and as an authenticator. Serious security problems are raised in any system where a single number is used both as identifier and authenticator. It is not unlike using a password identical to a user name for signing into e-mail. Or like using the SSN as a bank account number and the last four of the SSN as a PIN for automated teller machines.

The SSN as National Identifier

The issuance of a single, unique number to Americans raises the risk that the SSN will become a de jure or de facto national identifier. This risk is not new; it was voiced at the creation of the SSN and has since been raised repeatedly. The SSN was created in 1936 for the sole purpose of accurately recording individual worker's contributions to the social security fund. The public and legislators were immediately suspicious and distrustful of this tracking system fearing that the SSN would quickly become a system containing vast amounts of personal information, such as race, religion and family history, that could be used by the government to track down and control the action of citizens. Public concern over the potential for abuse inherent in the SSN tracking system was so high, that in an effort to dispel public concern the first regulation issued by the Social Security Board declared that the SSN was for the exclusive use of the Social Security system.

In passing the Privacy Act of 1974, Congress was specifically reacting to and rejecting calls for the creation of a single entity for the reference and storage of personal information. A 1977 report issued as a result of the Privacy Act highlighted the dangers and transfer of powers from individuals to the government that occur with centralization of personal information:

In a larger context, Americans must also be concerned about the long-term effect record-keeping practices can have not only on relationships between individuals and organizations, but also on the balance of power between government and the rest of society. Accumulations of information about individuals tend to enhance authority by making it easier for authority to reach individuals directly. Thus, growth in society's record-keeping capability poses the risk that existing power balances will be upset.

Many medical providers are using the SSN as a patient identifier, thus hardening the number as a de facto national identifier. As David Miller noted in testimony before the National Committee on Vital Health Statistics:

"It should be noted that the 1993 WEDI [Workgroup for Electronic Data Interchange] Report, Appendix 4, Unique Identifiers for the Health Care Industry, Addendum 4 indicated 71% of the payers responding to the survey based the individual identifier on the Member's Social Security Number. However 89% requested the insured's Social Security Number for application of insurance. Clearly the Social Security Number is the current de facto identifier..."

But individuals and companies are resisting such use of the SSN. Acting on employees' suggestions, I.B.M. has requested that health companies stop using the SSN on insurance cards. According to IBM, fifteen insurers, which cover about 30,000 of the company's 500,000 employees worldwide have either not responded or indicated that they will not comply with the request.

The SSN and Identity Theft

The widespread use of the SSN as an identifier and authenticator has lead to an increase in identity theft. According to the Privacy Rights Clearinghouse, identity theft now affects between 500,000 and 700,000 people annually. Victims often do not discover the crime until many months after its occurrence. Victims spend hundreds of hours and substantial amounts of money attempting to fix ruined credit or expunge a criminal record that another committed in their name.

Identity theft litigation also shows that the SSN is central to committing fraud. In fact, the SSN plays such a central role in identification that there are numerous cases where impostors were able to obtain credit with their own name but a victim's SSN, and as a result, only the victim's credit was affected. In June 2004, the Salt Lake Tribune reported: "Making purchases on credit using your own name and someone else's Social Security number may sound difficult -- even impossible -- given the level of sophistication of the nation's financial services industry. But investigators say it is happening with alarming frequency because businesses granting credit do little to ensure names and Social Security numbers match and credit bureaus allow perpetrators to establish credit files using other people's Social Security numbers." The same article reports that Ron Ingleby, resident agent in charge of Utah, Montana and Wyoming for the Social Security Administration's Office of Inspector General, as stating that SSN-only fraud makes up the majority of cases of identity theft.

Because creditors will open new accounts based only on a SSN match, California has passed legislation requiring certain credit grantors to comply with heightened authentication procedures. California Civil Code § 1785.14 requires credit grantors to actually match identifying information on the credit application to the report held at the credit reporting agency. Credit cannot be granted unless three identifiers from the application match those on file at the credit bureau.

From my [partial] bibliography - Six Sigma, Monte Carlo Simulation, and Kaizen

2009-11-17T08:34:00.006-05:00

From time to time, I've made reference to "My [partial] bibliography" at the bottom of this blog. One of the articles cited near the top of this list, Six Sigma, Monte Carlo Simulation, and Kaizen for Outsourcing, recently drew some complimentary feedback that I've pasted here {this is unabashed self promotion}:

{click on the image above for larger view}

Here's a small section from the article:

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Vagueness, Logic, and Ontology: Fuzzy Ontologies

2009-11-07T10:55:00.007-05:00

In traditional ontology theory, concepts and roles are crisp sets. However, there is a great deal of fuzziness in the real world.

For example, one may be interested in finding “a very strong flavored red wine” or in reasoning with concepts such as “a cold place”, “an expensive item”, “a fast motorcycle”, etc.

A possible solution to handling uncertain data is to incorporate fuzzy logic into ontologies. Unfortunately, these fuzzy ontologies have shortcomings – reasoners for fuzzy ontologies are not yet so polished as those for crisp (aka traditional) ontologies.

Possible use of a fuzzy ontology

When performing a query on a document, it is a usual practice to extend the set of concepts already present in the query with other ones which can be derived from an ontology. Typically, given a concept, its parents and children can also be added to the query and then searched in the document.

Extending queries

A possible use of fuzzy ontology is to extend queries with, besides children and parents, instances of concepts which satisfy to a certain degree the query. Here’s an example. You are given a clothes ontology and a query looking for “a very long and black coat.” In the ontology there are two instances of coat: X which has property “long” with value 0.7 and Y which has property “long” with value 0.3. Thus, it is natural to extend the original query adding, not only parents and children of the concept “coat”, but also the instance X, because \long = 0.7 can be interpreted as “very long”. On the other hand, the instance Y is not added to the extended query since \long = 0.3 does not mean “very long”.

Mathematical representation of a fuzzy concept

The fuzzy concept “Young_Person” is defined as follow:

The linguistic term Young may be defined by a trapezoidal function as shown graphically in the next figure, its mathematical representation.

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Representation of a fuzzy ontology in Protégé

Fuzzy Protégé for Fuzzy Ontology Models

A good deal of work has been conducted to build tools for the creation of fuzzy ontologies.

Fuzzy Protégé is a semi-automatic collaborative tool for the construction of fuzzy ontology models, built as a Protégé 3.3.1 tab plug-in. For more information on this plug-in, click the following link.

http://protege.stanford.edu/conference/2009/abstracts/S10P2Ghorbel.pdf

Fuzzy OWL 2

The prior post to this blog introduced Web Ontology Language 2 (OWL 2), a new version of a standard for representing knowledge on the Web that had been announced by W3C just that day.

Fuzzy OWL2 Ontology is an OWL ontology to represent fuzzy extensions of the OWL and OWL 2 languages. For more information on this subject, click the following link.

http://webdiis.unizar.es/~fbobillo/papers/ISMIS2009presentation.pdf

Vagueness, Logic, and Ontology

Some people are clearly bald (Picasso), some are clearly hairy (the count of Montecristo), and some are borderline cases. Achille C. Varzi, Department of Philosophy, Columbia University, New York, starts here and presents a very interesting discussion on Vagueness, Logic, and Ontology in an easy-to-read paper reached by clicking the following link.

http://www.columbia.edu/~av72/papers/Dialogue_2001.pdf

Studies in Fuzziness and Soft Computing

http://www.springer.com/engineering/book/978-3-540-71257-2?cm_mmc=Google-_-Book%20Search-_-Springer-_-0

Web Ontology Language 2 - A new version of a standard for representing knowledge on the Web

2009-10-27T13:02:00.005-04:00

Today, W3C announced a new version of a standard for representing knowledge on the Web. OWL 2, part of W3C's Semantic Web toolkit, allows people to capture their knowledge about a particular domain (say, energy or medicine) and then use tools to manage information, search through it, and learn more from it.

Furthermore, as an open standard based on Web technology, it lowers the cost of merging knowledge from multiple domains.

Communities organize information through shared vocabularies.

Booksellers talk about "titles" and "authors," human resource departments use "salary" and "social security number," and so on. OWL is one W3C tool for building and sharing vocabularies.

Consider the application of OWL in the field of health care. Medical professionals use OWL to represent knowledge about symptoms, diseases, and treatments. Pharmaceutical companies use OWL to represent information about drugs, dosages, and allergies. Combining this knowledge from the medical and pharmaceutical communities with patient data enables a whole range of intelligent applications such as decision support tools that search for possible treatments; systems that monitor drug efficacy and possible side effects; and tools that support epidemiological research.

As with other W3C Semantic Web technology, OWL is well-suited to real-world information management needs. Over time, our knowledge changes, as does the way we think about information. It is also common to think of new ways of using data over time, or to have to combine data with other data in ways not initially envisioned (for example, when two companies merge and their data sets need to be merged as well). OWL is designed with these realities in mind.

OWL can lower software development costs as well by making it easier to design generic software (search tools, inference tools, etc.) that may be customized by simply adding more OWL descriptions. For instance, one simple but powerful feature of OWL is the ability to deduce two items of interest as being "the same" — for instance, that "the planet Venus" is the same thing as "the morning star" and as "the evening star." Knowing that two items are "the same" allows smart tools to infer relationships automatically, without any changes to software.

The new features in OWL 2 are based on the features people most requested after using OWL 1. OWL 2 introduces OWL profiles, subsets of the language that offer easier implementation and use (at the expense of expressive power) designed for various application needs.

To get started with OWL 2, see the OWL 2 Overview (click here) and OWL 2 Primer (click here).

Probabilistic Reasoning for OWL DL Ontologies -- Reasoning about Uncertain Domain Knowledge

2009-10-27T11:24:00.012-04:00

Pronto is an extension of Pellet that enables probabilistic knowledge representation and reasoning in OWL ontologies. Pronto is distributed as a Java library equipped with a command line tool for demonstrating its basic capabilities. (There is no 1.0 release!) The figure below outlines the relationships among Pronto, an OWL DL Ontology, and the editor that might have created the ontology. Pellet supports reasoning with the full expressivity of OWL-DL (SHOIN(D) in Description Logic jargon) and has been extended to support the forthcoming OWL 2 specification (SROIQ(D)).

Pronto offers core OWL reasoning services for knowledge bases containing uncertain knowledge; that is, it processes statements like “Bird is a subclass-of Flying Object with probability greater than 90%” or “Tweety is-a Flying Object with probability less than 5%”. The use cases for Pronto include ontology and data alignment, as well as reasoning about uncertain domain knowledge generally; for example, risk factors associated with breast cancer.

Pronto adds the following capabilities to Pellet:

* Adding probabilistic statements to an ontology (using OWL's annotation properties)

* Inferring new probabilistic statements from a probabilistic ontology

* Explaining results of probabilistic reasoning

Pronto depends on Pellet, which is included in the Pronto release package. It also relies on Ops Research's OR-Objects package, which needs to be downloaded separately.

To download Pronto, click here.

To download OR-Objects, click here.

The features of Pronto (in addition to the features of Pellet) are outlined in the file basic.pdf, located in the /doc directory of the Pronto download.

If you are interested in a rigorous description of the approach taken by Pronto, read the paper by Thomas Lukasiewicz “Probabilistic Description Logics for the Semantic Web,” which is cited under Resources in basic.pdf.

For further reading on Probabilistic Reasoning, click

http://clarkparsia.com/weblog/2007/09/27/introducing-pronto/

http://klinov.blogspot.com/2007_11_01_archive.html

http://clarkparsia.com/weblog/2007/10/02/using-pronto/

For further reading on Pellet features, click

http://clarkparsia.com/pellet/features

An upcoming post will discuss ontologies that use fuzzy logic.

Electronic medical records systems are not classified as medical devices -- This may have serious consequences.

2009-10-24T14:11:00.006-04:00

This is an interim post. The promised post on ontologies that benefit from fuzzy or probability-based logic is coming.

"We wouldn't want to go back, but Electronic Health Records (EHR) are still in need of significant improvement."

-Christine Sinsky, an internist in Dubuque, Iowa, whose practice implemented electronic records six years ago.

More than one in five hospital medication errors reported last year -- 27,969 out of 133,662 -- were caused at least partly by computers, according to data submitted by 379 hospitals to Quantros Inc., a health-care information company. Paper-based errors have caused 10,954 errors, the data showed.

Between 2006 and 2008, computer errors also contributed to 31 deaths or serious injuries -- twice as many as were caused by paper errors, although numbers of these serious cases were decreasing, Quantros said.

Legal experts say it is impossible to know how often health IT mishaps occur. Electronic medical records are not classified as medical devices, so hospitals are not required to report problems. In fact, many health IT contracts do not allow hospitals to discuss computer flaws, according to Sharona Hoffman, a professor of law and bioethics at Case Western Reserve University in Cleveland.

"Doctors who report problems can lose their jobs," Hoffman said. "Hospitals don't have any incentive to do so and may be in breach of contract if they do. That sort of secrecy puts the patient at risk."

Click here to see the complete Washington Post article

Collaborative Developement of Large, Complex and Evolving Ontologies (e.g., SNOMED CT and GALEN) using a Concurrent Versioning System (CVS)

2009-10-20T13:59:00.012-04:00

Prior posts here have talked about ontologies as though they magically appear and seamlessly meet a variety of challenges faced by the developers of computer applications. In this and a subsequent post, I'm going to touch upon several of the difficulties present in the creation and use of certain ontologies. What follows below is a few words on the use of Concurrent Versioning Systems (CVS). My next post will discuss the gap between the majority of today's ontologies and a real world that's filled with a good deal of vagueness and uncertainty that these ontologies can't describe all that well.

OWL Ontologies are being used in many application domains. In particular, OWL is extensively used in the clinical sciences; prominent examples of OWL ontologies are the National Cancer Institute (NCI) Thesaurus, SNOMED CT, the Gene Ontology (GO), the Foundational Model of Anatomy (FMA), and GALEN.

These ontologies are large and complex; for example, SNOMED currently describes more than 350,000 concepts whereas NCI and GALEN describe around 50,000 concepts. Furthermore, these ontologies are in continuous evolution; for example the developers of NCI and GO perform approximately 350 additions of new entities and 25 deletions of obsolete entities each month.

Most realistic ontologies, including the ones just mentioned, are being developed collaboratively. The developers of an ontology can be geographically distributed and may contribute in different ways and to different extents. Maintaining such large ontologies in a collaborative way is a highly complex process, which involves tracking and managing the frequent changes to the ontology, reconciling conflicting views of the domain from different developers, minimising the introduction of errors (e.g., ensuring that the ontology does not have unintended logical consequences), and so on.

In this setting, developers need to regularly merge and reconcile their modifications to ensure that the ontology captures a consistent unified view of the domain. Changes performed by different users may, however, conflict in complex ways and lead to errors. These errors may manifest themselves both as structural (i.e., syntactic) mismatches between developers’ ontological descriptions, and as unintended logical consequences.

Tools supporting collaboration should therefore provide means for: (i) keeping track of ontology versions and changes and reverting, if necessary, to a previously agreed upon version, (ii) comparing potentially conflicting versions and identifying conflicting parts, (iii) identifying errors in the reconciled ontology constructed from conflicting versions, and (iv) suggesting possible ways to repair the identified errors with a minimal impact on the ontology.

In software engineering, the Concurrent Versioning paradigm has been very successful for collaboration in large projects. A Concurrent Versioning System (CVS) uses a client-server architecture: a CVS server stores the current version of a project and its change history; CVS clients connect to the server to create (export) a new repository, check out a copy of the project, allowing developers to work on their own ‘local’ copy, and then later to commit their changes to the server. This allows several developers to make changes concurrently to a project. To keep the system in a consistent state, the server only accepts changes to the latest version of any given project file. Developers should hence use the CVS client to regularly commit their changes and update their local copy with changes made by others. Manual intervention is only needed when a conflict arises between a committed version in the server and a yet-uncommitted local version. Conflicts are reported whenever the two compared versions of a file are not equivalent according to a given notion of equivalence between versions of a file.

Change or conflict detection amounts to checking whether two compared versions of a file are not ‘equivalent’ according to a given notion of equivalence between versions of a file.

A typical CVS treats the files in a software project as ‘ordinary’ text files and hence checking equivalence amounts to determining whether the two versions are syntactically equal (i.e., they contain exactly the same characters in exactly the same order). This notion of equivalence is, however, too strict in the case of ontologies, since OWL files, for example, have very specific structure and semantics. For example, if two OWL files are identical except for the fact that two axioms appear in different order, the corresponding ontologies should be clearly treated as ‘equivalent’: an ontology contains a set of axioms and hence their order is irrelevant.

Another possibility is to use the notion of logical equivalence. This notion of equivalence is, however, too permissive.

Therefore, the notion of a conflict should be based on a notion of ontology equivalence ‘in-between’ syntactical equality and logical equivalence.

Conflict resolution is the process of constructing a reconciled ontology from two ontology versions which are in conflict. In a CVS, the conflict resolution functionality is provided by the CVS client.

Conflict resolution in text files is usually performed by first identifying and displaying the conflicting sections in the two files (e.g., a line, or a paragraph) and then manually selecting the desired content.

Errors in the reconciliation process can be detected using a reasoner, but this too is complicated.

Collaborative Protégé is just one among several recent proposals for facilitating collaboration in ontology engineering tools. [See the following references for more information on this topic.] Such tools would allow developers to hold discussions, chat, and annotate changes.

Collaborative Protégé online demo http://protegewiki.stanford.edu/index.php/Collaborative_Protege
http://smi-protege.stanford.edu/collab-protege/

Collaborative Ontology Development with Protégé (2009)
http://protege.stanford.edu/conference/2009/slides/CollabProtegeTutorial.pdf

Noy, N.F., Tudorache, T., de Coronado, S., Musen, M.A.: Developing biomedical ontologies collaboratively. In: Proc. of AMIA 2008. (2008)

Noy, N.F., Chugh, A., Liu, W., Musen, M.A.: A framework for ontology evolution collaborative environments. In: Proc. of ISWC. (2006) 544–558

My next post will discuss the need for ontologies that benefit from fuzzy or probability-based logic when a domain has vagueness or uncertainty.

Demographics update: Visits to this blog

2009-10-16T14:22:00.017-04:00

I noted in my June 11 post

Today, the report shows

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From Star Schema Ontologies Stored in an RDBMS (e.g., i2b2) to Other Ontology Stores and The Semantic Web

2009-10-13T13:01:00.016-04:00

Recent posts here have discussed ontologies saved in relational databases (see, for example, my September 11 and 24 posts); while other posts have been about different kinds of ontology stores and the Semantic Web (see, for example, my September 27 and 6 as well as my October 11 posts). If one reads only this blog, one might think that there is no work to exploit the advantages of both approaches in a single system afoot. But, there are. A number of investigators are looking into applications that support connections to both a variety of RDBMS schemas and other forms of ontology management.

What if i2b2 built Semantic Web graphs instead of relational stores? What if it had an OWL-defined Ontology, instead of a relational-schema? Click here.

Semantic Web will be part of i2b2 and will allow it to correlate unique variable names across consortium sites (e.g., white, Caucasian) and for information retrieval. Click here

From Stanford ( Russ Altman et al ) on the west coast to Harvard ( Isaac Kohane et al ) on the east coast in the U.S. Click here.

Ontology Systems. Click here.

i2b2. Click here.

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Mapping Ontologies - Tools, a Suite, and an Application

2009-10-11T12:18:00.006-04:00

Before continuing, I want to devote a little space to fleshing out the subject of Mapping Ontologies, which I have alluded to in a couple of earlier posts. Mapping is a process in which we first try to find similarity between individual elements of two ontologies. We compare the elements on the basis of their names and attributes.

Using Protégé

Note: Protégé (see my August 24 post below) is probably the most popular ontology editor available.

Click here.

Using NeOn Toolkit

Note: The Watson plug-in to the NeOn Toolkit (see my September 27 post below) allows the user to select entities of the currently edited ontology and to automatically trigger queries to a remote ontology.

Click here.

A proposed Web app that addresses a real-world situation with the help of ontology mapping, probabilities, and Jena - a Semantic Web framework for Java.

When incorporating data semantics into the searching process, the correctness of searching can depend directly on mapping results.

Keywords: Protégé, OWL, Jena, Probability

Click here.

A Comprehensive Suite of Tools

A presentation by the former lead developer of Protégé-OWL

Click here.

Uncertain Knowledge, Ontologies, and Reasoners – A Discussion of Semantic Ambiguity in the Presence of Statistical Uncertainty

2009-10-08T13:18:00.020-04:00

Before continuing with uncertain domain knowledge, the subject of this and future posts, I’d like to give an example. I’ll introduce a scenario in which both semantic ambiguity (refer to my prior post) and statistical uncertainty (refer to the tutorials in the right-hand column of this blog) are present.

One of the limitations of most current description logic (DL) reasoners (refer to my August 6 & 24 posts below) is the inability to handle uncertain knowledge. It is a serious obstacle to the expansion of the Semantic Web, to name just one technology, because many domains of human interest contains knowledge that cannot be represented with absolute certainty. One example of an uncertain domain is medicine, in particular, disease diagnosis. Symptoms, causes and consequences of many diseases are uncertain which complicates conceptualization of such domains in formal ontologies and thus restricts machine understanding.

The next two figures, rendered without further explanation, illustrate that the difficulties introduced by semantic ambiguity of a deterministic kind can be made even more difficult when there is a need to consider statistical uncertainty at the same time. This might be the case when a patient is seen by one doctor and then asks a second doctor for his or her opinion.

However, these days, a good deal of technology is often employed by doctors before they speak to patients and to each other.

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To be continued . . .

"Bernstein at Harvard" -- Segue to Probability, Semantic Amiguity, etc.

2009-10-03T15:17:00.011-04:00

My prior post was about Watson, a tool for accessing multiple and usually heterogeneous online ontologies, but never once mentioned the word "probability." However, the recognition of uncertainty in the real world is sometimes needed within description logics, the underpinning of ontologies like OWL. Because of its importance, I'll take up the topic of uncertain domain knowledge in my next post.

For the present, however, I've embed here the 4 1/2 minute video "Bernstein at Harvard," which includes many of the terms - e.g., probability, meaning, semantic ambiguity, meta, language, and knowledge - that I'll use in my upcoming rant. Hope you find this segue as relevant as I do.

Note: Semantic ambiguity arises when a word or concept has an inherently diffuse meaning based on widespread or informal usage. This is often the case, for example, with idiomatic expressions whose definitions are rarely or never well-defined, and are presented in the context of a larger argument that invites a conclusion.

For example, “You could do with a new automobile. How about a test drive?” The clause “You could do with” presents a statement with such wide possible interpretation as to be essentially meaningless. Lexical ambiguity is contrasted with semantic ambiguity. The former represents a choice between a finite number of known and meaningful context-dependent interpretations. The latter represents a choice between any number of possible interpretations, none of which may have a standard agreed-upon meaning. This form of ambiguity is closely related to vagueness.