Dear Prospective Employer,

Published on December 1, 2009 by Bob in General. 3 Comments Tags: .

workerBased on the job description, I am a perfect candidate for this position…

As I’ve previously discussed, my company was sold this past summer. Since then they announced that our operation will be moved to Seattle by the end of the year. SonoSite has been very professional and generous, but I have decided to stay in San Diego.

I made this decision several months ago, but since I will be employed until the end of the year, I have not been very active in my job search. Until now.

So, if you’re reading this you may very well be an employer looking to hire someone like me. You might have gotten here from my Stack Overflow Careers CV or even directly from my resume.

There is one question that I can answer up-front:

Q: What are your long-term career goals? More specifically, do you want to do development or do you want to be a software project manager?

A:  This is the fork in the career road that most software engineers eventually get to. I’ve done both and my preference is in-the-trenches software design and development. I get the most enjoyment from building solutions in a collaborative team environment.

Thank you for your consideration.

Sincerely,

Bob

If you’re also looking for a job, I wanted to share a little.

About a month ago I came across a “Principal Software Engineer” position that I thought fit my skills and interests pretty well. I submitted my resume and got a full day interview a couple of weeks later. I hadn’t done an interview in over four years. Here are some of the highlights:

  1. I was asked the usual technical programming questions. Mostly about .NET/C#, e.g. see Dot Net Interview Questions. Since I’ve asked the same questions to prospective employees a number of times, I think I did pretty well on these.
  2. The software design problem was also pretty typical. How would you design a 4-way stop light control system?  Hint: Ask about requirements. Even though you have assumptions about how something this familiar works, others may have a very different perspective.
  3. The dreaded logic question. I got The 8 ball problem. I hate these things.  I eventually got to the 3-try solution, but the 2-try was beyond my cognitive powers. Oh well.

Even though I was not offered the job, the overall experience was generally good (the rejection part sucked).  I think their definition of “Principal” was different than mine.

Every company has different interviewing techniques and practices.  It seems that large companies have developed the most rigorous (and onerous) methods. Google is known for its over-the-top questions: 15 Google Interview Questions That Will Make You Feel Stupid. A more pragmatic approach, e.g. How I Hire Programmers, makes sense: “Are they smart? Can they get stuff done? Can you work with them?”. I’m not sure many companies can afford to invest that much in interviewees though.

Speaking of “Are they smart?”, Jonah Lehrer’s article Vince Young talks about the relationship between an IQ test and the performance of NFL quarterbacks.  I think the same basic concept applies to developing software products. As important as writing good code is, each engineer must also be able to understand the business needs and really listen to marketing/sales and of course the customer (“emotional intelligence”).  There is no IQ test for that.  “Genius is one percent inspiration and 99 percent perspiration” (Thomas Edison) also applies.

Interviewing is a two-way street so I would be remiss if I didn’t mention The Joel Test: 12 Steps to Better Code. Don’t forget to ask good questions.

Anyway…

Just like the rest of the job market these days, the competition for all types of developer positions is also pretty intense. The trick will be finding that perfect match between my skills and the employer needs and environment. We’ll see how it goes. Wish me luck!

UPDATE (12/3/09):  The Codypo Test, aka 8 Questions To Identify A Lame Programming Job

Stackoverflow Overflow

Published on November 19, 2009 by Bob in Programming. 2 Comments Tags: .

I really like SO. It’s quickly become an invaluable resource for finding and getting programming answers.

I generally browse the new questions to see if there’s anything I might be able to a answer.  Even when you find a question you already (think you) know the answer to, it still requires  some research.  Answering questions is a great exercise.

A couple of weeks ago I started to take notice of how fast the question count was increasing.  So I decided to track it and quantify the growth. Here’s what I found:

SO-Count-L

So on average there are about 1472 new questions every day! That means when I browse through my 50 or so new questions, there are more than 1400 other ones that I’m not seeing. And that’s if I visit every day.

Yeah, yeah — I know about searching, using the tags, unanswered questions, etc.  What’s remarkable to me is the shear volume of questions.  Two things strike me about this:

  1. There seems to be a lot of question duplication. You can see that when you go to a question and look at the related questions on the right hand column.
  2. My sense is that the number of views per question is also going down.  I don’t know for this sure, but it would follow that there must also be fewer answers per question.

These are just anecdotal observations on my part.  I didn’t mean this to be an exhaustive analysis of SO, and I’m not trying to be critical. It just seems to me that the “weight “of SO is bound to become an issue in the future.

SO is a great site and I’m sure Jeff and Joel are very aware of these patterns and are plotting solutions while the rest of us sleep.

So based on 14 days of data – :) -  here’s about when the number of questions will hit future milestones:

SO-Count-Future

We’ll have to wait and see if these predictions become true.

A Medical Device Gateway Data Standard?

Published on November 18, 2009 by Bob in Google, Interoperability, Medical Devices, Microsoft and PHR. 1 Comment Tags: .

The Wipro OEM medical device gateway press release makes it all seem so easy (my highlight):

The device, consisting of interfaces that can feed-in data such as blood pressure, pulse rate, ECG reading and weight from the respective devices, is connected to the gateway that would format it into standard patient information and transmit it to either public health data platform such as Google Health or to private platforms like Microsoft Health Vault.

What exactly is “standard patient information”?  Maybe they’ve finally developed the magic interoperability bullet.  Yeah, right!  I’m sure companies like Capsule see these kind of claims all the time.  Statements like these are unfortunate because they give the impression that health data interoperability is a given. Of course we know that is not the case.

Also, since when is Google Health a public health data platform?

Hat tip: Avantrasara

UPDATE (11/19/09):  Wipro ties up with Intel for rural medical solutions

iPhone Health Applications for Medical Professionals

Published on November 1, 2009 by Bob in Health 2.0 and PHR. 4 Comments Tags: .

Epocrates-iphoneThere are a lot of iPhone health and fitness applications available. Many are for the general public. Here are some vetted lists that target medical professionals:

Update (11/3/09):

There’s an entire Web Site devoted to this subject:

iPhone Medical & Health Apps: news, reviews, trends

Hat tip: John Zaleski

Standards should be as Simple and Stupid as Possible

Published on October 31, 2009 by Bob in Interoperability. 1 Comment Tags: .

Great post by Adam Bosworth:

Talking to DC

Hat Tip: Joel on Software

Also see Dreaming of Flexible, Simple, Sloppy, Tolerant in Healthcare IT and Liberate the Data!

Selling Anonymized Health Data

Published on October 18, 2009 by Bob in EMR and PHR. 0 Comments Tags: , .

anonymous350The New York Times article When 2+2 Equals a Privacy Question raises some serious medical data privacy concerns.

But by 2020, when a vast majority of American health providers are expected to have electronic health systems, the data mining component alone could generate sales of up to $5 billion…

The magnitude of data needed to generate that kind a revenue is significant.  The likelihood that “de-identification” of someone’s health information will occur is very high.  “Anonymized” Data Really Isn’t points out the same thing that the NYT article does:

Computer scientists over the past fifteen years show that it is quite straightforward to extract personal information by analyzing seemingly unrelated, “anonymized” data sets.

The demand for the secondary use of health data (and here) is high because it is believed it will

Significantly improve the quality of patient care and offers the promise of even greater benefits in the future.

Many feel that use of secondary health information should be regulated by the government.

Here’s a good overview that covers many health data secondary use issues: Toward a National Framework for the Secondary Use of Health Data: An American Medical Informatics Association White Paper.

UPDATE (10/20/09): Also see the Wired article Medical Records: Stored in the Cloud, Sold on the Open Market.

The Desperate Need for Simplicity

Published on October 13, 2009 by Bob in Agile, Interoperability and Programming. 0 Comments Tags: .

Ted Neward’s article “Agile is treating the symptoms, not the disease” touches on several important points about the software industry.

  • Modern software development tools and technologies require a significant learning curve.
  • Development methodologies (like Agile) exist for managing complexity, but do not reduce the load of these technologies.
  • In the last decade there has been no “Next Big Thing”, like Access was in the 90s.

What’s most interesting to me is:

We are in desperate need of simplicity in this industry. Whoever gets that, and gets it right, defines the “Next Big Thing”.

What’s true in the broader software world is also generally true in Healthcare IT.  In HIT there has never been an Access equivalent, just a lot of pieces and parts trying unsuccessfully to work together.

The need was touched on in Liberate the Data!.  Simplicity is desperately needed in order to create the “First Big Thing” for HIT interoperability.

UPDATE (10/14/09):  More commentary:

Canyon Fire: To Close for Comfort!

Published on October 5, 2009 by Bob in General. 0 Comments Tags: .

It’s that time of year again. In Oct. 2007 over 1500 homes went up in flames in San Diego. It wasn’t close to us then, but now I understand the danger much better.

I left work a little early because of the Packer-Viking game (MNF starts at 5:15 on the West Coast).  As I approached our Condo complex I saw smoke bellowing over the roofs. My wife had also just gotten home and we watched with amazement the canyon below going up in flames no more than 25 yards from our patio.

canyon-fire

A neighbor had called 911 a few minutes before, but the 15 or so minutes prior to the SDFD arrival was tense. The fire spread amazingly fast. Large shrubs literally exploded into flames. The wind was blowing pretty hard in our direction, but seemed to wane and shift a little, which slowed its progress some.

We collected photos and valuables and got them in the car, ready to escape.

Fortunately, the SDFD came to the rescue in time. A fire helicopter did a couple of water drops, but it was the firefighters that saved the day.

canyon-fire-out
Wow, close call!

I better get back to the second half. Go Pack!

UPDATE: Oh well. Brett and the Vikings will be at Lambeau on Nov. 1. It’s a long season…

Medical Data in the Cloud

Published on September 26, 2009 by Bob in Cloud Computing and EMR. 1 Comment Tags: .

secure_documentI just ran across a three-part series of articles by Practice Fusion:

Medical Data in the Internet “cloud”:

Being an EMR in the cloud requires Practice Fusion to address these issues in depth. If you’re thinking about putting health information in the cloud like I’ve previously discussed, these articles are worth a careful read.

Hat Tip:  Healthcare IT News

UPDATE (10/1/2009):

Some commentary on the Practice Fusion EHR:  Cloud based EHRs – a response to PracticeFusion.

UPDATE (10/5/2009): EMR Vendor Practice Fusion’s CEO Interview

Access to Medical Data: Are PC Standards and PHRs (You) the Answer?

Published on September 22, 2009 by Bob in EMR, Google, Interoperability, Medical Devices and Microsoft. 0 Comments Tags: , , .

Dana Blankenhorn’s article Give medicine access to PC standards makes some good points about the medical device industry but (IMHO) misses the mark when trying to use PC standards and PHRs as models for working towards a solution.

I’ll get back to his central points in a minute. One thing I find fascinating is the knee-jerk reaction in the comments to even a hint of government control.  How on earth can someone jump from “industry standard” to a “march towards socialism”? We saw the same thing at this summer’s town hall meetings and in Washington a couple of weeks ago.  The whole health care debate is just mind boggling!

Anyway, let’s focus on the major points of the article. First:

Every industry, as its use of computing matures, eventually moves toward industry standards. It happened in law, it happened in manufacturing, it happened in publishing.

It has not happened, yet, in medicine.

Very true.  In the medical device world, connectivity and interoperability are hot topics. A couple of recent posts — Plug-and-Play Medicine and Medical Device Software on Shared Computers — point out the significant challenges in this area.  In particular, the development and adoption of standards is a very intensive and political process. But where’s the incentive for the industry to go through this? Dana’s comment addresses this (my emphasis):

The role I like best for government is in directing market incentives toward solutions, and not just to monopolies or bigger problems.

The reason health care costs jump every year is because market incentives cause them to. Those incentives must be changed, but the market won’t by itself because the market profits from them.

Only government can transform incentives. …

Like it or not, this may to the only way to push the medical industry to do the right thing.  But those other industries didn’t need government intervention in order to create their standards.  Using PC (or other industry) standards as a model for facilitating medical data access just doesn’t work.  The health industry will have to dragged to the table kicking and screaming, and the carrot (or stick) will have to be large in order for them to come to a consensus.

Second, I don’t see the relationship between the use of PHRs and the promotion of standards.

By supporting PHRs, you support your right to your own data. You support liberating data from proprietary systems and placing it under industry standards.  You support integrating your health with the world of the Web, and the benefits such industry standards can deliver to you.

Taking responsibility for your own health data is great, but both Microsoft HealthVault and Google Health are proprietary systems.  Just because your data is on the Web doesn’t make it any more accessible.  And even if one of these PHRs did became an industry standard, it would have very little impact on how EMRs communicate with each other or medical devices in general.

There are no easy answers.

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