The Integrative Stream

New year, new blog.

March 28, 2009 at 11:53 pm by Will Crawford in Ramblings | No Comments

If you’ve been following this blog recently, you’ve been wasting your time, since I haven’t posted anything in the last fifteen months. I took the hiatus because I prefer to blog about what I’m interested in, and the things that I was interested in during 2008 were covered by non-disclosure agreements.

A few weeks ago, though, I sat down with a notebook and wrote down about 70 blog topics. I started talking about the list with a few of my colleagues, and the result, launched on Friday, is info.rmatics – a new blog covering healthcare IT and health policy as well as software design, development and product management, both in the healthcare field and more broadly.

So if you’re reading this, head over there. I’ve got four other people to help, so the update frequency should be just a little bit better…

More Windows Vista

November 28, 2007 at 11:17 pm by Will Crawford in Ramblings | 2 Comments

Yes, quite on the blog lately. We just finished up PCHRI 2007, which was a not inconsiderable part.

An update on Windows Vista – last weekend I gave up and reinstalled Windows XP on my new home machine. I installed Google Desktop and TaskSwitch XP, and am essentially back to the same feature set as under Windows – except that the computer runs faster and doesn’t crash. And I can print multiple copies of documents.

There just has to be a pony in here somewhere…

September 1, 2007 at 8:12 pm by Will Crawford in Ramblings | 3 Comments

A few months ago my mother’s computer died. She got a new one, with Windows Vista on it. Since she’d been running Windows 2000 before, any new machine was going to have a new interface, and I suggested that she just go all the way to the “state of the art” and get it over with. A few weeks later I decided I needed to replace my home workstation, and bought a new system myself, equipped with Vista Ultimate.

I’ve been using it for a few weeks now, and have developed opinions. My initial impression was positive – cautiously so, but positive. The new operating system was peppy enough, but my new workstation has a top-of-the-line, quad-core processor and four gigabytes of RAM, plus the graphics card that ate Manhattan. To put things in some kind of perspective, the graphics board in this system has more raw computing power than my first five computers combined, and that’s without springing for the really fancy ones that the games use. And I didn’t have any of the installation issues people have reported, but then again, I bought the thing entirely preconfigured. It’s a Systemax from Tiger Direct, incidentally, and I’m actually quite happy with it – nice machine, well integrated, quick shipping, and not loaded down with demoware. They even tossed in a one year subscription to CA Antivirus, rather than the 30 day trial you usually get, and the whole package was well under $2,000, including a terabyte of storage, dual DVD drives and sundry other extras.

No, the problem is Vista. The new user interface is fine, and didn’t take that long to figure out. And the new windows are very pretty. The periodic crashes are not as pretty. It doesn’t happen that often while I’m working, but I frequently come back to discover my computer has reset itself. Others report similar experiences. Configuring external devices was also a challenge – my home printer is attached to a Windows XP system, and while I was able to get it working with the new Vista machine, it took several arcane networking moves to do it, including some driver updates (easy) and NetBIOS reconfigurations (not entirely obviously).

Then mom tried to print multiple copies on her Vista machine. It didn’t work. One copy came out. She needed about 150. This was not good. She clicked a lot, and asked me why, again, I had burdened her with this loathsome operating system? Subsequent research showed that many drivers for Vista don’t implement the full feature set for some older printers – like the four year old HP Laserjet 2200D she had. “Full feature set” apparently includes printing multiple copies. No solution has yet presented itself. I just tried printing multiple copies on my trusty Samsung – and no success.

So what do I like about Windows Vista? Precious little. To be fair, the design of the Windows Explorer interface has improved somewhat, and having search implemented in the operating system (albeit just like what I used to get from Google Desktop) is a nice touch. But they had better get that service pack out soon.

Transparency in Senior Leadership

June 6, 2007 at 1:31 pm by Will Crawford in Ramblings | No Comments

More on the role of blogging in business.

I’ve been thinking a lot over the last few weeks about the evolving transformation of consumer mentalities. Tools are changing. Will younger consumers expect a more transparent business environment?

Smokers Denied Surgery

June 4, 2007 at 8:11 am by Will Crawford in Ramblings | No Comments

Jason Shafrin looks at the story.

Links

May 31, 2007 at 7:54 pm by Will Crawford in Ramblings | No Comments

West on the Verge of a Medical Crisis – Daily Telegraph

The Content Concentration Process

May 29, 2007 at 9:02 am by Will Crawford in Ramblings | No Comments

I have a roughly half-hour interview for this article:

InformationWeek: Doctors Debate Giving Patients’ Online Access To Health Data

It got sliced down to one quote. There was some really good stuff there, too. The whole feature is a nice layman’s overview of current progress in health information exchange and electronic health record adoption.

And I’m back!

April 23, 2007 at 12:02 pm by Will Crawford in Ramblings | No Comments

Friday was my final day as an employee of the Federal Government. I never did hear back from the ethics department about what I could blog on – and not blog on – without approval, so I played it conservative over the last ten months and ended up blogging very little. While there are still a few areas I feel obligated to avoid (and you’ll have to wait for the autobiography to hear the tell-all bits), as of this week I’m going to start getting back to the blog on a regular basis.

To start with, on Monday I’ll be hosting The Carnival of the Capitalists. For a sneak peak, check out this week’s CoTC at The Geek Practioners Blog, then come back Monday for the finest in business blogging, as selected by me. And there’s more to come.

Cultural Context

April 6, 2007 at 10:57 am by Will Crawford in Ramblings | No Comments

Research indicates that cultural context is the key to reading facial expressions. Anybody who has tried to do business abroad has encountered this. What I didn’t realize is the extent to which this tendency extends to the Internet. Specifically, emoticons. The American “Happy” emoticon is (extra space to keep the blog from turning it into a pretty picture):

: )

Wherease in Japan:

^_^

The 18 Mistakes That Kill Startups

March 11, 2007 at 6:43 pm by Will Crawford in Ramblings | 1 Comment

I’m a little behind on some web sites, so I just saw Paul Graham’s The 18 Mistakes That Kill Startups, even though he posted it back in October. Oh well.

I’m going to quote number six, because I’ve seen this happen so many times that it’s worth emphasizing – and it’s not something that most other discussions of startup companies manage to pay attention to.

6. Hiring Bad Programmers

I forgot to include this in the early versions of the list, because nearly all the founders I know are programmers. This is not a serious problem for them. They might accidentally hire someone bad, but it’s not going to kill the company. In a pinch they can do whatever’s required themselves.

But when I think about what killed most of the startups in the e-commerce business back in the 90s, it was bad programmers. A lot of those companies were started by business guys who thought the way startups worked was that you had some clever idea and then hired programmers to implement it. That’s actually much harder than it soundsâ€”almost impossibly hard in factâ€”because business guys can’t tell which are the good programmers. They don’t even get a shot at the best ones, because no one really good wants a job implementing the vision of a business guy.

In practice what happens is that the business guys choose people they think are good programmers (it says here on his resume that he’s a Microsoft Certified Developer) but who aren’t. Then they’re mystified to find that their startup lumbers along like a World War II bomber while their competitors scream past like jet fighters. This kind of startup is in the same position as a big company, but without the advantages.

So how do you pick good programmers if you’re not a programmer? I don’t think there’s an answer. I was about to say you’d have to find a good programmer to help you hire people. But if you can’t recognize good programmers, how would you even do that?

Early Helpdesk Support

February 17, 2007 at 6:13 pm by Will Crawford in Ramblings | 1 Comment

Via Engadet. Mostly just a way to play with embedded video in the blog. But, really, who hasn’t been there?

Just back for a second

February 5, 2007 at 12:46 pm by Will Crawford in Ramblings | 1 Comment

Still not blogging regularly because I’m not sure what I’m allowed to blog about without violating policy. But this is safe:

Risk Management for Pilots from my father’s blog. He writes about things for pilots. I’m not a pilot, I’m a frequent flier. It’s less work, and they bring you peanuts, which I never get when I fly with dad. If he had better airplane snacks, I might go with him more often. It’s a theory.

But flying is an interesting proxy for other things – with nothing but an eastern-bloc piston trainer between you and a 20,000 foot swan dive (or a fiery hole in the ground), you have to think about managing risk. So too in organizational development.

Quick Updates and Brief Thoughts

October 28, 2006 at 10:53 am by Will Crawford in Biomedical, MBA, Ramblings | No Comments

Three unrelated items:

Our Personal Health Records Conference at Harvard Medical School was a big success. More soon – we’ll be posting proceedings and video from the keynotes.

Utility companies should not charge extra for online bill payment. Pepco (the DC electric utility) apparently does this. You pay more – and more than the cost of a stamp – for the privilege of saving them money. Obviously, I’m paying my DC electric bill with a good old fashioned paper stamp.

All web sites for chain stores should be able to identify mobile web browsers. When a mobile user connects, the interface should optimize for the one thing that you’re likely to be doing when accessing, say, Staples.com, from a mobile phone – finding the nearest store! Needless to say, Staples.com does not do this (and when I did find the store finder, it didn’t work). Google does a pretty good job of this, although it’s hard to get at file attachments from mobile GMail.

And that’s the wrapup for this Saturday morning, October 28th.

Multidinous MIPS, Multiple Monitors, Man Machine Mergers

September 29, 2006 at 12:24 pm by Will Crawford in Gadgets, Ramblings | No Comments

My friend Jim pointed me to an article in Slate on why you should buy a bigger monitor. It’s a good article, and you should probably buy a big monitor. I use two medium sized ones, which is more or less the same thing. Computers these days are fast – will buying a slightly faster one actually make you more productive?

The article triggered a thought, which is this: we’re at something of an inflection point in personal computing. As the article points out, upgrading computers to get a faster processor just isn’t something you have to do all that often anymore, unless you’re a hard-core gamer. The last time I bought a desktop computer was because I needed another physical computer, not because it’s predecessor had gotten to slow.

So innovation has shifted to finding better ways to get at that processing power. Multiple monitors are an easy way to to do that, at least for people with an Internet oriented working style. It’s incredibly useful for software developers – so much that one of the first things I look for when evaluating a software development team is whether they have enough screen real estate. If they don’t, it’s a pretty good sign that management is saving money in a spectacularly wasteful way. Working on a 15″, or even a 17″ monitor requires a tremendous number of context changes – and each of those changes, besides taking time, distracts the developer from the flow of the task in a way that glancing to the other side of the screen doesn’t.

So for those programmers, buying a bigger screen is going to increase productivity a lot more than a marginal processor speedup would. The effect is less for the average business user, but it’s still real. And a second monitor is cheap – under $250 for a 17″ LCD.

Another example is the scroll wheels that started appearing on mice in the late 1990s and are now pretty much ubiquitous. Being able to scroll a web page without clicking on the side of the window or reaching for the keyboard is a huge time saver. And the scroll wheel was the first major advance in the physical connection between the user since the mouse itself. It’s no surprise that Logitech has come out with the Revolution MX which, in addition to sporting a $99 price tag and a web site that would be more appropriate for a Japanese luxury sedan, purports to take the scroll wheel revolution one step further.

It’s ultimately all about price and performance. Back in January I wrote about Ndyio, which takes another approach to the profusion of raw processing power. It’s a cheap little box that connects a bunch of monitors and keyboards to a single computer running Linux. I’d lost track of it until yesterday, when I saw it mentioned in the Economist’s Technology Quarterly. It solves the problem of what to do with all that surplus computing power by sharing it. Ideal for third world cybercafes, where hardware costs are still a big deal, but also potentially useful for corporate environments and schools, which could benefit from the lower administrative costs associated with having fewer systems to administer.

My readers, if they haven’t abandoned me completely during the blog-dry spell, will likely have other examples.

30,000 Feet

September 26, 2006 at 6:13 pm by Will Crawford in Gadgets, Ramblings | No Comments

Just a quick check-in, as I still haven’t figured out exactly how I’m going to maintain this site during my Federal career. Although, to be fair, that’s a bit of a cop out, since I’ve been busy enough.

At the moment I’m on the way to HelsIT, the the Health IT conference in Norway. I’m giving a talk on healthcare delivery in the US, and introducing a workshop on the electronic personal health record.

The cool thing is that I’m currently at 37,000 feet (11,200 meters) according to the captain of this Airbus. We’re somewhere over New York. And, thanks to the magic of Boeing’s soon-to-be-discontinued satellite Internet system, I’m online. I haven’t tried Skype yet, but I’m going to give it a shot momentarily.

Sadly, the business model for Boeing didn’t work out – they couldn’t get enough carriers to sign up, and the service is being discontinued as of the end of this year. So I’m glad to have had a chance to try it, even though it means that I’ll spend my next intercontinental flight griping about how I don’t have Internet access.

SAS, incidentally, is a great airline. I’m up in Economy Flex, which has some extra legroom, and, more important, AC power at every seat. So my laptop is plugged in, wide open, and online. It’s like being in the office, except people come by and bring me drinks. And I can simultaneously work and watch Mission Impossible III.

Questionable Carnival of the Capitalists

September 4, 2006 at 4:48 pm by Will Crawford in Ramblings | No Comments

In a very positive way, of course. Starling Hunter has an excellent question themed edition of the Carnival of the Capitalists up at The Business of America is Business. As usual, great production values.

Where have I been, you may ask? Determining the limits of my freedom of speech. I expect to be back to a normal posting schedule shortly, particularly after PCHRI 2006 is over.

Spammers Again

July 8, 2006 at 5:43 pm by Will Crawford in Ramblings | 1 Comment

It doesn’t show up for readers because I have moderation turned on, but this blog attracts a lot of comment spam. Thankfully, Akismet (the WordPress 2.0 spam filter) catches 99.9% of it without my having to look. It’s caught over 2,500 attempts since I installed it a few months ago. A few snuck through today, and it seems to be because the link spammers have started to take over public wiki pages, and are using the comment spams just to link to the wikis. And since the wikis are on real sites, often at universities, it’s not so obvious to the filter that the content is not legit. Sneaky, and it’s probably going to be a problem for wikis going forward.

A Personal Change of Venue

July 6, 2006 at 5:29 pm by Will Crawford in Biomedical, Ramblings | 2 Comments

I’ve been a little quiet here the last few weeks; mostly because I’ve been going flat out to get ready to relocate to Washington, DC. I haven’t mentioned it up to this point because I was waiting for the final confirmation paperwork, and you never really know with government until things have settled down.

So here’s the big announcement: I’m taking time off from MIT Sloan and from the Harvard-MIT Division of Health Sciences & Technology to join the staff of the Office of Policy at the Centers for Medicare and Medicaid Services in Washington, DC. Specifically, I will be focusing on healthcare information technology and its implications for the present and future of Medicare and Medicaid. I start on July 23rd.

Those who know me well are aware that I’ve already had a fascination with government. While, this time last year I did not expect to be in a government position right now (certainly not an extended duration one), I’m pretty pleased that everything worked out.

As for the implications for this blog: I’m honestly not sure. The main issue is that I may have to scale back my discussion of healthcare IT issues and possibly of broader public health policy issues as well. It goes without saying that anything discussed on this blog does not represent the opinion of the United States Government, nor does my hiring represent an endorsement of anything I may have written here to date. There are very few federal employees who maintain active web sites, which means there are few models. I will be consulting with the ethics office over the next few weeks to determine what the boundaries are. Practical considerations may play just as much of a role, in which case the posting schedule here may shift to less frequent, longer articles.

As for the process of moving? Not fun. Not fun at all. I’ve managed to avoid moving more than a 2.5 hour drive at a time for my entire adult life, and over the last five years I’ve bought a lot of furniture. The truck comes tomorrow, and am I ready? No.

Plus-Size Gorillas

June 30, 2006 at 3:09 pm by Will Crawford in Ramblings | 1 Comment

BusinessWeek has two interesting articles, on Google’s product development process and lack of non-search category-leaders.

I’ve been wondering about this for a while: is Google now an 800 pound gorilla with all the manueverability of an 800 pound gorilla? Small companies with tight cash flow need to focus their efforts. Google, at the moment, doesn’t.

Carnival Time

June 19, 2006 at 2:21 pm by Will Crawford in Ramblings | No Comments

The Carnival of the Capitalists is up at Blog Business World. Good stuff this week.