Wednesday, April 4, 2012

Transition of care market is worth 1.5 billion $ in 2011

According to some estimates, transition of care [from emergency room to the primary care] is the costliest part of the healthcare delivery system in the US. Out of estimated 150 million emergency room visits reported in 2010-11 across all 50 states, 80% of such visits resulted in follow-ups with primary care physician [PCP]. But for only 5% of all such reported PCP visits – relevant clinical information such as procedures performed, medication administered and tests conducted were available to the attending primary care physician. [In other words, for 114 million visits no ER information was available to the PCP] Estimated cost involved in chart chasing, mailing, faxing, phone calls, etc. is estimated to be in the range of 1.5 billion dollars in 2011 and projected to grow to 2.9 billion dollars by 2014 – whooping 24% growth.

Interesting observation is that HIE will not reduce this cost in near future as HIE implementation and adoption is moving really slow. There are many vendors operating in the middle offering multitude of delivery alternatives such as smart scans, electronic fax on demand and automated chart routing systems based on the primary care provider information [if such information is available]. None of these solutions are either improving or enhancing the quality of care.

With so much focus on Accountable Care Organizations [ACO][1], let’s hope that ER-PCP weak link will also be addressed seriously

1. ACO :

Saturday, March 31, 2012

Future of ASP.NET driven LOB applications on Windows8 / WinRT platform

As usual, Microsoft is driving the Win8 bus with high level demos and pep talks. But not much information is available on the future of main stream, data intensive line of business [LOB] applications driven by server side programming [ASP.NET web forms / MVC, etc.] in WinRT ecosystem. Sure, these applications will run without any glitch on Windows 8 in desktop mode – heard this zillion times. But haven’t heard enough on – future of ASP.NET driven LOB on Windows 8 –WinRT/ Metro stack?

Based on Google driven research done in last few weeks – think, following approach will work for the data driven LOB applications with metro style HTML5 / CSS / JavaScript based UI

Data from RDBMS server will be exposed via entity framework [or any other ORM of choice] via repository pattern. ORM model will be wrapped via WCF service layer pattern to provide standard CRUD operations. REST based WCF service will support JSON so that client can easily consume / interact with the data via JavaScript in the client UI.

Again, this is my take [may be naïve take] on how LOB applications might work in Win8/WinRT /Metro environment. Will appreciate constructive criticism / suggestions/ alternative approaches or your take on this amorphous stack.

Excellent Summary available @


Friday, March 30, 2012

SQL Server 2000 and EF

Take a look @ the image - SQL Server 2000 will not work with entity framework