Practical Theory

In the past, I was part of a project focused on redesigning core business functionality. My approach was influenced by fundamental theory. I ended up redesigning the underlying complex database into third normal form. It had 40 tables. When I presented this to the team, the reaction was mixed. From surprise to frustration, I heard that 40 tables are way too much and we need simpler and scalable design.

In following months, another team approached this problem from fundamentally different manner more focused on code first approach. This team initially produced key-value based database with 20 tables. This solution was finalized for implementation.

Now we are close to the implementation and over last few months, the team working on this project had to add lot of additional tables to address functional and non-functional requirements. Finally, this data model is ready with 51 tables.  Lot of core features like data validation and integrity are bolted on to the initial model.

Point of this post is not to turn this into A Vs B design discussion, but to highlight the fact that proven design principals and practical theory like relational algebra; category theory etc. saves lot of implementation headaches and eliminates / minimizes complexity.  In my opinion, quite often this proven strategy is neglected for short term gains, inter/intra team dynamics or just lack of respect for theory.  What you think? What is your experience? 

ICD Manager

ICD Manager look-up screen

ICD 9 to 10 details based on CMS GEM

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 : http://en.wikipedia.org/wiki/Accountable_care_organization

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 @ http://magenic.com/Portals/0/Magenic-White-Paper-Assessing-the-Windows-8-Development-Platform.pdf

Ciao

SQL Server 2000 and EF

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

Windows 8 Programming Stack

My take with few additions

Original Slide from MS

SIlverlight and XAML are not dead but HTML 5 and Javascript are supported out-of-the box.

Good summary available @ http://www.zdnet.com/blog/microsoft/microsoft-to-developers-metro-is-your-future/10611

Numbers and Pictures!