WirelessDoc

Speech recognition for cellphones: one upgrades, one quits

First the one that quit.

I had signed up for Sprint's Voice Command ($5/month) for my Treo 700p over a month ago only to recently receive a letter saying that they are discontinuing this service as of July. Basically, you dialed "*" and then a prompt would come on. You then spoke the contact's name, but this wasn't using the contact manager on your phone (or at least on the Treo, I don't how other phones work). You had to go online to the Sprint Web site and enter these contacts into a contact database. I recall using their import function to pull the names off my phone, but this didn't work at all. Maybe that's why this service is being stopped.

The Sprint Web site is working a lot better than it did not too long ago. Whenever you change your plan, they send you an SMS and an e-mail. If you have a question about your plan, you can chat with a rep online, and then the transcript of this conversation is sent to you via e-mail.

And the one that I upgraded.

I was also trying out the Voice Control based on Nuance technology ($6/month), but initially I didn't think that I'd keep it.

The Nuance Voice Control Web page is very helpful for setting up your phone and learning how to operate the software. It even has screens customized to represent your phone. (The screenshot here is showing an old version of the software.)

On the Treo, after you install the software, the side button is reprogrammed so that when you hold it down, it launches the software and beeps to let you know it's ready. While still holding down the button, you speak the command according to the list they provided on the Nuance Web site. It sends the info to their services which then sends the text and commands back to the phone to do the task. The time it takes to do this is the big issue.

I decided to finally review this product after getting the Sprint letter to see if I was going to discontinue both services. Voice Control prompted me to download the new version 1.5, which also made me download the new Palm installer before that. The upgrade was free and went on without a hitch, so I began my testing.

The fastest function is a Google search, and it works remarkably well. I was able just to say "Search New York Cancer Consortium" while still on the dial pad screen, and in less than 10 seconds it brought up the Treo browser and some hits on Google. This particular search would have taken some effort with thumbtyping, so for searches like this one, it's a real convenience. Or, you can say "Find bookstore 10019," and it will give you a Google map of bookstores in Manhattan. Another real convenience.

You can also create a small e-mail message, or add an appointment to your calendar, but this is only a convenience if you're on the go and can set the phone down or put it back in your pocket while it does its thing. It might take 20 seconds or more, or even sometimes not at all. I would like to have the ability just to make a quick note into the memo pad, but it won't allow this.

As far as calling people in your phone's contact manager, it averages around 5-10 seconds, so if you're willing to accept this wait, it works well.

I have to say that overall, I wish Voice Control would work faster, but even then I think it's worth keeping

This week: Python, Cobbler, Rocks and RNA

Where I'm going this week:

Tomorrow: New York Linux Users Group (NYLUG) Python Workshop

Wednesday: NYLUG General mtg--Subhendu Ghosh on the Cobbler Provisioning System, and Robert Rusinko on Using Rocks to build Linux Clusters.

Thursday & Friday: From RNA to Humans--two full days of speakers looking at evolution from the point of view of molecular biology at Rockefeller University. This I'll cover on my other blog, Lexicillin QD.

EHRs, PHRs, PCHRs discussed in the April 17 NEJM

It was one of those late night reading sessions that kept me going till the sun came up. I had taken a nap earlier in the evening, so I was fully awake all through the night. Anyway, I had printed out these articles concerning the electronic health record, mostly about PHRs, published in the April 17 issue of the New England Journal of Medicine.

Here's a brief summary of each, but each is worth talking about to a greater extent in future blog posts.

In the Perspective section of the NEJM, there are two articles, the first "Personally Controlled Online Health Data--The Next Big Thing in Medical Care?" looks at the use of EHRs as they will be implemented by private companies such as Google and Microsoft, and those companies allied with the non-profit consortium called Dossia.

Dossia (www.dossia.org), founded by AT&T, Intel, Wal-Mart, and five other large U.S. employers, plans to offer a voluntary means of storing personally controlled health data to about 2 million employees and 5 million dependents and retirees, as well as making other services available. The platform uses an open-source technology, Indivo, developed at Children's Hospital Boston. Dossia's long-term goal is a portable and secure lifelong record that will be available regardless of a person's employer, insurance plan, or physician; employees who leave a participating organization will still be able to use the system, possibly for a fee. Pilot testing is ongoing.

Mention is made of how these companies' efforts to store online data outside of the health care system are not subject to HIPAA regs. "Dossia, Google Health, and Microsoft HealthVault are not covered entities, the data they store may not be as private as consumers assume, and a person's 'control' could turn out to be limited."

The second Perspective piece, "Off the Record--Avoiding the Pitfalls of Going Electronic" voices some concerns I've been thinking about, that is, there are certain aspects of the electronic that be its very nature tends to lessens the value of clinical information it contains.

The ability to cut and paste previous entries or the use of check boxes or dumping lab data into the record, all produce volume but with little analysis leading to a "Where's Waldo" effect of trying to find a useful appraisal of the patient's condition.

This is what happens when non-clinicians think that any medical record is similar and is as easily created and maintained as banking records.

"Tectonic Shifts in the Health Information Economy" is the first of two articles in the Sounding Board section. It looks at the use of personally controlled health records (PCHRs) for clinical research.

The authors see the while the use of PCHRs "is driven largely by a need to provide assistance with clinical care processes, it will also profoundly affect the biomedical research enterprise."

They see five hurtles that need to be overcome for their in research to be fully implemented:

1. standard data formats
2. hospitals and doctors' practices need to make data available electronically to patients
3. CLIA labs must be allowed to release results to patients
4. structured data must available for analysis and computation, ie, the paper-based records be converted
5. since there is not universal patient identifier in place, new approaches to establishing ID and trust are needed

"Electronic Health Records, Medical Research, and the Tower of Babel" makes the case for the adoption of the standards needed such as a data language in the form of HL7, and clinical research data as envisioned by CDISC.

They mentioned the FDA's Critical Path Initiative for establishing a standard for the collection of research data. Also the Clinical Data Acquisition Standards Harmonization is working towards this goal.

 

Sharing photos online

  Flag pin 
  Originally uploaded by BKMD

I've been experimenting with the various ways to link to photos in Twitter.

This is a photo I recently upload to Flickr. This works well for blogging since I can create a blog post right in Flickr. I want to do the same thing for Twitter.

TwitPic allows you to upload and create a Tweet for Twitter. It's easy enough to do but they seem to overcompress the pictures they host, so much that the compression artifacts are a little offputting.

VistA & Open Healthcare News

The Roger Madura's latest issue is out (PDF).

The TOC:

Feature Stories
1. The VA: An Agency in Crisis
2. Clinica Adelante Implements WorldVistA EHR
3. Picis Adapts Perioperative Solution to VistA
4. Informatix Rolls Out PAMS
5. VistA Health Network
6. CBO Report on VA Model and VistA
7. Tolven Health Open Source Solution

News Clippings
Events

Open Health Tools, Inc. promotes use of open source software in health care

Open Health Tools, Inc. is a consortium formed by organizations in Australia, Canada, UK and the US to promote the use of open source software in health care.

This initiative is based on the model of the Eclipse Foundation, a community of open source software developers. Skip McGaughey, a co-founder of Ottawa-based Eclipse, is executive director of Asheville, N.C.-based Open Health Tools.

According to their PDF press release, these are the OHT inaugural members:

Government Agencies:
Canada Health Infoway, Inc.
National e-Health Transition Authority (Australia)
National Health Service, Connecting for Health (United Kingdom)
Veterans Health Administration (United States)

Health standards agencies providing open, neutral, international standards for the effort:
Health Level 7
Healthcare Services Specification Project
International Health Terminology Standards Development Organisation
Object Management Group

Academia and research:
Linköping University, Sweden
Oregon State University, Open Source Lab
Mohawk College, Ontario

Vendors and open source organizations providing compelling medical software,
services and equipment solutions:

B2 International BT CollabNet
Eclipse IBM Innoopract
Inpriva JP Systems Kestral
NexJ Systems Ocean Informatics Oracle
Ozmosis Palamida Red Hat

Python on Windows XP in a hurry

[This was condensed from Richard Dooling's blog post Python On XP: 7 Minutes To “Hello World!” He also has a lot of good recommendations for online tutorials and other resources. The comments on his blog post are also very helpful.]

First go to the ActivePython download page.

The latest file for Windows XP is now: ActivePython 2.5.2.2 for Windows (x86): MSI - 21.7MB

Install per the instructions.

Launch the PythonWin Editor. This brings you to the command prompt of the Python interpreter.

Type: print "Hello World!" after the >>> prompt. (If you copy and paste any code, be aware that smart quotes will cause an error message--at least this is what happened for me.)

That's it.

Guido van Rossum created Python, naming it after Monty Python and not the snake

You can download various free versions Swaroop CH's A Byte of Python. Here're some interesting bits I noticed:

Why not Perl?

If you didn't know already, Perl is another extremely popular open source interpreted programming language. If you have ever tried writing a large program in Perl, you would have answered this question yourself!In other words, Perl programs are easy when they are small and it excels at small hacks and scripts to 'get work done'. However, they quickly become unwieldy once you start writing bigger programs and I am speaking this out of experience of writing large Perl programs at Yahoo!

What Programmers Have to Say

• Eric S. Raymond is the author of 'The Cathedral and the Bazaar' and is also the person who coined the term 'Open Source'. He says that Python has become his favorite programming language [http://www.linuxjournal.com/article.php?sid=3882]. This article was the real inspiration for my first brush with Python.

• Bruce Eckel is the author of the famous 'Thinking in Java' and 'Thinking in C++' books. He says that no language has made him more productive than Python. He says that Python is perhaps the only language that focuses on making things easier for the programmer. Read the complete interview [http://www.artima.com/intv/aboutme.html] for more details.

• Peter Norvig is a well-known Lisp author and Director of Search Quality at Google (thanks to Guido van Rossum). He says that Python has always been an integral part of Google. You can actually verify this statement by looking at the Google Jobs [http://www.google.com/jobs/index.html] page which lists Python knowledge as a requirement for software engineers.

• Bruce Perens is a co-founder of OpenSource.org and the UserLinux project. UserLinux aims to create a standardized Linux distribution supported by multiple vendors. Python has beaten contenders like Perl and Ruby to become the main programming language that will be supported by UserLinux.

If you're still reticient about making the plunge, you can get some convincing from Richard's Why Python on Windows XP?

Richard mentions The Python Cookbook by Alex Martelli. You can buy the hard copy or chose from among the 2167 free recipes listed online.

Here's the Beginner's Guide Overview on the Python.org wiki where you can get a quick view of the main features of this scripting language.

Bookshelf: Python and Tobias Wolff

I picked up Beginning Python by Norton, Samuel, Aitel et al, and Our Story Begins by Tobias Wolff on my way to the train to New Jersey to visit my sister for dinner.

There's a pretty good Borders Books right near Penn Station, and even though it's only a 45-minute ride to New Brunswick via New Jersey Transit, my reflex is to pick up some new reading material.

The Python is book is for my transition from the Microsoft world of Visual Basic to a much larger universe of open source scripting. I made this decision a while back, and it's just coincidental that the Google App Engine requires Python.

Tobias Wolff's Our Story Begins is a collection of ten new short stories along with 21 classics. I vaguely recall reading a biography of Hemingway that gave his list of best short story writers. It included de Maupassant, Chekhov, Tolstoy and others. Wolff is on my list.

You can listen to T. Coraghessan Boyle reading Wolff’s short story “Bullet in the Brain” (scroll down to the "ONE WITH A BULLET" podcast) in a podcast that's part of The New Yorker series. There's also a brief discussion at the end of the reading.

Toumaz Technology and Consortium partners get 7.1 million Euro grant To develop wireless blood glucose monitor

In their latest press release, Toumaz Technology Limited is announcing their participation in a consortium that has been awarded a grant of 7.1 million Euros ($11 million) to develop a wireless blood glucose monitor using their Sensium system, which is basically a microchip sensor, radio and battery small enough to be inserted within a bandage.

The grant award, made under the Seventh Framework Programme (FP7) of the European Community, will fund a four-year research and development project into the “DIAdvisor™” portable glucose prediction system, that will utilise Toumaz’s ... Sensium™ wireless body monitoring technology.  The large-scale project is being coordinated by Novo Nordisk A/S, ... and will be delivered by a consortium of 13 medical, industrial and academic partners, including the European region of the International Diabetes Federation (IDF).

The full list of participants in the DIAdvisor consortium is:

Novo Nordisk AS (Denmark)
Johannes Kepler Universitaet Linz (Austria)
Lunds Universitet (Sweden)
Universita Degli Studi di Padova (Italy)
Centre Hospitalier Regional Universitaire de Montpellier (France)
Toumaz Technology Ltd (UK)
Sensor Technology and Devices Ltd (UK)
Ondalys SARL (France)
Romsoft SRL (Romania)
Institut Klinicke a Experimentalni Mediciny (Czech Republic)
RICAM, Oesterreichische Akademie der Wissenschaften (Austria)
Ramboll Danmark A/S (Denmark)
Federation Internationale du Diabete Region Europe (Belgium)

Groundswell: The tumescent trend called social technology

"Groundswell: winning in a world transformed by social technologies" is the new book by Charlene Li and Josh Bernoff, of Forrester Research. I found out about it from a press release for a presentation by Josh sponsored by the MIT Enterprise Forum.

While I mostly write about wireless technology, I think it's just as important to talk about the wetware: the social forces that influence how people decide to use technology. The book does cover case studies where health care companies have implemented Web-based methods of surveying their customers.

Groundswell? I guess this metaphor for expansion is safer than Web 1.0 bubble imagery. I mean, you wouldn't think of a groundswell bursting. I can't picture a groundswell, and it's not the most mellifluous word, but I guess works as a unique term you can position high in Google's Page rank.

Starting with the introduction, the reader finds out that this book came out of the report produced by Forrester Research in 2006 called "Social Computing," which was prompted by their clients' questions. The authors cite the reason they wrote this book:

We wanted to give our clients, and the world, a clear perspective on the whole trend, not just pieces of it, with a clear set of strategic recommendations.

The book begins with the story of Kevin Rose, the creator of Digg, specifically one day just under a year ago when a blogger posted the secret encryption key for HD-DVDs.

It started to gain importance on Digg, but the lawyers coaxed Kevin to remove the link to this blog. However, by the end of the next day, 3,172 blogs had mentioned that number. Point: you don't have an undo button for the Web.

The book goes on to talk about the importance of relationships. It's mostly about how folks decide to buy things through word of mouth rather than caring about the company's grand branding efforts. They explain blogs and RSS. I would think that if you didn't know about these you're hopelessly behind the learning curve, and should spend my time on the Web instead of reading this book.

Next, we come to the Social Technographics Ladder (STL). These are the Creators, Critics, Collectors, Joiners, Spectators and Inactives who comprise the social networking food chain in order of decreasing involvement with online forums.

The authors then look at the online support groups for cancer and obesity patients. They appear to play an important role even though these patients don't populate the higher end of the STL. They state that health care companies are hampered by a heavily regulated industry that in a way that "put[s] the brakes on the kind of free innovation in marketing that most ordinary manufacturers can employ."

Another reference to health care is made in discussing who determines a company's reputation. M.D. Anderson is rated number one by US News & World Report annual listing of cancer treatment centers, and they pride themselves in upgrading their technology to include the latests in cancer treatments, but in reality patients have decided to go to other centers because of the up to 4 hour wait during treatment sessions. This cancer center finally decided to hire a company to produce and manage a private community of cancer patients to discover the real issues these patients are concerned about.

In another section Memorial Sloan Kettering is used as a case study where they similarly wanted to find out what their patients where thinking. They couldn't justify the expense of hiring Communispace which charges $180,000 for the first six months, and $20,000 per month after that, but they were able to convince the National Comprehensive Cancer Network, of which they are a part, to pick up the tab and use it for the entire network.

Another case study is Masschusetts General Hospital which offers something called CarePages. It's a blogging tool that can be read by invitation only, and meant for patients or their close family members to post updates on their hospital course so that relatives can keep informed and respond.

This book isn't an exhaustive review of social networking. It's mostly a how-to guide for businesses either to blog or to create forums so that they can keep tabs on their brand. Facebook is given a few pages, and Twitter ever fewer.

I think the biggest flaw is that the authors don't look beyond Web 2.0 to future trends that will bring us closer to the much vaunted semantic Web.