Technology highlights

Health 2.0 - 2009 (San Francisco) - Day 2

2009-10-07T08:35:00.001-07:00

8:40am - 3 Health 2.0 CEOs & a President!

Adam Bosworth, CEO, Keas

The idea with Keas was to start small trying to help a small number of people and scaling from there. Chronic diseases are life style disease. Keas tries to address these issues.

Quest Diagnostics has been a great partner. We also have good partnership with MS Health Vault and Google Health.

Lessons learned: try to be modest, get out early your product and learn from your customers!

Roy Schoenberg, CEO, American Well

Bottom line: try to make our customers (e.g. the Pentagon) happy. We seems to be at the right place at the right moment, especially now with the Health Care reforms that are taking place. American Well for patient it is convenience (immediate gratification, cost etc ...), for the physician and the payers, the solution brings efficiency, more revenue and ROI.

In Q1 2010 we will deploy our application to more PCP and specialists networks.

Christopher Schroeder, CEO, Health Central

We offer a more holistic experience than other web sites, a sense of connection and empathy. We are more focus on the consumer side of the issues.

Alexandra Drane, President, Eliza

We have 43% click through from email. We have the ability to look at the data that we store overtime and improve our system. We had to acquire a company to quickly get the social network infrastructure and experience.

9:30am - The Consumer Aggregators
27% of American go online to seek HealthCare related information and services.

Wayne Gattinella, WebMD - The market more mobile, more global and more personal! - Focus on continuity of care. Demo of WebMD on the iPhone. We need to demonstrate the utility of the Health 2.0 applications. Adoption is key.
Roni Zeiger, Google Health - New launches: (e.g. Google flu trend) - Demo of MDLiveCare.
David Cerino, Microsoft Health Solutions - Demo of My health Info.

11:00am - Data Drives Decisions - Panel

Tools and platforms to support decision-making by doctors

Rex Jakobovits, McKesson - Upload online version of medical images / Pacs systems. Demo of MyPacs.net - more than 100K medical images. Fine grained search capabilities on images (CGI/perl based web site). Help radiologist to look at challenging cases to learn and solve related cases.
Lance Hill, Within3 - Customers are hospitals, Pharma, Research centers. Demo of Within3 medical social network in the context of a medical conference (running on Amazon EC2). Issues with publishing abstracts of papers shared between peers before publication.

Tools and platforms to support decision-making by patients

Sanjay Koyani, FDA - Pushing information to consumers and providing not only services but also a platform. - Show recalls database from FDA (4000 products) . The dailygreen.com integrated FDA widget (e.g. on Salmonella peanut recall). Collaborates with CDC as well. More than 20,000 sites are using FDA widgets.
John deSouza, MedHelp - Online and mobile applications to help patients deal with specific conditions (e.g. breast cancer). Data can be shared with other patients. Mobile applications available as well.
Hugo Stephenson, iGuard - Offer online and paper based tools related to drugs interactions - Launch in oct 2007 - 2M US citizen registered - 25 times more registered by paper! Demographic and statistic numbers available online on these patients. Includes recalls information. Business model based on revenue from clinical trials. Hope to have 3M users in the coming months.

The impact of Health 2.0 tools and platforms on clinical research

Kristin Peck, Pfizer

Alexandra Carmichel, CureTogether - Patient data sharing site - Lot of data on depression. Offers correlation (e.g. depressions & fibromyglia)

Jamie Heywood, PatientsLikeMe - Very detailed statistics on patients with similar conditions. Compare data with clinical trials.

Amy DuRoss, Navigentics - Comparison of personal and general population genetic information as well as risks factors.

12:30pm - IDEO design competition

Finalist winner of the IDEO competition is LabCheck Plus (Satellite Laboratory Services) - The fastest growing dialysis lab in the US. Users are Nurses, Physicians, Patient care technicians etc. The process involved ethnographic field studies, focus groups and usability testing.

1:00pm - Launch

Pathway Genomics - Genetic tests for $348 - Includes ancestry and health tests . Done by saliva.
Remedy Systems - Web based Portal & Mobile Portal - ePrescribing application at the point of care
AccessDNA - WebMD for genetic testing compare DNA testing providers. Offer personalized reports.
CarePass - Online and Mobile solution
TrialReach.com - Multimedia online tool to find and understand clinical trials.
DNA Guide - Personal online genomic map (includes DNA Classifieds).
Unity Medical - ultimedia online content to help diagnosis. Technology to push content to the desktop (e.g. videos relevant to the user). ***
Livestrong - Help to determine how food can impact users/patients. Includes interactive graphs.
Healthline - Web site offering health related content
BiodiMojo - To help families who raise teenagers.Includes health and fitness tracking goals, journal. Send mojos by notifications and community tools related to teenagers.
RelateNow - To help families that have children with autism, including reducing the cost of the therapy. Offer collaboration tools for the family and the health care professionals.

2:00pm - Innovations in Health 2.0 Tools: Showcasing the Health 2.0 Accelerator

Combined demos by:

MediKeeper - PHR with a portal look and feel including a health risk management.

change:healthcare - Cost saving alerts and analysis

Kryptic - portal integration hub

Sage - EHR integration tools and platform. Supports CCR imports

MedSimple - Online questionnaires to prepare medical encounters (electronic patient history).

PharmaSURVEYOR - Medication safety survey (interaction and toxicity of individual drugs).

Polka - Mobile observation engine - manage prescriptions and observations.

ReliefInsite - Pain management system.

Keas - Launch Keas Beta - Personalized care plan. Includes todo list, history of tasks and report cards. Uses CCR . Import data from Google Health and Health Vault.

Kinnexxus & MedSimple - Kiosk dashboard for elderly and online application for care givers. 3:30pm - Health 2.0 Around the world

See also:

Day 1 - Health 2.0 - 2009 - SF

Fresh from Health 2.0: two dozen of the most innovative new health apps (VentureBeat)

Health 2.0 - 2009 (San Francisco) - Day 1

2009-10-06T08:17:00.000-07:00

This year, the Health 2.0 conference 2009, San Francisco takes place at the Design Center Concourse at 635 8th Street (at Brannan). It is an old dark wood train loading station which contrasts interestingly with the image of health care in general where everything is supposed to be bright and clean. The setting is similar to last year with round tables of ten people that facilitates social contacts. On the back of the building on what was the loading platforms are more than 30 exhibitors. This year the crowd is roughly the same size, between 950 to 1000 people (got these numbers from Matthew and Indu). The conference was well organized as usual, expect the wireless connections that were very poor!

The focus of this year is the platforms for mixing and aggregating data, applications services and channels, including mobile devices, social networks , widgets and portal applications.

8:30am - Introduction by Matthew Holt and Indu Subaiya

In the past, health 2.0 was essentially about user generated health care, then the issue of connecting to providers started to be important. More recently the partnerships to reform delivery was the focus. This year, as data drives decisions and discovery, tools and platforms seems to take more and more importance .

8:50am - Keynotes by Aneesh Chopra, Assistant to the President Obama & CTO, Office of Science & Technology Science.

Building blocks of innovation: the US need a more modern and secure infrastructure
How do we control costs?
How to ensure that we have the skills professionals?
The synergy of innovation between health care and energy, IT, green technology
Promotion of enterprise creation since this is where the growth of productivity comes from
Help promote public data sets (e.g. CMS, VA) as soon as possible
Promotes innovations in various areas including mobile

9:15am - Panel Clinical Groupware and the Next Generation of Clinician-Patient Interaction Tools.

Clinical Groupware is the next generation of EHR
Panel includes people from Myca, American Well, RMD Networks (showing reachmydoctor.com), Vision Tree Software, Relay Health.
A lot of demos focus on the communication aspect between patients and physicians.
Payment reform is needed to promote these types of tools

9:50am - Adoption of Health 2.0 Platforms by Physicians on Main Street

The bottom line is culture change for technology and tools adoption.

11:15am - Payers and Health 2.0

Anvita : clinical Analytical tool data analysis
Health Innovations - Focus is now to reduce cost from Ambulatory care, ER, CT, MRI etc.
Blue Cross Blue Shield (BCBS)
Cigna (8.5M customers in USA, 41M worlkdwide). Presence on Facebook, partnership with Intuit.
State of Minnesota Management & Budget
Kaiser Permanente - (8.5M users, 10 states esp CA) - Focus on chronic care management.

Including demos from:

Adam Lee - Intuit (Health Expense tracker, claim assistant) - Very intuitive tools! available to 27M users by the end of the year! Partners with Cigna, United HealthCare, Medical Mutual. ***
Fred Goldstein - US Preventive Medecine (thepreventionplan.com)
Karl Ulfers - Optum Health HealthWorldWeb
Daniel Kogan - HealthWorldWeb

12:00pm - Doctor Office special showcase demos

The doctor channel (partner with publishers, lots of channels, videos, documentaries ..). Not clear what is the business model (compete with Youtube?). Should be part of a PHR.
rxvantage (For providers Office tools, alerts, scheduling ) - Started in RI -
Practicefusion (Web based PHR/EMR - on the Cloud for patient. Has a professional view - including scheduling). Based on Saleforce. Contains adds that can be removed for $100/month. The data does not belong to the patient.
BoundaryMedical (Tool and framework, provider and patient portals - give the ability to create a product/project in less than 30 mn)
Phreesia (streamline billing and payments - integrated with EMRs - for patient and providers) ***
MdDigest - (Opens source platform and solutions for patient and physicians - .net based) - (e.g. Healthforge practice monitor)
Spinal Disorders Registry - based on Microsoft HealthVault, integrate with Cisco video and Webex conference system - 50K patients - Seems a specific feature of an EMR
Ozmosis - Tools such as Health Alerts (partner with Veratect)
Phytel (Patient registry, reporting and analytics) -
Doctations (Interoperability platform and tools? 3 tiers: Free, $33/mo, $1033/mo) - 22 partners
Dr Chrono (Pratice Management + notifications reminder through voice over IP, IM etc) offer an App Store.

2:00pm - The Patient is in.
Highligthing the importance of personalization of the applications.

Kaiser permanente
Edventure
Users of Health 2.0 applications - Video describing uses of various applications:
Lifemojo
Quitnet
Sensei
Care.com
TheCarrot.com
BioIQ
23andMe
Metavante Health Manager

3:40pm - Breakout sessions

Gaming and HealthCare
Health 2.0 Tools for Administrative Efficiency
Search and Content

Usability and Healthcare Portal Applications

2009-09-18T14:41:00.000-07:00

A healthcare portal application is usually more than just an aggregation of portlets. To be really usable, a portal application needs a clear and well defined interaction model between the portlets. In addition to this, since speed and ease of use plays an important role in the quality of care for the patients and the clinical adoption of the solution, the performance of the portal application must be excellent.

Creating portal themes:
The theme of a portal application typically includes portal header, navigation (horizontal and/or vertical), portlet chrome, and footer for controlling the general look and feel of a portal application. It might also include CSS and JavaScript for controlling the look and feel of portlets.

The way themes are created varies from one portal server to another. Fortunately, the overall layout of a portal application and the look and feel of the individual portlets can be separated from the underlying functionalities of the portlets. This separation makes branding much easier and facilitates the porting of the application to other portal servers.

There are several approaches to creating a custom theme for portal applications. Certain vendors (e.g. IBM Websphere) offer portal theme builder, portlets that provide minimum functionalities to create basic themes. For more sophisticated themes and branding of a portal application, developers and designers will start with an existing theme and modify it (e.g. Liferay). Themes are usually a combination of HTML, CSS, images and javascript files. Designers typically use tools such as eclipse plugins, Dreamweaver, Photoshop, Fireworks, etc to modify these files.

Personalization in HealthCare Portal Applications:

Personalization is one of the key features of portal applications. If granted personalization rights, users can personalize their portal Web pages based on their specific roles and authorization schemes.

Themes and layout can also be changed manually by the user or programatically based on the user profile. Additional personalization mechanisms (e.g. using a business rule coupled with user profile matching engine) can also be integrated with the portal solution.

Personalization can be very valuable for care givers, as a means to organize the general views or dashboards associated with their daily tasks in the most comprehensive and efficient way. Personalization can also be important for patients. For example, diabetes patients might want to view medical content related to their diagnosis while cancer patients might want to see their treatment protocols on personalized portal pages.

Liferay Portal 5.2 Systems Development - Book review

2009-08-25T15:28:00.000-07:00

Recently Packt Publishing Ltd sent me a copy of the new book from Jonas X. Yuan untitled "Liferay Portal 5.2 Systems Development" for review.

In this post, I would like to give my feedback including some input from my colleagues who have read parts of this book.

I personally read all the 12 chapters which cover a large variety of topics related to developing portal application with Liferay 5.2 including JSR-286 portlets, EXT and SDK, JSP/struts based portlets, portal pages management, tools, CMS and WCM, personalized community, Layout templates and themes, Inter Portlet Communication (IPC), collaboration features of Liferay, Staging, publishing and APIs.

Reading the book from the front to the back is probably not the best way to take full advantage of the content. I would rather recommend to use it as a reference to Liferay 5.2. application developments.

This book is particularly valuable if your project includes high level of customization, using Liferay Extension Environment and or the integration of Content Management System (CMS) capabilities, as well as Web 2.0/social and collaboration features. The content of the book is consistent with Packt publishing practice to "focus on producing cutting-edge books for communities of developers, administrators, and newbies alike".

If you are an architect, a graphic designer, developer or a build manager, you will find ample step by step configurations and recommendations, code sample, tips and best practices on developing portal applications with Liferay 2.5.

Sometimes, the content is so rich with code snippets, variable names and configurations paths, that the mix of various fonts makes the text a little bit difficult to read, or at least slows your reading. Fortunately, the granularity of the chapters is fine enough that you can jump directly to a very precise topic. The index is also very handy.

I like the fact that the author combine best practices that are specific to Liferay (e.g. Liferay has a property called theme.images.fast.load for performance optimization) and general good web site programming practices (e.g. the use of CSS sprites and the placement of javascript code).

The fact that most of the book describes the development of a specific and complex portal application (Sesame Workshop) is a good thing since you can see how every pieces of the solution are put together. You can even download code sample from Packt Publishing. However, additional examples would have been nice too. It would have been also interesting to see alternatives to JSP and Struts MVC framework such as development based on JSF, RichFaces and/or ICEFaces.

The chaper 9 on Layout templates and themes is very useful, although starting with EXT rather than the Liferay SDK is quite harsh. Also a discussion on the development process: how graphic designers and developers can work more efficiently together would have been very useful in this chapter.

Overall I highly recommend using this book as reference book if you plan or are involved in a portal project based on Liferay 5.2. Even though your overall configuration/architecture might be different, you will find practical tips and solutions to integrate and customize most features of a portal application.

If you are new to Liferay in general (developer or graphic designer) and want to learn the potential of the platform, you can also definitively use this book for specific topics.

How to update a TrustStore

2009-07-30T08:32:00.000-07:00

When it comes to security, I often got questions from engineers related to truststore update.

Let say you have a truststore with a certain number of trusted certificates that are used for SSL authentication and you want to add or replace a certificate.

You will need a tool such as Portecle which is a java based is friendly GUI application for creating, managing and examining key stores, keys, certificates, certificate requests, certificate revocation lists and more.

Open your initial truststore with Portecle:

I then use Microsoft Internet Explorer (IE) to access, view and save your additional/new trusted certificate.

In this example, I am using ICW Lifesensor Personal Health Record (PHR) application because I want to add the associated certificates to my TrustStore (the goal is to to enable secure access to PHR accounts):

Use Portecle to import this new trusted certificate in your trust store:

Your updated truststore is now ready to use!

Community One 2009

2009-06-01T13:38:00.000-07:00

This year Cloud Computing was really the buzz word at Community One in the West Coast (San Francisco)!

Cloud Computing was in fact the opening topic by Dave Douglas on the general session (the other topic was Open Solaris).

It was interesting to learn that SUN Cloud offer started only few months ago, but it has been quite successful with more than 3000 people using it every days.

Dave did introduce also a couple of interesting companies that offer applications that run on the SUN Cloud infrastructure:

Moonwalk uses the cloud to save data for disaster recovery.
Vertica : Column oriented DBMS with a version for the cloud.
WebAppVM : Virtual Machine - to migrate from local machine to the cloud.
Apache Hadoop a software platform that helps write and run applications that process vast amounts of data (using MapReduce).

Security is still a concern in the cloud. Sun seems to take security quite seriously. It participates to the Center for Internet Security and offer tools to encrypt data as well.

There also a very good material on programming languages and the Cloud from Ted Leung Principal Engineer at SUN who presented an overview of cloud computing architectures and the ways they interact with programming languages. He covered various topics : Security, Concurrency, Performance, Distribution, Operational Considerations and Domain Specific Languages (DSL).

Ted introduced some of the innovations in the Cloud infrastructure including storage and computing in the Infrastructure as a Service (aaS) layer, Virtual Machine Images (Stack aaS), AppEngine, Heroku, Zembly (Platform aaS), Salesforce (Software aaS).

Infrastructure aaS issues:

No predefined Software Stack
You have to do everything
Languages cannot help

Stack aaS issues:

You get whatever language is in the stack
Depends on the quality of the stack interaction
Languages can help, part of the stack interaction
Services are not part of the stack

Platform aaS issues:

Specialized high performance Data Access/Storage (CouchDB, Big Table, Key/Value Stores, Non Relational DB, Map Reduce)
Identity
Asynchronous messaging (XMPP, Queing)
Payments
You get whatever language is in the platform
Platform inlcudes network services beyond language runtime
Leads to a service oriented system
Part of the difference is the quality of the integration

Software aaS issues:

SaaS application may or may not be programmable
The SaaS may have its onw language
Learning curve/training
Integration

Characteritics of the Cloud Environment:

Multitenants
Heterogeneous
Scalability is a goal
Elastic/Provisioned by machine
Monitored/Audited
Services Oriented

The most interesting part of the presentation was certainely the part dedicated to languages with a comprehensive overview of specialized programming languages for the Cloud.

Areas where languages intersect the Cloud:

Security/Resource Control
Performance
Concurrency
Distribution
Operational Considerations
Domain Specific Languages

There are two language models for the cloud:

Sandboxing (Java, Pypy, Google AppEngine)
Capabilities (Caja, Joe-E, E)

Projects and Languages targeted to address Cloud issues:

Transactional Memory (Haskell, Clojure)
Actors (Erlang, Scala, Axum/F# ...)
Futures (Java, Python, Ruby libraries)
MapReduce (Hadoop, Disco)
Persistence Data Structures (Clojure)
Tuple Spaces (Jini/JavaSpaces, GigaSpace, Blitz, Tspaces ...)

Monitoring and instrumentation is also an important issue in Cloud Computing. DTrace for example (integrated with the latest Open Solaris version) is a powerful tool to analyse resource usage/behavior (e.g. which files are accessed throughout the whole stack).

Other topics at Community One:

There were also other interesting topics besides Cloud Computing:

OpenSolaris:

Network vitualization
Snapshot using ZFS (very cool@!)
Optimization of storage devices using Flash drives
(these days, the bottle neck for a applications is data read/write on storage devices!)
SUN 7000 Storage: New enterprise storage appliance - 800 customers in just 4 months. up to 1/2 Petabytes of storage!

SUN Master Data Management 6.2 - (presentation by Parijat Prosun Kar):

To help managed the business context data of entities or objects involved in business transaction (great for Context Management!)
Can be used in System aggregation/federation (e.g. portals)
Just in time business models require agility and integration across the enterprise
Help ongoing mergers and acquisitions
Compliance and localized governmental requirements
Includes a Master Index Studio, Data Integrator, Data Quality, Data Mashup/Services, Data Migrator
see also Mural (Open source Master Data Management from SUN)

Atmosphere: a POJO based framework using inversion of control (IoC) to support Comet.

IceFaces / AjaxPush: updates on the J2EE Ajax framework presentation by IceSoft.
Here is an example that uses Liferay Portal platform.

Android: some good tips about the use of adapters, bitmap scaling, background refresh.
By the way, the next version of Android (Doughnout) is expected in Q3 of 2009.

JRuby: updates on the Java implementation of the Ruby.

Speech Technology and HealthCare

2009-05-22T16:12:00.000-07:00

Recently, I was invited to participate to a meeting of AVIOS (Applied Voice Input Output Society) local chapter in Menlo Park, California to discuss the use of speech technology in HealthCare and Medicine.

Speech technology is not widely used in healthcare at the moment. The healthcare industry is still focusing on efficiency and cost saving by solving systems integration, re-wamping legacy systems and making paper based processes digital.

Dictation and transcription for EMRs

The most successful type of applications is probably dictation/transcription for electronic medical records (EMR).

Speech recognition, enhancing productivity and reducing medical costs as a result. In this domain, Nuance is one of the market leader.

The products and services of Nuance Healthcare are used at more than 5,000 hospitals and by more than 400,000 providers.

Nuance’s on-premise Dictaphone Enterprise Speech System (ESS) components support recording the dictation audio, managing the audio and the resulting transcription process, transcription document distribution, and online reporting.

Dragon medical is another product from Nuance with which physicians dictate in real-time into their EMR in their own words letting them instantly review, sign, and make their notes available for other clinicians. This include Medical Vocabularies, covering nearly 80 specialties and subspecialties and regional accent support.

Potential use for Care and Disease Management

Besides dictation/transcription there are some additional potential uses of speech technology in other domains related to heathcare. Care and Disease Managament is one of them.

Organizations/companies like Lifemasters have call centers where nurses help to help patients with chronic disease achieve optimal health by closing the gaps between recommended and actual care (evidence-based medicine) and encouraging patients to adopt a healthy lifestyle and reducing the overall cost of healthcare. Speech technology could be used to complement and optimize this type of services: virtual operators, voice activation services, automatic text-to-speech combined with voice-over-IP reminder and notifications (e.g. to take drugs, schedule an exam, do certain types of exercices etc ...). Companies like requall and Jott already provide this type of notification infrastructure that can be delivered on mobile phones for example.

Other Areas

Additional research areas in speech technology and healthcare include:

Using speech/sound recognition to monitor eating behavior

disease assessment (e.g. parkinson over the phone, although this disease is very complex and voice is probably not the most important factor)

using speech recognition for medical transcript anonymization to be used as corpora

Conclusion

Overall, there is a big potential for use of Speech Technology in the healthcare industry.

The recent improvements in Text-to-Speech make it very attractive to healthcare, especially to non life critical applications.

Speech recognition accuracy is sometimes still a problem, but it is well suitable for sub-languages with specific vocabulary. It might be more difficult to be used directly by patients/health consumers, especially senior citizens where the language can be altered by their conditions.

HIMSS 2009 - How Consumers use PHRs (KP)

2009-04-23T09:30:00.000-07:00

While at HIMSS 2009 in Chicago early this month I did attend a very interesting talk from Judy Derman and Jan Oldenburg from Kaiser Permanente untitled: "How Consumers use Personal Health Records (PHRs) : lessons learned".

Kaiser Permanente (KP) has a very large user based (2.5M consumers/patients and 13,000 healthcare professionels) for their online services (a portal accessible at www.KP.org portal and My Health Manager, a Personal Health Record (PHR) built with the help of EPIC).

In this talk, Judy and Jan described the lessons learned from usage patterns on these web applications.

The consumers/patients are motivated by the fact that they can act on their information. It is not just about looking at a medical record, but act one it. Example of useful actions include:

start changing health related behavior
refill a prescription online
make appointment with their doctor
send email with care professionals
access educational programs (some of the most popular are: diabetes, depression, insomnia, weight management)

The consumers will trust these applications and the associated medical information as long as it is :

transparent
accessible
consistent
secure
timely and accurate

Kaiser Permanente study shows that the implementation success factors include:

early adopters are leaders in usage and feedback
there is a strong leadership from senior leaders
importance of clearly define explicit and articulated benefits
allocate appropriate and sufficient resources to do the job
resource must have appropriate skills
involve stakeholders / members / patients early in the process
make decision at the appropriate level
provide tools to support implementation (marketing material and toolkits)
use standard prcedures
use effective and integrated marketing
simplify the "getting started" mechanism (one step activation + pre-populate heath record)
drive adoption with multiple channel marketing

The Kaiser PHR was launched in January 2007 and has reached 2.7 users by April 2009.

In 2008, 84% of the users choose the "One step activation" mechanism and 54% of KP members signed-in with 40.8% of user male and 51.2% female.

Here are the top features in the last two years:

Here are some statistics/facts about the Email/secure messaging service of the KP PHR:

6M emails in 2008 sent to doctors (13M since the launch in 2007)
600,000 emails per months in 2009
14% of messages are written by physicians and clinicians
14,000 physicians are using emails regularly

One of the benefits of the email services is that the patients using email were 7-10% less likely to schedule an appointment.

Here are some statistics/facts about the Lab/test results service of the KP PHR:

16.7M test in 2008
61M tests results available online
31M since launch
certain tests are not online (HIV, genetic tests ...)

Here are some statistics/facts about the Presciption refill service of the KP PHR:

5.6M refill in 2008
increase of 26% in 2007-2008
Up to 23% of refill are done online

HealthCare and the benefits of a Portal Strategy

2009-03-31T08:34:00.000-07:00

The idea that software should be componentized (built from prefabricated components) has been proposed more that 40 years ago. However it is only recently, with the advent of Service Oriented Architecture (SOA) and Software as a Service (SaaS) that effective software componentization methods to integrate systems and develop solutions have been available.
These methods help promote code reuse, low-cost system development, contribute to software quality and to more flexible IT infrastructures.

Software componentization can help software companies acquire and maintain a competitive advantage by developing, deploying and maintaining services and solutions faster, cheaper and better than their competitors. Using Web and Mobile based Graphic User Interface (GUI) components is the most common way for users to interact with IT systems.

The ability to create customizable and reusable front-end software components is especially valuable for software companies and their partners. Combined with cost effective deployment solutions such as Cloud Computing, new services can quickly be bundled, offered and tuned for specific targeted sets of customers and later rolled-out to new markets very easily.

Componentization can also help to rapidly make custom changes (such as re-branding or re-skinning) since the presentation layer is isolated from the service layer. Aggregated in web portals, front-end components can be layered on top of existing data structures, enterprise and legacy systems as well as third party services.

In healthcare for example, portals can offer a unified and personalized view for healthcare professionals, and provide real-time access to a selected patient's clinical information. The same portal infrastructure can be also customized for the patients and their care givers.

Portal technology provides ways to integrate information, people and processes across organizational boundaries. It provides a secure unified access point (SSO), often in the form of a web-based user interface, and is designed to aggregate and personalize information through application-specific component or portlets.

Another characteristic of the portal technology is the fact that content management can be decentralized allowing richer content and more efficient update of the data and information presented to the users.

A portal approach brings benefits to your customers/end-users (healthcare professionals and patients), your development, professional service and IT teams, but also your partners!

benefits for your end-users: Portal solutions also offer rich user experience by leveraging Web 2.0 technologies and specific components (e.g. wikis, blogs, message boards, widgets, social networking, maps, SSO, etc). Portal customization and personalization also offers to the end-users a more personalized experience based on their profiles such as their role in the organization or user group and preferences (e.g. choice of layout and look and feel).
benefits for your development team: This includes a common architecture for the aggregation of heterogeneous components and services, a clear separation between the presentation layer and the service layer, and the fact that portlets are based on standard technologies (e.g. JSF, Spring, Spring MVC, Hibernate, JSR-168, JSR-286, WSRP 1.0/2.0, AJAX, Java EE, or even Flex).
benefits for your professional service and IT teams: Portal technology can save substantial costs to both the professional service team in charge of creating solutions using a portal approach including the ability to create and combine quickly customized components that are easy re-branded for various customers is clearly a good return on investment (ROI).
benefits for your IT department: For the IT department, in charge of deploying and maintaining services and applications, to be able to run multiple portal sites, each with a unique domain, on the same portal server reduces avoids to duplicate hardware and image instances. Portlets can be deployed at run-time (hot deployment) reducing down time for the user and facilitate the maintenance of the applications. In addition to this, specific content, branding, layout and skins can be stored and managed independently of the application in a content management system, saving costs during development, deployment and maintenance.

For the past couple of years, there has been a clear interest in the healthcare industry, not only in the US, but also in Canada and Europe to use portal frameworks as a solution to aggregate heterogeneous services and applications. There are still a lot of important and sensitive issues to address for this type of solution in the healthcare industry (security, auditing capabilities, user and content management, integration, performance, scalability, availability, quality assurance, lifecycle management, maintenance and monetization).

Next week (April 4-8 2009) at HIMSS-09 in Chicago, it will be interesting to see if the trend is confirmed and how many vendors have been repackaged their solutions using portal technology.

Liferay and Flex Ajax Bridge (FABridge)

2009-02-28T16:51:00.000-08:00

I am using Liferay to create highly interactive and componentized web applications and solutions for the healthcare industry. Adobe Flex is one of the technology I am using the create portlets for Liferay. One challenge is the communication between portlets and between the core layer of the portlet that access services and wrapping GUI layer (JSP/HTML and Javascript).

Adobe Flex 3.0 SDK now contains the Flex Ajax Bridge (FABridge) developed by Adobe Labs.
Flex Ajax Bridge is a small library that can be help you expose an flex application (Action Script graph) to scripting by Javascript.

To show how FABridge works in Liferay. I have created very simple Flex application that show a button. I then modify the label of the button at runtime via javascript.

The code for the Flex application is very simple:

<?xml version="1.0" encoding="utf-8"?>
<mx:Application
 xmlns:mx="http://www.adobe.com/2006/mxml"
 xmlns:fab="bridge.*">
 
 <fab:FABridge bridgeName="flash" id="flash" /> 
    
 <mx:Button id="button" label="Original Button" width="150"/>
 
</mx:Application>

The Flex application needs to refer to the action script part of the FABridge library (FABridge.as).

Likewise, your Javascript will need to refer to the Javascript part of the library (FABridge.js).

The build.bat file is a simple command (mxmlc main.mxml -output main.swf) for building the SWF file. But you can also use Flex Builder for this.

Here is how the resulting SWF file looks like inside a very simple Liferay portlet:

The code for the wrapping portlet is contains inside the view.jsp file. I am using SWFObject 2.0 to integrate the SWF file.

I am also using JQuery (I have added manually JQuery 1.2.6 lib - but I assume that I could leverage JQuery that comes with Liferay) to highlight the SWF container in green if the bridge succeeds at changing the content of the button:

If there is an expection, which is the case when the portlet is added in Liferay in Internet Explorer (IE 7.0) - refreshing the page works however! ). Then the container is highlighted in red:

Here is the whole code of the JSP file:

<%@ taglib uri="http://java.sun.com/portlet" prefix="portlet" %>

<portlet:defineObjects />
<script type="text/javascript" src="<%= request.getContextPath() %>/js/swfobject.js"> 
  swfobject.registerObject("myId", "9.0.0", "expressInstall.swf");
</script>
<script type="text/javascript" src="<%= request.getContextPath() %>/js/FABridge.js"></script>
<script type="text/javascript" src="<%=request.getContextPath()%>/js/jquery-1.2.6.js"></script>

<script type="text/javascript">

   accessFlex();
   
   function accessFlex()  {
       
        var initCallback = function() {
            try {
                    var root = FABridge.flash.root();
                    root.getButton().setLabel("Modified by FABridge");                       
                    $("#swf_div").css("border","3px solid green");    
            }
            catch(err) {
                $("#swf_div").css("border","3px solid red");
            }  
        }
        
        FABridge.addInitializationCallback("flash",initCallback);
    }
    
</script>


<div id="swf_div"> 
<object id="myId" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" width="350" height="70">
  <param name="movie" value="<%= request.getContextPath() %>/flex/main.swf" />
  <!--[if !IE]>-->
  <object type="application/x-shockwave-flash" data="<%= request.getContextPath() %>/flex/main.swf" width="350" height="70">
  <!--<![endif]-->
    <p>Alternative content</p>
  <!--[if !IE]>-->
  </object>
  <!--<![endif]-->
</object>
</div>

Flex Web Service Introspection Wizard and BlazeDS

2009-01-07T10:37:00.000-08:00

In my previous post, I mentioned that if you want to fully use Flex 3.0 Web Service introspection wizard, you will need to either use Adobe LifeCycle Data service, or have a cross domain file installed on the server that expose the web services you want to use.

However, if you use only BlazeDS, the web service wizard can still be useful to better understand which type of objects you obtain when calling 3rd party web services (besides looking at the wsdl file and debugging ResultEvent.result content).

In this post I will describe how to use Flex Builder 3.0 to introspect the ICW LifeSensor Web Service API. Then I will build a small Flex based portlet to display information related to a patient who has his medical information stored in the LifeSensor Personal Health Record (PHR).

A. Introspecting the Web Services

For this, you will need to know the WSDL URL of your web services.

In the case of LifeSensor, I am accessing the WSDL file over HTTPS which is protected with a login and password but you can also test the intropection wizard with free available web services available on the internet.

From Flex builder (I am using Flex Eclipse plugin), select "Data/Import Web Service (WSDL)...":

Then select the folder you want to import your classes to, click next, then enter the WSDL URL and click next again:

First you select the list of the operations you want to import. In my case, I just want to import the operation findAccessibleRecords.

You can also change the default value of the packages for the classes that are going to be generated and the main class name.

In my case, I just kept the default values, respectively com.lifesensor and RecordModuleWebServiceImplService.

It just takes few seconds to generate the proxy classes:

Even though I am importing only one operation from LifeSensor, a little bit more than 80 classes are generated.

RecordInfoXto and its dependent classes structure is very close to the object returned by the web service call. Therefore I will be using only the following files:

AddressXto.as
CodeSystemXto.as
CodeXto.as
DateXto.as
EmbeddedObjectXto.as
RecordInfoXto.as

/**
 * RecordInfoXto.as
 * This file was auto-generated from WSDL by the Apache Axis2 generator modified by Adobe
 * Any change made to this file will be overwritten when the code is re-generated.
 */

package com.lifesensor
{
    import mx.utils.ObjectProxy;
    import flash.utils.ByteArray;
    import mx.rpc.soap.types.*;
    /**
     * Wrapper class for a operation required type
     */
   
    public class RecordInfoXto extends com.lifesensor.EmbeddedObjectXto
    {
        /**
         * Constructor, initializes the type class
         */
        public function RecordInfoXto() {}
           
        public var academicTitle:String;
        public var address:com.lifesensor.AddressXto;
        public var birthDate:com.lifesensor.DateXto;
        public var birthPlace:String;
        public var familyName:String;
        public var gender:com.lifesensor.CodeXto;
        public var givenName:String;
        public var middleName:String;
        public var scope:String;
        public var subjectId:String;
    }
}


   public class AddressXto extends com.lifesensor.EmbeddedObjectXto {
  /**
   * Constructor, initializes the type class
   */
  public function AddressXto() {}
          
  public var city:String;
  public var corpus:String;
  public var country:com.lifesensor.CodeXto;
  public var flat:String;
  public var line1:String;
  public var line2:String;
  public var organization:String;
  public var postalCode:String;
  public var state:com.lifesensor.CodeXto;
  public var streetAddressLine:String;
  public var zipCodeExtension:String;
 }

        public class CodeXto extends com.lifesensor.CodeSystemXto
 {
  /**
   * Constructor, initializes the type class
   */
  public function CodeXto() {}
          
  public var key:String;
 }

 public class DateXto extends com.lifesensor.EmbeddedObjectXto
 {
  /**
   * Constructor, initializes the type class
   */
  public function DateXto() {}
          
  public var isoDate:String;
 }

B. Creating the Flex component using BlazeDS

In a previous post, I have described in details how to create a BlazeDS application that uses BlazeDS to access web services. This one is very similar.

The proxy-config.xml describes the web service end-points and channel:


<destination id="ws-lifesensor-record">
        <properties>
            <wsdl>https://record2.us.lifesensor.com/phr/services/v2-5-0/RecordWebService?wsdl</wsdl>
            <remote-username>????????</remote-username>
            <remote-password>????????</remote-password>
            <soap>https://record2.us.lifesensor.com/phr/services/v2-5-0/RecordWebService</soap>
        </properties>
        <adapter ref="soap-proxy"/>
    </destination>

First, I import the generated classes. Then populating the RecordInfoXto object is straightforward:


import com.lifesensor.*;

private function findAccessibleRecords_result(event:ResultEvent):void {

  if (event.result != null) {
    var all_records:ArrayCollection = event.result as ArrayCollection;
    var record:Object = all_records.getItemAt(0);
                    
    // State
    var state:CodeXto = new CodeXto();
    state.key = record.address.state.key;
                    
    // Country
    var country:CodeXto = new CodeXto();
    country.key = record.address.country.key;
                    
    // Address
    var address:AddressXto = new AddressXto();
    address.streetAddressLine = record.address.streetAddressLine;
    address.city = record.address.city;
    address.postalCode = record.address.postalCode;
    address.state = state;
    address.country = country;
                    
    // Gender
    var gender:CodeXto = new CodeXto();
    gender.key = record.gender.key;

    // Birth Date
    var date:DateXto = new DateXto();
    date.isoDate = record.birthDate.isoDate;
                    
    // Record 
    patient_record = new RecordInfoXto();
    patient_record.givenName = record.givenName;
    patient_record.familyName = record.familyName;
    patient_record.gender = gender;
    patient_record.address = address;
    patient_record.birthDate = date;
    }
}

The resulting Flex based portlet is very simple (with a very compact code):

BlazeDS and secure Web Service access

2008-12-18T08:27:00.000-08:00

In a previous post, I described how to use Flex/BlazeDS to a access remote Web Services.
This time, I am explaining how to access a secure Web Service that requires basic authentication using the same mechanism. This involves additional changes in the configuration files.

My goal is to create flex components that access ICW Lifesensor public Web services.
The additional complication is that the access to wsdl file required authentication over HTTPS.

Fortunately, I have the login and password of a Lifesensor Account (patient), so I can use them
to access the Reporting Web Services in order to retrieve medical data entries. More information about the Lifesensor APIs and Web services are available on the ICW Developer Network.

To illustrate my point, I will use a very simple Web Service call getVersion that return some general information about the web services such as the Axis version and build date (Lifesensor uses the open source Apache Axis framework to provide Web Services).

In the wsdl file for Version, the port description shows that the getVersion operation does not have any parameter, so the call to the Web Service will be straightforward:


<wsdl:porttype name="Version">
 <wsdl:operation name="getVersion">
  <wsdl:input message="impl:getVersionRequest" name="getVersionRequest"></wsdl:input>
  <wsdl:output message="impl:getVersionResponse" name="getVersionResponse"></wsdl:output>
  </wsdl:operation>
</wsdl:porttype>

BlazeDS offers a Proxy to access remote servers. This is necessary, if you do not have a crossdomain.xml file on your remote server. As a result, there will be two hops. One from the shockwave component on the client to the Proxy, the other one from the Proxy to the remote server where the Web Services reside.

For security reasons, both bops have to be secure, as a result, the initial SWF access and loading has to be done through HTTPS. In my case, my application (and the BlazeDS proxy) is served by Tomcat 6.0 that has been configured for SSL.

The first configuration change is in the proxy-config.xml. Besides the fact that the URL is now using HTTPS protocol, you will need also to specify the soap URL instead of using a wildchard in order to avoid a RPC Fault since "a destination that allows multiple domains or ports does not allow authentication".

Also, since LifeSensor is using basic access authentication, the easiest way to avoid the pop-up window from your browser asking you for the login and password (especially for the first hop, which is not relevant), is to set them in the proxy-config.xml initially via remote-user and remote-password tags.

     <destination id="ws-lifesensor-version">
       <properties>
           <wsdl>https://record2.us.lifesensor.com/phr/services/Version?wsdl</wsdl>
           <remote-username>?????</remote-username>
           <remote-password>?????</remote-password>
           <soap>https://record2.us.lifesensor.com/phr/services/Version</soap>
       </properties>
       <adapter ref="soap-proxy"/>
   </destination>

The MXML flex file is not very different from a Web Service access with no authentication. The following code is just specific to the Lifesensor Web Service API:


<mx:Script>
     <![CDATA[
       ...
       private function getData():void { webService_LS_Version.getVersion.send();}   
       ...
    ]]>
   </mx:Script>
   <mx:WebService id="webService_LS_Version" destination="ws-lifesensor-version" useProxy="true">
       <mx:operation name="getVersion"
               resultFormat="object"
               result="getData_result(event);"
               fault="getData_fault(event);">
       </mx:operation>
   </mx:WebService>

Calling the Version Web Service from LifeSensor (via an application on https://localhost:8443/) returns the following text:


"Apache Axis version: 1.4
Built on Apr 22, 2006 (06:55:48 PDT)"

In addition to this, my recommendations will be to use Flex remote debugging and a HTTP debugging proxy such as Charles or Fiddler which can be very handy to understand and debug AMF and SOAP based HTTP wrapped requests.

Also, Flex Builder 3.0 has very nice Web Service Introspection tool. Unfortunately, you will need to have a cross domain file on the server you want to introspect or have LifeCycle Data service to use the generated proxies. Apparently, if you only use BlazeDS, there are no direct ways to use the generated code out of the box. However, you can use some of the generated classes to store some of the data you obtain from the Web Services. This will be the topic of my next post.

Flex z-index and Liferay Portal

2008-11-19T09:13:00.000-08:00

We recently encountered an issue when embedding Flex/Flash applications in Liferay Portlets.

The shockwave (.swf) file was showing on top of the liferay navigation menu:

The usual solution is to specify the z-index for the div layers.
There are even some very cool things you can do with Flex overla y.

Liferay however is a third party portal platform and if you don't want to have to change the source code or extend Liferay, a quick fix is to use the wmode argument for the embedded flex application:

<div>
   <embed wmode="transparent" src="<%= request.getContextPath() %>/flex/clinical_data.swf" height=250 width=500>
</div>

You just have to redeploy your portlet and now the menu appears on top of your portlet:

Liferay Portlet using BlazeDS

2008-11-13T14:03:00.000-08:00

In my previous post, I explained why and how I used BlazeDS, a server-based Java remoting and web messaging technology, to call remote Web Services easily from Adobe Flex applications.

In this post I explain how to create a Liferay portlet that uses Flex and BlazeDS.

Creating the Liferay Portlet

Creating a new portlet is straightforward. Under ./liferay-plugins-sdk-5.1.1/portlets at the prompt I just typed the command: create messier_object "Messier Object WS". As a result, a messier_object-portlet folder is created with the skeleton of a working portlet (the first argument of create is the name of the portlet (always postfixed with '-portlet'), the second argument is the title of the portlet).

I then modified the category name of messier_object-portlet/docroot/WEB-INF/liferay-display.xml to ICW.Test.

<display>
   <category name="ICW.Test">
      <portlet id="messier_object">
   </portlet>
</category>

I then added the Flex code by copying my testing Flex Application Test_Flex_WS_messier.mxml under the docroot folder.

Integrating the target shockwave file in the view.jsp file is also straightforward:

<div>
   <embed src="<%= request.getContextPath() %>/Test_Flex_WS_messier.swf" heigth=350 width=350>
</div>

Adding BlazeDS Libraries and Configuration Files

I then added a set of 10 jar files (backport-util-concurrent.jar to flex-messaging-remoting.jar) that came with the turnkey BlazeDS installation sample code inside the WEB-INF/lib folder.

In addition to this, I had to copy the four BlazeDS configuration files:
messaging-config.xml, proxy-config.xml, remoting-config.xml, services-config.xml.

The services defined in these files are generic and can be reuse if you want to access remote data either through Messaging, HTTService, WebService or RPC/AMF remote procedure calls.

Only proxy-config.xml contains a specific web service destination (ws-sesame) to access astronomical data for the application.

Content of messaging-config.xml:

<?xml version="1.0" encoding="UTF-8"?>
<service id="message-service" class="flex.messaging.services.MessageService">
<adapters>
<adapter-definition id="actionscript" class="flex.messaging.services.messaging.adapters.ActionScriptAdapter" default="true" />
<adapter-definition id="jms" class="flex.messaging.services.messaging.adapters.JMSAdapter"/>
</adapters>
<default-channels>
  <channel ref="my-streaming-amf"/>
  <channel ref="my-polling-amf"/>
</default-channels>
</service>

Content of proxy-config.xml:

<?xml version="1.0" encoding="UTF-8"?>
<service id="proxy-service" class="flex.messaging.services.HTTPProxyService">

<properties>
<connection-manager>
<max-total-connections>100</max-total-connections>
<default-max-connections-per-host>2</default-max-connections-per-host>
</connection-manager>
<allow-lax-ssl>true</allow-lax-ssl>
</properties>

<default-channels>
<channel ref="my-http"/>
<channel ref="my-amf"/>
</default-channels>

<adapters>
<adapter-definition id="http-proxy" class="flex.messaging.services.http.HTTPProxyAdapter" default="true"/>
<adapter-definition id="soap-proxy" class="flex.messaging.services.http.SOAPProxyAdapter"/>
</adapters>

<destination id="DefaultHTTP">
<properties>
</properties>
</destination>

<destination id="ws-sesame">
<properties>
<wsdl>http://cdsws.u-strasbg.fr/axis/services/Sesame?wsdl</wsdl>
<soap>*</soap>
</properties>
<adapter ref="soap-proxy"/>
</destination>

</service>

Content of remoting-config.xml:

<?xml version="1.0" encoding="UTF-8"?>
<service id="remoting-service" class="flex.messaging.services.RemotingService">
<adapters>
<adapter-definition id="java-object" class="flex.messaging.services.remoting.adapters.JavaAdapter" default="true"/>
</adapters>
<default-channels>
<channel ref="my-amf"/>
</default-channels>
</service>

Content of services-config.xml:

<?xml version="1.0" encoding="UTF-8"?>
<services-config>

<services>
  <service-include file-path="remoting-config.xml" />
  <service-include file-path="proxy-config.xml" />
  <service-include file-path="messaging-config.xml" />
  <default-channels>
     <channel ref="my-amf"/>
  </default-channels>
 </services>

<channels>

  <channel-definition id="my-streaming-amf" class="mx.messaging.channels.StreamingAMFChannel">
      <endpoint url="http://{server.name}:{server.port}/{context.root}/messagebroker/streamingamf" class="flex.messaging.endpoints.StreamingAMFEndpoint"/>
  </channel-definition>

  <channel-definition id="my-amf" class="mx.messaging.channels.AMFChannel">
      <endpoint url="http://{server.name}:{server.port}/{context.root}/messagebroker/amf" class="flex.messaging.endpoints.AMFEndpoint"/>
      <properties>
          <polling-enabled>false</polling-enabled>
      </properties>
  </channel-definition>

  <channel-definition id="my-secure-amf" class="mx.messaging.channels.SecureAMFChannel">
      <endpoint url="https://{server.name}:{server.port}/{context.root}/messagebroker/amfsecure" class="flex.messaging.endpoints.SecureAMFEndpoint"/>
  </channel-definition>

  <channel-definition id="my-polling-amf" class="mx.messaging.channels.AMFChannel">
      <endpoint url="http://{server.name}:{server.port}/{context.root}/messagebroker/amfpolling" class="flex.messaging.endpoints.AMFEndpoint"/>
      <properties>
          <polling-enabled>true</polling-enabled>
          <polling-interval-seconds>4</polling-interval-seconds>
      </properties>
  </channel-definition>

  <channel-definition id="my-http" class="mx.messaging.channels.HTTPChannel">
      <endpoint url="http://{server.name}:{server.port}/{context.root}/messagebroker/http" class="flex.messaging.endpoints.HTTPEndpoint"/>
  </channel-definition>

  <channel-definition id="my-secure-http" class="mx.messaging.channels.SecureHTTPChannel">
      <endpoint url="https://{server.name}:{server.port}/{context.root}/messagebroker/httpsecure" class="flex.messaging.endpoints.SecureHTTPEndpoint"/>
  </channel-definition>

</channels>

<logging>
  <!-- You may also use flex.messaging.log.ServletLogTarget -->
  <target class="flex.messaging.log.ConsoleTarget" level="Error">
      <properties>
          <prefix>[BlazeDS] </prefix>
          <includeDate>false</includeDate>
          <includeTime>false</includeTime>
          <includeLevel>true</includeLevel>
          <includeCategory>false</includeCategory>
      </properties>
      <filters>
          <pattern>Endpoint.*</pattern>
          <pattern>Service.*</pattern>
          <pattern>Configuration</pattern>
      </filters>
  </target>
</logging>

<system>
  <redeploy>
      <enabled>true</enabled>
      <watch-interval>20</watch-interval>
      <watch-file>{context.root}/WEB-INF/flex/services-config.xml</watch-file>
      <watch-file>{context.root}/WEB-INF/flex/proxy-config.xml</watch-file>
      <watch-file>{context.root}/WEB-INF/flex/remoting-config.xml</watch-file>
      <watch-file>{context.root}/WEB-INF/flex/messaging-config.xml</watch-file>      
      <touch-file>{context.root}/WEB-INF/web.xml</touch-file>
  </redeploy>
</system>

</services-config>

Do not forget to copy the definitions of the listener and the MessageBroker Servlet in your web.xml file.

Compiling the Flex Application

To compile the Flex application that will be encapsulated into the portlet, you will need to specify the portlet name as context root:


mxmlc -strict=true -show-actionscript-warnings=true -use-network=true \
-services=WEB-INF/flex/services-config.xml -context-root=messier_object-portlet \
-output=./Test_Flex_WS_messier.swf ./Test_Flex_WS_messier.mxml

Deploying the Portlet

To be able to access BlazeDS from the portlet, you will also need to copy the BlazeDS war file in tomcat under .\bundles\tomcat-6.0.16\webapps.

To compile and deploy the whole portlet just type the command 'ant deploy' at the prompt in the messier_object-portlet folder.

You can then add the portlet and test it:

How to use BlazeDS for Web Service access

2008-11-07T10:19:00.000-08:00

I was recently asked to investigate how quickly aggregate medical content from various sources in a portal environment. One path I explored was to use Adobe Flex as front-end technology and access remote web services such as the ones offered by ICW LifeSensor.

With Flex 3.0 you can easily use a Web Service directly from your MXML or ActionScript code, including .NET based web services.

However there are some restrictions. For security reasons, applications running in Flash Player on client computers can only access remote data sources if one of the following conditions is met:

Your SWF file is in the same domain as the remote data source.
A cross-domain policy file is installed on the web server hosting the data source.
You use a proxy and your SWF file is on the same server as the proxy.

Since the Web services I want to use are not under my control and I know they do not have a cross-domain policy files installed, the only solution left is for me to use a proxy.

The good news is that BlazeDS, in addition to add RPC capabilities to Flex, acts as a Proxy, so won't have to write my own!

Installing and trying BlazeDS

BlazeDS is really easy to install. I choose to download the turnkey version to start because it includes a runtime environment (Apache Tomcat) and lot of samples.

After download and unzip, the only things I had to do was to start the database for the samples (Hypersonic/HSQLDB) and start tomcat and point to http://localhost:8400/samples/. The "Take the test drive" of the tutorial contains a section (sample 2) using web services. The sample code is accessible in .\blazeds_turnkey_3-0-0-544\tomcat\webapps\samples\testdrive-webservice\src\main.mxml:

     <mx:Application xmlns:mx="http://www.adobe.com/2006/mxml"   backgroundColor="#FFFFFF">
 
       <mx:WebService id="srv" destination="ws-catalog" useProxy="true" showBusyCursor="true"/>
 
        <mx:DataGrid dataProvider="{srv.getProducts.lastResult}" width="100%" height="100%">
          <mx:columns>
                  <mx:DataGridColumn dataField="productId" headerText="Product Id"/>
                  <mx:DataGridColumn dataField="name" headerText="Name"/>
                  <mx:DataGridColumn dataField="price" headerText="Price"/>
           </mx:columns>
       </mx:DataGrid>
 
       <mx:Button label="Get Data" click="srv.getProducts()"/>
 
   </mx:Application>

The destination of the web service is defined in .\samples\WEB-INF\flex\proxy-config.xml:

   <destination id="ws-catalog">
       <properties>
           <wsdl>http://livecycledata.org/services/ProductWS?wsdl</wsdl>
           <soap>*</soap>
       </properties>
       <adapter ref="soap-proxy"/>
   </destination>

Installing and trying BlazeDS

The next step for me was to try to build a new Flex application from scratch
that uses a web service from an outside domain.
I decided to use one of my favorite free testing Web service,
the "CDS - Centre de Données astronomiques de Strasbourg"
located in Alsace, France which provides access to Astronomical data,
including Messier Objects.

Sesame is one of the apache axis based services hosted by CDS.
In the same way, this new service is declared in the proxy-config.xml file:

      <destination id="ws-sesame">
        <properties>
            <wsdl>http://cdsws.u-strasbg.fr/axis/services/Sesame?wsdl</wsdl>
            <soap>*</soap>
        </properties>
        <adapter ref="soap-proxy"/>
    </destination>

The Flex program is very easy to construct.
I have a list of Messier Objects in a combo box with their IDs (Mxxxx)
that are passed as argument for the SesameXML web service operation (see WDSL file).
The web service call indicated that BlazeDS is used as as proxy (useProxy="true")
and define two ActionScripts methods to handle the result coming back
from the remote service and to handle any error (respectively  getData_result and getData_fault).

<?xml version="1.0" encoding="utf-8"?>
<mx:Application xmlns:mx="http://www.adobe.com/2006/mxml" layout="absolute">

    <mx:Script>
        <![CDATA[
            import mx.controls.Alert;
            import mx.rpc.events.ResultEvent;
            import mx.rpc.events.FaultEvent;
   import mx.utils.ObjectUtil;
            
            // This software uses source code created at the Centre de Données astronomiques de Strasbourg, France.

            private function getData():void { webService.SesameXML.send();}
            private function getData_result(evt:ResultEvent):void {textArea.text = ObjectUtil.toString(evt.result);}
            private function getData_fault(evt:FaultEvent):void {Alert.show(evt.type);}
        ]]>
    </mx:Script>
    
    <mx:WebService id="webService" destination="ws-sesame" useProxy="true">
        <mx:operation name="SesameXML"
                resultFormat="object"
                result="getData_result(event);"
                fault="getData_fault(event);"> 
                <mx:request>
    <name>{messier_object.selectedItem.data}</name>
  </mx:request>
        </mx:operation>
    </mx:WebService>

 <mx:ApplicationControlBar dock="true">
        <mx:Button id="button" label="get Messier Data" click="getData();" />
        <mx:Spacer width="10%"/>
        <mx:ComboBox id="messier_object" width="200">
            <mx:dataProvider>
               <mx:ArrayCollection>
                  <mx:source>
                    <mx:Object label="Crab Nebula" data="M1"/>
                    <mx:Object label="Butterfly Cluster" data="M6"/>
                    <mx:Object label="Butterfly Cluster" data="M6"/>
                    <mx:Object label="Ptolemy Cluster" data="M7"/>
                    <mx:Object label="Lagoon Nebula" data="M8"/>
                    <mx:Object label="Wild Duck Cluster" data="M11"/>
                    <mx:Object label="Great Globular Cluster in Hercules" data="M13"/>
                    <mx:Object label="Eagle Nebula" data="M16"/> 
                    <mx:Object label="Omega Nebula" data="M17"/> 
                    <mx:Object label="Trifid Nebula" data="M20"/> 
                    <mx:Object label="Sagittarius Cluster" data="M22"/> 
                    <mx:Object label="Sagittarius Star Cloud" data="M24"/> 
                  </mx:source>
                </mx:ArrayCollection>
            </mx:dataProvider>
           </mx:ComboBox>
    </mx:ApplicationControlBar>

    <mx:TextArea id="textArea" editable="false" width="100%" height="100%" />
 
</mx:Application>

Building the SWF file

To build your shockwave executable file, it is important to indicate where the services
configuration file is located, so the BlazeDS stub is added to the *.SWF file
running in the browser inside the Flash Player and will make the connection
of the BlazeDS proxy.

   mxmlc -strict=true \
-show-actionscript-warnings=true \
-use-network=true \
-services=WEB-INF/flex/services-config.xml \
-context-root=samples \
-output=testdrive-webservice/main.swf testdrive-webservice/src/main.mxm
In fact, services-config.xml describes the different services
that the web application is using:

 <services-config>
    <services>
        <service-include file-path="proxy-config.xml" />
        ...
   </services>
   ....
 </services-config>

You will also need to modify your ./docroot/WEB-INF/web.xml file
by adding the definitions of the listener and the MessageBroker Servlet definition.

<web-app>
    <display-name>WebTest</display-name>
    <description>Application with Samples</description>

    <context-param>
        <param-name>flex.class.path</param-name>
        <param-value>/WEB-INF/flex/hotfixes</param-value>
    </context-param>

    <!-- Http Flex Session attribute and binding listener support -->
    <listener>
        <listener-class>flex.messaging.HttpFlexSession</listener-class>
    </listener>

    <!-- MessageBroker Servlet -->
    <servlet>
        <servlet-name>MessageBrokerServlet</servlet-name>
        <display-name>MessageBrokerServlet</display-name>
        <servlet-class>flex.messaging.MessageBrokerServlet</servlet-class>
        <init-param>
            <param-name>services.configuration.file</param-name>
            <param-value>/WEB-INF/flex/services-config.xml</param-value>
        </init-param>
        <load-on-startup>1</load-on-startup>
    </servlet>
    <servlet-mapping>
        <servlet-name>MessageBrokerServlet</servlet-name>
        <url-pattern>/messagebroker/*</url-pattern>
    </servlet-mapping>
 
</web-app>

Here is the result after querying information about Messier object (M1 - Crab Nebula):

The next task for me to see how to integrate BlazeDS in a portal environment
such as Liferay and explore authentication to Web Services and security features associated
to the use of BlazeDS.

Health 2.0 - 2008 (San Francisco) - Day 2

2008-10-23T08:55:00.000-07:00

Second day of the Health 2.0 2008 conference.
* the presentation from Sermo's CEO was quite impressive, especially in terms of number of US physicians that are part of their network.

3 Health 2.0 CEOs

JonathanBush, CEO AthenaHealth

process medical claims from doctors and put them into charts (EMR)
40 millions different cases
in business for 10 years
try to make the doctor office paperless
process paper based documents (40,000 per day)
Statistics: doctors get 11% more revenue when using AthenaHealth
89 pages of paper come every day for each doctor (mostly by Fax & Teleprinters)
business model: fee based (by the doctors)

Daniel Palestrant, MS, CEO Sermo

social network for doctors
company started 3 years ago
90,000 US physicians 7,000 added each months
20% of the US physicians at end of the year.
direct communication between physician and drug manufacturers (e.g. Pfizer) and the result is published for the whole Sermo community.
should be cash positive sometimes next year
extension to the international market planned in 2009

business model: no charge for the physician (in fact they pay the doctors to be part of the network), no advertising, get revenue from sponsors (e.g. drugs manufacturers)
work with FDA
Partnership with Bloomberg.

Kerry Hicks, CEO Healthgrades

provide rating and information on healthcare services
5000 hospitals and most of the physicians, nursing homes etc ...
13 millions piece of information coming each month
list 88 conditions
information on 40,000 prescription drugs
users: 55% women, 45% men
partnerhip with Google
80% of the traffic comes from patients who have seen the patient in the last 30 days

Panel: Health 2.0 around the world

Video:

India: diagnosis over the phone including SMS (300 millions cell phones in india), 720 millions by 2012.
UK: UK: how to reduce healthcare cost

Thomas Liedtke, Emerging Health Care, ICW

statistics show that 20-30% of the patients get the wrong medication
OptiMed deployed for AOK, Germany
compliance control device
use iPhone to scan medication

Marlene WinField, SVP, NHS connecting for health

improve universal HealthCare in UK
aggregate services for patients
15 million patients
enable two ways communications between patients and care givers via a Personal Health Organizer / PHR called healthspace

appointments, calendar, reminders,
over the counter medication
access to health organizer
audit trail for users (who logged etc ...)

Alex Savic, CEO Alensa

based in switzerland
customers in Romenia, Serbia
eCmmerce platform for para-pharmacy products (selling drugs online is still illegal in Europe)
health blog network is very useful to help monetize their content (premium posts canbe paid by mobile phone).
biggest issues are legal issues in europe.

Paul Meyer, chairman Voxiva

company started 7 years ago
provide patients with tips and information on living with a chronic condition
e.g. disease surveillance system (Peru 2002)
e.g. interactive risk assessment on hearth and cardiac conditions via SMS (Mexico 2007)
tools to quickly build applications (e.g. diabetes risk profile population)

Josh Nesbit, FrontlineSMS

enables users to send and receive text messages with large groups of people through mobile phones.

Deb Levine, ISIS

non profit organization located in Oakland, CA
SMSs for prevention and referral
Sexinfo, Realtalk, Data violence prevention etc ...
E.g. SMS to 61827 'HIVinfo' or 'Text Meds'

Doug Solomon, CTS, IDEO

design company (device, software, organization)
integrate human, business, technology aspects

Brooke Partridge, CEO, Vital Wave Consulting

provide HealthCare studies for emerging countries

Deep Dive: American Well

Demo of the AmericanWell, an online medical care services product:

online services for patients and physicians
two way conversation (video conference or voice over IP) between doctor and patient
patient:

agenda, assessment, provider search, message center, health profile and history.

integrated with Health Vault
ability to rate the service delivered by the doctor
forward conversation to the patient PCP

doctor:

claim submitted automatically

HMSA Online Care:

Hawaii - 7,000 members
rural country with a large growing senior population
uninsured young population

Panel: Tools for Consumers
Personalized, Analytical, Supporting Decisions, Enabling Transactions

Kevin Nolan, CEO ADAM

ADAM content using the iphone

David Clymer, CEO, MyMedLab

purchase test online
go to a local lab
results are reviewed and put into a PHR
available in 47 US states (except RI, NJ, NY)

Linda Avey, Co-CEO, 23andMe

account can be shared
study paternal/maternal Halogroups
study health risks (clinical reports, research reports)
compare family, friend genes

Mari Baker, CEO, Navigenics

goal: introduce personalized medecine in HealthCare
offers access to a genetic counselor
estimated lifetime risks
recommendations to reduce health risks

Adam Bosworth, CEO, KEAS

demo of My Health Plan

todo list, overall progress, lab results, meal, exercise action plan

import data from google health
tracking vital signs and process over time
warning about health risks

Roy Schoenberg, CEO AmericanWell

demo online services for patients and physicians

Stan Nowak, CEO, Silverlink

Michael Cho, CEO, Destination Rx

50 millions customers
help manage medicine cabinet
provides warnings about drug interactions
offer ways to lower cost (therapeutic alternatives/generics) including dosage
therapeutic alternatives covers 200 tops drugs in the US

Erick VonSchweber, CEO, PharmaSurveyor

regimen survey tool
transferred from partners (Google, Destination Rx ...) using CCR
interaction drugs panel
ability to replace one drug by another one if there is an elevated risk

Alexandra Drane, President, Eliza

Marlene Beggelmman, CEO, Enhanced Medical Decision

demo: doublecheckmd: Decision support tool for patients

use questionnaire
offer medical recommendations/advices

Stefanie Fenton, Director Market Development, Intuit Quicken Health Group

Getting Past the Privacy Conundrum

Carol Diamond, & Josh Lemieux Markle Foundation

presentation of connectingforhealth.org

Kepa Zubeldia, EVP, Ingenix

James Dempsey, Policy Director, Center for Democracy and Technology

Phillips Marshall, VP, WebMD Health

Richard Dick, CEO, You Take Control

Jennifer Gilburg, Verisign

demo of VIP : a consumer solution for authentication
one time token ID generated by hardware token
hosted service
SSO usable across different web applications

Robert Shelton, CEO, private Access

goal: harmonization of privacy and access
demo of PrivacyLayer

Alan Viars, CEO, Videntity

Verification and authentication tools
REST based API
verification by voice over IP + Pin & voice recognition

Panel: Genomics online
* For the patient, there is a benefit knowing in advance the health risks associated to his/her genetic background. This type of information give some type of empowerment to the patient as well.

Linda Avey, Co-CEO, 23andMe

$399 per genetic analysis study
4-6 weeks for the result
23andWe: sharing information about surveys (phenotype)

Tera Eerkes, CEO, QTrait

Genetic testing
$99 per genetic analysis study
dashboard with risk factors
technical reports that can be shared with the physician
non technical report to share with friends and family
specific tests for mate/couple genetic matching to reduce health risks

Mari Baker, CEO, Navigenics

partnership with affymetrix and Microsoft HealthVault.
scripps genomics health initiative

Ilya Kupershmidt, Co-founder, VP of Product Management , NextBio

1/2 million users (researcher, consumers)
60 million pages of resources
use public experimental data
clinical trials information
use ontology to summarize the relevant information data

Daniel Reda, Co-Founder, CureTogether

demo of CureTogether
health tracking tools will be added
data to be use for gene discovery
twitter for your health

Demo Panel: Disease Management 2.0

Stan Nowak, CEO Silverlink, Silverlink

recommendation: try to model and automate the routine healthcare activities

communication programs for disease management
a way to drive behavior (to reduce cost and improve performance of chealthcare).
interactive phone calls with health coach
educate patients how to save money on drugs

Suneel Ratan & Ileana Welte, SVP, Health Hero Network

recommendation: keep give supports to your customers to improve the relationship with the patient

health body applicance / tele-health platform
connect patients and care givers (e.g. institutions)
27,000 customers every day
biggest provider to the veteran administration
reduce customer care cost by 20%

Neal Kaufman, CEO, DPS Health

recommendation: try to mimic face to face visits

weight management program application
internet coach send notes to the patient using past performance
integrated with an EMR
lessons, workbook, tracking plan, resources and communication tools
graphs showing performance
send weekly feedback
GUI need some refreshing/update (need a modern look and feel) !

Don Kemper, CEO, HealthWise

recommendation: help each person to help themselves, improve their live and say no to the caregiver when needed!

guided self disease management
$60 per nurse call
for details, send email to moreinfo@healthwise.com

Neal Kaufman, CEO, DPS Health

Health 2.0 - 2008 (San Francisco) - Day 1

2008-10-22T10:17:00.000-07:00

This year, the Health 2.0 2008 conference crowd is definitively larger than last year. I was expecting also a larger exhibition as well, but in fact, the action really seems to take place in the panel discussions and meeting people and peers rather than on the demo booths. However there were some interesting demos during the panel sessions.

The future of Health 2.0 (Indu Subaiya - Matthew Holt)
What is the best way to engage people to use Heathcare Apps?

=> A survey provided some interesting information:

most frequent channel is conversation
social media is much more credible when coupled with Health expertise (e.g. blogs, videosharing, wikipedia).

=> Tools are changing dramatically (Personalized, Analysis, Decision support, transactions)

Search Social networks (still the top application), tools, content, Transaction data
Health 2.0 Accelerator initiative (To help launch Health 2.0 related ventures).

Keynote : Here Comes Health - Clay Shirky

Clay talked abou this boook:
Here Comes Everybody: The Power of Organizing Without Organizations

aggregation is different: a group of patient behave different from single patients
add more value (interaction between participants adds synergy
information: most of the traffic on the internet is between people, not computers

e.g Yahoo! 178,000 groups in Yahoo! groups
patient centric medicine (me and people/patients like me).

Documentary: The Great American Health 2.0 Motorcycle Tour
An interesting video created by Health 2.0 wher David Kibbe visits (on a motorbike) new Health 2.0 companies and models models throughout the US

Context: 47 millions americans do not have Health coverage
Hello Health : New business model of primary care physicians and their patients
Minute clinic: data is uploaded to Microsoft Health Vault and Google Health
Change Healthcare
Google Health
Healthline
MedHelp
Kosmix

Panel: The role of the Consumers Aggregators

Wayne Gattinelle, Philip Marshall, WebM

presentation of the Verizon HealthZone (branded WebMD web site/application)
alert, visit, Conditions, Medications, Allergies, Surgeries, Immunizations, Tests
medication advisor: decision support for cost and benefits

Michael Yang, Yahoo!

collaboration with water front
deal with healthgrades
presented new visual design for the next generation applications
new front door access from Yahoo! Health
a profile page describing the physician will be available
collaboration with water front media
deal with healthgrades

Roni Zeiger, MD, Product Manager, Google Health & Brad Crosslin, PDX (Google partner)

Demo showing integration of Google Health with pharmacies

Myer 10 Millions patients
Duane Reade (export data into Google Health)

Peter Neupert, Health Solution Group, Microsoft

partnership with Kaiser (glimpse at the demo)
demonstration of PHR (www.myhealthManager.com) 2.5 millions users currently.
capabilities to export data into Microsoft HealthVault
shows which information is sent to Microsoft (wrapped into a HL7 document)

Mark Bertolini, President, Aetna

3rd largest insurance in the US
3200 IT personal
cost of care tool
partnership with Microsoft (Health Vault)
PHR

7 millions users by the end of 2008
one million of alerts every 3 months

Panel: Search, UGc and the Long Trail, Matthew Holt & Indu Subaiya
- Personalization is very important

Venky Harinarayan, Co founder, Kosmix/Right health

demo of Right health

vertical search engine

search results on medical content, community, forums

2nd web site after WebMD

aggregate services

Well Shell, CEO, HealthLine Networks

content provided from 20 partners
70% of the search are related to symptoms
learning centers automatically generated
drug search including FDA alerts and drugs interaction checker
patient decision support as outcome of the search

Steven Krein, CEO, Organized Wisdom

use a team of medical personal to search Google and hand craft search results
long tail search: very specific and personal questions (e.g. side effect of hip surgery) that are answered by organized wisdom.
research notes + top resources that are created for aggregated groups of users
20,000 patient cards
Organized Wisdom is going to create profiles for every doctors, dentists and practitioners.

Tom Eng, President, Healia/Meredith Group

vertical search engine: provides high quality trusted results (patent pending algorithm)
health communities: locate patients close by and 'ask questions' feature.

Bill Allman, The H ealthCentral Network

Ben Heywood, PatientsLikeMe

300 patients answering questions related to ALS & Lithium
look at prediction models for patients (evidence based medecine).

Daniel Palestrant, Founder and CEO, Sermo

millions of questions on their site
very interesting study case of allergy form Victoria's secret Bras that was detected by Sermo after studying new group posts.

John De Souza, CEO, MedHel

Gilles Frydman, Founder ACOR(Association of Cancer Online Resources)

provides specific information not found on google (e.g. very rare medical cases)

Demo Panel: Managing Money in Health 2.0
* Money starts to play a role in Health 2.0 as transactions start to take more importance.

Christopher Parks, CEO, Change HealthCare

demo: tool to share, compare and track healthcare expense
business models: licensing by employers
detailed medical bills
summary by family member, by provider, by service date, by health issue
average cost per providers for 5 providers in the same area <= nice!

Stefanie Fenton, Quicken Health Group, Intuit

demo of Quicken Health to be launch in 2009 for UnitedHealthcare, CIGNA HealthCare, and Medical Mutual of Ohio initially
business model: pay per transaction + license fees
visited more than 300 people to understand their healthcare finance need (the amount of bills/paper tracks can be very large)
3 years of development
health plan claims are dowloaded
claims to be paids, deductibles with break down on each items how it is reimbursed (as tooltips)
payment history with patterns of spending that can be exported for taxe purpose

Phil Micali, CEO, Bwell-inc.com

demo of bwell informed launched last year (B2B and B2C)
business models: licensing by employers
include saving accounts, health profile, compare family plans <= very nice!

Chini Krishnan, CEO, Vimo & GetInsured.com

Brandt Cannici, Co-Founder and COO, Medicaresaver.com

demo of medicaresaver.com
business model: commisions and strategic partneships
includes therapeutic interchange proposal and generate letter for doctor <= cool!
compare restricted and non-restricted plans
focus on seniors
no advertizing, HIPAA compliant

Demo Panel: Clinician Social Networks

Rex Jabovits, Mypac.net

YouTube or Flickr for radiology
more than 18,000 cases containing more than 90,000 images
Sharing of medical images (flash + ajax)
free service funded in part by the National Institutes of Health.

Jason Bhan, Co-founder, Ozmosis

online Medical Knowledge Exchange
accelerates learning and knowledge exchange across medicine
journal club, clinical cases, groups etc ...

Michael Sands, Co-Founder, MedicalPlexus

ecosystem/network in which doctors and life science researchers can connect, interact, and share their work
learning from and Sharing Knowledge with other professionals/colleagues using questions and answers

Lance Hilll, CEO, Within 3

private professional networking site for health and life science practitioners to find, connect and collaborate (the linkedin for medical practitioners)
ability to communicate news and event information
find colleagues with similar interest by location
consultation with specialist on atypical cases, new treatments etc ...
offer ways to build communities
REST APIs will be available in 2009 to access member data

Tobin Arthur, CEO, iMedExchange

online community for physicians

The ABCs of Google Health Data API

2008-09-30T19:29:00.000-07:00

Recently, I have been involved in a small project to aggregate medications from various Personal Health Records (PHR), including Google Health.

The documentation for the Google Data APIs Client Library and the Health Data API is quite complete and extensive. But it can be also be quite complex for someone who want to develop quickly a prototype or just test a proof of concept using these APIs.

Since I was going to develop my project in Java, I first downloaded he most recent GData Java Client Library (version 1.22 with samples - 6.8 MB).

The sample code can be used out of the box for a simple stand-alone java testing program.

I did import the sample code and the library in my IDE (eclipse) and just changed the credentials (sample.credentials.username and sample.credentials.password) in gdata/java/build-samples/build.properties using my google health account login and password.

To run the Google Health sample program, at the prompt under ./gdata/java just run: ant -f build-samples.xml sample.health.run

The next step for me was to reuse the sample code to develop a web application (I am creating small Liferay JSP based portlets).

Google offers two platforms for the developers to test their applications:

Google Health (production server, highly secure)
H9 Sandbox (fewer restrictions than the production version

For my small web project I initially tested my code against H9, as recommended by Google.
The main reason is because the authentication with H9 is more simple than with Google Health production.

The application I wanted to build is supposed to connect to various PHRs (ICW LifeSensor, Microsoft Health Vault and Google Health/H9) and retrieve the medication lists. For Google I don't need to enter a login and password in my web application since I am going to use Google AuthSub mechanism:

By clicking on the Google 'connect' button, I am redirected to the Google AuthSub web site:

     <input id="btn_connect_google" name="Disconnect" type="submit"
         value="Connect" onClick="connectToGoogle();return false;"/>

Here is the Javascript function I use for URL redirection:

     function connectToGoogle() { 
       if (btn_connect_google.value == "Connect") {
          window.location.href = googleAuthSubURL.value;
       }
       else {
          btn_connect_google.value = "Connect"; 
       }
     }

I construct the AuthSub URL in advance in my JSP java code:


public String getGoogleAuthSubURL(HttpServletRequest request) {
     
       gh9s = new H9Service("ICW-H9Medications-1.0");

       String nextUrl = "http://localhost:8080/sample/hello.jsp";
       String scope = "https://www.google.com/h9/feeds/";
     
       boolean secure = false;
       boolean session = true;
    
       String authSubLink = AuthSubUtil.getRequestUrl(nextUrl, scope, secure, session);
       authSubLink += "&permission=1";
       authSubLink = authSubLink.replaceFirst("/accounts/AuthSubRequest", "/h9/authsub");
     
      return authSubLink;
   }

I store the URL in an hidden field:

   <input type=hidden id="googleAuthSubURL" value="<%= getGoogleAuthSubURL(request) %>" >

You can refer to the Google Data API and Google Health API, including security settings for AuthSub Request and application identification (for logging purpose).

I am redirected to the Google AuthSub WebSite where I can choose which H9 account I want to use.

Then I am redirected back to my original application, with a single use token associated to the request. I can then parse the request and extract the token that I exchange for the token session:

  http://localhost:8080/sample/hello.jsp?token=1%2FBtOEh.....lsYenOFQ&permission=1

  if (gh9s != null)  {        
      try {
        
         // Extract Single Use Token for the session
         String queryString = request.getQueryString();
                  if (queryString != null) {
           
                      String singleUseToken = AuthSubUtil.getTokenFromReply(queryString);
                 
                      if (singleUseToken != null) {
                        String sessionToken = AuthSubUtil.exchangeForSessionToken(URLDecoder.decode(singleUseToken, "UTF-8"), null);
                        gh9s.setAuthSubToken(sessionToken);
                        System.out.println("Google SetAuthSubToken");
                          
                        URL profile_url = new URL(PROFILE_DEFAULT_PATH);
                        System.out.println("Google ProfileURL:"+profile_url);
                        gh_feed = gh9s.getFeed(profile_url, ProfileFeed.class);
               
                        createReferences(gh_feed.getEntries());
                      }
                  }
            } catch (AuthenticationException e) {
                throw new RuntimeException(e);
            } catch (IOException e) {
                throw new RuntimeException(e);
            } catch (ServiceException e) {
                throw new RuntimeException(e);
            }
        }

For my portlet version (Liferay), I just had to replace the definition of the current URL:

   String singleUseToken = AuthSubUtil.getTokenFromReply(getCurrentURL(request).getQuery());

   private URL getCurrentURL(HttpServletRequest request) {
    try {
       return(new URL(request.getScheme(), request.getServerName(), request.getServerPort(), request.getAttribute("CURRENT_URL").toString())); 
    } catch (MalformedURLException e) {
    throw new RuntimeException(e);
    }
   }

The next step is to obtain medication entries by parsing the Google CCR data feed:

  private void createReferences(List entries) { 
     if (entries != null) {
        for (ProfileEntry entry : entries) {
           System.out.println("Google CCR:"+entry.getContinuityOfCareRecord().getXmlBlob().getBlob());
                 GoogleCCRWrapper ccrWrapper = getDomRepresentation(entry);
                 if (ccrWrapper.containsMedications()) 
                    medication_list.add(ccrWrapper.getMedication());
                    source_list.add(SRC_GOOGLE_HEALTH);
         }
      }
   }

The GoogleCCRWrapper java class parses the CCRg XML data feed:

    public GoogleCCRWrapper(String xml) {
        DocumentBuilder builder = null;
        try {
            builder = documentBuilderFactory.newDocumentBuilder();
        } catch (ParserConfigurationException e) {
            throw new RuntimeException("Error creating DocumentBuilder.", e);
        }
        
        try {
            document = builder.parse(new ByteArrayInputStream(xml.getBytes()));
        } catch (SAXException e) {
            throw new RuntimeException("Error parsing XML.", e);
        } catch (IOException e) {
            throw new RuntimeException("Error parsing XML.", e);
        }
    }


public boolean containsMedications() {
        return document.getElementsByTagName("Medications").getLength() > 0;
    }

    public String getMedication() {   
     Element e = getElementFromDocument("Medications");
     e = getElement(e, "Medication");
     e = getElement(e, "Product"); 
     e = getElement(e, "ProductName");
     e = getElement(e, "Text"); 
     return getText(e);
    }

Here is the resulting portlet (Google Health and Lifesensor Medications):

Liferay Portal : My first impressions

2008-08-29T20:22:00.000-07:00

My company ICW creates Health Care web applications and solutions.

We have a need to create reusable components that can be bundled into highly customizable and personalized web applications. Our stack uses Java Enterprise and Web 2.0 technologies, so we naturally turned to the open source Liferay Portal.

This was my first experience with Liferay. By looking at the features, it seems that this portal solution had a lot of things we were looking for:

A well recognized open source product (1.5 million downloads, 6000+ registered participants ...)
A business-friendly MIT License
Compatibility with all major servers, databases and operating systems (we are using Tomcat, Oracle, Windows for development and Linux for production).
Compatibility with our stack (J2E) and light container (Spring).
An easy way to create new skins and branding
An integrated content management system
Highly secure platform (especially important for Health Care applications)

Installing Liferay (version 5.1.0) was a little bit longer than expected (>1 GB), but after this, it went pretty smoothly besides minor MySQL configuration issues. This installation included all the source code of Liferay (I did not have to customize the code initially, but it seems nice to have all the source code available in case ...).

I did create a specific project for our need - a portal version of our Personal Health Record (PHR) - call phr-portal-assembly (see screen shot on the left):

I liked the fact that the runtime portion of the portal is contained inside the project: bundles/tomcat/ (although this takes a lot of space if you have several projects).

To be up and running, you just have to start MySQL and Tomcat and open a browser at http://localhost:8080/web/guest/home (I am using Firefox).

I find it easy to create new plugins (portlets and themes). You just have to open a prompt under the liferay-plugins-sdk-5.1.0/portlets or liferay-plugins-sdk-5.1.0/themes directory and use the command:

create new_portlet_name new_portlet_title and
create new_theme_name new_theme_title

I was then able to start to modify my portlet skeletons (by modifying the default view.JSP file under docroot) and redeploy them (without having to restart tomcat!) by using the ant deploy command. Easy and efficient!

For the themes, I was a little bit different: The style sheet changes/differences is specified under the docroot/_diffs and the new theme is built by adding the differences to the default classic look and feel.

Becoming familiar with the portal application itself was not too complicated. Especially with version 5.1.0 which can give admin rights to any type of users, so I was able to customize my portal page without having to log a as an administrator.

To make the border/chrome disappear, I just had to click on the look-and-feel icon.

This opens a new window where I had to uncheck 'Show Borders' and refresh the browser.

After this, I had to uncheck the 'Toggle Edit Controls' check box.

The resulting portal had the same look and feel as our initial PHR, but was now highly customizable.I did some also some quick tests with different layouts and themes that was provided by one of my colleague with fast and good and results. We also did some tests encapsulating an existing Flex based application and some widgets with great success.

Overall my first impression of Liferay portal is a very positive one.

I am now looking forward to tackle the re-factoring of our existing products with this technology (we are using JSF, Ajax and Flex as front-end technology)!

IEEE HealthCom 2008

2008-07-06T18:05:00.000-07:00

The Tenth IEEE International Conference on e-Health Networking, Applications & Services (IEEE HealthCom 2008) takes place from 7th July to 9th July 2008 in Singapore (BioPolis - Matrix building 4th floor).

130 attendees. 50% from oversea.
papers: 40% acceptance rate

Below are my notes of the presentations/sessions I have attended:

Keynote: A Road to Disease Prevention through Telemedecine and e-Health - Prof. Luis Kun Ph.D. FAIMBE, FIEEE.

Very interesting presentation on various topics: Interoperability and Globalization!

Interoperability is needed not only in Technology, but also in Process and People.

Dimension of time in CPR: Very often patient Dental, Mental health, Behavioral, Immunization, Prenatal, Labor and Delivery, Family postmortem related information is often not available at the hospital which increase medical errors.

We need single PHRs throughout the lives of the individuals (e.g. Dod and VA administration do not have access to non-military information sources).

Longitudinal Health Record (LHR) and intelligent Data WareHouses will be able to acquire and store multi-modality medical Data, fuse it into clinical records, along with laboratory, anatomical pathology, pharmacy, imaging and bio-molecular data, importing data from existing EHR.

However, privacy, confidentiality and ethical issues remain.
Prof Kun also mentionned the HRBA (Health Record Banking Alliance), a way to promote community repositories of electronic health records - in competition with Goolge Health & MS Health Vault private initiatives?
Mobile interoperability: we need better wireless devices integration through standards.
More use of micro-systems body worn, implanted mobile systems and location based systems.
Chronobiology and chronotherapeutics: taking in consideration the time when you take drugs can be very important.
PHRs should be compatible across countries (to take into account he health history of immigrants for example).

Globalization We are more interdependent that we think, thus increasing health risks, war, pollution:

Populations size and migration increase.
Food is imported/exported from more and more countries.

Global dust cloud across continents can help transmit diseases.

Session: Geriatrics and Eldercare : a lot of various sensors and methods are used automatically to track behavior.

IC Tag Monitoring System Identifies an Unusual Pattern of Toilet use by Patient with Vascular Dementia - (Japan - Hospital Chubu region)

Tags are put on the shoulder of the patients with patches.

Technology is used to complement training of personnel provides more precise real time monitoring, especially at night-time.
Allow statistical studies when merged with demographic and other health related data.
Discover specific unusual behavior patterns - e.g. a patient can walk up to 10 km per day, or up to 150 times per day to the toilet (non incontinent patient).
Future work will involve combination of tracking staff activities with patient activities.

Automatic detection of Activities of Daily living from detecting and classifying electrical events on the residential power line - Norbet Noury - (university of Grenoble)

Goal tracking: tracking systems, used to trigger alarms.
Watteco : a detector placed in the main electrical supply board to detect instantaneous signatures.
Issues: non automatic learning system: setup has to be done manually.
Use different weight for various appliances.
Issues: need to take into account seasonal variations
Activities tracking:

feeding, grooming, toilets, day vs night activities

Smart Wireless Continence Management System for Elderly with Dementia.

use sensor / wetness detection / placed in diapers (cost $50 per sensor -reusable).
plan to use RFID as well
care giver alerted through LED, Buzzer, 3D /GUI and SMS alerts.

Eating Activity Primitives Detection - a step towards ADL recognition.

basic safety, daily living and social interactions

person location
use of potential harmful objects

Combination of sensors: motion detecting PIS, pressure, accelerometer, RFID.

Approaches and Principles of Fall Detection for Elderly and Patient.

4 types of falls: from sleeping, from sitting, from walking or standing, from standing on ladder, stool.
Devices

Wearable devices (postures, motion) - e.g. walking sticks

Camera based (inactivity detection, body shapec change, 3D head motion)

Ambiance devices (presence, posture)

Session: Knowledge Management and Ontology in HealthCare.

Design and implementation of a Knowledge-Based Applications in Specimen Collection

Tests collection by phlebotomy stations - tracking done via ATOM system
Barcode Lab Information System (LIS) based demographic and session ID labels are added to testing tubes/containers.
COW (Computer on Wheels) systems at point of care (used by doctor and phlebotomist).
Reduce the number of human errors dramatically.
Issue: multiple distributed systems can still lead to errors (e.g. if there has been delays in the production of the lab results).

An Ontology-Based Framework for Managing Semantic Interoperability Issues in e-Health (Singapore).

Need to decouple domain knowledge from underlying intelligent agent infrastructure.
Use ontology (explicit domain knowledge) used by multi-agent systems.
However, domain knowledge can be very complex.
Semantic interoperability is an issue in Health Care - same object for various terms e.g. Anemometer or Sphygmomanometer.
Context must be brought in.
Use of dialogs/predictions
Issues: multi-language interpretation

Management of Mobile Social ntework services for families with Developmental Delay Children (Taiwan)

Assessment of User Satisfaction with an Internet-Based Integrated Patient Education System for Diabetes Management.

different types of formats are used (e.g. text, powerpoint etc ...)

A Framework for Personalized HealthCare Service Recommendation (South Korea)

see Healthcare provider recommendation system (Bachus et al.) - US patent
However there is a need for personalization
HSRF provides personalized results.
Integrated with MUSS - Mobile U-Health Service Ststem (see Lee et al)
Health Status is a combination of Bio Signals & Symptoms
Health Vector is generated from patient information.
Heuristic calculates the distanced between users vectors and vectors of services
Use satisfaction / user feedback to refine the recommendations.
Technology use is JSP, AXIS, MYSQL

Session: Security and Privacy in HealthCare

A Web-Based Wireless Mobile System design of Security and Privacy Framework for ubiquituous HealthCare (u-HealthCare) - San Jose, CA

SSL, data encryption, Windows based solution

Secure WBAN Usng Rule-Based IDS with Biometrics and MAC Authentication - India

Use Wireless Sensor Networks (sink +sensor) for medical monitoring.
Take into account constraints in Sensor Network Security
Use strong public key Cryptography technology
Cost factor is the limitation
Denial of service are the type of attacks that are prevented

Privacy-preserving EHR linkage using pseudonyms identifiers.

Need to allow patient to keep certain linkages private (e.g. abortion, drug addiction clinics)
Need to link only records belonging to the same patient
Need to override privacy rules in emergencies?

Session: Discovery

Highly Interactive and User Friendly Web Application for People with Diabetes

based on open platform (openEHealth.org)

Training Program for e-Health in Tokai University (Japan)
Ride Comfort Analysis Based on Tilting Train Simulator for e-Health Train (Korea)
Development of the Support System to Help Team Care for Home Care
Security and Privacy fro WiMoHS (Wireless Mobile Healthcare System)
A Case Report on a e-Learning for Health Initiative in the Philippines
Comparison and Optimization of Methods fro Intra-Disc Vascular Architecture Extraction

Keynote: e-Health from the hands of Patients - Prof Yu-Chuang (Institute Biomedical Informatics, National Yang-Ming University Tapei).

H2H Exchange: Medical Information Exchange Center. Attempts to interconnect EHRs were not very sucessful. The main reason is that the providers were reluctant.
Could ATM machines be a model for Hospital-centric exchange? The problem is that hospitals are afraid to loose patients/customers (in the case of ATM machines, bank accounts are not transfered, whereas EHR transfer would be similar to full bank account transfer).
Patients should be the one who initiate the transferts: H2P2H exchange and the content of Health Record belongs to the patient.
Standard format?
Health Smart Card started in 2004 was a success however.

23M Health Smart cards (non RSA card)
100K Health professionals would would have RSA cards
issues:

too small for EHR (8KB)

patients do not have a reader for their card

TMT: Taiwan Electronic Medical Record Templates (2007-2011)

70 templates, 24K data elements, 3 years.
A couple of days are necessary to map templates to hospital documents
Patient centric, initiated and own exchange (PIX).
XML based, signed , but not encrypted
Masking function available for the user to keep privacy
Patients will be able to use viewers at home to see their records (open source)
Data can be stored on USB disks or to Health Data Bank
11 largest hospitals (27K beds) -
2000 pilot patients
Would expand to 7M (30% of the population) in 5 years.

TET (Travelers Electronic Health Summary)

template-based approach

Endorsed by APEC, IMIA, EFMI, AMIA, APAMI
some degree if international interoperability
88 data elements. Similar to CCR.

Session: e-Health

Assistive Care Loop with Electronic Maternity Record -D.B. Hoang - Univ. Sydney.

provide alert, notifications, advices (SMS, email)

A Framework for Assessing ICT Preparedness for e-Health Implementation
Information and Communications Technology Needs Assessment of Philippine Rural Health.

few people own laptops, but a lot of people have cell phones.

An Approach for E-Health System Assessing ICT Preparedness for e-Health Implementations.
An Empirical Analysis of Reduction of Medical Expenditures by the e-Health System: Further Results.
Challenging Interoperability and Bandwidth Issues in National e-Health Strategies by a Bottom-up Approach: Establishing a Performant IT Infrastructure Network in a Middle East . State Vienna University of Technology.

Session: Communication Technology in Mobile HealthCare

Power and Delay Aware Mobile Application Data Flow Adaptation: the Mobihealth System Case study - Kataryna Wac - University Geneva.

patient tele-monitoring services (cardiac sensor: HR, SpO2, pleth, 3 led ECG, alarm (128 Hz)
use 2.5/3G WLAN and bluetooth andTMSI box (NL)
started in 2001 with Vodafone (Mobihealth) - worked with mobihealth, vodafone and Myotel
in 205-06 (project HealthService24)
in 2004-08 : Freeband-awareness - location, time, standing status of the patient.
in 2008 - MobiHealth BV - Commercial application
in 2009 - Myotel project
study the optimization of the battery consumption (li-ion polymer 1490 mAh), match delay requirement to emergency/non emergency case.
Mobile device: Qtek 9090, Windows Mobile 203 (battery drain!)
WWLAN (802.11b) & WWAN-GPRS (class 10: 4+1/3+2 slots)
Appplication flow: 5-14 Bytes, 128 Hz, aggregation 1 sec of Data., compression (ZIP) 38-85%, TCI/IP end to end path. continuous 1.2, 1.5, 5.5 or .7.7 kbps or burst 5.5 or 7.7 kbps

A study on Intra-Body Communication for Personal HeathCare Monitoring System - Waseda University, Japan

use human body (skin and muscle) as signal transmission medium
use ECG (future plan to use other types of sensors)
use central hub
use 3-USB receiver Unit (USB2.0/1-1 12mbps
transmiter: Agilent E443B, receiver: tektronix WCAA230
75 MHZ is found to be the optimal frequency for intra-Body human skin communication (electrostatic coupling model).
weather and sweating have small effects on the results.

A Platform for Personalized Mobile u-Health Application Design and Development - Korea

MUSS Mobile U-Health Service System (Application Platform) + Workbench
Application model i sbased on 5 phases (sensing, Questionaire, Data processing, Disease Management User feedback).
MUSS: 3 layers

Component : combine web services
Process : BPM engine
Application: Application Designer + scenario player are store in application portal

Application designer generates Application scenario in XML format for stand alone or web application.

Process consist of activities

the platform is written in Java
the client is written in C++ and C#
Heath Care specialist can create questionaires via the Questionaire composer.
Example: Stress Application

sensing: Bluetooth PPG sensor
questionaire: stress response inventory

Future work: application designer will use conditional and more complex workflow.

Google IO 2008

2008-06-02T08:36:00.000-07:00

Keynote: Client, Connectivity, and the Cloud - Vic Gundotra, Vice President, Engineering

Historically access to computing and deployment of applications have not been easy

in the 50s & 60s Mainframe were powerful but not very accessible, deployment was easy (terminal were dumb)
in the 70s & 80s PCs were not powerful, but accessible, deployment were difficult (complex deployment on all clients)
since the 90s Internet made access to power and deployment easier, but there is sill some progress to be made

Google wants to move the internet forward by

making clouds more accessible (providing more power to web applications)
making clients (browsers) more powerful
keeping (internet) connectivity pervasive

Technologies offered by Google to achieve these 3 goals*

Google Gear s: an open source browser extension that lets you create web applications that run offline.It lets you store and serve application resources locally, store data locally in a fully-searchable relational database, and run asynchronous JavaScript to improve application responsiveness - to be compared with Adobe AI R
Androi d: a software stack for mobile devices including an operating system, middleware and key applications.
Google App Engine(Google Cloud) - New MEMCACHE & Image APIs available - (see also pricing) - to be compared with Amazon Elastic Compute Cloud (Amazon EC2)
Google AJAX Search API
Google Chart API
Google Data APIs
Google Gadgets API
Google Maps API
OpenSocial OpenSocial defines a common API for social applications across multiple websites.With standard JavaScript and HTML, developers can create apps that access a social network's friends and update feeds.

Identity: OpenID
Authentication + Authorization: OAuth
Applications: OpenSocial - see reference implementation:Apache shindig

Google Web Toolkit *Version 1.5 available with support to Java 5* - The Google Web Toolkit (GWT) is an open source Java software development framework that helps you produce user-friendly AJAX applications. With GWT, you can use your favorite Java development tools to build AJAX applications without having to tackle the steep learning curve of JavaScript/CSS browser quirks. GWT has bee used to develop Google Health
YouTube Data API - Integrate YouTube videos into your website or application.

See other blo g on this topic

Keynote: Imagination, Immediacy and Innovation... plus a little glimpse under the hood at Google
      Marissa Mayer, Vice President of Search and User Experience

Google focus on most popular Web Applications on the Web:

EMail
Social Networks
Blogs
News
Search
...

"The simplest design is probably the best"

e.g. in Google Search, everytime a search query is done, it hits between 700-1000 Google servers. This involves load balancers, mixers, several search engines (image, blogs, books, news, videos, maps ...). The whole process takes 0.16 seconds. However the GUI still hides the complexity of the process and remains very simple. E.g. Use an unified logging/authentication/authorization system (eg. OAut h)

On User Usability

a lot of studies are done regularly with a lot of statistics gathered on very small changes on Google Applications. e.g. small changes such as the space between lines e.g. testing various background colors
performance remains one of the most important criteria for users
user want instant feedback (e.g. uploaded content should be available right away)
novice users become very quickly experts users (e.g. simple google search page to iGoogle portal).
It is therefore important to not spend too much effort to coach novice users and/or provide too much guidance (this could slow expert users)
experts users are those who will being more revenue
usability studies should target expert users
Google uses a mix of direct user feedbacks (such as emails), existing applications user studies (instrumentation + metrics) and testing new designs changes with controlled panels of

Use an Happiness Matrix for your products to measure user satisfaction
Use Design more as a Science than an Art
Try to think 10 years ahead- Goal: Aim at quantum leap (a good example is the iPhone)
Build on real flexible technologies
Be Scrappy. Revel in constraints. Google works in small groups and create quickly prototypes for testing and try to address very difficult problems that seem impossible to solve.
Imagination is a muscle : Do not hesitate to brain storm about crazy projects with your team even if you do not intend to make a product of it. Try to come up with solutions and mockups (at Google 50% of the product features come from 20% time given to Googlers to work on personal project).
On Google Health: We will never be able to have all the medical record information online, but Google hope to make a difference in this domain too.
On Future Directions for Google Applications and Services

All: Personalization
Search Engines:

search on Phones
search on Graphs
Location based search (GPS will be soon integrated by default in most cars and vehicles)
Take into account previous search to improve future searches.

See other blog on this topic