The Itinerant Engineer

Personally-controlled health records (PCHRs) have great potential. Today, a patient’s “medical record” is actually a fragmented set of charts, discharge records, prescriptions, and more, sharded across the numerous places the patient has received treatment during his lifetime.

PCHRs increase record portability by (1) standardizing the way medical data is stored, and (2) putting it all in one place. Centralization comes with the additional benefit that the patient has full control over who can access his records.

Of course, centralization begets the question of who stores the records. Google, Microsoft, and Dossia are vying for pole position, with three different approaches to the storage and retrieval of health data.

This post recounts my experience getting started with HealthVault, Microsoft’s offering.

About me

I’m pretty average as software developers go: mid-twenties, primary computer is a Mac. I use git for revision control, unfuddle for project tracking, and mostly develop in Rails. I’ve been a professional developer for 3-4 years.
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In technical circles, it’s well known that the smartest people cluster in Silicon Valley. The excellent, the prodigious, the well-off, and the well-educated head to Silicon Valley to find their tribe.

The rate of information exchange in a place like Silicon Valley can be hard for outsiders to fathom. On a recent trip, I serendipitously ran into a Berkeley Ph.D. while waiting for the Caltrain. After a few minutes of conversation, we discovered that he’d known my academic adviser while the two were students at Berkeley. We got into a lengthy, and fascinating, discussion of database semantics which continued on the train, all the way from San Jose to San Francisco. I can’t imagine this kind of thing happens routinely in many other places.

However, Silicon Valley’s hyper-connected, homogeneous population breeds the worst kind of groupthink. So many smart people clustered together, and the best business ideas they can come up with is to make iPhone games? Foursquare just made waves by passing the 2-million-user mark, but let’s not forget, that’s less than 1% of the US population. Adrian Holovaty’s remark a while ago on Signal vs. Noise caught my attention:

Another big plus for working from a non-web-2.0-echo-chamber city is the diversity of people and professions. My friends here in Chicago are furniture makers, architecture students, journalists, professional musicians, philanthropists, cops, lawyers.

While I’d agree that it’d be a great motivator to live in a place saturated with other Web developers, it’s also helpful, from a product focus standpoint, to be around people who don’t know what the f—k RSS is.