Bill McDaniel: Navara Software Engineering

We Humans are capable of learning new interfaces fairly quickly. Consider the slight variations in telephone keypads – how long does it take us to dial an unfamiliar telephone?  How difficult is it to use an unfamiliar automated cash machine?  How quickly do we learn the shortcuts for a new mobile phone?  Certainly these examples cite both excellent universally acceptable design practices but also our ability as humans to adapt and learn new designs easily.  More interesting – I propose it takes the average person less time these days to learn an unfamiliar interface than it did 15 years ago, and I attribute this to the fact that we are presented with new interfaces much more frequently now than we ever have been before.

Case in point:  Video game controllers have come a long way in the past 15 years.  Atari’s now-nostalgic one button joystick interface bears no resemblance to Microsoft’sXBox 360 ergonomic controller with it’s astounding 25 buttons.  Every year another new interface is presented, normally around the time that Santa Claus requires his wish list, and the next plastic race car wheel or wireless band instrument is marketed to eager consumers hungry for a new interface to master.

In business software, the same issues occur.  Interfaces grow and change throughout the system life cycle.  With time, all interfaces must adapt to support increased functionality – or just as likely increased marketability!

This prospect was once expensive and cumbersome for mobile software, because of the complexity and unique resources required to develop for these relatively obscure platforms. Navara partners use the Navara Design Center to quickly and visually create and modify interfaces for the most popular mobile platforms, so the interface can easily change as the users’ needs change.  So when the next change comes depend on Navara, and let’s solve the interface puzzle together.

René Zeldenthuis:  Software Developer

De hoeveelheid data neemt steeds maar toe en we willen steeds meer data offline tot onze beschikking. Te denken valt aan het op het mobiele toestel beschikbaar hebben van een postcode database of misschien wel het gehele klantenbestand. Dit heeft automatisch ook tot gevolg dat de hoeveelheid data die wordt overgestuurd groter wordt; dit is eenmalig. Nog interessanter wordt het om de gegevens allemaal actueel te houden en dit op een zo slim mogelijke manier te doen. Het is nu eindelijk zover; alles is doordacht; de specificaties zijn klaar en een compleet nieuw synchronisatieprotocol wordt momenteel geïmplementeerd!

Wat er zo vernieuwend is aan dit nieuwe protocol zijn de volgende vier hoofdbestanddelen:

• Slechts veranderingen worden doorgestuurd. Hierdoor is het niet nodig om bij een wijziging (van bijvoorbeeld één postcode) de gehele database over te sturen. Ook is het niet meer nodig om een referentie van de aanwezige gegevens over te sturen naar de server.
• Bij het verbreken van de verbinding tijdens het synchroniseren kunnen alle gegevens dusver ontvangen toch worden verwerkt; het protocol is geheel ‘restartable’.
• Er wordt gebruik gemaakt van http/https. Hierdoor gaat dit nieuw protocol door de aanwezige proxy servers en deze poorten staan mestal open in de firewall. Verder is het https protocol (dat bijvoorbeeld ook voor telebanking wordt gebruikt) tegenwoordig standaard voor het versturen van gevoelige data.
• De Navara client bilijft altijd verbonden. Indien er gegevens worden ontvangen die relevant zijn voor de client worden deze direct doorgestuurd (push). Ook worden gewijzigde gegevens van de gebruikers direct teruggestuurd. Uiteraard worden deze gegevens opgespaard indien er geen verbinding mogelijk is en deze direct verstuurd zodra dit weer mogelijk is.

Uiteraard is het wel nodig dat er gebruik wordt gemaakt van een nieuwe client en server dit dit protocol kunnen ondersteunen. Dit zal even lastig zijn maar hierdoor wordt Navara nog sneller, veiliger, rubuster en actueler!

In elk software bedrijf waar complexe producten worden ontwikkeld, kom je op een punt dat er een verandering gewenst is om de markt nog beter te kunnen bedienen. Dit kan inhouden dat er nieuwe technologieën op de markt zijn die geïntegreerd moeten worden om toekomstige ontwikkelingen aan te kunnen of nieuwe features implementeren waar de huidige markt op wacht.

Hoe ingewikkelder het product, hoe lastiger het wordt om dit naast het onderhoud en huidige roadmaps in te plannen. Bij dit soort projecten wordt vaak gekeken of er gebruik gemaakt kan worden van tijdelijk extra capaciteit. Mogelijke keuzes zijn dan detachering of outsourcing. In het laatste geval kan er gekozen worden voor nearsourcing, wat inhoudt dat het project geoutsourced wordt maar vaak binnen Europa, in bijvoorbeeld Bulgarije of de Oekraïne.

Nearshoring heeft in ons geval als voordeel dat de ontwikkelaars maar met 1 uur tijdsverschil in een virtueel ontwikkelteam productief kunnen zijn,  het kennis niveau vrij hoog is, Engels op redelijk tot goed niveau is en last but not least er weinig cultuur verschil  is (zeker als je dit vergelijkt met outsourcing naar landen als India).

Het meest uitdagende in een out/nearsourcing project is, naast het project management, kennis overdracht. Hoe maak je duidelijk wat de specificaties van de geplannde taken zijn als je niet ‘face-to-face’ zit. Gelukkig is Oost-Europa maar een paar uur vliegen, dus met meer ingewikkelde specificaties kan het ook echt ‘face-to-face’, maar in de meeste gevallen is het makkelijker om gebruik te maken van hulpmiddelen als GoToMeeting of Skype en een goede projectmanagement methode.

Voor Navara is na onderzoek gekozen voor de projectmanagement methode SCRUM. Door de interactieve manier van werken, in vergelijking met de traditionele software ontwikkeling methodes, is het team enorm betrokken in het planningsproces-

Dit uit zich onder andere in:

• Grooming sessies: feature specificatie rondes voor het definiëren van specifieke features. Op deze manier hoeft de specificatie niet van te voren volledig op papier te staan en kan het gehele team meedenken over de specificatie.
• Sprints: duidelijke, korte implementatie periodes.
• Burndown Chart: duidelijk beeld over de huidige stand van voortgang.
• Backlog: overzicht van alle items die ingepland staan voor het project voorzien van heldere prioriteiten.
• Task Breakdown: Features opgesplitst in taken van 1 tot 2 dagen die zelf door een ontwikkelaar binnen een Sprint opgepakt kunnen worden.
• Daily Standup Meetings: Elke dag een korte meeting met het gehele team (vaak niet groter dan 5 tot 6 mensen) waarbij de vragen, ‘Wat is er gedaan sinds de laatste meeting?’, ‘Zijn er problemen met de taken?’, ‘Wat staat er op de planning tot de volgende meeting?’.

We zijn nu een jaar bezig, en de keuze voor nearsourcing en de SCRUM methode Blijkt een hele goede te zijn. Wij zijn uitermate tevreden.

Over SCRUM

SAP.  No three letters command such a wide range of emotion in the enterprise.  Well, in the late 90’s perhaps CRM came close.  Large-scale enterprise-wide systems are incredibly complex.  It’s a major investment not only financially but emotionally.  For those who have lived through an SAP implementation, the aftermath is varied:  Some are delighted, some frustrated, and everyone can agree that it’s a long, long road.

As far as installations go, SAP may be one of the most costly and complex systems in the world.  Multi-year installations are common.  SAP is so complex that many consulting businesses focus exclusively on the system.  Teams of dozens of engineers and analysts working around the clock and around the globe provide customization and integration services while project managers attempt to keep their schedules on track.  As with any long-term systems project, extensions are also common – and therefore frustration and confusion are common as well.

The roller coaster ride of emotions is understandable.  SAP often replaces many home-grown systems and affects the very heart of every business that adopts it.  Often a complete overhaul of the core systems that control every unique aspect of a business are collaborated into one system for the whole of the business. This big of a change does not come without stress for those who will use it.

Specialized Solutions

With such a wide range of customizations available, SAP can be considered a blank canvas.  This is fantastic for allowing a customer the ability to design their dream-system; and a nightmare for those who could use a little suggestion.  Of course, infinite customization takes (infinite) time and money – and when some specific system needs are identified, it can take an extremely long time and a large amount of resources to implement them.  For some businesses, searching for a third-party to provide additional specialized functionality has proven to be a great decision.

Both the strength and the weakness of wide-scope systems like SAP is in its flexibility and complexity.  Wide-scope systems are so flexible that they introduce a high level of complexity.  Enter third-party solutions which provide very specialized functionality, such as Mobility in a relatively simple product.  These solutions focus on a much more narrow set of functionality and work in conjunction with many different types of large-scale systems such as SAP.  Because they are so narrow in focus, these specialized solutions can provide increased functional and technical capabilities without increased complexity.  Over the course of the systems life cycle, the benefits of using a specialized solution increase even more as change control and enhancements are much easier and quicker to implement than with a more complex wide-scale system. The flexibility: complexity relationship changes dramatically and the customer gets the best of both worlds – a capable solution that is quick to implement and change.

Increased Functionality without Complexity

By using third-party products for specialized functionality, suddenly we don’t need teams of dozens of people.  We don’t need years to develop and implement.  By focusing on one specific functional need, specialized third-party solutions eliminate much of the complexity that would be required to configure a wide-scale system to perform the same tasks.  The resources required to use a specialized product are drastically reduced which translates into a quicker and greater ROI, and much less stress for everyone.

Hardware manufacturers have been keen to find the next evolution beyond the phone and PDA. It’s ironic that it took Apple’s iPhone to renew interest in a segment that was hyped as far back as 2004 by Bill Gates who famously evangelized the platform. You might recall a variety of hardware partners such as HP and Toshiba launching tablet PCs. Unfortunately, reception was lukewarm at best due. Whether it was due to an OS that wasn’t optimized for tablets or the high prices, the segment never took off. Today, it’s a different story.

The rumor mill is abuzz about Apple coming out with their own tablet and each day there are more fantastic rumors which are creating such a frenzy that mainstream media has picked up on them. The iPad / iTablet is joining the ranks of the Lock Ness Monster and Bigfoot.

Whereas in 2004 Bill Gates had to educate and promote the tablet concept, five years later, people are fascinated with the platform and its potential. Let’s take a collective deep breath however and get past the quest for gadget nirvana. What is the use case for a tablet beyond?

Where the Smartphone or PDA is the digital equivalent of a Post-it note, the tablet replaces the paper-forms of a field-worker. Big enough to show relevant information in a convenient lay-out; mobile enough to carry around.

Important questions of course are how the devices will deal with Battery life, connectivity, if they offer instant–on, cost, etc… If this all is better than the Phones that we currently use, tablets might have a future. It is good to know that Navara not only works on all important PDA platforms, it also runs on tablets.

My Mobile Work Order will bring your office into the 21st century. Powered by Navara, the leader in mobilized workflow solutions, it is now possible eliminate paper work orders by having them delivered electronically to your employees on their PDA or Smartphone*.
 
It couldn’t be easier. Your work orders are created at the My Mobile Work Order website and transmitted wirelessly to your employees where they are completed on their mobile device. You simply check the website for the status of the work orders. No expensive back-office system, no paper trail, no hassles. It’s that easy! See how it works:

Navara's stand on 60+ tradeshow

This trade show is aimed at people in care for the elderly people. All kinds of companies working in that area are exhibiting on the show:  from Miele Professional to Industrial Clothing.  It is amazing to observe that the attandance of the IT companies was very law.  IT solutions, like the portable EMR, Ambulance Solutions and many others are a necessity for each organization in the industry to save time on administrative processes and focus on care.

The visitors of EXPO60+ are foremost interested in finding new possibilities and benefits for the healthcare sector.

For more information about mobility solutions in healthcare visit www.navara.com

De bezoekers zijn op zoek naar een softwarematige oplossing die voorziet in rapportage, tijdregistratie, informatievoorziening over contactpersonen en medicijn gebruik van de cliënten, kostenbeheersing maar ook persoonsbeveiliging.

Gedurende de dag waren er verschillende sprekers die diverse onderwerpen aansneden als kosten beheersing, efficiëntie, kwaliteitsverbetering en aanbestedingen.

Stephan van Pol, manager ICT van Vitalis zorggroep, sprak namens Unit4Agresso over hoe over te gaan van papieren registratie naar digitale registratie van tijd en zorg.

Met Cura Mobile van Unit 4 Agresso kunnen zorgverleners via een PDA real time direct van de gegevens van zorg- en behandel type registreren. Zie hoe het werkt!

Op deze dag presenteert Unit4Agresso hun product Unit4Cura Mobile, een zorgapplicatie wat ontwikkeld is met behulp van de Navara Software.

Deze mobiele zorg toepassing helpt namelijk zorgverleners hun zorgtaken efficiënter uit te voeren door direct toegang te bieden tot belangrijke gegevens uit het dossier van de patiënt. Daarnaast wordt de benodigde tijd voor een bepaalde zorgtaak nauwkeurig bijgehouden. Metname voor de facturatie naar alle verschillende financiers in de zorg zoals zorgkantoren betekent dit een enorme vooruitgang. 

Landelijke Thuiszorgdag Programma:

http://www.sbo.nl/congressen/10e-landelijke-thuiszorgdag/programma

Meer informatie over Unit4Cura mobiele toepassing: 

http://tinylink.com/?CqWrAly3wn

With the transition to electronic health records mandated by the US government, healthcare providers must invest heftily to make the switch. Including a mobility solution can turn a big EHR investment into an even bigger return.

American Recovery and Reinvestment Act of 2009

According to the recent PricewaterhouseCoopers US report “Rock and a Hard Place: An analysis of the $36 billion impact from Health IT stimulus funding,” ARRA includes the goal of modernizing healthcare and reducing long-term costs through the use of information technology. Despite these well-intentioned ambitions, many healthcare organizations will likely find difficulty in coming up with the necessary funding to purchase EHR systems, comply with the government standards and make sure their system works well with others. Overall, the Act will have the most benefit for organizations with EHR systems already in place because theirs will be closer to the “interoperablility standards,” thereby receiving the most funding.

As the title of the PricewaterhouseCoopers report suggests, the plan sets aside a $36 billion stimulus package for early adopters of the government-certified systems and it has admirable objectives. President Barack Obama stated in his joint address to Congress this year, “Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down cost, ensure privacy and save lives.” In order to put the plan in motion, the HITECH Act pushes physicians to adopt an EHR system by offering incentive payments to those who do and later reducing Medicare payments to those who do not.

Yet even with the benefit of stimulus incentives, most healthcare organizations will find for the short-term, they are on the losing end of the equation. Government funding will not immediately offset the cost of implementing the system. However, one good – or better – piece of news hails from the IT mobility sector. Experts in IT mobility suggest that adding mobility solutions to existing and new EHR systems can make the difference in showing return on investment sooner rather than later. The trick is to locate a mobility solution that is efficient and cost-effective to implement.

“Implementing an electronic health records system is just the first step,” according to Yves Neidlinger, National Channel Manager for Navara, an international company specializing in middleware mobility solutions. “Providing users with patient information regardless of their location or type of device is another. No wonder most EHR providers are already looking for technologies to mobilize their applications.”

Despite the fact that using an EHR can reduce errors and make access to shared information easier, healthcare providers cite funding as an obstacle to implementing a new system. The ARRA provides funds to healthcare providers that implement a government-certified EHR system because in order to make EHRs the most beneficial to the US healthcare system overall, most healthcare organizations would need to be using these interoperable systems. Obviously, the switch across the sector cannot occur overnight.

When the Office of the National Coordinator for Health Information (ONC) surveyed healthcare providers who had already implemented an EHR system, the findings showed that initially gains in efficiency were limited by a slowdown during the implementation of the system. Additionally, funds and time were required to train staff and maintain the system. The survey showed that overall, providers did not receive financial benefit from instigating an EHR system. Financial benefits have a better chance of occurring among large healthcare institutions. Nonetheless, these systems do bring healthcare to a better level. “Limiting or getting rid of paper forms and documents generates a huge move toward efficiency,” says Elias Crum, Navara Vice President. “It saves on paper, people, expensive transposition and typographical errors.”

Government Incentives Will Not Cover Costs of EHR Implementation

While there is no question whether EHR systems will lead to big gains for the US healthcare system overall, the PricewaterhouseCoopers US report explains that the incentives won’t actually cover the costs of implementing the system. Still, with Medicare reimbursement penalties for those who do not comply and a deadline of 2015, healthcare providers don’t have much choice other than to get on the IT ball.

Unfortunately, PricewaterhouseCoopers says that the stimulus finding for health IT is a “small carrot” compared to the amount of resources it will take to get the technology up and running in time. Providers who do not use government-certified EHRs by 2015 will face penalties.

PricewaterhouseCoopers’ analysis shows that the stimulus incentives to comply with the new requirements for setting up and maintaining EHRs do not come near to compensating the overall costs. When added to the possibility of future penalties from reduced Medicare reimbursement, the situation becomes more extreme. Medicare penalties will begin in 2015 and be fully implemented by 2017.

Physicians can receive up to $44,000 each for adopting certified EHR systems, but their overall costs will exceed these incentives. PricewaterhouseCoopers estimates a total cost range for a three-physician practice at $173,750 to $296,000. Considering the hefty upfront investment of implementing an EHR system, adding a mobility solution from a middleware provider can make the expense more cost-effective in the long run, but also bring faster benefits in the short term.

Mobility Solutions Add Efficiency and Financial Benefit to EHR System

“Not only do healthcare providers want access to real-time data anytime from anywhere, but they also want the additional subsidies from the US government for doing it,” says Neidlinger. An EHR solution alone can reduce administration costs by up to 50 percent, but taking that EHR mobile allows multiple providers to quickly and easily access the records. This greatly increases the return on investment.

“If a doctor accesses a patient record from a PC, that’s a certain dollar savings,” says Neidlinger. “If the doctor gets that same information from an iPhone or Windows Mobile Device, that’s an additional savings.” Working with a middleware product like the Navara Mobility Suite allows the EHR system to become mobile with virtually no development time because the applications have already been created and are continuously updated to work with new software and hardware. Mobility makes the upfront cost of implementing an EHR system, a move toward both time and cost efficiency.

Navara’s Leading Mobility Technology

Rather than a healthcare software provider creating a mobility solution from scratch, working with a middleware mobility provider can make adding the technology simple and fast. While it could take many months and thousands of dollars for a software company to write new code, and plenty of man-hours to keep that code updated, Navara’s mobility solutions are easy to implement because they are already created and are updated continuously. Navara provides middleware solutions that can easily mobilize any EHR systems onto handheld devices. Since Navara’s solutions work with any Smartphone like BlackBerry or iPhone, integration requires no changes to existing applications. With a Navara mobility solution, ISV and OEM partners can avoid timely and costly software development. Navara’s ease of customization means the middleware product is invisible to the end user – the healthcare providers who are spending time and money implementing the costly EHR systems. Navara stands out in the mobile application development arena through its uncommonly easy to deploy technology platform. “Overall there is a trend to mobilize applications in order to work more efficiently, thereby saving time and money,” said Neidlinger. “Navara offers a platform to software manufacturers that helps them develop a mobile extension of their product very easily.”

Navara’s Mobility Suite provides a low cost, high performance platform to extend the reach of applications to mobile workers. Navara can implement a mobile version of almost any application for a fraction of the cost of traditional development. Even better, the new mobile interface can be operational within a matter of hours.

Navara’s mission is to support all major mobile devices and integration technologies. Through constant development, Navara is able to support the latest mobile devices, operating systems, networks and hardware. This commitment ensures that Navara’s partners will continue to be able to offer the best mobile solutions to their customers through the lifecycle of their mobile interface product. Navara has yet to find a software application with which its mobility solution does not work.

Navara Helps Allscripts Clients Generate Immediate Response from Healthcare Providers

Navara recently presented a middleware package to Allscripts that allowed the healthcare software company to offer its clients enormous savings in response time. By using the OEM package from Navara, Allscripts was able to quickly make their Referral Management solution available via Smartphone or BlackBerry, which translates into immediate response time between post-acute healthcare providers and the hospitals they serve. Because they used Navara’s existing toolkit, Allscripts avoided the need to develop a mobile version of their own, which would have been a time-consuming and costly effort.

“The benefit really is to the customers I am serving,” said Greg Thurau, Vice President Product Management of Allscripts. “Using a Smartphone, post-acute care providers can receive and review electronic hospital referrals and respond back to the hospital right away.” Since the response time is shortened, the hospital is able to discharge the patient more quickly, leading to an improved relationship between the extended care provider and the hospital as well as efficiencies in the patient’s transition from one level of healthcare to the next. Improved efficiency and better patient care are exactly what the HITECH Act was intended to promote.

Navara’s products help independent software vendors in healthcare IT mobilize their existing solutions either through OEM solutions or standard products.

At this year’s Healthcare Information and Management Systems Conference (HIMSS), Neidlinger noticed a trend toward mobility in every aspect of technology in healthcare. “Walking the show floor, I started to notice that increasingly healthcare is becoming mobile,” he said. “Virtually all of the vendors either had a mobile offering or were in the process of planning one. For some companies this meant having mobile tablets that doctors can carry around, while for others it means having access to patient information on a BlackBerrry or iPhone.”

Mobility Solutions Make Vital Step Forward in Future of US Healthcare IT

When considering the EHR options, healthcare organizations are left with little choice but to comply within the next six years. As providers make the sizable investment in an EHR system, they will want to receive all of the benefits possible. By adding a mobility solution upfront, providers can immediately begin to see even more increased efficiency and return on investment. Tapping into the government incentives and avoiding the loss of Medicare benefits are just the beginning of what healthcare IT has to offer providers and patients. Implementing a mobility solution and get providers on a much faster road to HIT success.

Navara stands out in the mobile application development space through its uncommonly easy to deploy technology platform. Founded in 1998, Navara has office throughout The Netherlands, the United States, Germany and Belgium. Navara is a division of RAM Mobile Data. Navara can be reached by calling +1 866-759-5794. Additional information is available at www.navara.com.