How to demo software

Joel Spolksy, geek god, tells us what he learned about demoing software -- after a world wide software demo.

How to demo software - Joel on Software:

...It’s already all a blur. 26 cities. 6 weeks. 2913 attendees. $160,000. 23 hotels, one Cambridge college, one British library, and a “Sociëteit Het Meisjeshuis.” (“Gesundheit!”)...

Stuff like this is like finding diamonds scattered on the front lawn.

It's hard to remember there was a time this sort of thing wasn't freely available.

America, the richest third world nation

Twenty six years ago I watched a long line of children and teens waiting for dental care. This was in the north of Thailand.

The dentists pulled bad teeth, one after the other. I don't recall any anesthesia, there wasn't time for much.

I think one of the children cried, and I recall a sense of disapproval from his peers.

It was a long time ago.

Things have changed since then. Now we have those lines in America ...

Health and Medicine - Insurance - Health and Managed Care - Doctors - New York Times

... The group, most often referred to as RAM, has sent health expeditions to countries like Guyana, India, Tanzania and Haiti, but increasingly its work is in the United States, where 47 million people — more than 15 percent of the population — live without health insurance. Residents of remote rural areas are less likely than their urban and suburban counterparts to have health insurance and more likely to be in fair or poor health...

And so each summer, shortly after the Virginia-Kentucky District Fair and Horse Show wraps up at the fairgrounds, members of Virginia Lions Clubs start bleaching the premises, readying them for RAM’s volunteers, who, working in animal stalls and beneath makeshift tents, provide everything from teeth cleaning and free eyeglasses to radiology and minor surgery. The problem, says RAM’s founder, Stan Brock, is always in the numbers, with the patients’ needs far outstripping what his team can supply. In Wise County, when the sun rose and the fairground gates opened at 5:30 on Friday morning, more than 800 people already were waiting in line. Over the next three days, some 2,500 patients would receive care, but at least several hundred, Brock estimates, would be turned away. He adds: “There comes a point where the doctors say: ‘Hey, I gotta go. It’s Sunday evening, and I have to go to work tomorrow.’...

Dental care is particularly in demand.

Comet Holmes - it's quite simple

This isn't unusual.

Comet Holmes and the case of the Disappearing Tail | The Register

"Amateur astronomers the world over have been stunned and amazed by the weirdest new object to appear in the sky in memory," wrote Sky and Telescope .

"The comet shocked skywatchers as it went from a dim 17th magnitude then suddenly to 3 magnitude" wrote Theo from the Pacific Northwest.*

Zorgonian battle cruisers always do that on approach to the target system.

Consumers Union Toy Safety campaign: sign up now

Via TMW I've learned that Consumers Union has an advocacy campaign for toy safety. They want inspections funded and they want a real inspection program.

Of course I signed up immediately. They generate email to senators and file names.

Kmart's lead jewelry was the most recent episode I've commented on. It's only one of many such.

Highly recommended, though of course what we really need is to get the GOP out of the government.

Be sure to use your spam email (for me that's a Yahoo account). I don't trust CU not to spam me.

Next they can tackle generic drug quality. Our son uses a medication which recently came to use with an unusual scent and a somewhat different appearance. It's produced by a Spanish chemical/pharmaceutical vendor that obtains products from "Asia" (meaning China).

We're not giving him any more until we check this out.

I remember a time when it would never have occurred to us to worry.

Sign the toy petition. Mostly, though, don't forget we need a different government.

The hidden insurance problem: they can play the game better than we can

Last week I wrote that it is impossible for a sane human to truly judge the value of employment benefits, particularly health care benefits.

That complexity is not accidental. Complexity facilitates deception. The consumer can't really price the product, but the vendor can. A product that seems to offer good consumer value may be a trap.

It's a huge competitive advantage. Companies that don't leverage it will disappear, until finally it's the only way to play the game.

Bob Herbert provides a great example of the game in action:

It’s Not Just the Uninsured - Bob Herbert - New York Times:

...The next round of bad news came in a double dose. One night, after coming home from school, Brittney suddenly found that she couldn’t walk. The cancer had attacked her spinal cord. As the doctors geared up to treat this new disaster, Ms. Hightower received word that her insurance policy had maxed out. The company would not pay for any further treatment.

Ms. Hightower was aghast: “I said, ‘What do you mean? It was supposed to be a $3 million policy.’ ”

She hadn’t understood that there was an annual limit of $75,000 on benefits. “It was just devastating when they told me that,” she said.

Most of the debate about access to health care has centered on people without insurance. But there are cases like this one all over the country in which individuals are working and paying for coverage that, perversely, kicks out when a devastating illness kicks in...

Few consumers would knowingly purchase an insurance policy with a $75K yearly cap, but that cap can make the coverage very profitable.

The best way out of this trap is to create offerings that apply across a state or region, and make the available to all persons in the region. This allows newspapers, consumer organizations, and government to analyze plans and expose deception. The next best option is to create standard care scenarios and require insurers to describe how their plans would operate under the scenarios.

Lastly, we could make insurance companies liable when a "reasonable person" would be unable to understand the true costs and benefits ofa given plan.

There are lots of ways we could make things better - even without reforming the health care system.

A year from now, we might even hope that some of them might become law.

The best pro-Hillary argument

The best argument for Hilary:

Hillary Fries the Waffle - Gail Collins - New York Times:

...All these people believe pretty much the same thing, and when it’s time to take on the Republicans, I would prefer the candidate who knows how to change the subject and stack the deck."...

The best argument against: Bush-Clinton-Bush-Clinton.

Krugman on social security: I think he's wrong

Well, it's not that he's wrong by the numbers, it's that he's being politic.

I think he's right when he says the GOP attacks on social security are ideologically motivated and deceptive, and I agree that Obama has shown he's not ready to be president by falling for that ploy.

On the other hand, he's being tricksy when he deemphasizes the (small) rationalist part of the GOP attack on social security.

First Paul's blog post today, with emphases mine:

Long-run budget math - Paul Krugman - Op-Ed Columnist - New York Times Blog

... Start with the current position. Last year, federal spending on Social Security, Medicare, and Medicaid was 8.5 percent of GDP, equally divided between Social Security and the health care programs. Dismal long-run projections, like those of the GAO, have this total rising by 10 percentage points of GDP by mid-century.

So, how much of this is a Social Security problem? Pundits like Tim Russert love to point out that in its early days Social Security had 16 workers paying in for every retiree receiving benefits. But this is irrelevant; looking forward, we’ll see the worker-beneficiary ratio fall from about 3 to 2 as the baby boomers retire. This will raise the percentage of GDP spent on Social Security from about 4 to 6 — that is, a rise of about 2 percentage points of GDP, which is a small fraction of the entitlements problem. See, for example, this chart from my NY Review of Books piece on the subject.

What’s more, Social Security has already been strengthened to deal with this rise. In 1983 the payroll tax was increased and adjustments made to the retirement age, so as to build up a trust fund. According to the “intermediate” projection of the Social Security trustees, this trust fund will be exhausted in 2041 — but they also present a more optimistic scenario, based on economic assumptions that don’t seem at all outlandish, in which the trust fund goes on forever.

This brings us to the claim that the trust fund doesn’t exist, because it’s invested in government bonds. The full explanation of why this is sophistry is here.

I followed Paul's link. These are his words from that document (emphases mine):

...The lesser problem is that if you say that there is no link between the payroll tax and future Social Security benefits - which is what denying the reality of the trust fund amounts to - then Greenspan and company pulled a fast one back in the 1980s: they sold a regressive tax switch, raising taxes on workers while cutting them on the wealthy, on false pretenses. More broadly, we're breaking a major promise if we now, after 20 years of high payroll taxes to pay for Social Security's future, declare that it was all a little joke on the public.

The bigger problem for those who want to see a crisis in Social Security's future is this: if Social Security is just part of the federal budget, with no budget or trust fund of its own, then, well, it's just part of the federal budget: there can't be a Social Security crisis. All you can have is a general budget crisis. Rising Social Security benefit payments might be one reason for that crisis, but it's hard to make the case that it will be central.

So, is it plausible that Greenspan & Co pulled a fast one in 1980, and that our government can break a major promise?

Cough.

Of course it's plausible.

That's where Paul is being politic. I respect him for that - there's no alternative in today's world.

Still, by his own words, it's only if you assume an honest and responsible government that we face a health care funding crisis; if you assume a corrupt, stupid and sleazy government, one only half as bad as our current regime, we do face a general budget crisis.

We can attack that crisis by defunding social security (the GOP plan, though motivated more by ideology than budgetary sanity), or by limiting what we spend on health care (a rational alternative, or by inventing a new, vastly cheaper, health care system (the optimists proposal).

Or, we could slow the progression of the physiologic Alzheimer's process by 10%. That would enable delayed retirement and it would substantially reduce future health care costs. It would resolve our pending financial crisis.

Anyone for investing in Alzheimer's disease research?

How bad a recession?

I read the Economist yesterday.

It's like seeing an old friend that's been hitting the sauce hard. When I left her she still had some of the old style, but now she's a gutter drunk - a slightly less stupid reflection of the WSJ's editorial pages.

She still has some of her old habits though. She's again projecting a US recession, though hoping China will save the rest of the world.

The Economist has called about ten of the last three recessions, so I pay more attention to DeLong, Krugman, and the Econbrowser. Thing is, they tend to agree that a recession is probably underway.

So then the question is how deep will it be.

I'm not an economist, so I don't have to worry anyone will act on my speculations. I'm also a "glass half empty and poisoned besides" [1] kind of guy, so I do tend to over call these things. (A bit like the old Economist, which also had a strong pessimistic streak [2].)

I think the severity range is probably wider than what we were accustomed to under Clinton or even Bush I. During those days (more with Clinton) we had governments that actually worried about national finances. With Bush II our economics is pretty much supply-side loony.

If government policies matter, then there's a good chance we're far outside a stable operational range. If the physics of economics matter, we have farther to fall.

So I'm pessimistic [2]. Of course, I always am!

[1] If the glass is poisoned, then being half-empty may result in a painful but non-lethal dose. So you see, I'm really an optimist in deep disguise.

[2] I follow the neuropsych literature on pessimism. It turns out that humans are programmed for irrational optimism -- probably because it's good for the species even if it leads to unwise individual actions (like launching a startup). So, if one adjusts for the human bias towards irrational optimism, I'm truly a rational realist.

Kmart's lead jewelry - slow learners

Kmart's low priced jewelry turns out to have a lot of lead in it, even the pieces labeled lead free. It's safe to assume they're manufactured in China, since everything is.

No great surprise, but they handled it surprisingly badly (emphases mine)...

Kmart Items Marked Safe Had Lead - New York Times

... Ms. Johnson took the [lead detection] machine home to practice using it. On a whim, she aimed it at her daughter’s new earrings. Every part of the “lead free” jewelry contained lead, she said. One piece, a metal charm hanging from a necklace, contained 520,000 parts per million of lead. By comparison, the Consumer Product Safety Commission is considering a ban on children’s jewelry with concentrations of lead higher than 600 parts per million, said Scott Wolfson, a spokesman for the commission.

“As a mother, it really frightens me that there’s something that looks completely benign that could kill my child,” Ms. Johnson said.

She said she complained to Kmart a month ago but received no response. She also filed a complaint with the safety commission. Ms. Johnson has not yet received any word from the commission, which does not comment on specific complaints.

“If we were to find a product with 52 percent total lead, it would be recalled immediately,” Mr. Wolfson said. “That would be a dangerous product for children.”

The jewelry is marketed to adults and is not intended for children, Mr. Brathwaite said in his statement. Kmart declined to disclose which companies make or supply the Accessories line.

Kmart must be taking stupid pills. They should have come up with a much smarter response.

Epocrates for the iPhone

Epocrates is a must-have product for many physicians. It started out on Palm and moved to Microsoft's PDA platform (whatever they call it today), but the first is dying and the second deserves to die.

There's a Blackberry solution I believe, but the BB is very corporate. It's not very interesting if you don't use an Exchange server.

That leaves ... yes ... the iPhone.

Epocrates sent this out today. Clearly they want to be there...

Epocrates Supporter,

Thank you for your interest in using Epocrates software on the iPhone.

We are pleased to inform you that our free online drug reference has now been optimized for the iPhone and iPod touch. Simply point your Safari browser to http://m.epocrates.com/iphone.

Please note that we are eagerly awaiting the Software Development Kit (SDK) that Apple recently announced will be available in early 2008 to provide you with iPhone software that can be downloaded to your device.

Sign up through our Support Center to receive updates as we strive to better serve iPhone customers.

Eagerly is probably an understatement. If Apple really does deliver on their vague SDK promises, there will be a tsunami of medical applications developed for the iPhone.

BTW, I think they will deliver.

PS. I think they used to spell it ePocrates. Looks like they changed.

Come the clones

I used to think that one good feature of the religious right was that they might slow the day we harvest clones for organs.

Then came the eugenics revolution and the end of Downs syndrome. Emily is convinced there's a causal relationship between the rise of 21st century eugenics and the collapse of the GOP's anti-abortion movement. (Oh, you didn't notice it had collapsed? It has.)

Next came the American embrace of torture. At least 50% of Americans, in most polls, are just fine with torture.

Now this:

Monkey Embryos Cloned for Stem Cells - washingtonpost.com

...Researchers in Oregon reported yesterday that they had created the world's first fully formed, cloned monkey embryos and harvested batches of stem cells from them...

If it works in monkeys it will work in us.

So now we have our stem cell source. Next up will be to let the clone produce differentiated tissues that we have a use for. Then it will be early organs.

I knew I'd miss the religious right.

Global warming in Minnesota: no more outdoor ice rinks

Global warming is not a theory in Minnesota, and in the Twin Cities in particular. Last year there was almost no cross country skiing anywhere in the state, and there were only a few weeks of outdoor ice. This winter looks no better for outdoor skating.  Emphases mine.

Old Man Winter getting a little wimpy

... This winter will likely be warmer-than-normal again across most of Minnesota, according to a forecast released Thursday. And if trends continue, it will be winter nights where warming could be most pronounced.

Twin Cities winter lows, averaged over the most recent 30 years, have increased 1.6 and 2.0 degrees over the official normals. It's an increase that University of Minnesota Extension climatologist and meteorologist Mark Seeley called "emphatic."

He noted that the dynamic is right in line with what most global warming science has outlined. Warming should be most obvious in northern latitudes on winter nights because heat is more effectively trapped by greenhouse gases during long sunless hours than it is during the more volatile days of summer.

Also, Seeley said, recent studies have indicated that a warmer atmosphere, which has more heat-trapping water vapor, may be generating more heat-trapping clouds.

While more moisture may also result in more snow, National Weather Service meteorologist Karen Trammell added that warmer conditions can also mean less continual snow cover, which allows the ground to absorb more radiation.

The Twin Cities, of course, ought to be getting warmer overall as heat-absorbing pavement spreads outward. But the numbers also show that winter temperatures across the entire state have been on a nearly steady and steep upward trend for about 20 years, with seasonal averages since 1998 running above anything in the 106-year record....

The nights are what make the ice rinks work -- or become puddle pools. Warmer nights means no more outdoor hockey.

Our mayor is working to put up some rinks with coolers -- we only need a 2-4 degree drop at night to get the ice to work. Life in MN without ice skating and hockey is significantly less fun.

The only bright note is we're entering La Nina season, so we might get some snow cover up north.

We need a web page of unit conversion disasters

Someone needs to put together a web page of metric/english unit conversion disasters. This was only one of many:

Damn Interesting » The Gimli Glider

...Pearson and Quintal had determined the fuel weight by multiplying the the number of dripsticked liters by 1.77, as indicated by the documentation. However, unbeknownst to the pilots and the fuel crew, this multiplier provided the weight in imperial pounds; the new, all-metric 767 was based on kilograms, and required a multiplier of 0.8. As a consequence of this documentation disconnect, Flight 143 had left Montreal with roughly half the necessary fuel...

Halamka's Health Care CIO Blog: essential reading

John Halamka has just launched a personal blog: Life as a Healthcare CIO. Here's his bio:

John D. Halamka, MD, MS, is Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.

The "practicing emergency physician" part is where he passes the bounds of reality. (I gave up the practice part years ago.) Just when you think you've met the most hyper-manic person possible, another one comes along.

Now he has a blog. God knows how long it can possibly last. Even he must have some limits, though it is possible he's a visitor from the post-Singular future.

So is the blog any good? Maybe it's just marketing material?

Um, no.

It's not good. It's really, really, good.

I'm going to call out a recent post on email and then reference a few more. Emphases and [inline comments] are mine. Note he uses a BB [1]:

...I receive over 600 email messages each day (with virtually no Spam, so they are all legitimate) and respond to most via Blackberry. How do I triage 600 messages? I use these 10 rules to mentally score each email:

1. E-mail marked with a “high importance” exclamation point must pass the “cry wolf” test. Is the sender a habitual “high importance” e-mailer? Are these e-mails actually important? If not, the sender's emails lose points.
[I use "low importance" markers much more often than "high importance".]

2. I give points to high-priority people: my senior management, my direct reports, my family members and my key customers. [I use an Outlook rule that assigns email a colored flag based on similar criteria]

3. I do the same for high-priority subjects: critical staff issues, health issues and major financial issues.
[Halamka is using a BB, I don't think he emphasizes clear subject lines enough. The subject line should describe the topic, justify the email, and (if applicable) state the action requested.]

4. I rate email based on the contents of the “To,” “cc” and “bcc” fields. If I am the only person in the To field, the e-mail gets points. If I am in the To field with a dozen other people, it’s neutral. If I'm only cc’d, it loses points. A bcc loses a lot of points, since I believe email should always be transparent. E-mail should not be used as a weapon.
[Only BCC yourself. Never BCC anyone else. When you want to BCC use Forward a copy instead. My Outlook flagging rules put any email where I'm not on the To Line into a "read later" bin.]

6. I downgrade email messages longer than five BlackBerry screens. Issues that complex require a phone call.
[Most BB users won't tolerate more than two screens. Halamka is unusual. I aim to keep my emails under 500 vertical pixels in Outlook, and the first two lines are for BB users: they contain the key information. The rest is reference and it's minimal. Longer stuff is a blog post.]

7. Email responses that say only “Thanks,” “OK” or “Have a nice day” are social pleasantries that I appreciate, but move to the bottom of my queue.
[He's being polite.]

8. Email with colorful backgrounds, embedded graphics or mixed font sizes lose points.
[I like to use indentation to structure my email. I need to see how that renders on a BB.]

9. I separate email into three categories - that which is just informational (an FYI), that which requires a short response and that which requires a lengthy, thoughtful response. I leave the lengthy responses to the end of the day.
[I put the words FYI in the title and I set message priority to "low".]

10. More than 3 emails about a topic requires a phone call or meeting. Trying to resolve complex issues via and endless ping pong of emails is inappropriate...
[Definitely.]

Some other essential-reading Halamka topics include:

• Data, Information, Knowledge, and Wisdom: everyone should build HCIT systems this way
• My Gadgets: Ubuntu Dell (!!) and an iMac. He's a geek. Note he travels 400,000 miles a year. He's waiting for his Apple subnotebook. I knew he had to be a Mac guy.
• The Tyranny of the Urgent: 50% of his time is not spent on crisis management.
  • "I spend 50% of my day on email, phone calls and the tyranny of the urgent, but reserve 50% of each day for those projects which will create revolutionary change three years from now. To do so requires two kinds of plans".
• The Dark Side of Going Public: Stay private if you can.
• The Unfriendly Skies - Videoconferencing: 400K travel -> his tricks. "PolyCom seems to really have a business quality desktop teleconferencing solution that enables me to connect with collaborators using H323 protocols"
• Bar codes, RFID, and Patient Safety: bar codes work
• Personal Health Records: a definitive overview
• The Open Source desktop has finally arrived: Lord, he's a geek
• Exploring Instant Messaging: uncertain value
• Security Standards for the Country: The HITSP list, essential Health Care IT reading.
• The Top 10 Things a CIO Can Do to Enhance Security

Wow.

Where do I get a Halamka fan club t-shirt?

[1] There are significant differences between Blackberry (or iPhone for that matter) email and email with a full keyboard and display. My hunch is that five years from now we'll decide that BB-email was a significant step backwards for business communication, but it does enforce brevity.

Creating good side-effects of evil actions: reCAPTCHA and more

Recently we read that spammers and other crooks were offering "porn prizes" to people in return for CAPTCHAs interpretation. They're hoping to reduce the cost of their current strategy, which employs humans in low-cost labor zones.

That's the evil side.

The good side strikes back ...

reCAPTCHA | Cosmic Variance

... CAPTCHA, you will not be surprised to hear, is ubiquitous. Luis figured out that the little buggers are filled out about sixty million times per day by someone on the web. So, as the inventer, he first felt a certain amount of pride at having exerted such a palpable influence on modern life. But after a bit of reflection, and multiplying sixty million times by the five seconds it might take to fill in the form, he became depressed at the enormous number of person-hours that were essentially wasted on this task...

...Thus, reCAPTCHA was born. At this point you should be able to guess what it does: takes scanned images from actual books, with which optical character recognition software are struggling, and uses them as the source material for CAPTCHA’s...

Presumably they use a statistical model, since the "right answer" is not known at the start. The first people to decipher the CAPTCHA get a "bye", but as answers converge a "correct" answer emerges and serves as the standard. Once a 95% confidence interval is reached then the reCAPTCHA would be retired.

So even spammers, who will also attack these CAPTCHAs, will end up completing a social good. If they develop software that's exceptionally good at solving reCAPTCHAs, they can then sell their software to OCR companies.

Fascinating.

Another example of a "good" side-effect of evil intent is that SSN cloning (persona cloning) can sometimes promote the credit record of the victim.

We all need to look for other opportunities to create side-effects of evil actions that have good effects.

Here's one. Create a myriad of sites that look interesting to hackers, but actually contain nothing of great value (ideally contain items that have deceptive value). Design the encryption key so that solving it helps with some social-good computation, such as protein modeling. Let well-funded hackers both waste resources and solve interesting problems.

The Centers for Disease Control, for example, receive 1-2 attacks per second from IP addresses based in China (AMIA conference, 2007). It would be nice to get something useful out of those efforts.