Home Forums Discussions Feedback and Recommendations An Idea to accelerate requested AC improvements

I've posted this as a comment in a recent topic, but I'm going to post it on its own and see if anyone thinks this may be an idea . . .


Perhaps Amazing Charts can do what our government would love to do - ask AC users if they would voluntarily contribute a one time extra donation/payment (according to their individula comfort level) with that donation specifically directed towards a requested improvement.

Jon has stated privately that the biggest impediment toward implementing new improvments (eg letter writer, interventions sections etc) is the lack of manpower and financial resources of his company.

Bert already has documentation of the most user-wanted changes. If Jon could provide an estimate their implementation costs, I wonder if we could organize some type of ? Amazing-Charts-A-thon? (think NPR or MDA) where users could donate specifically to reach a goal to implement one of the improvement of their choice. For example, Say, , the cost of hiring a programmer to institiute a word-compatible letter writer is $10,000. or the cost of a non-overdocumented allergies section may be $2000, or a modifiable "imported items" section is $5,000. Those goals could be posted with users making one time contributions to reach that goal. Without any one individual enduring financial hardship, we could donate to reach our goal of any one of a numbe of specific target improvemnt goals. (AC is already very reasonably priced, thousands of dollars less than other systems, and users might be willing to pitch in, particularly as the changes benefit users both convenience and efficiency/bottom-line).

Thoughts??




Idea #2.: Perhaps Jon may be willing to let some of the users actually do the heavy-lifting and write in some of the code for improvement into the program ourselves? I have the sense a number of users are programming-savvy and might be willing to write the actual code for some of the desired improvements, which could then be submitted to the AC programming staff for review, tweaking and implementation . (I'd volunteer, but I don' know how to write code).

Any thoughts? . . .Anyway, just an idea for trying to accelerate change.


Bruce Morgenstern (Neurology)
Denver, CO

Bruce,
Your idea of having users underwrite specific improvements in AC has been floated before. I happen to like it. Unfortunately, Jon B does not. I didn't spend the time to search the board, but I know he has responded negatively about the idea here. One quote from Jon in 2009 is "unfortunately, throwing programmers at the problem doesn't work (I've tried this). Having a feature doesn't make it usable". Just a couple of weeks ago I heard the idea proposed to him again, and he was equally unenthusiastic. It just doesn't seem to fit with his idea of how the program and company should develop.

I appreciate your comments -

It is inconceivable to me that Jon wouldn't want to proceed:

We have a roadmap of user suggestions, sorted by popularity (thanks to Bert) - This is the kind of improvement feedback corportations pay large amounts of money to obtain. Here it is free - how to improve the program suggested by users intimately familiar with and dedicated to the program, and ranked by popularity

. . . And now we have a propsal for the users to acutally underwrite the cost for some of those improvements to lessen or perhaps minimize the cost of those improvements.

What am I not understanding?

Bruce

A long time ago, Jon found that changes made for some users made other users unhappy. Thus, he makes changes very conservatively.

He has Bert's roadmap, and I would expect that they use it as a guide to improvements.

If you make changes to one area, they often cause problems in others. If you are trying to correct the V6 problems, then add the changes by a separate programmer to improve the letter writer (for example) you may wind up chasing down problems all over the place. Are the new errors from your V6 changes or from the letterwriter new code?

Thus, programming proceeds at the pace that Jon has determined. I for one accept that as insurance that the program proceeds in a slow orderly pace.

I suspect that money is not the roadblock to implementing the changes. While I may have a somewhat different priority to what should be fixed, if you look at the changes over the past 2 years, they are impressive and significant, as well as consistent in their overall direction.

Unfortunately, we have all been sidetracked by Meaningful Use and the Chase for the Government Money (sounds like the title to the next Indiana Jones movie)

Hi Wendell,

What you say, certainly about the intertwining of improvment side effects does makes sense, although I do wish he could proceed on parallel courses, both pursuing the Crystal Skull, eh . . . meaningful, use AND improving the product basics.

Bruce Morgenstern,Neurology
Denver CO

Everyone,

I understand the desire to get things done faster. However, as a developer, I must strongly disagree with both recommendations.

---The first recommendation: Allow users to donate extra money for their pet features.

In the short run, this would be a great idea. In the long run, it could prove disastrous. Right now, bugs are fixed based on usability impact, in other words, bugs that are most prominent to the most users. So a bug that sometimes causes AC to crash when you attempt to log on will be fixed before the bug that causes AC to crash when you click on HELP | ABOUT. As for features, the features that get requested the most or are dictated by government are the ones that get done first. Bert's feature of having his face put on the HELP | ABOUT screen will get done last (if at all) whereas the feature that removes 5 mouse-clicks when entering a new patient demographic will get done first (or sooner, at least).

Let's say Bert is a multi-millionaire and he wants some XYZ feature added to AC and he wants it right damn now. To someone like Bert, contributing a few grand to this end is easy peasy. So what we have is the possibility that Bert's new feature or bug fix - a feature or bug fix that may not help anyone else other than Bert - gets done first because Bert had the cash and you didn't. What we have now is an arms race - a cold war, if you will. You'll have all the new features and bug fixes for the top 5 - 10 AC customers getting done whereas the little JBS's and little Lawrence_Barris's of the world are forgotten.

---The Second Recommendation: Allow outside coders to help.

This sounds so easy - but in fact it is next to impossible.

Problem 1. Sharing the source code. In order for people outside the development staff to contribute the source code for Amazing Charts would have to be shared. Understand that the source code to AC is really the only thing that gives AC a competitive advantage. Once it goes out and gets on some torrent site, it's game over. Obviously, as I'm sure someone is going to point out, that's what NDA's are for. Unfortunately, an NDA is a sheet of paper that says you may be sued for disclosing something. It does not prevent you from disclosing it. While I am loathe to even think of anyone on this forum betraying the trust of AC or their fellow members, I must point out that it takes only one bad apple and then the damage is done. Sure, AC can sue, but the damages collected will not cover the actual damage done.

Problem 2. Actually sharing the source code. An infrastructure would need to be created to actually allow contributing members to download the source code, work on it, upload their changes, have their changes validated, and then built into the new product. The build process would need to be automated. Two readily available products come to mind: Microsoft Team Foundation Server and FogCreek's Fogbugz. Of course, both cost money and will need to be hosted and maintained all of which also costs money.

Problem 3. Give outsiders tools they need. Anyone working on the source code for AC would need, at the minimum, a copy of Visual Studio and a computer to run it on. Plus, any third party tools in use by AC such as the ComponentOne suite (www.componentone.com). We are talking an easy $2000.00 to $2500.00 per contributer to pull this off.

Problem 4. Standardization. AC would need to publish coding standards for everyone to follow so all source code is consistant. Someone would need to watch dog this and reject sub-standard code.

Problem 5. Enforcement. What happens if Bert is asked to work on a feature or fix a bug that does not affect him? How can we count on Bert to not check in code he wasn't asked to work on or make unauthorized changes? Believe it or not, it really isn't cool to "fix this quick bug over here because I happened to notice it when I was looking around over there."

All of these problems would need to be solved.

My apologies, everyone, I don't mean to rain on anyone's parade. However, I have been a software developer for a long time and I constantly - daily even - fight this battle. Everyone wants their stuff quick and easy and cheap and doesn't understand why their feature isn't getting done first because it would really help everyone out. I'm sorry, but it just doesn't work that way.

JamesNT
Disclaimer: My mentioning of Bert's name is for entertainment and example purposes only. Bert is a great guy and goes over and above the call of duty.

James,

Thanks for the orientation to the real way it works. I see the difficulties.

However, I think that AC could "open up" their EMR a little to perhaps allow interested parties to commission or write "apps" that would enhance the the functions that AC provides in a basic form. I'm thinking of all the extensions that have been written for Firefox, for example.

This approach (the gradual exposure of a documented interface), is a (if not the) path to success. Some of the greatest developments of the last 10 years are the result of focused, integrate-able innovation. The release of address-able, integrated interfaces are key to the viral growth and success of Facebook, Twitter, and Google.

The added holistic benefit is that AC can remain focused on their core value, while enabling other innovators to add value for AC users.

disclosure - we are working on projects that might benefit from such an approach, but I still recommend that approach whether it impacts our business or not.

I really think Bert's picture would be the first bug fixed. Wait, that didn't come out right.....

Once upon a time there was this guy who came up with this bright idea of a Lil' Blue Wagon. He sold 100 wagons. Kids loved the wagon and sales steadily climbed. Along came this woman who wanted to build a wagon and she did, but in order to avoid copyright laws, she made hers green. She sold 100 green wagons in her first year and soon her company was doing as well as the blue wagon company.

Now shortly thereafter quite a few customers from each company went to the makers of both wagons and said we think we would like your wagons better if they were red. Nonsense said Blue Wagon CEO, it's just how I like it, and besides it may break the wheels. But, the CEO of the green wagons thought well if 75% of my customers like red, then I will paint them red. Well, the Radio Flyer Red Wagon was born and the rest is history.

The moral is while you may be making impressive and significant changes, if none of these changes are what your customer base asked for you'll end up being a blue wagon.

We aren't talking big sweeping changes here. Allowing one to name the own folders in II likely won't crash the program. AC adds the time of birth in the demographics, yet still won't allow one to save two pharmacies. Granted, this is a bad time to make updates to the program given all the Unmeaningful Use stuff. But, I still as yet have not seen a single suggestion by a user make it into AC. If we are a subset of all the potential buyers out there, it only makes sense to incorporate some of our ideas.

Hi All

I'm sure some were waiting for my response. So, here it is.

James?s post is solid. His points made are to educate how proper development should be done.

However, AC must take note of their loyal members. I have seen Bert?s ?Super-Duper? development poll. I must say, I am quite impressed. It?s well done. The development poll is like handing CANDY to developers. AC has no excuses, outside of meeting the government?s criteria. I saw where votes from Bert?s poll were completed in February. I don?t know how many features were put in v6.0.9?

Dr. Morgenstern (Brucel), I actually like your ideas, with wanting to improve AC?s most wanted features. But, I must agree with my fellow developer, James. There would have to be a solid foundation set in place. AC is not there yet. We could only hope that they get there soon!

The other option is going the third-party route. This is the route I?ve chosen. Most folks here probably have heard about my Rolodex alternative. It leaves room for what Dr. John (ryanjo), and Indy suggested - universal interfacing or integrating with other developers, and business (healthcare) products. It would definitely take AC to whole another level of success. I totally agree. AC would have to get their development infrastructure in check, first.

I could probably do a prototype of how a new Letter Writer could look? Let me know your thoughts?

First and foremost I would like to thank all of you for reading my post and seeing that my point was to indeed educate and not just shoot holes in an idea. The professionalism and raw intellectual acumen on this forum continues to impress on an almost daily basis. Believe me when I tell you, I am not as fortunate elsewhere with other groups of individuals with advanced degress such as yours.

Despite my post, even I must agree that some of the features asked for should have made it into the product by now. Obviously not all of them but one would think at least 1 or 2. So we are still at the question of just exactly what is going on. I think this entire problem can be solved by Jon just giving a roadmap or maybe an update. Something along the lines of:

"Ladies and Gentlemen. Right now are goals are to implement features A, B, and C. However, in the latest version 6.x, we are also aware of problems D, E, and F. Once we are done and have a solid 6.x product out the door, we will then begin our next update which will include features X, Y, and Z."

JamesNT

We have suggested that numerous times.

Lawrence,

A picture's worth a thousand words. I would do it.

Thanks, Bert for the green light.

Give me a little time. I will have to view AC current dialogs (Print Encounters/Send Letters and the Letter Writer) to come up with a generic prototype. I?ll create another thread when the prototype is ready. Then it will be open season from there.

Keep in mind, folks this would only be a prototype, to brain storm against. This will not be a functional product. It will be for sharing purposes to get folks involved to creating something useful. I?ll keep you all posted when it?s ready.

Hi All

To see screen shots of the prototype (Could this be the future Letter Writer?) click here.