Apple Crap – iMac From Crapple

September 30th, 2012

iMac

The Gripe – Our family’s one and only experience with Apple computing has ended in frustration. Our iMac now produces a grey screen. The machine works (we know that from running the machine in its quirky voice mode), but the monitor does not. We see a grey screen that moves from light grey to a darker grey as we manipulate the machine’s brightness control. Perhaps we shouldn’t judge Apple based on this one bad experience, and that’s probably true. But the web is littered with crApple and Apple crap content–content posted by legions of disgruntled Apple customers–so apparently we’re not alone in our frustration.

The Problem – According to the Apple technician we consulted, the source of our iMac’s problem is its logic board. More specifically, faulty capacitors on the logic board. We were told that iMacs of our vintage suffered from poor-quality capacitors on their logic boards, and when they fail, the monitor is affected. Approximately $900 to fix.

Corporate Greed – Considering the excessive purchase price of our iMac and the unconscionable margins Apple enjoys by producing its products overseas (see below), Apple certainly could have afforded quality $0.10 (ten-cent) capacitors for my machine over the poor-quality $.06 (six-cent) capacitors it chose. Yet Apple chose the cheaper, poor-quality capacitors instead. Thanks for thinking of your customers, Apple. Thanks for thinking of me, Apple.

But I get it. I truly get it. I don’t agree, but I get the corporate perspective. It’s all about the margins. Those cheaper capacitors no doubt contributed to handsome corporate bonuses and stock options at Apple in the year my iMac was produced. Picture the Apple corporate pigs feeding at the trough, their blood-filled cheeks glowing brightly as they gorge on the dollars coming through the door. Their appetites are insatiable, and they’ll do anything–literally anything–to keep the feeding frenzy going.

Competitor Quality – So, after only five (5) years of use, our iMac is dead. I’m writing this post using a DELL machine that is twelve (12) years old. Except for the occasional power outage, this machine has been turned on and running continuously for over twelve (12) years (including the original hard drive). At well less than half the cost, we’ve seen well over twice the life span. Now that’s what I call quality. Hats off to DELL, and sad commentary for Apple.

The Social Context – Perhaps like Toyota and other corporate behemoths, Apple seems to have lost its way. After Steve Jobs (who I mostly admired) died, Tim Cook took the reigns at Apple. Shortly after his appointment to his CEO post, Mr. Cook was quoted as saying the following in response to a reporter’s question on whether, considering its tremendous financial success, Apple should think about bringing jobs back to America (as you may know, Apple products are produced at the planet-sized assembly facility of Foxconn in Taiyuan, China):

[sic] It’s not Apple’s responsibility to create jobs in America. Apple’s responsibility is to produce its products in the most cost-efficient way.

This utterly soul-less response from the humorless and unemotional Mr. Cook, offered at a time when Americans and others around the world were (and still are) feeling the pain of the ongoing global recession, confirms that he is the right person to lead Apple into the future–the right person for Apple’s shareholders anyway; but sadly, not the right person for Apple’s customers. By definition, corporations are soul-less and incapable of possessing morals, honor or integrity. Only humans can possess human attributes. But corporations are led by humans, and to my way of thinking, corporate leaders should possess and exhibit morals, honor and integrity. Corporate leaders should have a social conscience, and Mr. Cook is no exception. Pleasing Wall Street is important for any publicly-traded company, but when a corporation emphasizes pleasing Wall Street over all else, that’s when I get off the bus. It’s too late for Steve Jobs to get a conscience, but it’s not too late for Mr. Cook.

To lighten things up a bit in the midst of this otherwise negative post, check out this great article on Foxconn from The ONION (unlike you Mr. Cook, I do have a sense of humor): Sweeping New Labor Reforms Allow Foxconn Employees To Work In Inhumane Conditions From Home.

Action Plan – Well, as you might guess, my family won’t be buying any Apple products in the foreseeable future. As value-oriented consumers, we’re happy to pay a higher price for something if the higher price brings higher quality. But based on our experience, and that of countless thousands of others around the world, that value-proposition equation doesn’t balance for Apple products. In addition to Apple’s quality problems, when we consider that Apple’s corporate leaders are totally devoid of any social conscience, the message is clear: No crApple, no crApple. No crApple for me!

Software EAR Compliance

May 31st, 2011

We get lots of questions from software firms concerning export of their software to a foreign country and compliance with the Export Administration Regulations (EAR) administered by the United States Bureau of Industry and Security (BIS).

EAR Compliance Services – The firm does offer software EAR compliance services, and you can learn more about that part of the firm’s practice here.

Compliance for Software Export in General – If you plan to export your software to another country, you need to determine the ECCN for your software offering from the CCL within EAR. Your ECCN, together with the identity of your customer, the customer’s intended use for your software, and your customer’s domicile country will determine whether you need a license from the BIS, or an applicable exception, in order to export your software.

Special EAR Rules for Certain Software – If your software includes encryption, or it natively supports connectivity with a mobile device, you may have additional steps to take before exporting your software.

Penalties – The Export Administration Regulations are largely self-administered, which means the onus is on you — as a software developer or licensor — to determine and discharge your compliance obligations. Substantial penalties apply to violations of EAR.

Information Technology – Penny Wise and Pound Foolish

May 30th, 2011

The inspiration for this article came while I was reading Innovation Atrophy: How Organizations Can Fight It in the current print issue of Information Week. The article highlights the negative impact on IT innovation that occurs during prolonged periods of shallow IT budgets, which made me think about some recent experiences with one of my sell-side clients.

IT Spending Cycles – When it comes to information technology, organizations tend to cycle among three states: 1) spending on IT, sometimes aggressively, in order to serve a growing business, improve efficiencies, gain a competitive advantage, etc.; 2) cutting back on IT expenditures, which can mean stopping ongoing projects, prohibiting new projects, downsizing IT departments, etc.; and 3) maintaining the status quo, neither spending significantly more nor cutting back significantly on IT expenditures in total. In fact, IT is probably not special in this regard. Organizations’ other forms of capital investment probably cycle in the same way.

So, cutting back on IT expenditures is nothing new, and cutting back severely during tough economic times is very common. But what I find interesting is how organizations decide what or who to cut during spending downturns, and what or who to add during spending upturns. And of these two, what occurs during spending upturns is the most interesting.

Budgets Return – After periods of budget cuts, layoffs, and general austerity, IT departments will eventually see dollars added back to their budgets. This is always an important turning point because IT staffers realize the worst is probably over. Less distracted by the possibility of additional layoffs, they can now get about their work in earnest, and indeed that’s what they would prefer to do. Everyone is more upbeat, and their enthusiasm shows.

But artifacts of the austere period linger. Many within the IT function, and especially those at the top, realize the need to “make up for lost time” and to justify their existence. The result is a sense of urgency that is tempered by conservatism and a heightened awareness of accountability. No one wants to misstep, and now is clearly not the time for another failed or over-budget project. Those precious new dollars added to the budget must be spent wisely.

Cheap Versus Frugal – For those IT functions that have hit bottom and are now on the rebound, I understand their natural tendency toward conservatism. And I can accept that frugality is probably a natural, and even necessary, component of that conservatism. But as we all know, there’s a difference between being frugal and being cheap.

Some recent experiences with one of my sell-side clients demonstrates the distinction between frugal and cheap in the context of information technology. This client sells a unique solution to accessing and better utilizing data generated within enterprise applications. The client sells a “limited” and “full” version of its solution, and with the limited version priced at 70-80% of the full version, there is an incentive for its customers to purchase the full version. Sometimes the limited version is adequate for a customer, but sometimes it’s not.

In the past three months my client has sold limited versions of its solution to customers that would definietly derive more benefit from the full version. The limited version might satisfy 20% of these customers’ needs, and the full version might satisfy 100%. In these instances, the additional expense of the full version was justified, and buying only the limited version probably was not.

So, why didn’t these customers purchase the full version of the solution when doing so was truly in their best interest? Well, I think, because they were being cheap. They were in conservative mode, and they were mistaking cheap for frugal. I saw the correspondence between my client and these customers’ business persons, and it revealed the state of conservatism in which each customer was then operating. Despite my client’s sincere encouragement to purchase the full version, these customers refused. The customers were unable to distinguish between traditional “upselling” and buying what was ultimately best for them (and only fractionally more expensive). Concerned about its reputation and potential liability, my client asked me for the first time to document in the License Agreement for these customers the functionality the customers would NOT achieve with the limited version of the solution.

Lesson – The lesson here is not for IT functions to be mindful of the distinction between cheap and frugal. That rule applies in all contexts and under all circumstances. Rather, I believe the lesson for IT organizations is to be acutely aware of the distinction during periods of budget rebound and conservatism. Being blinded by one’s conservatism can lead to stupid decisions. Being penny wise and pound foolish is — well — just that. Sometimes it’s wise to buy a Chevy sedan instead of a Cadillac, but it’s not wise to buy a Chevy sedan when what you really need is a slightly more-expensive truck. If you can’t afford the truck right now, then don’t buy anything.

Guide – Software Licenses

January 4th, 2011

Software License Checklist

A software licensing guide and checklist prepared from the Licensee perspective. Use this checklist for any software acquisition, but it should be especially valuable for customized software and development projects whose cost and risk elements are always much greater. You are free to use this checklist as you deem appropriate, but please read the Disclaimer that appears below.

Scope of Software License

  • Exclusive or non-exclusive license (just you, or others can license)
  • Named-entity or enterprise license (affiliate use)
  • Transferable or non-transferable license (consider need to transfer internally for tax or other reasons)
  • Object code or source code (source code rare outside of open source applications)
  • License extends to updates and enhancements
  • Number of installed copies (production, test, QA, disaster recovery)
  • Licensee modifications (ownership and other issues)

Software License Type

  • Perpetual (usually preferred)
  • Term (usually avoid)
  • Subscription (SaaS and variants – may be preferred)
  • Revenue-based (avoid)
  • MIPS (avoid)
  • Instance (avoid)
  • Floating (a/k/a “concurrent license” or “network license”; may be desirable for expensive software with a small and defined user base)

Software Use and Restrictions

  • Designated server
  • Designated operating system (Windows, etc.)
  • Database compatibility (SQL, etc.)
  • Physical location
  • Users
  • Virtualization issues

Software License Warranties

  • Conformance (functionality in accordance with documentation and specifications)
  • Conformance warranty of unlimited duration
  • Material errors or defects
  • Integration (third-party software, including middleware)
  • Testing and acceptance
  • Compliance with all state and federal law, rules and regulations
  • Perpetual support
  • Flex option (license fees can be applied to new releases or different products)
  • Good copy of software (including defective media)
  • Bug fixes
  • Licensor title
  • Infringement
  • Copyright registration (infringement and enforceability issues)
  • Malware
  • Destruction or corruption of system data
  • Duration of warranties (may vary by subject matter; commence upon productive use)
  • Remedies and exceptions

Software Support and Maintenance

  • Support levels
  • Remedy for breach of support obligations
  • Priority of bug fixes
  • Duration of support (current versions, etc.)
  • Effect of stopping maintenance (parking, etc.)
  • Reverse maintenance options
  • Consider no maintenance option
  • Virtualization issues

Confidentiality

  • Your organization
  • No press releases or other publicity (leverage for fee reductions)
  • Standard of care (recipient standard but no less than reasonable care)
  • Return of confidential information

Ownership Issues

  • Base software (typically no transfer by Licensor)
  • Custom software (work made for hire)
  • Licensor modifications
  • Licensee modifications
  • Licensee data
  • Ideas and suggestions for improvement

Source Code Escrow

  • Escrow agent
  • Release terms
  • Who pays for escrow
  • Source code delivery and validation
  • Licensee rights upon release event

Dispute Resolution

  • Escalation and time frames
  • Arbitration and mediation
  • Enforceability of arbitration award or mediation decision
  • Jurisdiction and venue
  • Award of costs
  • Services of process by means allowed for notice

General Software License Provisions

  • Bind assignors (sale of Licensor or its assets)
  • Choice of law and venue
  • Notices
  • Independent parties (relationship of vendor and vendee)
  • No waiver of breach
  • Interpretation and construal

Software Implementation Issues

  • Detailed CSA and SOWs
  • Selection of Licensor or third-party contractor personnel (“A-Team” issues)
  • Roles and responsibilities (Licensee versus Licensor)
  • Licensee expectations and Licensor or third-party contractor standard of performance
  • Phases and time frames
  • Deliverables and milestones
  • Insurance requirements
  • Security requirements
  • Right to replace personnel
  • Remedies for failed implementation (software buy-back, service fees, etc.)
  • Testing and acceptance
  • Roll-out strategy (big bang, phased, etc.)

DISCLAIMER: The above checklist is provided for informational purposes only, and you should not rely upon it for any purpose. The checklist is NOT intended to be comprehensive, and other factors and considerations will certainly apply to your acquisition of any software product or any software customization or development effort. Further, the importance of each criterion above will necessarily vary based on the needs and preferences of your organization. You are encouraged to use the checklist in combination with other relevant resources, including when appropriate, the advice and counsel of an attorney with software licensing experience.

Floating Software License

December 24th, 2010

Computer Aided DesignWhat Is It? – Also known as a concurrent license or network license, a floating software license is a license to use a software application that “floats” among multiple users. For example, you could have 20 authorized users under a single floating license. The catch is that only one user can use the application at any point in time. Or, you might have four floating licenses to the application, in which case 4 users could use the application simultaneously.

When Should I Use a Floating Software License Approach? – Whenever a software application is very expensive and not used continuously by members of a user base, you should think about a floating license approach. The approach allows you to reduce license costs while still satisfying user needs.

Limitations – Not all software developers offer a floating license option and insist on a direct user license approach. In addition, if your organization experiences variable work loads, with peaks in development or production cycles, that may mean that members of the application user base are competing for the float-licensed application during peaks. So, don’t be penny-wise and pound-foolish in your use of the floating software license approach.

EHR Incentive Program Registration

December 24th, 2010

EHR Incentive ProgramThe Centers for Medicare and Medicaid Services (CMS) has announced the opening of registration for the EHR Incentive Program. Eligible Professionals and Eligible Hospitals may register on and after January 3, 2011. You can learn more about the EHR Incentive Program, eligibility requirements, registration requirements, and attestation requirements here.

CMS is encouraging Eligible Professionals and Eligible Hospitals to register as soon as possible. It is possible to register before installation or implementation of an EHR system.

Selecting The Best EHR Software

December 19th, 2010

EMR SelectSelecting EHR Software – Choosing the best Electronic Health Records (Electronic Medical Records) software for your organization can be a challenge. So many respected EHR vendors to choose among, and so many marginal EHR vendors to avoid. And a multitude of EHR feature and function points to consider, many of which are critical to your needs, and many of which are unimportant and may actually get in your way.

Objective EHR Decision Support – The firm worked with Olive Consulting Group over several months to create and refine a powerful EHR decision support tool called EMR Select. By combining Olive’s experience with HIT and EHR with the firm’s information technology procurement expertise, we have created an EHR selection and decision support tool that has no peer. Neither Olive nor the firm accepts any commission, referral fee or other remuneration from any EHR vendor. EMR Select is 100% objective and unbiased. Learn more about EMR Select here.

EHR Vendors Covered – At present, EMR Select covers offerings from sixty-two (62) of the best ambulatory EHR vendors, and we are adding coverage of additional EHR software vendors.

Evaluation Criteria – EMR Select includes 300+ discrete EHR software evaluation criteria for physicians and physician groups, and 1200+ EHR software evaluation criteria for hospitals. The analytic and scoring tools within EMR Select allow you to compare EHR software offerings efficiently and reliably.

RIS PACS RFP Evaluation Criteria

December 18th, 2010

RIS PACS

RIS/PACS Requirements Set – We now have a robust RIS/PACS requirements set loaded within VendorSelect, the firm’s proprietary eRFx Tool. You can learn more about VendorSelect here.

Don’t Start From Scratch – Building a requirements set and evaluation criteria for any information technology project can be a daunting task, and RIS/PACS projects are no exception. You can jump-start your RIS/PACS project by starting with our field-tested requirements set. You also have the flexibility to add new requirements and drop others.

RIS/PACS Vendors – VendorSelect is already wired to the leading RIS/PACS vendors and services providers, so your sourcing stage is simplified. Issue your RFI and RFP with a few clicks of your mouse.

RIS/PACS Project Support – As always, we’re here to support your use of VendorSelect and the vendor negotiations and contracting phases of your RIS/PACS project. Feel free to contact us for more information about using VendorSelect for your RIS/PACS project.

Controlling Software Costs – Shelf Ware

December 16th, 2010

Dollar Fan
Why You Have Shelf Ware – You may have purchased a software package or bundle with several modules (at an incredible discount!), and you implemented some modules but not others. Or, you may have decommissioned certain software over time. Shelf ware is software that is licensed to your organization but not presently deployed.

Hidden Costs of Shelf Ware – Unless you have made other arrangements, your organization is probably incurring annual maintenance expense for each shelf ware license in inventory. There’s an “out of sight, out of mind” aspect to shelf ware, and most organizations simply don’t track their software license inventories closely enough to uncover unnecessary expenses.

Stop Wasting Dollars – Get a handle on your software license inventories (there are lots of good reasons to do so) and look aggressively for shelf ware. When you find it, you have some decisions to make.

If you know for certain that will never implement those extra modules from a packaged purchase, then by all means, cancel the maintenance. Check also the see whether your software vendor has a license exchange program that would entitle you to exchange licenses to non-used software for software that you might use.

If you might implement those modules at some point in the future, see if your vendor has some version of a “parking” program whereby you can suspend maintenance payments during a period of non-deployment without incurring a maintenance penalty upon deployment and resumption of maintenance.

Time Well Spent – No one is fond of pouring over license inventories and analyzing them against usage reports. But if you take the time, you might find some substantial savings for your organization.

EMR “Meaningful Use” Defined By ONCHIT

January 5th, 2010

Doctor EMR PC

Long-Awaited Criteria – ONCHIT has finally issued regulations that define “meaningful use” of EMRs, the major qualifying criterion for the EMR adoption incentives provided by ARRA.

You can view the text of the regulations here.

Stage 1 criteria take effect in 2011. Stage 2 criteria will apply in 2013, and Stage 3 criteria in 2015 (both to be defined at a later date).

Major Elements of the Meaningful Use Rules:

CPOE

Practices: Use CPOE for orders involving medications, laboratory, radiology, and referrals.
Hospitals: medications, laboratory, radiology, blood bank, PT, OT, RT, rehab, dialysis, consults, and discharge and transfer.

Orders do not have to be sent electronically to the fulfilling department (lab, pharmacy, etc.)
Practices must enter 80% of their total orders directly by the clinician into the CPOE system. Hospitals must have 10% of all orders entered by CPOE.

Clinical Checking of Orders

Real-time screening (drug-drug interactions and drug-allergy contraindications), formulary check, user ability to maintain screening rules, track user responses to alerts.

Problem List

Longitudinal current and active diagnoses coded in ICD-9-CM or SNOMED CT.
80% of unique patients must have at least one coded problem/diagnosis, with “none” being an allowed entry (hospitals and practices).

E-Prescribing

Practices only.
Must send 75% of non-controlled substance prescriptions electronically.

Active Medication List

80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Medication Allergy List

Longitudinal with allergy history.
80% of unique patients must have at least one coded entry, with “none” being an allowed entry (hospitals and practices).

Demographics

Practices: preferred language, insurance type, gender, race, ethnicity, and data of birth.
Hospitals: all of the above plus date and cause of death if applicable.
80% of patients must have demographics recorded as structured data

Vital Signs

Height, weight, BP, BMI, growth charts for patients 2-20 years old, temperature, pulse.
80% of patients aged 2 and over must have blood pressure and BMI entered.
Children 2-20 must have a growth chart.

Smoking Status

Record if current smoker, former smoker, or never smoked.
Must be recorded for 80% of patients.

Structured Lab Results

Display results, translate LOINC codes, allow maintenance based on new results.
Must record as structured EHR data 50% of all results that are delivered in positive/negative or numeric format.

Patient Lists

Allow user to select, sort, retrieve, and output patient lists based on demographics, medications, and conditions.

Report Quality Measures to CMS and States

Calculate, display, and submit quality measure results

Patient Reminders

Practices only: issue based on patient preferences, demographics, conditions, and medication list.

Five Clinical Decision Support Rules

Beyond drug screening, based on demographics: diagnoses, lab results, or medication list. Real-time alerts and suggestions based on evidence. Track response to alerts.

Eligibility

Allow user to record and display based on eligibility response from insurer.
Must cover 80% of unique patients.

Submit Claims

Must submit 80% of all claims filed electronically.

Electronic Copy of Health Information to Patients

Allow user to create an electronic copy of test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospitals must also provide a discharge summary but not procedures.
Must provide an electronic copy of health information to requesting patients within 48 hours.

Electronic Copy of Discharge Instructions

Hospitals only.
Must provide electronically to 80% of discharged patients who request them.

Timely Patient Access to Health Information

Practices only: diagnostic results, problem list, medication list, medication allergy list, immunizations, and procedures. Within 96 hours of availability.
Must provide to 10% of unique patients.

Clinical Summary of Each Office Visit

Practices only: diagnostic results, medication list, procedures, problem list, immunizations.
Must provide for 80% of office visits.

Information Exchange

Enable electronic sending and receiving of diagnostic test results, problem list, medication list, medication allergy list, immunizations, and procedures. Hospital requirements also include a discharge summary.
Must conduct at least one test of exchanging information.

Medication Reconciliation

Compare and merge two or more medication lists into a single list that can be displayed in real time.
Must be performed in 80% of encounters and care transitions.

Submit Data to Immunization Registries

Must conduct at least one test of submitting information.

Submit Lab Results to Public Health Agencies

Hospitals only.
Must conduct at least one test of submitting information.

Submit Syndrome Surveillance Data to Public Health Agencies

Must conduct at least one test of submitting information.

Protect Electronic Patient Information

Unique identifier, emergency access for authorized users, session timeout, encryption where preferred, encryption when exchanging information, maintain audit logs, provide integrity check for recipient of electronically transmitted information, verify user identities and access privileges, record PHI disclosures.
Must conduct a security risk analysis and implement security updates.