Those who do not understand history are condemned to repeat it.

We are currently seeing companies race to create electronic health information systems with profoundly unqualified developers. In a domain where the data dictionary is a few hundred million rows, the reference information model has 25 classes, made from 75+ different data-types (not counting the huge range from collections, mix-ins, and template/generic types) you don’t want people emailing a standards organization for help with questions like:

“I just was asked to implement a [standard, very basic summary of a persons health history] CCD/C32—do I have to read all of the standard or can someone tell me what to do?” (Answer: no, hire someone who knows what they are doing and keep your hands in your pockets)

“What is Schematron” (Answer: http://www.google.com/search?q=schematron)

Wait until these developers start getting named as individuals in malpractice lawsuits as perpetrators of pain/suffering/loss of life/loss of family; and software engineers loose their house and cars….whoo…hoo…hoo, won’t that be a change. Malpractice insurance is probably pretty cheap now, better lock in a quote. They will even get your favorite undergrad CS professor in their testifying that you were already reckless and they warned you to be systematic, oh how they warned you.

Welcome to healthcare. Start coding like you will get sued for every-time a mistake causes harm. Betcha double check those threads for deadlock and race awful carefully.

Writing some types of software is not a late-at-night hacking on your own. Sometimes sprinting between scrums leaves a hell of a lot of details, modeling, test-first work undone.

For critical systems (e.g. healthcare) formal code review, red-team testing, model drive development, internal validation, monitoring/logging every class, guarding every method, catching all exceptions, validating input before it is sent and after it is received need to be the normal day-to-day method for writing electronic health records systems, order entry systems, pharmacy systems, etc. etc. etc.

This isn’t a game. Although the industry desperately needs people with computer game design–nobody does better user interfaces than game designers. Hard to play = pink slip! Ha. Wish I could do that with my team.