There is only one 192.168.1.1

My parents' laptop was marooned in one room of their house, chained by a wired connection to the DSL modem. I decided that adding a wireless router (Linksys WRT160N in this case) would be great to untether the machine. I expected the installation to be limited to daisy-chaining the new router between the DSL modem and the laptop, setting up a few things (admin password, SSID, wireless security and band options) and enjoying wireless connection in 5 minutes. And to do it all from 400 miles away. Piece of cake!

This could be a long blog post because my projected 5 minutes rapidly expanded into 5 hours, but I'll keep it short. Trouble manifested itself when after several failed attempts we reverted to old wired setup (new router not connected) and I noticed the laptop reporting being connected to a gateway at 192.168.1.1 - weird! Did I mention that the laptop runs Vista and I wanted to mock around with it as little as possible? So why would a DSL modem be at 192.168.1.1??? As usual, an extended Googling session brought clarity to this murky issue. Verizon's DSL modem - Westell 6100F in our case - turns out to be a router/modem combo! This box was acting as a router and the modem, and when new Linksys entered the picture, we had two devices - both routers! - competing for 192.168.1.1 address. No wonder things weren't working right.

I found excellent instructions on how to turn Westell's router functionality off, placing it in "bridged" mode, and effectively making it into dumb modem. Scary thoughts crossed my mind; "bridging" sounded eerily similar to "bricking," and being 400 miles away, last thing I wanted was a bricked Verizon's box! Nonetheless, after some deep breathing, we carried out the instructions. A few tense moments ensued when Westell in its new bridged mode was not connecting to the Internet. Turns out my parents particular flavor of Verizon's DSL uses PPPoE and newly dumbed-down Westell was no longer providing the necessary authentication information. Luckily, at this point configuration of Linksys proceeded smoothly and it was all too happy to take over the necessary PPPoE duties and we were online in no time.

Moral of the story? There can be only one 192.168.1.1! One for each private network, that is.

Raw Burgers and Future of Clinical Decision Making: A Ramble

The inspiration for this post was the final episode of "The Next Iron Chef". I was definitely psyched to see Jose Garces win. There was a moment in the show when the other finalist, Chef Mehta, served the judges a dish featuring a pork burger, and they commented that the pork was undercooked or even raw. This got me thinking - here are highly trained professionals, experienced practitioners of the art of cooking, and they are making such basic mistakes? In this day and age of advanced technologies, can't we come up with some gizmo to stick inside that burger patty, take its temperature and figure out - definitively - its state of doneness? Why rely on these rules of thumb (or rather the thenar eminence) - pun intended - by touching the meat to gauge whether it will still moo when I cut into it? Why am I talking about this? Well, think intravenous lines placement by highly trained professionals, experienced practitioners of the art of medicine. How are these lines placed? Essentially, by blindly poking around until you find the right blood vessel! Why not use the fancy technology? There are portable ultrasound thingies that help to visualize the needle and the vessel. Yes, they are far from perfect, but nothing new will be developed unless there is a demand for it, and there will be no demand until we stop thinking that relying on technology somehow makes doctors less cool.

Of course, same goes for information technologies. In his blog entry "Health IT: What’s the Future?" Steve Downs of Robert Wood Johnson Foundation recaps themes from a recent "Discovery and Innovation in Health IT" workshop. One presenter focused "on the need for cognitive support, showing a hockey stick graph of the number of facts that will be relevant to a given clinical decision over time (this theme reappeared several times over the two days). The number is expected to reach 1000 by 2020, while the number of facts that a human can contemplate while making a decision remains stuck at um, five." Healthcare practitioners need clinical decision support (CDS). I am surprised that such a statement could still be considered controversial...

Just like those ultrasound vein visualizing gizmos, CDS technologies are far from perfect. Thus far the CDS efforts are targeted at individual systems. The challenges are to figure out how to get/represent/manage/update/share clinical care guidelines logic that drives CDS recommendations, how to surface these recommendations to clinicians at the right place and time in a workflow-aware fashion so that they do not dismiss them outright, how to make these recommendations "actionable" to facilitate carrying out an order should a clinician decide to follow a recommendation. Necessarily, these efforts are hard - if not impossible - to generalize. These systems tend to be tightly bound to their initial implementation environments and are therefore non-interoperable in any meaningful way.

Ken Mandl and Zak Kohane proposed an idea of a plugin-friendly platform instead of a typical monolithic EHR. For this to work, the underlying clinical data must be handled in a way that abstracts it from individual applications. Alternatively, leave your monolithic applications alone and pool your data into a near-real-time repository that is application-agnostic. Ether way, if data can be separated from applications (how's that for a radical idea?), there is hope for the kind of interoperability that would result in scalable CDS. Automated processes are needed to abstract and represent domain knowledge encoded in clinical guidelines so that it can be machine-processable (consider baby-steps like HQMF); and it will probably take a miracle to figure out how to deliver CDS recommendations to practicing clinicians in such a way that they are useful. But despite these challenges, if the right incentives are in place to ensure a healthy demand for CDS technologies, we will see progress. The end-goal is the realization of the potential of healthcare IT - safe, appropriate, timely, high-quality care.

Newton MessagePad 2100 is back

Apple Newton MessagePad 2100
Originally uploaded by matveyp

No, Apple is not resurrecting the Newton, but my very own Newton MessagePad 2100 is making a comeback. It is running an NPDS webserver software and is available online! Come visit and leave a note on my Whiteboard if you'd like.

I owned this Newton since 1997 and early in its life it served as my primary computer - I did my wordprocessing, printing, e-mail, Telnet, etc. on this machine and it was fantastic. Since about 2002 I tried on and off to keep it up and running as a webserver. You can learn more about its setup when you visit. In short, the Newton is connected to my home network via Ethernet by way of a PCMCIA card.

What is different this time around? First, I did not want to rely on pre-MacOS X operating system (namely System 9) to connect to the Newton for synchronization, software uploads and backups. But I ran into a catch-22: Newton connection tools (NCX) available for MacOS X require a piece of software to be installed on the Newton. My solution was to fire up Classic mode on my old and trusty PowerBook G4, download and install original Apple's Newton Connection Utility, and use that to install the required package on the Newton. That worked flawlessly. And now I can connect to my Newton right from my MacBook Pro!

I also needed to take care of what is known as the Y2010 bug - read more about it here.

Lastly, I wanted to make sure that Newton's clock is accurate. For that I ended up using NewtSync.

There is a community of Newton enthusiasts who continue to use this incredible machine to do wonderful things. For example, this tracker shows which Newtons are online at any given moment. I am grateful to folks who continue to work on maintaining existing capabilities and developing new ones. I hope that by keeping my Newton online I am participating in some small measure in ensuring that innovations represented by this platform are recognized and appreciated.

Image files to PowerPoint slides Automatically

Imagine that you (a Mac user, of course) have a bunch of image files (say, screenshots) that you need to get into a PowerPoint presentation. How do you do it? Well, in PowerPoint you would create a new slide, go under Insert menu, pick "Picture…", in the subsequent dialog box navigate to where your image files are, pick one, hit "Insert" and then repeat the process as many times are there images to include. The question is - aren't computers supposed to make your life easier??? I encounter this scenario quite frequently, and so I figured that investing a bit of time into trying to figure out how to do this right was worth it. The solution is based on Apple Automator and uses Snow Leopard revamped Services (if you are not using Snow Leopard, this is still imminently doable with Automator). Here we go.

Launch Automator and choose "Service" on initial prompt

Set the selectors in the upper right gray bar as shown on below

Find the poorly named but highly useful "Create PowerPoint Picture Slide Shows" action and drag it in:

File > Save

I named my service "Add to PowerPoint Presentation"

You're done!

To test, select some image files in Finder, then go Finder > Services > Add to PowerPoint Presentation. Viola!

Next time you find yourself with a heap of images that need to go into PowerPoint (or any other repetitive kind of task), right when your mind starts to get numb just imagining what you are about to start doing, ask yourself - won't it be better to have my computer do this for me? Then take a little time, figure out a cool solution, and write about it so I can find it!

Paste unformatted text in Word 2008 for Mac via keyboard shortcut

I often need to paste text into Word 2008 for Mac but frequently need to make sure the formatting does not clash with existing document. The only way Word lets you do it is to go Edit > Paste Special… then manually select Unformatted Text and hit OK. Way, way too many steps and keyboard/mouse switches for a simple and frequently used action. Ideally I want to accomplish this with a keyboard shortcut. Older versions of MS Office for Mac supported VB scripting, and there was an easy native solution; as you know, Office 2008 dropped that support. So people who know turned to Apple Script. And I turned to Google to find those people… The solution:

In AppleScript Editor, open a new document and paste this in:

try
set theClip to Unicode text of (the clipboard as record)
tell application 'Microsoft Word' to tell selection to type text text theClip
end try

Save as Script; name it "Paste Plain Text\omV.scpt" and place it into ~/Documents/Microsoft User Data/Word Script Menu Items

Now, when you need to paste unformatted text, hit Option+Command+V and - viola! - magic happens.

Enjoy!

Minute Clinic

Minute Clinic at CVS rules! I went in today for a flu shot and was very pleasantly surprised. Actually, it reminded me of my visit to another Minute Clinic location 2 years ago - I also went in for a flu shot and also walked out smiling and surprised at how nice and effortless and well thought-out the entire process was. It's an experience that is entirely different from all other healthcare-related interactions you would typically deal with. Little to no wait. Smiling, likable, nice personnel. In-and-out - exactly how I like my interactions with healthcare system to be, if I must interact with it. Also, on the geeky side - their IT is very impressively done. You register at a kiosk outside - touch-screen PC with good (not excellent, but good) interface walks you through a few screens of demographics and typical questionnaire about your allergies, etc. Quick and painless. There's a question about whether you like to get access to your records and you need to provide your e-mail address if that is what you want. One I got home, there was an e-mail waiting with instructions to click on a link to verify my identity. Another nice touch - I had to enter a code found on my paper visit receipt which I was given upon leaving the clinic - this way the system was able to not only verify my ownership of the e-mail, but also verify my identify, but in a completely unobtrusive and seamless way! Once I completed the simple registration process online, I saw the records from both of my visits to Minute Clinic - complete with all information, even including vaccine lot numbers! In addition, there were two buttons - one for exporting my records into Google Health and another for Microsoft HealthVault. As easy as clicking a button - literally! Pleasant, simple, transparent - overall two thumbs up. If only they had H1N1 vaccine there...

Russification of Macintosh

My venerable Russification of Macintosh site has not been updated in a while, mostly due to the fact that the free hosting provider has been ignoring my pleas to restore access to the files. There've been some recent developments and I wanted to make sure that my fellow Russian-speaking computer users have uninterrupted access to the wisdom and goodness that is the Russian phonetic keyboard layout. Hence this update in my blog.

If you are a Mac user, things have gotten substantially easier since I originally started providing information about getting your Mac to "type" in Russian. Macs come with all the necessary pieces in place - fonts, keyboard layouts, applications that are ready to deal with Cyrillic alphabets right out of the box. One crucial thing is still missing, however - if you are not familiar with key layout in a standard Russian typewriter, you will find it difficult to use Apple-supplied Russian keyboard layouts. This is where my phonetic keyboard layout comes in - it makes it to super-easy to type in Russian because majority of letters are arranged in such a way as to correspond phonetically with latin keys on your keyboard. Here's what my keyboard layout looks like:

There are two things that prompted me to make this update in my blog - first, keyboard layout files are no longer available for download from the original website; and second - MacOS X 10.6 "Snow Leopard" finally did away with old way of specifying keyboard layouts in favor of newfangled XML-based files. I made a quick version of my layout in the new format and have been testing it for a while; it is now ready for wider audience.

Dear users, please enjoy!

Keyboard Layout for MacOS X 10.6 "Snow Leopard" and above

Download this file: ruskbd106.zip

Unzip it by double-clicking on it

Place contents into either /Library/Keyboard Layouts or ~/Library/Keyboards folder

Go to System Preferences -> Language & Text -> Input Sources tab and enable the new layout - it is called "Russification"

Log out and log back in

Switch to this layout to type in Russian; switch back to your default layout when you're done

Option key accesses certain letters not present in regular layout

Apostrophe is in the upper left instead of "~" (tilde) key - this feature is unique in Snow Leopard version

If you use this layout, consider making a donation to support availability and continued development!

Keyboard Layout for MacOS X 10.2 "Jaguar" to 10.5 "Leopard"

Download this file: ruskbdx2.zip

Unzip it by double-clicking on it

Place contents into either /Library/Keyboard Layouts or ~/Library/Keyboards folder

Log out and log back in

Go to System Preferences -> International -> Input Menu tab and enable the new layouts (you truly need only one - "Русская - AppleStd")

CapsLock toggles between Latin and Cyrillic layout:

• CapsLock up -> Latin
• CapsLock down -> Cyrillic

Shift key functions normally in both configurations, producing capital letters.

Option key accesses certain letters not present in regular layout

If you use this layout, consider making a donation to support availability and continued development!

Keyboard Layout for Windows

Now you can have the same easy-to-use phonetic keyboard layout you came to trust on your Mac when using Windows. I understand that you would rather be using your Mac, but sometimes we simply have no control over these things. So while you have to put up with Windows, at least you do not have to put up with a typewriter-style keyboard layout!

Should be compatible with Windows 2000 and XP (limited testing performed on XP only)

Instructions

Download this file: RU-MBP.zip

Unzip

Double-click "RU-MBP" to install

Configure XP

Start->Settings->Control Panel->Regional and Language

Languages Tab, in "Text services and input languages," click

"Details..."

Under "Installed services," click "Add..."

Under "Input language:" select Russian

Check "Keyboard layout/IME:"

Choose "Russian Phonetic Student Keyboard Layout," click "OK"

There are now 2 Russian keyboard layouts; remove the one named "Russian"

One the same window under "Preferences" click "Language Bar..."

Check "Show the Language bar on the desktop" and click "OK"

A few more "OK" to dismiss the remaining windows

Now, use Left Alt + Shift to activate the new layout you just installed!

If you use this layout, consider making a donation to support availability and continued development!