Roger Deetz

Meetings-can-be-better Monday! I've been chatting virtual collaboration this past week and remembering the old adage, "if all you have is a hammer, everything looks like a nail" Y'all, the video meeting gets heavy use, but we have so many other tools in the box! Before you schedule your next Teams or Zoom call, get curious about whether you have asynchronous methods of getting the job done. First up, the dreaded "let's hop on camera and brainstorm" #thiscouldhavebeenanemail #bettermeetings

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In 2001, a group of developers gathered in Snowbird, Utah, to challenge the status quo. They saw an industry stifled by a system that prioritized processes over people. This visionary meeting led to the creation of the Agile Manifesto whose principles defined Ascendco’s approach to software development. In healthcare, where complexity reigns supreme and change is constant, this resonates deeply. We can't afford to be bogged down by rigid structures. We need to be nimble, adaptable, and most importantly, focused on the people we serve. That's why the very first principle of the Agile Manifesto strikes a chord with me: Individuals and interactions over processes and tools. Let me tell you a story. Kristi Scholl, one of Ascendco’s Data Specialists, has been with us through countless Go-Lives. Witnessing firsthand the daily routines of our users, Kristi noticed a discrepancy in how peel packs were tracked in our software vs. how they were assembled in reality. Through conversations and real-world observation, she identified a way to streamline the process, making their lives a little easier. That's where the best design and ideas come from, spending time in the real world, observing what they're doing and finding ways to make the software make their day easier. We'll take those ideas and put them through a rigorous agile development process, but the origin story of that improvement has nothing to do with software development itself. It started with Kristi and what she was seeing and those interactions she was having with the people who use our software every day. At Ascendco, agile isn't just a methodology, it's how we're wired. It's about empowering individuals like Kristi to identify problems and fostering the interactions that lead to solutions. In the ever-evolving world of healthcare, that's the key to keeping our patients at the heart of everything we do.

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✨ A lesson in writing clear requirements… with a little Friday humor! ✨ Picture this… You’re on a cross-functional product team—whether as a product manager, designer, software developer, or QA engineer—and it’s your job to communicate exactly what needs to be built. Your colleague depends on your instructions to successfully create the end product. Sounds easy, right? Well, not always. Clear requirements can make or break whether a product solves the intended problem. But what does clear really mean? A recent video gave me a funny reminder of this: A dad challenged his kids to write down instructions on how to make a peanut butter and jelly sandwich, and he followed their instructions EXACTLY—with not so exact results 😂. After a few rounds of trial and error, the kids finally got better at explaining, and voila! A successful sandwich. It’s just like product development. Requirements need to be clear, complete, and delivered in a way that your team can follow without missteps. Along the product development lifecycle, you’ll come across several requirement types, such as: ✨ Business Requirements: Why are we doing this? What value are we creating? ✨ User Requirements: What do users want or need to accomplish? ✨ Functional Requirements: How will we implement these features? ✨ Design Requirements/Specifications: How should it look, feel, and behave? ✨ Technical Requirements: What infrastructure is required (databases, APIs, etc.)? And, as the video hilariously reminds us... ✨ Testing Requirements (a.k.a Test Cases): How do we verify that we built what we set out to build? Each one is crucial. Each one can either launch or derail a product. Throughout my career—whether as a research leader, product leader, or now CTO—I’ve had to write (and refine!) requirements of all kinds. It’s truly an essential skill for any PM to master. So… what do you think? Can you tell me how to make a PB&J? 🍞🥜🍇 #productmanagement #productdevelopment #fridayhumor #innovation #thoughtleadership

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We transformed Gundersen Health System's (now Emplify Health) Digital Front Door to make patient access more convenient. The result? A thoughtful, flexible digital experience that drives growth and builds long-term trust and loyalty. "Phase2 has been a wonderful partner. Especially the depth of the bench. There were heavy development times with the CMS launch and then there were times where we needed digital strategists and help with analytics and tagging. The ability to flex the expertise to meet our needs has been great." –Kendra Maggert, Marketing Director, Gundersen Health System (now Emplify Health) Read about the work we did with our partner Acquia here: https://hubs.ly/Q02DsV3P0

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EHR Interoperability: Clinicians needs still aren’t being met 47% of clinicians said they couldn’t easily access patient data from outside organizations through their EHRs, according to a recent study by KLAS - https://lnkd.in/gnAHHk2A It’s interesting that after 20 years, with so many EHR vendors and custom solutions built, the actual needs of doctors still aren’t fully met. Regardless of the EHR vendor, interoperability remains a major pain point for clinicians. #ehr #interoperability #healthcare

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The Centers for Medicare & Medicaid Services (CMS) confirmed that personal data for nearly 1 million Wisconsin Medicare beneficiaries was compromised due to a MOVEit vulnerability, first exploited in May 2023.    Here’s what you need to know: ■ Delay in detection: Despite patching the MOVEit vulnerability in June 2023, an additional review in 2024 revealed unauthorized access before the patch was applied. ■ Massive impact: Over 946,000 people are being notified, and CMS is offering free credit monitoring services for those affected. ■ Wider implications: The MOVEit breach is considered one of the largest data breaches, affecting thousands of organizations globally.   For IT professionals managing critical systems, this incident highlights the importance of continuous monitoring and re-evaluating cybersecurity measures after initial threats are addressed.   Link to full article: https://lnkd.in/eDw3MDU6 #CyberSecurityNews #CyberSecurity #SecurityNews #InfoSec #DataBreach #Medicare

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Super interesting (and technical) breakdown on how the folks at ClickHouse are transforming the simple, flexible JSON format into something that can be leveraged at hyperscale. An excellent example of how sometimes scale can make you do crazy things.

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Fellow engineering leaders, how do you and your teams handle product and technical bets that fall outside of annual planning? At Cedar, we've developed a framework to mitigate risk and provide clarity in such scenarios, helping us avoid pitfalls like the sunk-cost fallacy. Our approach is structured around three key steps: 1. Pitch, 2. Manage, 3. Pivot or persevere. By following this process, I’ve found we have a much better understanding of the success, or failure, of our bets. I recently shared our framework in detail in a post created in collaboration with Coda after receiving interest in this framework from my recent talk on this topic - https://lnkd.in/g5zGQX3V. You can explore it here: https://lnkd.in/gdEvsMKw. The post not only outlines the framework but also offers templates for immediate use. I welcome your feedback and insights on how you approach this challenge. Is it similar to Cedar's method, or have you discovered a different approach? Share your thoughts! I also want to thank those who helped refine my thoughts on this blog: Jonathan Collette Aaron Zollman Justin Hales Latham Arneson Annie Lux Craig Beveridge

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🎺 Feature Friday (is that a thing? I'm running with it...) New on capture.dev this week - take your product feedback beyond random screenshots and use your camera and mic to add extra context to those more difficult to explain issues. Think of it like a Loom, except: 👉 Devs get all of the technical info they need, like network requests and console logs, for zero extra effort. 👉 Record directly in your browser, with no extra software or extensions needed Free to try now over on capture.dev

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My hobby lately has been playing around with generative AI. In my excitement leading up to getting my new Pixel 9 Pro phone later next month I played around with Google Gemini. Well, they got a lot of work to do, because I found it to be pretty awful. I used VS Code with the official Google Gemini + Cloud extension (for the Gemini run) and ClaudeDev (for the Claude run), running Python 3 in a WLS session. #ai #gemini #google #claude #python

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🧼🧼 The dishwasher state 🧼🧼 Popular coding languages ressemble a list of instructions. Do this, do that, etc. For my dishwasher uses, that would be: fill with dirty dish, place detergent pod, start machine, empty clean dishes, and then repeat. Well, I never do that. Instead I *start* with placing the detergent pod, then the dirty dish, etc. Why? Because a dishwasher without detergent can never fulfill its function. The desired outcome (clean dish) is entirely dependent on having detergent in the machine. So any time the dishwasher spends in a state without detergent is creating a risk: the risk that the machine ends up running without detergent. Now we can derive an easy rule: the dishwasher should have detergent at all time. This rule can be checked and enforced every time the dishwasher is filled, which gives several chances to catch a mistake, versus only one when we place the detergent immediately before starting the machine. This soapy example actually yields real programming lessons I use at Centaur Labs. 1. When your code is a list of instructions, don't assume they all get executed correctly. If one fail, in which *state* is your code/data? Is it OK? 2. Identifying dependencies between elements before writing code leads to better design and less bugs, at little cost. 3. Writing instruction is fine, but explicit rules are more powerful, as they can be checked and enforced.

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If you're the kind of person who's excited about all the recent S3 feature announcements (bucket policy unlocks via temporary root sessions, up to millions of buckets per account, pagination and region filtering for ListBuckets, conditional writes, ListCallerAccessGrants API) and you're attending re:Invent, then you should come to our storage track session, STG306 Advanced security patterns on Amazon S3. Learn how to use all the exciting new stuff securely in the most interactive format available at re:Invent!

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The Most Admired Healthcare Leaders in 2024 Dr. Tim Calahan Driving Innovation and Improving Outcomes at Michigan Medicine through Cloud Transformation Good health is imperative to leading a happy, contented life, and is a basic human desire and right. However, from the beginning, mankind has been in a constant battle against disease. That’s why the healthcare field has always focused on supporting innovations that advance our ability to prevent, treat, and cure a variety of conditions. From sheer human brilliance to advanced technology, it makes use of every available resource to further that goal. 👉 𝑫𝒊𝒈𝒊𝒕𝒂𝒍 𝑴𝒂𝒈𝒂𝒛𝒊𝒏𝒆: https://lnkd.in/dHKy88ra #healthcareleaders #admiredleaders #timcalahan #CTO #healthcare #DrivingInnovation #leadership #digitalbusiness #Strategies #AI #enterprise #technology #visionary #cloudcomputing #patientcare #HealthTechRevolution #innovatehealthcare #efficiency #doctors #FutureReady #ciotimes #ciotimesmagazine #moderntech #it #data #treatment #patientcare #cloudtechnology #transformation #cover #cloudtechnology #HealthTechRevolution #automation #coverstory

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The Most Admired Healthcare Leaders in 2024 Dr. Tim Calahan Driving Innovation and Improving Outcomes at Michigan Medicine through Cloud Transformation Good health is imperative to leading a happy, contented life, and is a basic human desire and right. However, from the beginning, mankind has been in a constant battle against disease. That’s why the healthcare field has always focused on supporting innovations that advance our ability to prevent, treat, and cure a variety of conditions. From sheer human brilliance to advanced technology, it makes use of every available resource to further that goal. 👉 𝑫𝒊𝒈𝒊𝒕𝒂𝒍 𝑴𝒂𝒈𝒂𝒛𝒊𝒏𝒆: https://lnkd.in/dDDvB9-d #healthcareleaders #admiredleaders #timcalahan #CTO #healthcare #DrivingInnovation #leadership #digitalbusiness #Strategies #AI #enterprise #technology #visionary #cloudcomputing #patientcare #HealthTechRevolution #innovatehealthcare #efficiency #doctors #FutureReady #ciotimes #ciotimesmagazine #moderntech #it #data #treatment #digitalmagazine #patientcare #cloudtechnology #transformation #HealthTechRevolution #automation #coverstory

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I've seen the story pop up on my feed twice now and I feel like I need to comment on it. The premise of this article to me misses the point of testing. Testing is not an afterthought. It is not something you tack on to a project. Testing should be built into and even precede development of a product by following test driven development. You write the tests before you write the code so that you know what result you're looking for. This article appears to represent the idea that generating tests for existing code will catch bugs and improve the code. But what if the code itself, although it functions, does not solve the business case? AI generated code, even by the article's admission, could result in faulty tests or hallucinated tests which make no sense anyway. Therefore, my very core rejects this article, and I advocate for proper test driven development processes. #tdd #ai #testing https://lnkd.in/gXspdPEH

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Having a ton of fun writing an ORM for V2 of Case Kit. Typescript has such an incredible type system. I have autocompletion for column names, the ability to include relations, relations of relations, etc etc etc... all returning properly typed data (no classes in sight). It's been really satisfying seeing it coming together, and it's been great getting my hands dirty with some (relatively) complex generics. And to head off the obvious question… why aren’t I just using Prisma? Well there’s a couple of things I’m doing differently that I think are marginally better: there’s no code generation involved here, it’s just types (inspired by Drizzle); there’s no Rust binary you need to deploy, and it hews much closer to Postgres behaviour and syntax (the aim here is not to abstract away which database you’re using). But the real blocker to me using Prisma was that its extensions don’t support modifying queries of nested relations - a hard requirement for me due to the way I have multitenancy and soft deletes set up. It’s not shown in the video but the Case Kit ORM lets you write simple middleware that will be applied to every level of a nested query. Perfect for setting timestamps or adding clauses on tenant id or things like that.

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If you want a lesson on inspiring loyalty in those who work for you, and garnering deep respect from the people who work with you, spend thirty minutes with Alexis Chitwood, MBA, PSM1, for whom phrases like "put people over process" go way beyond the words! "We follow the principle of people over process, putting people first the same way that we put our creators first. There’s a large sense of community and support at Raptive enforcing that idea that we can achieve more when we work together, and those lessons will stay with me forever." https://lnkd.in/eCYG_mw6

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This weekend, I’m diving into prototyping with AWS HealthLake and encountering some interesting challenges. I’d love to hear your thoughts on them. 🔄 Conversion Complexities: One of the major hurdles is converting data from CSV files, HL7 messages, or SQL databases into the FHIR (Fast Healthcare Interoperability Resources) model. This transformation process is not straightforward and took me almost few hours for patient and insurance FHIR resource 🔄 Resource vs. Bundle Decisions: Another critical aspect is deciding how to store the data once it’s in FHIR format. Should it be stored as individual resources or as bundles? Each choice has implications for performance, scalability, and data integrity. 🔄 Developer Knowledge: Additionally, working with AWS HealthLake still requires developers to have a solid understanding of healthcare interoperability standards and practices. This specialized knowledge can be a barrier for many teams. 🔄 Additional Challenges: • Ensuring data consistency and quality during conversion • Managing the increased complexity of FHIR structures • Addressing potential security and compliance concerns As I work through these challenges, I’m curious to hear from you: Have you faced similar issues? How have you solved them without relying on third-party interoperability developers? Your insights could be incredibly valuable as I continue this prototyping journey. #AWS #HealthLake #FHIR #DataConversion #Interoperability #HealthcareIT #Prototyping #DataChallenges

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