As healthcare systems around the world evolve into a fully digital experience, developers in the healthcare industry look for a language and platform to focus their attention on. PHP has not been a slacker by any majority. From its easy database integration to its ever evolving speed and maturity, PHP in the healthcare industry today is a widely adopted tool and it may surprise you just how widely it is used.

    PHP has been around since the mid 90s originally created as a scripting language to interface with binaries written in the C-programming language (5). After iteration and iteration popularity has blown up to create the basis for over 80% of the active web today (1). Thats right, 8 out of every 10 websites you have visited are most likely made with PHP. A couple major sites you may know of is Facebook, WordPress, Flickr, and Wikipedia just to name a few (1). PHP is known for its ease of use and fully integrated server side scripting. Since its been around for a while and still considered modern, you’ll be hard pressed not to find any senior developers to hire who know how to program in PHP. That is not to discredit younger developers either. In the past 10 years, we have seen a market share grow from 11% to 26.2% worldwide. That is only about ~6% less than the already popular C# and ~15% less than Java at 40% of the market share. (6). This gives anyone in the industry hope that PHP as a language should stick around for at least the next 10 years. (Obviously until something way better comes along.) So why choose PHP for programming in the healthcare industry? Simply because of its high availability, adoption, and great integration with databases. Something hospitals have an ever growing number of as we approach an always connected world in 2021.

    From 2004 to 2017, hospital adoption rate of digital EHR (Electronic Health Record) systems has blown up to 96% (2)! And for good reason too. Having an EHR compared to paper records have helped save lives by having live, up to date, accurate information that can be sent from floor to floor, hospital to hospital, or anywhere that’s needed really. This amount of data created is massive and what other language to handle large amounts of data in conjunction with a database than PHP. Data needs to be entered in forms all the time, and having an always available system or webpage to import patient data is vital to the EHR system’s success and PHP is perfect for sending forms of information into a system. PHP is huge in creating web apps in healthcare. An application that can be added and accessed from any device, whether desktop, mobile, tablet etc is an amazing tool to collect and retrieve vital data, records, and insurance connections for the patient (1). The exponential impact on quality of service isn’t just for the patient, but for the healthcare workers, ie doctors, nurses, techs, is highly beneficial to them and the industries success. As a patient, being able to order prescriptions online, schedule appointments, see past visits, or view lab results instantly or as soon as they become available is amazing. Something unheard of 20 years ago! Especially in 2020 with our current COVID-19 pandemic, seeing test results as fast as possible is vital to everyone’s safety and its all mostly done with PHP! PHP isn’t just for web apps too, its a full blow programming language that enables developers to create great applications for any app store to help, for example, connect patients and doctors over video chat. Easy migration of web apps to standalone phone, tablet, and pc apps is a wonderful experience that expedites development, cuts down on costs, and reaches an even broader audience for patients. Something the industry has been trying to solve to save lives and make everyone live healthier as a result. Many EHR systems are connected to massive databases run using MySQL, SQLite, FrontBase, Oracle, IBM, OBDX and so much more, all highly compatible with PHP (1). PHP is famously web based and used for many social media platforms, so it is known to handle large amounts of simultaneous visitors at once. This is exactly what any healthcare EHR system needs to run efficiently, stay available at all times, and cater to any number of users, anywhere in the world (3).

    Development, integration, and high availability enable lots of data to be produced and stored for many many uses. Big Data comes to mind and its impact on the healthcare industry and as a whole (7). With vast amounts of data about patients, visits, location, sickness etc, trends and predictions can be produced to help us as humans understand what’s going on around us. Specifically prediction, finding when the next pandemic may hit and how to isolate it and stop it is now most likely priority number one in the industry. Enabling real time alerts based off location, patient data, and past results is already a thing today. For example, if you have an Apple Watch and lets say you fall with fall detection on or your watch tells you that you’ve been having irregular heart rates, that data can be sent to your doctor with a push of a button to diagnose you before anything major, like a heart attack, could even occur. And with all that data collected, the watch can suggest different workouts and ways to keep you in shape if it detects anomalies that can be corrected. Isn’t that amazing! PHP, if implemented correctly, is also highly secure (5). With more secure ways built right in to handle user data connecting to servers to be stored. After chatting with a few friends in the healthcare developer side of the industry, they all confirm that they have seen a push with prediction, analytics, and just broadly, the impact of Big Data information integration. All thanks to the input and systems that run using PHP. 
​
    This highly customizable, expandable, and reliable platform to develop with here to stay and I can only predict its adoption will grow exponentially in the healthcare development world. PHP is widely adopted, easy to develop on, and highly secure if built right, perfect for the healthcare industry.


Follow Daniel Burns on Twitter, @DBurnsOfficial

Ad:

   This week I was surprised to read about the direction AT&T has put out for the future of its acquired satellite tv service DirecTV. At an investor conference John Stankey, president of AT&T, admitted that DirecTV is no longer seeking subscribers for its service. DirecTV has seen its subscriber count fall from 20 million to 16 million since they bought the company for $49 billion back in 2015. Initially seen as a great addition to AT&T’s media arsenal is now becoming a pain in the neck that might have to eventually be cut off.​
​
    Stankey said AT&T will continue to sell DirecTV but only in “more rural or less dense suburban areas.” Given that DirecTV was originally launched in 1994 as a way for rural subscribers to watch tv in areas not covered by traditional cable, its not much of a surprise that strategy isn’t working too well today. “But in terms of our marketing muscle and our momentum in the market, it will be about software-driven pay-TV packages." AT&T TV (Starting at $50), not to be confused with dying Uverse, made its debut this past week and has been greeted with poor response due to its need for equipment rental and a two year contract upon signing up. This structure is exactly what people are trying to avoid by streaming in the first place. Anyone can go out and buy an Apple TV or streaming device that can run apps and services such as Netflix, Amazon Prime, Hulu, and YouTube TV. So the need to rent a device that can do the same thing doesn't appeal to consumers anyone. 

    AT&T isn’t the only company trying to push this model of renting their own device. Both Cox and Comcast have a wireless standalone smart box that runs on Comcast’s X1 platform allowing basic cable and apps over the internet. It just doesn’t make sense to rent a box anymore to watch tv. If you just buy an Apple TV 4K for example, it offers a way more premium experience to users than anything big cable can put out. In fact the AT&T box required for its new streaming service is just a custom made Android TV box with its own AT&T branded skin on it. Nothing too special about it at all. So AT&T’s decision to cut back on DirecTV’s service ends up making a-lot of sense from a marketing perspective.

    One big draw to DirecTV is its NFL Sunday ticket which gives you access to every live game across the country in one package deal. But in two years their contract with The NFL is set to expire and it doesn’t look like AT&T is planning on renewing it either. As AT&T looks to expand its presence in the now crowded streaming market with HBO Max and now AT&T TV, it needs to shift its resources away from aging DirecTV. There have been talks of selling off DirecTV after Sunday Ticket expires to satellite competitor Dish Network. Who ironically also owns Sling TV in the streaming TV space. According to Wall street analyst firm MoffettNathanson; about 6 million subscribers ditched satellite and cable in just 2019. If this were to happen Dish would be the only satellite TV provider in the US to cater to those who still need satellite tv with a combination of over 25 million subscribers. With the emergence of 5G and internet seemingly almost everywhere these days, steaming tv is bound to be the go to when available. Whether the streaming market is becoming too crowded is another story to cover.

    So, what happens to anyone wanting to sign up for DirecTV in urban areas? Looks like its tough muck for them. Just switch to streaming because it's the end to a long and pricy era in traditional pay tv. There are two main live tv streaming services that I see still remaining. YouTube TV ($49.99), which is owned by Google, and then there’s Hulu with Live TV ($55), which is owned by Disney. Both services have big backing and carry so much potential to survive if they can keep prices down. Or at least low enough when combined with the price of internet so that it's still a better deal than the traditional cable package of yesteryear.

   In my strongest opinion, cable tv is just about dead and DirecTV is just another nail in the coffin. It was a terrible purchase by AT&T and I’m pretty sure they see that now. Before AT&T bought them their service was decent, very competitive to cable (at least in the first year), and their technology was actually pretty good. But it all went down hill as they were bought, left to rust, and streaming tv apps on flashy new platforms looked a lot better. So here’s one last toast to DirecTV as its put out to the pasture and sold off for scraps.

Follow Daniel Burns on Twitter, @DBurnsOfficial

Ad:

      Jimmy Iovine is an American record producer who founded Interscope Records in 1990.  In 2006 he and rapper Dr. Dre founded Beats Electronics. Apple bought Beats and their just off the ground music streaming service in May 2014 for $3 billion dollars. Apple then turned that service into Apple Music and still continue to make and sell Beats products today, but with an Apple accent. I recently read an article from The New York Times written by Ben Sissaro interviewing Iovine on leaving Apple. And it was what he said about the music streaming industry that got me thinking. Music streaming services need something to set them apart from each other and, at the moment, they are all pretty much the same. Iovine outlined a central problem with streaming services today calling them utilities.

    “And the streaming music services are utilities — they’re all the same. Look at what’s working in video. Disney has nothing but original stuff. Netflix has tons of original stuff. But the music streaming services are all the same, and that’s a problem.”

    What he said is what I hope other streaming services pick up on loud and clear. Music streaming services need exclusivity and original content to survive. Much like Disney and Netflix have original content they produce for themselves. As we know with original content in video, it draws people in and creates a loyal fan base of viewers who come to watch exclusively on a platform for a certain show or movie. But with music, all the services pretty much have the same catalog of artists and albums to choose from. Aside from special exclusive releases, it all ends up on all the services eventually. You don’t see a Netflix made show on Amazon Prime Video and you will probably never will. So what’s stopping, let's say Apple or Spotify from doing the same thing? The only thing comes to mind is record labels and contracts with artists. If Apple would sign artists to do exclusive content just like they do with TV+, then I think they would succeed over Spotify by bringing in more loyal listeners. It wouldn’t be very hard for them either. Apple has had a way better track record of having good relationships with artists versus Spotify. If you remember the Taylor Swift pay rights debate, Apple responded. Spotify has been in deep water before by paying artists less on their service compared to Apple. This isn’t just happening with streaming tv video, the online streaming gaming community is seeing this happen with Amazon’s Twitch competing with Microsoft’s Mixer. Mixer picked up an exclusive deal with previous Twitch streamers Ninja and Shroud in hopes to attract more subscribers to its new service. To some degree it has succeeded. Iovine highlights the biggest problem with growing a music streaming service.

    “It doesn’t scale,” Iovine said. “At Netflix, the more subscribers you have, the less your costs are. In streaming music, the costs follow you.”

    Even with a healthy growing number of subscribers the same pay rate per play, due to contracts and equal opportunity deals with artists and record labels, doesn't go away unless the actual service, like Apple, were to sign with the artist, produce and record in house, and release their song or album exclusively as original content. Apple has some very smart people working for them and Spotify does too. So one day I suspect this will happen. In fact, this will need to happen to keep rates the same and to make music streaming more profitable. This also applies to Spotify's growing podcast service in competition to the gold standard, Apple's stand alone Podcast app. Whether or not this leads to tiered pay levels of service remains to be seen. But something has to be done and the name an Apple Music Original doesn’t so sound crazy.

Quoted WSJ Article

Follow Daniel Burns on Twitter, @DBurnsOfficial

Ad:

Ad:

Ad:

With the improvement of technology and miniaturization wearable tech is getting more and more advanced every year.  Wearable devices consist of three main categories; smartwatches, health and fitness devices, and AR/VR (Augmented Reality and Virtual Reality). Just like smartphones and computers in general, these devices are getting smaller and smaller while gaining power and capability the world couldn’t of imagined 5 years ago.

    For smart watches, the dream started in the 1930’s on television with the imagined radio commutation watch warn by Dick Tracy himself. Today this is a laughable reality with the addition of popular smartwatches being constantly connected, used as communicators, every single day. Smart watches started out as being a companion device to the smartphone. Connected via bluetooth, the smart watch was a way to display notifications and alerts on your wrist, track steps, and later monitor heart rate. Most of all still do very well today as those are the bare minimum specs to become a “smart watch.” There are a ton of smart watches on the market today from Apple, Samsung, Fitbit, LG, and the now defunct Pebble. But let’s look at the Apple Watch as the gold standard of smartwatches. After all, the Apple Watch now towers over any completion thanks to its massive 80+% growing market share. It started out as a really stripped down companion to the iPhone with all the basic features, an OLED display, thick shell, and only single day battery life. Now the current Series 5 is bigger, thinner, more powerful than the first 4 iPhones, has an always on display, and connects via LTE and Wifi alone when the iPhone isn’t in range. The Apple Watch has become the next iPod so to speak with its small form factor, and ability to stream and store millions of songs directly form your wrist with the help of some bluetooth EarPods or AirPods. Since the introduction of the Series 4, Apple has added the ability to take an ECG anytime on your wrist in addition to regular heart rate monitoring. Which is crazy cool and the first of its kind to be FDA approved!

    Which perfectly leads us into the health and fitness category of wearable devices. There are a numerous players in this category from the makers of Polar, Garmn, Nike, Basis, Withings, and now including Apple. These devices don’t just monitor heart rate and activity, but some can track blood pressure, sleep patterns, and other types of physical activity. Some devices can be worn around your chest with a strap, belly, arm, and wrist. Most people now prefer the wrist because of its convince and less restrictiveness during workouts. In the past chest worn devices were more accurate than wrist warn but every year sensors, data, and now AI has filled that gap along with the previously mentioned user convenience towards wrist warn being the preferred. The Apple Watch and some other devices have been credited numerous time with saving peoples lives thanks to early detection using the devices. For example the Apple Watch will let you know if you have afib thanks to monitoring for irregular heart rates, high heart rates, and now low heart rates. May have been pre diagnosed before doctor confirmation of symptoms thanks to the incredible capabilities of the Apple Watch and wearable devices as a whole. You can even thank the device in emergency situations when your phone is out of reach thanks to fall detection, automatic 911 calling, and on star type emergency button convenience.

    Other types of wearable devices now include AR and VR goggles and glasses. With VR or virtual reality googles, you can put them on and step into a whole nother world dreamed up by game developers. VR goggles and handsets rest over your head and slide onto your face covering just your eyes and ears. Using two small but high pixel dense screens and lenses, the VR goggles let you see something unlike the real world and move about the virtual space to play and explore to your hearts content. Now AR or augmented reality you overlay information on top of the real world. This can be done with glasses and small transparent screens or projections onto your eyes. It can also be achieved on your smartphone using its camera and moving about the room. In both situations you can use your hands and controllers to play and position items. It really is a unique experience that is best just explained by actually doing it in person. VR and AR is powered either internally in the goggles or glasses like a smartphone or externally through a one cable solution connected to a gaming computer or a computer with a graphics card capable of powering the experience. The most successful VR devices on the market are from Oculus and HTC with the Rift and the Vive while AR glasses have been made by Google with the Google Glass or Microsoft with its Hololens.
​
    Wearable technology has come a long way thanks to the evolution of technology and Moores law. Miniaturization of components and complete systems have enabled devices like smart watches and VR glasses to become more powerful and more capable. I can’t wait for the day we wear AI powered communicators and step into full room virtual worlds just like Star Trek and The Orville alike have imagined. Dream on and virtual reality might just become our reality.

Follow Daniel Burns on Twitter, @DBurnsOfficial

When it comes time to buy a new monitor to go along with your new computer, in addition as a second display, or even replacing an outdated one for your current setup, the decision you have to make may seem like daunting task. Not to worry, let's break down the three main types of displays and their varying technologies to find the best use case for your next monitor. We will be going over specifically flatscreen monitors , after all it is 2019 and no one is buying a CRT (Cathode Ray Tube - Tube Type Large Monitor) brand new anymore.

    Let’s start with size, one of the most important aspects to when selecting a monitor. Get it? Aspects? Anyway, if your current monitor has a small screen size of lets say 17”- 22” inches, measured diagonally, and you think its on the small size then by all means upgrade to your hearts content. Of course there are limitations to size when it comes to how much room you have on your desk, what it’s being used for, how far away do you sit from the screen, and then of course budget. Monitors, when compared to TVs have a different guide or general rule to how close you should sit in front of them. You can do a quick Google search about monitor distance relevant to your size that you want to select. You will even find calculator to input custom distances and sizes aside from the basic charts. For example if you have a 24 to 29” inch monitor the general rule is to sit an arms length away from the screen or about 4 feet for a healthy dosage of screen time. You will hear results will vary depending on use case allot during this paper because it really does. 

    Once you get your monitor size down now you will need to establish a budget and main use case. Generally if you want to save money the smaller the size of screen, then the cheaper they get. Then the bigger, the more expensive it gets, not including additional features and creature comforts. If you do everyday light email browsing, web surfing, and word processing then a cheaper and smaller screen with a resolution of 1080p at about $80 to $200 is fit for you. If you do that plus some light gaming then a bigger screen with a resolution of 1080p or 1440p that costs $200 to $300 is your ticket. But let's say you do some intensive gaming and edit photos and videos on the side, then expect to have a budget of $400 to $1,000 with a 4K resolution. Then at the very top of the market and you want it all, you’re an extreme gamer, or edit large videos and photos, then you already know you will be spending $1000+ on a single monitor with at least a 4K (2160p) or even 5K or 6K resolution these days. So adjust your budget to screen size and use case for the most part and screen technology will follow suit.

    Now let's get technical and get into the different types of monitors you may come across. Mainly three types of flatscreen technologies. First you might find cheaper and often smaller TN Panels which stand for twisted nematic. This is a type of LCD (Liquid Crystal Display) LED display that sacrifices color accuracy and viewing angles for perforce and budget. A TN panel has some of the fastest response times and high refresh rates for a display. For gaming, video editing, and just plain pleasure, having really fast response times and refresh rates is top priority. But a TN Panel also has some of the worst viewing angles on the market, meaning that when you view the screen at any other angel then straight on, colors, brightness, and clarity is greatly reduced. Next we have the middle child of display technology, the one that usually rides the line between price and performance. The VA panel or vertically aligned usually has the longest and slowest response times but really high refresh rates. You might not find a VA panel as often as a the other two because it's generally the most expensive. Best suited for viewing slo motion, high resolution playback during sporting events or slo mo shots on the shoot thanks to its high refresh rates. Colors and viewing angles on a VA panel are usually better than a TN panel thanks to its high contrast and image depth but when compared to the mack daddy of monitors, the IPS panel, it squashes them both. The IPS display, also called In-Plane Switching, is what you will generally find these days. Your TV is probably IPS, your phone’s screens are definitely IPS and most laptops are now IPS too. IPS panels give you the best color accuracy, contrast, brightness, and viewing angles out of any monitor. You can practically look at an IPS monitor at any angle, let's say 180 degrees to the side and not notice any degradation to quality and brightness. But they are currently the most expensive on the market for very good reason. Their refresh rates on the other hand are pretty lacking when compared to the others. But every year they are getting better and better and we are getting to the point where most IPS panels are good enough to be in a cheaper device or monitor.
​
    So let’s wrap this up. It all really comes down to your use case. For the average user and every day Joe Shmo in 2019 a 1080p, full HD IPS monitor, with a screen size of 21 to 24” that costs around $160 would be great for the masses. If you’re a gamer or video editor then a high refresh rate, 4K, IPS monitor for $600 with a size of 27 to 32” is your best bet. You will always want to look at longevity and being “future proof” as a factor for spending more as well. Then if you have no budget, well, go crazy and treat yourself. Once again it comes down to use case and budget, then the rest usually falls into place.

​Follow Daniel Burns on Twitter, @DBurnsOfficial