To Your Health

Microsoft recently announced the impending shutdown of its HealthVault service, effective November 20, 2019 (see https://www.healthvault.com/en-us/healthvault-for-consumers/) . I am sorry to see it go, but I understand the competitive pressures and shifting landscape that led to its demise. We can learn from studying its triumphs and errors.  

You’ve probably never heard of HealthVault (HV), which is part of the problem. HV is (soon to be was)  a personal health record that lives in the cloud. Think of it as your Live email account, except that it holds an electronic copy of your data from all health providers. Imagine that Dr. A tests your blood and gives you the result on paper. If you are extremely organized, you take that paper home and store it in a binder, which you bring on your visit to Dr. B, so she can see what Dr. A did. But if you’re like most people, the paper floats around your desktop for a month, until you spill coffee on it and toss it. If Dr. B needs something from Dr. A, she’ll call his office, and they’ll send her a fax. Not exactly today’s standard of care for any other industry, but somehow medicine seems to muddle through with it.

With HV, Dr. A’s computer would upload the data (with your permission) to your HV Record (HVR). Home medical devices, such as blood pressure readers, could also upload their measurements to your HVR. When Dr. B wanted that data, her computer would fetch it (again with your permission) from your HVR. The doctors’ systems don’t need to know anything about each other. All each system needs is an HV gateway.  Sounds like a good idea, doesn’t it? Yes, but:

Microsoft prioritized the user’s privacy, which doesn’t sound like a bad idea.  All the data in a user’s HVR is owned at all times solely and absolutely by that user. The user could grant Dr. A’s computer the right to access it, and then rescind that right at any time, without consent or even notification of Dr. A. Fine, customer in control and all that, but here’s the snag: this means that Dr. A’s computer system couldn’t use HV for its primary data storage, because his access could be cut off at any instant. HV offers nothing to assist developers of the doctor’s main clinical program. HV only offers interchange with whatever other HV apps might exist. It’s purely a network app, the utility of which grows with the square of the number of users, but which has no utility at all in a standalone situation. Few vendors considered that benefit cost-effective.  

Or sometimes even desirable. Given the consolidation in the health care industry, executives care greatly about communication within their own network, but not so much outside it. Boston’s Beth Israel Lahey medical center wants easy communication among its 4000+ doctors. It cares much less about easy communication with the 6700 doctors at Partners, the area’s other dominant practice.  

HV could also be difficult to use. Allowing Dr. A’s computer to access your HVR was cumbersome. His system had to negotiate with HV, passing it a security question and answer, providing you with a GUID and a URL. You had to navigate to that URL, correctly answer the security question and then type in the GUID. It was very secure – Dr. A’s system never saw your HV credentials, or even your HV user name. But it was too hard for most civilian users, especially if they were old (hence less computer-literate) or sick or both.

I liked HV from its inception. I taught some classes on it, consulted on several HV projects, proposed a book on it (that MS wouldn’t pay for), used it for my Xamarin CHF weight tracker app (see https://msdn.microsoft.com/en-us/magazine/mt814422.aspx).  But Microsoft never solved the chicken-and-egg problem: which vendors would put an HV gateway onto their apps, until enough others did? Almost every vendor took a wait-and-see attitude, and while everyone waited, nobody saw.  

Because, finally and most telling, the HV ecosystem lacked a killer app – one that users would join an ecosystem to use. The killer app for the IBM PC was Lotus 1-2-3; for the Macintosh, it was PageMaker; and for Windows, it was multitasking and Solitaire, not necessarily in that order. If Microsoft had somehow provided, say, a HV app that would guarantee an extra fifteen minutes of sleep each night,  they might have bought themselves enough adoption to start the virtuous cycle.

But Microsoft didn’t, and now they’re shutting down HV. So it goes. These are the lessons that Microsoft has, I hope, learned, and that you have now also learned on Microsoft’s dime. Bayete, HealthVault.

Punishment and Crime

Ladies and gentlemen, I have once again snagged a major scoop. Edward Snowden, still in Russian exile, has favored me with another leak. He’s annoyed that Obama pardoned Chelsea Manning but not him. “What do I have to do, get a sex change?” he fumed. He really enjoyed the firestorm when I published his leak of the Siri-Cortana affair (“Siri and Cortana Tangle”, April 2015, https://msdn.microsoft.com/en-us/magazine/dn948115.aspx).  So to stir up more trouble, he sent me this transcript of Vladimir Putin conspiring with his chief hacker, Roman Rodionovitch Raskolnikov.

Putin: Raskolnikov, that was great job you just did, hacking Democratic party.

Raskolnikov: Spasibo, gospodin [thank you, sir].

Putin: How you get into Hillary’s server?

Raskolnikov:  Was easy, just guessed password: “MadamPrez”.  Nichevo [hakuna matata].

Putin: Did she use it when she was secretary of state?

Raskolnikov: Are kidding, boss? She using it when Bill governor of Arkansas in 1979.

Putin: Does NSA not make her change it once in while?

Raskolnikov: Sure. Like everyone else in whole world, she just bump up last character. MadamPrez1. MadamPrez2. Pozhaluysta. [Please].

Putin: What you use for front end?

Raskolnikov: VB6, of course. Doesn’t everybody? We really screwed if Microsoft ever break compatibility. Might have to learn .NET. We call it .Nyet for reason, you know.

Putin: Obama said he retaliate against us: “When we want, in our own time and we may not even make it public.” Did he ever do anything?

Raskolnikov: Da. Someone sneak through black web and wipe out my high score in Tetris.

Putin: How bad?

Raskolnikov: Not terrible. Tetris is Russian game, after all. I get it back in afternoon. Have great hack, drop long block whenever I want it.

Putin: BTW, I’ve always wondered. Are you guy from Crime and Punishment?

Raskolnikov: Was my great grandfather. Dostoevsky really hammered him.  

Putin: Does book remind you of today?

Raskolnikov: Today more like The Idiot. I snagged Podesta’s password with classic spearphish: “Your password has been compromised. Please click on this link to change it.” Like candy from baby. My 6 year old knows better.

Putin: And there goes Plattski guy, publishing leak. I wish he’d just shut heck up.

Raskolnikov: So do his readers.

Putin: You told me you hack municipal birth record files, and his family name originally Platovsky. Has Russian blood, I hear.

Raskolnikov: Maybe we get him over here, then spill some of it.

Putin:  What next for you?

Raskolnikov: Well, Trump just proposed that US and we cooperate on cybersecurity plan. Think we should, boss?

Putin (chuckles): Sounds like putting wolf in charge of sheep herding. I like it.  Got other ideas?

Raskolnikov: I put bot on Trump’s Twitter feed, pretending be biggest fan. Start self-reinforcing positive feedback cycle. Never thought I get away with it. I mean, just name, Nicole Mincey. And Trump actually believe. Too easy, like dynamiting fish.

Putin: You must have read Plattski’s article on Ashley Madison chatbots.  (https://msdn.microsoft.com/magazine/mt620019).  Just present users stuff they fervently wish was true, then they’ll deceive themselves.

Raskolnikov: Works every time.

Putin: What you have for 2020 election?

Raskolnikov: Same as for Trump, boss. Email bots flooding inboxes, encouraging entire Democratic party to run for presidential nomination, promising grass roots support. They spend all time and money fighting each other, nothing left for run against Trump.

Putin: Is working?

Raskolnikov: Just look at Democratic candidates. Pete Buttigieg? Marianne Williamson? Robert O’Rourke? Shutki v storonu? [Seriously?]

Putin: You’ve earned vacation. Got plans?

Raskolnikov: I’ve always wanted visit Disneyland. They wouldn’t let Khrushchev go there when visited Eisenhower in 1959. I wanted to vacation there next winter, when cold here. But now they arrest me if I set foot in US.

Putin: That’s OK. I’ll just ask President Trump to pardon you, like sheriff guy.  Will you hack yourself  VIP pass so you won’t have to wait in line at Space Mountain?

Raskolnikov: Tough one, boss.  Hacking NSA is one thing, but Disney geeks are really on ball.  I think I’ll have to pay for that one myself.

Welcome, friend!

You’ve reached the new home of “Don’t Get Me Started”, which graced the back page of MSDN Magazine for almost ten years. (Archives here.) Microsoft recently retired that publication, so I’ve moved my column here. I’ll be keeping a regular monthly schedule. You’ll find the same wise-but-irreverent take on the state of the software industry. As always, you can depend on me to call ’em as I see ’em. So why not subscribe to notifications, using the button at the bottom of this page?  And send me email via this form if I can ever help you with anything. I look forward to continuing our friendship here.

David S. Platt teaches programming .NET at Harvard University Extension School and at companies all over the world. He’s the author of 11 programming books, including “Why Software Sucks” (Addison-Wesley Professional, 2006) and “Introducing Microsoft .NET” (Microsoft Press, 2002). Microsoft named him a Software Legend in 2002. He wonders whether he should have taped down two of his daughter’s fingers so she would learn how to count in octal. You can contact him at  the link above.