Recently Launched: Wardware 2.0

Over the last year I have had the pleasure to work with Airslie Ltd, a UK-based medical informatics company, and King's College Hospital (NHS Foundation Trust) to rewrite and extended their clinical observations and assessments system, Wardware®. Wardware enables the entry, analysis and display of Early Warning Scores and other patient datasets for clinical use locally or remotely on mobile and desktop computers. The application was originally built using PHP, sans framework, and the company who originally authored the application, Airslie, was motivated to rewrite it using an application framework. Their chosen framework was Ruby on Rails and they approached me to lead the development effort.

Desktop and Mobile views of Patient Chart

Facilitating the National Early Warning Score (NEWS)

The pivotal component of Wardware is the Observations and Assessments module. This module implements a number of assessments, including a key assessment for patient health, the - National Early Warning Score (NEWS). Early Warning Scores (EWS) are used to "quickly determine the degree of illness of a patient". This is determined by the scoring of physiological parameters such as temperature, heart rate and blood pressure. The total score assigns a patient to a risk category and the appropriate response, based on a predefined protocol, is carried out.

Physiological parameters are recorded using a mobile device, the MioCare Tablet, at the patient's bedside. The patient's charts, such as the NEWS chart can be viewed either on a desktop or the mobile device. The application has been developed using a Responsive front-end framework, allowing a single UI to be used for both desktop and mobile devices.

An extendible platform for supporting different assessments

The Observations and Assessments module is designed to be extended. It is a platform for implementing other assessments by simply configuring the physiological parameters and the assessment's calculator. Beyond NEWS, the Wardware installation at King's College Hospital is currently configured for:

• Glasgow Comma Scale
• Gastro-intestinal/Stools
• Body Mass Index

Key assessments summarized in configurable Wardboards and Charts

Key assessments scores for patients such as NEWS along with assessment frequencies and due times are summarized on the Wardboard.

Wardboard summarizing current admissions for a specific ward.

Assessments with a specific threshold (e.g. a NEWS score greater than two) are also summarized at a ward and site-wide level.

Observation and Assessment Charts are presented in three formats:

1. Graphical

2. Tabular with the most recent 20 observations

3. Tabular with all historical patient data paginated

A range of modules supporting a patient's tracking and analysis requirements

Wardware doesn't just support observations and assessments, it supports various tracking and analysis requirements to monitor a patient. Briefly these include:

• Oxygen Delivery Management, including the tracking of patient oxygen concentration targets
• Response Management, recording responses to assessments such as NEWS
• Device Management for surgical and urinary devices. Device Management tracks insertion and removal of devices for a patient, including the recording of complications
• Diarrhoea Management integrated with Stools based on the Bristol Stool type
• Blood Products Management (e.g. RBC, FFP, Platelets)
• Fluid Management tracking patient's fluid balance and reporting

Integrated admission management with the hospital's Patient Information Management System

Wardware's Admissions module completes the admission process by assigning patients to a bed in their designated ward. Admissions for wards are automatically populated through a custom module integrating Wardware with KCH's Patient Information Management System (PIMS) using the Health Level-7 (HL7) messaging format, "a set of international standards for transfer of clinical and administrative data between software applications".

And there's a lot more

There is a lot more detail I can go into, but this post is long enough. Here are some facets that I'll highlight here:

• Authentication and Authorization Management
• Patient search via bar code scan from admission bracelet
• Business Continuity Programme (offline storage of patient obs)

Domain Modeling Challenges

In future blog posts I will discuss some of the interesting domain modelling challenges of this project and how I leveraged Martin Fowler's Analysis Patterns. His patterns for observations and measurements is based on his work with the Cosmos Clinical Process Model for the UK National Health Service.

Recently Launched: Quarterly Co.

My last project at Dynamo involved the porting of a Rails application integrated with Recurly to Spree for Quarterly Co., an LA-based company. Quarterly is a subscription service, curating gifts by their selection of contributors shipped every three-months. Check out this beautifully written blog post written by Quarterly's founder, Zach Frechette, describing why he started Quarterly.

Key Objective

The key objective for this project was to move from their current model of billing their subscribers every three-months, to billing when a curated gift is shipped. Moving to this model also required some solid order management that their current application didn't provide. Spree, an open source e-commerce platform, was the chosen as the foundation for Quarterly's online business.

Technical Challenges

There were some interesting technical challenges for this project that included:

• Customizing Spree's "Product and Order"-based data model to support subscriptions.
• Migrating subscription data from two data sources, Recurly and the custom Rails application.
• Migrating an existing design to Spree's opinionated checkout flow.

Check out the screenshot's below or visit the site, you might find a contributor that you want to subscribe to. Treat yourself!

(A shout out to Rodrigo Dalcin, a Front-end Developer at Dynamo, who worked porting the front-end to Spree for this project. Thank you for all your help!)

Home Page

Contributor's Page

Recently Launched: Tarkett Sports CMS and Websites

An ongoing project I have been working on at Dynamo over the last year with Hugo Frappier is a custom CMS for Tarkett Sports, a division of the Tarkett Group, "a worldwide leader of innovative and sustainable flooring and sports surface solutions".

A multi-Site, multi-lingual CMS

Tarkett Sports required a multi-site, multi-lingual CMS to serve all the sites of their subdivisions. FieldTurf (North America) was the first to be launched on the new platform, followed by FieldTurf Europe and an API for their iPad sales tool, "Link". At the time of writing, Beynon Sports Surfaces and Tarkett Sports Indoor (North America) are set to launch within the month.

Built on Ruby on Rails and MongoDB

The CMS was built with the usual Rails stack, however MongoDB was used with Mongoid, an Object-Document-Mapper, instead of ActiveRecord and a relational database. This was my first venture in the world of NoSQL, and working with a schema less data store was a perfect match for the CMS. However, it did require a new way of thinking, such as being comfortable with de-normalizing data structures and ensuring those data structures can be properly index. For example, MongoDB does not allow indexing of parallel arrays.

Support a large content-base

Why a custom CMS? Why didn't we just use one of the prominent offerings such as RefineryCMS? I've implemented five RefineryCMS installations over the last couple of years, and Refinery's sweet spot is small websites. Tarkett Sports currently holds over 10,000 content items. Refinery's UI and tree data structure is just not appropriate for such a large content-base.

Publish content collections anywhere in the page hierarchy

We also took a novel approach to the page hierarchy. With platforms such as RefineryCMS and Radiant, structured content (think news and product catalog) containing large data sets are typically supported by creating custom Rails model view, and controller classes. There's usually wrangling to unify the site URLs with the routing system. The Tarkett Sports CMS supports the concept of a collection. A collection of structured content, small or large, can be published anywhere within the page hierarchy. No URL wrangling required, no custom controller class. Collections are a first class citizen.

Reduce custom classes, increase content type re-use

The benefit of all this is that it has reduced the number of custom classes required for a site by increasing the reuse of existing collections and content types. In the past, I have found myself creating custom controllers and models just to support a different content type with the same structure just so I can use it in a different part of the page hierarchy. The concept of publishable collections has solved this.

Below are a few screen shots, showcasing the different sites and portions of the administration screens.

FieldTurf (North America) Home Page

FieldTurf (Europe) Home Page

FieldTurf Products

FieldTurf Product Detail

Tarkett Sports CMS Admin: Pages

Tarkett Sports CMS Admin: Page Detail

Tarkett CMS Sports Admin: Page Publishing

Recent Launch: Yellow Bird Project Redesign

Earlier this year, I upgraded the Yellow Bird Project, a Spree store, from a forked version pre v0.90.0 to v0.50.x. For for my final project of the year, I upgraded Yellow Bird Project to v0.70.x, along with the implementation of a UI redesign. Jenna Holcombe (Dynamo) did a great job moving the YBP look to a grid-based design, which Daniel Wright (Dynamo) implemented this in Sass/Compass.
Since the redesign initiative included an upgrade to the latest version of Spree, I decided to upgrade the existing site and deploy that to production, before launching the redesign. This allowed me to upgrade our custom extensions to work with 0.70.x and iron out any kinks in the new version. While this was a smoother process than the upgrade earlier this year, it was the first time I had deployed to Heroku's Cedar stack using Rails 3.1 and the asset pipeline. I'm a big advocate of breaking down a project, separating major changes, and getting changes pushed to production early, even it there is a little duplication in work. The separate pushes to production for the upgrade and the redesign reduced the risk of something really going haywire with pushing both of these at once.
The redesign benefited the application from a platform, merchandising, and coding perspectives:

• Platform: While this initiative did not include a mobile version, the new grid-based design will allow us to cleanly develop a responsive design for mobile platforms in the future using media queries. Replacing hacks like Cufon with more modern technologies like web fonts just makes the UI code cleaner and performance snappier.
• Merchandising: The store now fully utilizes Spree's powerful Taxonomy and Product Group features. This allows YBP to respond to different marketing initiates such as seasonal events, for example Warm Winter Wear.
• Code: One of the cool things with this upgrade was the chance to refactor the code base. Shifting from ERB to Haml and plain CSS to Sass/Compass was a definitely a plus, however implementing a data model that capitalized Spree's catalog management was the biggest win. I was able to remove unnecessary extensions which simplified managing the products. YBP's Matthew Stotland is a code-savvy lad and appreciated the clean implementation. It's great to work on a project where the client appreciates the front-end as much as the code that drives it.

You can checkout the new design below, but better yet, visit the Yellow Bird Project and support a great cause.

Recent Launch: Mr. B's Gentlemen's Boutique for ALDO

Back in September, I had the pleasure working with Alex Nemroff (Interactive Designer) and Daniel Wright (Front-end Developer) at Dynamo on Mr. B's Gentlemen's Boutique, a new product line for ALDO Shoes. A tribute to Aldo Bensadoun, this project is dear to everybody's hearts at ALDO and I think we have made them proud. I was responsible for the setup and customizations to Refinery CMS, including the development of an extension to manage the catalog.

I always have a great timing working on projects Alex leads. He always gets us involved in all aspects of the project and the end result really does feel like a team effort. My favourite times throughout the project is sitting down together at the end of an iteration, reviewing what we have done, and what we can do to improve it in the next iteration. And it doesn't hurt to have a power house like Daniel on the front-end. He really knows his stuff.

Below is a video of the post-mortem at Dynamo, where Alex and myself talk about lessons learned throughout project. Unfortunately, we didn't capture the screen when recording this session (whoops, working on that), but I think you will find the discussion insightful. Please checkout the screenshots below, better yet, visit the site and checkout some beautiful shoes.

Post-Mortem at Dynamo

 

Screenshots

 

Recent Launch: Media Experts on Refinery CMS

Media Experts is a top Canadian media planning and buying agency. During the summer, I was tasked with the first iteration of their website, integrating it with Refinery CMS (thanks Dynamo!). One of the joys of using Refinery, is the ease of extending it with engines to support custom content types. For example the experts page seen below contained structured, repetitive data that was not suited for a page tree hierarchy:

By generating a custom engine, I was able to easily integrate this structured data into the website, without any impact on the original design or the website's navigation. You can view how the individual experts are edited in the screen shot below:

Please checkout the Media Experts' website and view additional screenshots below:

Home Page

Portfolio Index

Yellow Bird Project Spree Upgrade

During the spring, Dynamo asked me to upgrade the Yellow Bird Project to the latest version of Spree (at the time this was v0.50.2). The challenge for this project was managing the upgrade from a forked version of Spree, pre v0.9.0 back in 2009. One tool that was really useful was using Max OS X's FileMerge to compare database schemas, allowing me to determine what the new schema would and determine any naming conflicts with custom tables added previously.

The upgrade resulted in an application that can now be easily upgraded to future version of Spree and runs on a more stable, scalable platform thanks to Heroku.

The Yellow Bird Project is pretty cool - they work with a range of indie rock musicians to create some neat t-shirts that then benefit a charity chosen by the musicians themselves. So put away that ugly university hoodie and go get yourself some cool threads.

Recent Launch: de Gaspé Beaubien Foundation

OK, hardly a recent launch, de Gaspé Beaubien Foundation was actually launched in April, but I'm a wee bit behind in posting some of the neat projects I have worked on this year. I'm determine to get this resolved over the next couple of weeks.

de Gaspé Beaubien Foundation's website provides a platform to communicate the families contribution to their communities and the broader society. I worked with the great team at Dynamo on this one: Bob Beck, creative director was responsible for brand identity and video direction, Jenna Holcombe site design, and I was responsible for front-end development and CMS integration.

This is the first project I have used RefineryCMS, a Ruby on Rails-based Content Management System. While I have been a big fan of Radiant CMS, I like RefineryCMS for it's polish integrated interface. It worked great for this project, but I would use Radiant when a project has more complex requirements. The front-end was developed using HTML5 and CSS3. CSS was generated using Compass and Sass. Compass' CSS3 helpers are a real help abstracting away the mess of vendor extensions, and the CSS3 PIE integration giving older version of IE CSS3 capabilities is invaluable. All video is presented using HTML5, with a Flash fallback, all handled seamlessly by JW Player.

Check out the screenshots below and please visit the site to find out the great work de Gaspé Beaubien Foundation is doing.

Recent Project: Wayne Gretzky Estates

Not all projects need to be complicated! This was one of the simpler, low stress projects (yes they do exist!) of the year, working with creative director Bob Beck at Dynamo. I'm not a huge hockey fan, but who wouldn't want to work on a project with The Great One's name on it. For the tech geeks, Wayne Gretzky Estates is an online store developed using Spree, a Ruby on Rails e-commerce platform. Screen shots below.

Catalog

Gallery

News Index

News Article

Recent Project: "Aldo's Let's Dance" Fall Campaign

By the lack of blog posts this month, you might have guessed that I've been busy. You're right! I even failed to blog about a launch early this month. But here it is...

I had a great time working with Dynamo, located in the old port of Montreal, on Aldo's fall campaign, "Let's Dance". The concept is simple: upload a video of yourself dancing to Think About Life's Sweet Sixteen and let Internet groupies vote via Twitter, Facebook and/or YouTube. The entries have been fantastic, the traffic through the roof, and voter participate off the charts. It's definitely the most fun I have had all year. Check out the screen shots below and some technical details for those inclined, but better yet visit the site before 6th December to get the full experience before voting ends.

Thanks to Alex (Interactive Director), Jenna (Senior Designer) and Marie (Front-end Integrator) from Dynamo who made this such an enjoyable project to work on.

Home Page

Gallery

Video

Registration

Technical Details

"Let's Dance" is built using Ruby on Rails, tested with Cucumber and RSpec and deployed on Heroku. The application integrates several different services via Oauth: Twitter, Facebook and YouTube. By using Oauth we are able to track unique votes, as each vote is captured with the voters Oauth ID, but still allow visitors to share videos as many time as they wish.

Video uploads and approvals are managed using YouTube Direct and deployed on Google App Engine. While this saved development time, the open source application does not currently support Internationalization. It was possible to "hack" this in, but it was more time consuming than it should have been. Having said that, it was great to be able to off load all video processing and management to YouTube.

Deploying on Heroku is a huge help with the sudden influx of traffic. With campaign sites, there's no ramp up with traffic, so the application has to handle large amounts from day one. We monitor performance using NewRelic (on-demand application management), to ensure the application has the resources it needs for fast response times.

Need help with you Ruby on Rails application?

Please contact Nicholas Henry at Firsthand Web Design.