There’s a lot of talk in the US and other countries about the moment about Health Reform and how Personal Health Records (PHR) aka Electronic Health Records (EHR) from the like of Microsoft (HealthVault), Google (Google Health) and others (e.g. Dossia) are going to make things more efficient.

Sadly in a lot of cases the people they seem to make more efficient for are the Hospital Administrators and Insurance companies who’ve done a good job of letting costs spiral out of control to improve their shareholder returns rather than providing good value healthcare at low cost to the consumer and the tax payer.

Maybe adopting PHR frameworks is going to help reduce costs and make Doctors lives easier but without a personal-centric view I’m not sure how it’s going to help the recipients of health-care – you and me.

What happens if I’ve chosen to put my data into HealthVault yet the hospital I get admitted to only has a Dossia based system. What happens if I change dentists from a Google Health affiliated provider to a HealthVault practitioner. Will my Chiropractor in the US who uses HealthVault be able to access the X-Rays taken at a Medical Center in Australia or the UK?

And will any of them be able to access personal data the should be taken into account as part of holistic health based approach to maybe stave off the need for medical attention – personal training, gym and other exercise?

I use an Omron pedometer which I track in HealthVault via the WalkMe service. My Polar FT80 HRM however stores data in their service. I use the equally isolated gtFtr to track random workouts and weigh-ins. Other people may use something like a Nike+, FitBit or a Philips DirectLife (with personal recommendations) to track their activity and a Withings scale that twitters your weight to your followers. Every time I go to the gym there’s no record of what I actually did there (hence the need for a Gym Buddy) so there’s no way my doctor knows I’m actually following their recommendations or my personal trainer to see the results of my latest checkup.

There are initiatives like Continua to come up with common standards for connected equipment but at the moment they seem to have some IP requirements standing in the way of getting more people to the table.

Without a way to put the focus on the individual and get people to buy into the concept adoption will be slow and painful but if there’s a way for people to connect and see the impact of their choices (or the benefit of their good behaviors – as sites like Dental Optimizer try to go) I think the impact of PHRs will be more far reaching than just helping a few administrators cut down on their paperwork

Providing customer service costs money. Providing good customer service takes commitment and money. Money to hire the right people, commitment to provide a good level of service and learn from what your customers are telling you, and more money to actually do something about it.

What does indifferent customer support cost? While it doesn’t hit your bottom line today it’s going to have an impact when the customer doesn’t come back or shares a negative opinion and you lose business.

I know how tough it can be to provide good service. I spent some time running a support team for a software company as well as making sure we had support in place for premium services on some web properties. In every case there was a cost associated with creating service levels that made the customer feel you were on their side, and a cost associated with resolving the issue (sometimes engineering costs, sometimes time, sometimes smiling and giving a refund and hoping we’d do better next time) – from this I learned a simple lesson.

I learned that you don’t treat support as a necessary evil, you treat it as a pre-sales and marketing exercise and you focus on making happy people who are more likely to engage with you and your brand again. If you focus on getting them off the phone as quickly as possible with as little fuss as possible then you’ve already lost the battle.

As technology improves providing good service shouldn’t be hard. Companies like Starbucks, Comcast, HP and Polar all have multiple ways to talk to them – Live Chat, Twitter, Forums, Email, support systems like FogBugz – all of which allow tracking and continuity of engagement and potentially very public resolutions.

How they approach the task is very different and varies from ignoring negative comments and promoting positive ones through to active outreach and open communication. Sadly though even where individuals do a good job the process and attitude of the company lets them down (I’m looking at you HP – does it really take weeks to find out you don’t know how to change the assignments of buttons on a PC you make?!)

With a current issue with another company they have been great. Lots of communication and I’m sure we’ll resolve the issue and I’ll say nice things about them in the future.

The opportunity cost to HP of providing ineffective support is that I bought a new Acer machine at the weekend for home, so for want of a simple software fix they lost at least one machine.

Blogging has been great for a lot of folks as residual income from Amazon or ads at least covers the hosting and beer money.

As more people move to micro-blogging with services like Twitter the question has turned to how people (including Twitter themselves) can make money on these services.

Ad.ly like to think that they have an answer with sponsored tweets – though delivering one every couple of days at a buck a tweet (and a $50 minimum payout) it’s probably going to be a while before they see their first millionaire!

I thought I’d give it a try just to see how it compares to the other click-through stuff I have hosted here…

A few weeks ago I came across a really intriguing short story and an even more intriguing idea…

The idea was simple. If Robin could raise enough pledges to buy the story he would write and publish a book. It seemed like a great idea so I made a pledge – partly out of curiosity, partly because I really enjoyed the short story and wanted to read more and partly because I really like the idea of independent artists making it without needing big business.

Robin quickly raised the minimum and set out to create the book. Along the way for supporters he gave us insights via Kickstarter, email and twitter into the creative process and even opportunities to help shape the work as it evolved.

After an amazing short time a mysterious package arrived through the post – my copies of Annabel Scheme and the really cool this was seeing my name in the credits along with the other contributors.

View Full Album

(oh, and I’ve started reading and it’s everything Robin promised and more…)

By now you’ve probably seen the news – MIX10 is happening in Las Vegas in March and registrations are now open – sign up before January 15th and you save $600 off registration and get a free night at the Mandalay Bay (the new location for 2010)

MIX is a conference about designers and developers so the call is open for content – and once the submissions are in you’ll be able to vote on the sessions you want to see.

Of course, you’ll want to show your support so there’s a simple way to add some bling to your blog

<script type="text/javascript" src="http://blog.offbeatmammal.com/samples/mix10/mix10bling.js"></script>

if you define two variables in your javascript before you call the random blog bing script then you can over-ride the width and height - just like this

<script type="text/javascript">

var bling_width=120;

var bling_height=160;

</script>

<script type="text/javascript" src="http://blog.offbeatmammal.com/samples/mix10/mix10bling.js"></script>

In our house we have way too many cables (just ask my wife!). While a lot of the cables are just regular mains leads (though we try to optimize the way we use those) there’s quite a few wall warts for charging cellphones and the like.

While it’s not going to solve every problem there are a couple of mains chargers that also provide USB power – from iGo and Belkin for instance – but they still require cables. Well, I think my wife would approve of this idea – a mains outlet with built-in USB connectors (that only draw power when something is plugged in).

The TruePower UCS is available pre-order for only $10 – due in early 2010 as soon as it gets final UL approval.

It can be installed to replace any standard dual wall socket and provides standard mains power as well as 5V DC 600mA power to both the USB outputs.

This should help with some of the clutter though it doesn’t help with all the other transformers for the cableTV set-top box etc it’s a start.

Of course cable free power charging like the PowerMat is the real answer to the cable crunch but I suspect it’s a while before we can cut all the cords.

After seeing the Azure cloud hosting in action for Be A Martian (launched at PDC) I thought it would be an interesting experiment to take a small project that I was currently hosting on a traditional virtual server and see how easy it was to deploy to the cloud and what the results were.

Rather than detail the steps here I’d recommend you have a look at this great tutorial that outlines exactly what you need to do to get from File | New to opening the site in IE and seeing it run in the cloud.

While it’s not as easy as taking your existing .Net files and just uploading them to a server (and the SQL Azure process is a little complex compared to a normal SQL at the moment) but once you’ve gone through the process once I suspect, like a lot of things, it’s less challenging.

From a very quick play with the three main players I think Google’s App Engine is an interesting place to play but with fairly restricted language and database choices you do need to be comfortable with their offering to dive in and although it’s been around for a while I don’t know of any large projects deployed for real with it.

Amazon’s AWS has been around for a while and offers familiar environments to both .Net and open source developers and there are many real world examples of sites using EC2 and S3 to help them scale. While more flexible in environment than App Engine the Windows and SQL Server options offered in EC2 are pretty outdated at the moment.

Azure is very much the new kid on the block and is certainly still a little rougher around the edges than the others (for instance some of the database functionality doesn’t work with the current RTM SQL Server Manager tools, and there is no option for automatic scaling, you have to manually request new instances – which while great for managing costs isn’t so good for dealing with unexpected spikes). It’s certainly aimed more squarely at the professional developer rather than a hobbyist but it’s also very flexible – supporting both Visual Studio (as you’d expect) and Eclipse for development, and languages such as PHP and Java in addition to the .Net staples.

I suspect that whichever flavor you end up trying (and I’d recommend trying all three to get a feel for the options available and what features you might need to make your project shine) a lot of websites from simple blogs to enterprise critical projects are going to end up running as virtual instances in a robust, scalable and distributable environment.