My wife, Maria, manages the health care information for my family. God help me if I am ever in the position of having to tell an ER doctor about what antibiotics my children were on, when they had this or that bone broken, etc., without here there. This got me thinking about a better way to manage all of our important health-related information and was a perfect framework for a recent conversation I had with St. Louis entrepreneur, John Struckhoff.

John is the managing partner of a St. Louis startup called Health InfoSTAT. John and his team have produced a software solution to help manage you and your family's personal health care information, both online and off. In chatting with him about his product, it became apparent that he and his development team have not only designed a commercial grade S+S solution, but had the concept locked long before there was a buzz-phrase around it.

"Software"
John's product is called Solace, and it is a WinForm application built on .NET 2.0. The product is a very easy-to-use data entry application for your family's health care information. Everything from personal and medical emergency contact information to past surgeries to chronic conditions to a history of prescription medication you've been on. It's all there. Each member of your family receives a "profile" with their specific information stored in it. When you've completed entering all the information, the software generates a detailed report that you can print and bring to the doctor's office or hospital with you. And there it is, a comprehensive health history for you and your family. Wouldn't it be nice to not have to complete that long questionnaire every time you go to a new doctor and instead just hand them the report?

So, the first question I asked is, "Why build this as a client-side application instead of a web application?"

John explained that they looked at a 100% web-deployed solution at the beginning, but decided to build it as a "connected client" for a few keys reasons:

• Solid Security Management: While securing sensitive data on the web has come a long way, there are few things in a person's life more sensitive than their health history. Managing and persisting this data inside the client software reduces the number of times it needs to be transmitted across the wire and allows for a customized approach to cryptography and digital signature.
• Offline Capability: John describes his product as being "brain dead simple" to use. He is from the old school of software design that doesn't tolerate any application that requires the user to know anything about the Internet, networking or other technical concepts. In fact, he specifically mentioned that his father, who is in his eighties, is a key tester of the software -- if he can use it, anyone can use it. Solace manages its connection to the Internet and automatically alerts the user when they are trying to do something that requires a live connection. For the most part, Solace is designed to run mostly offline anyway, and when it does connect to services in the cloud, it does so on background threads, allowing the user to continue working on the desktop unhindered.
• Better User Experience: Beyond asynchronous background processes to improve performance, the user experience John was looking for in the software was very difficult to develop in standard web pages. Solace has seamless transitions between data entry screens and modal entry dialogs. While these things are doable with CSS and AJAX, it is a far more thorough and fluid experience on the client.
• Automated Updates: The initial drive to the web was based almost solely on being able to deploy updates quickly and invisibly to the user. To ensure that their client-side solution enjoyed this same benefit, Solace has the ability to perform automated updates. John and his team opted to build an update application so that they could control the software manifest, as well as push product, system and company information to the client.
• Document Management: Solace allows you to reference important health-related and legal documents, such as a living will, power of attorney, advanced directives, etc. Through the client side application, you can manage the location of the electronic versions of these document as well as referencing the location of the hard-copies. You can also view and manage access rights to these documents. Doing this on the web would require that the documents be uploaded and persisted on the web site, which may be superfluous to what the user actually wants.

"Service"
The Solace client experience is impressive in and of itself, and much of that is enabled by the interaction with services in the cloud. For example, the automated updates for the client application compare local file versions with those in an online deployment repository on the server and pulls down only the files that are needed. This significantly enhances the experience for users on slower Internet connections. It also has the capability to pull reference information managed centrally and cache it on the local machine, ensuring that users can add data to their profiles even if an Internet connection isn't available.

They've also created a lot of intelligence around the Internet connection itself, and I think this is an essential characteristic of any S+S solution. The application displays the status of the machine's Internet connection at all time. The process of checking for the connection runs in a background thread, so the status can be updated every couple of seconds without negatively impacting performance on the local machine. Also, keeping the mandate of a "brain dead simple" user experience in mind, the client checks for access to its services before the user is required to do any work that would require the Internet connection to be present. This is a very nice feature in that the user is spared having to enter several pieces of data only to find that they can't complete the task due to the lack of connectivity.

As it turns out, the service component of Solace represents the primary revenue opportunity for Health InfoSTAT. You see, all of the features and functionality I've described thus far is free for anyone to use -- just download and install the software. However, for a very small annual fee ($20 per profile per year or so), you can publish your data to the Heath InfoSTAT servers and make your information available online via the company's web site.

The scenario John outlined goes something like this: Imagine yourself in the emergency room after being in an auto-accident. You're unconscious and the ER staff is beginning your treatment. How would they know that you have an allergy to certain anesthesia's? That you had your gallbladder removed when you were a child? That you're currently on an antibiotic regimen? Leveraging the Emergency Access portion of the Health InfoSTAT web site (which also accesses the company's services infrastructure), medical professionals could access this information and any other pertinent information, including access to important medical and legal documents you have chosen to publish.

So beyond keeping the client software up-to-date, the service cloud for Solace provides a means of accessing your information anywhere on-demand while keeping the management and security model based on the client where it can be best leveraged.

"The Perfect Storm": Flexible Architecture and Outstanding User Experience
The real relevance of the S+S model Solace embodies is that this flexible and responsive architecture ultimately leads to an outstanding user experience. The ability to interact with services in the cloud on background threads creates a truly seamless experience for the user, who, in most cases, won't know (or care!) when the software is pulling data from the service, but will enjoy the fact that something that wasn't available to them a couple of minutes ago is suddenly there in the client ready to be used.

The flexibility of this architecture, especially the ability to push software updates and information down to the individual client, allows the HIS team to be very agile in implementing new features and patches to fix issues. John mentioned a couple of examples where a bug fix was reported by a user, examined by his team, a patch implemented and tested and rolled to the update server in less than an hour. This is the kind of deployment agility normally reserved for web server-based applications.

The important thing to understand here is that the entire web experience is originated and managed on the desktop itself inside the Solace application. This really brings the whole process full circle. In this case, the heavy lifting of the system is located on the high-powered client machine, where CPU cycles and memory abound. The web is a premium service offering, allowing authorized individuals to securely access the information published from the client. All components of the architecture are positioned to take full advantage of the strengths of their respective platforms.

If this sounds compelling, I encourage you to go take a look at the software for yourself. Like I mentioned earlier, Solace is free to download and use on your local machine. The only caveat is that you can transfer the local profile data files to another machine; that is a feature reserved for folks who subscribe to the service. If you check it out, I'd like to hear your thoughts on how the application work. I was drawn to this software because of its architectural implications, but I like that John and his team are focused not only on helping people manage their health care data better, but Solace might even save a life someday.