Medical records

Medical research is expensive and inefficient. New drugs, for example, must undergo lengthy trials before getting FDA approval. But not all the problems emerge during these trials; the FDA has insufficient resources to retest drugs it has already approved, and is often unwilling to withdraw approval for drugs that are on the market on the basis of evidence that is often not collected in a controlled manner. This puts people at risk; fixing it by expanding the FDA's testing activities is expensive.

Electronic medical records offer a way of collecting information about drugs that would allow the FDA to see patterns in large sample studies (since the sample is the population). This will make drugs safer.

There are other benefits to electronic medical records. Not all research in medicine is done in carefully planned studies in teaching hospitals. Much, though it's hard to say how much, is done by general practitioners and specialists who read journals, have ideas, and try things out; for example, new combinations or dosage levels of drugs.

Collecting information about such 'in situ' clinical trials - in aggregate of course - provides additional research data for scientists seeking to better understand things such as the interaction of drugs and physiology, and the progress and virulence of diseases.

These are just some of the benefits that need to be weighed against the potential risks of sensitive personal medical data falling into the wrong hands. There are implications for the private insurance market, but that is another story.

Virtual Elegance

The machine on which I do my simulation was a Fedora 9 based system with 4 320GB drives configures in three RAID arrays. The OS itself was in a RAID10 partition spanning all 4 disks. The swap partition is a RAID0 array, again across all the disks. Finally a RAID5 partition holds my data and three virtual machines (2 Fedora guests and one Windows XP).

The system was crashing several times a day - the mouse and keyboard would freeze in the guest and the only way out was a hard reset. Since Fedora is not one of VMWare's supported OSs, I decided to try Ubuntu, which is. The question was: could I pull the Fedora host OS out from under all this without disturbing the RAID array with my data and my VM disks. The process was complicated by the fact that the Ubuntu installer does not have RAID10 support, and an intervention is needed during the installation to download mdadm and configure RAID10 from the command line.

Many years ago, when I worked for IBM as an SE, I used to extoll the virtues of VM for its ability to allow testing before going live to all my S/360 customers; 25 years later this advice was still valid.

I set up a guest with four virtual disks on which I set up RAID partitions (10,0 and 5) to match the host configuration. I installed Fedora on the RAID10 array and mounted the RAID5 partition as /data, exactly matching the host OS configuration. Next I made a copy of the disks so I could repeat the migration process several times. Then I started the guest using the Ubuntu installer iso image, went though the installation process. When I finished I restored the Fedora disks and started again. After running though the installation three times to a point where I felt fairly comfortable, I did the same thing on the bare iron - and to my surprise and delight it worked like a charm. The RAID10 array was reformatted with the new OS while the RAID5 array was untouched and reassembled.

This kind of major change close to the hardware would normally have been the cause of a huge amount of grief - for example discovering that there is no RAID10 support in the Ubuntu installer might have thrown me for a loop if I had been working directly on the host. It's also a one shot game as backing out of an installation is impossible once any partition changes have been made. Testing the procedure in advance with VMware was invaluable. The feeling I had was that of the magician who's just pulled the tablecloth out from under a fully set table of dishes, glasses and cutlery.

It truns out that Fedora was the cause of the problem. With Ubuntu 8.04 LTS, the system hasn't frozen in 6 weeks. I've used Fedora since the first release of Core 1. It feels odd not to be using it, but at the end of the day I have other work to do.

Corporate Jets - the business case

What would be the case for leasing a corporate jet?

• The CEO needs to work while he travels.

Actually most working professionals work when they travel so it must be something else.

• The CEO's time is worth more than that of most working professionals.

A CEO with a salary of $10M (the average for Standard & Poor's 500 company) might save time if there is no waiting in line and no waiting for scheduled flights. If this saves him or her 4 hours per day of traveling, and the CEO travels 3 days a week or 150 days a year, and typically works a 16 hour day, the cost of this CEO's lost time would be about $1M a year. This is not quite enough to pay for the cost of owning and operating a small jet such as the Hawker 800XP which comes to about $2.4 per year. But if one adds the CFO and the COO who might be traveling with the CEO or traveling on the days when he is not, and assume that they are paid half the CEO's salary one could argue that time savings could amount to $2m.

Interestingly Avicor, an aviation consulting company, does not make this claim. What they do suggest is that meetings in-flight are where the money is saved - you can't hold a confidential meeting in coach (or business class for that matter). Here it's the travel time that counts. If one adds in-flight time to the time saved on the ground, and if one assumes flight durations on average of 3 hours, the CEO's useful time might come to $1.75M; the CEO and the top management team together would then likely save the cost of the jet.

Of course this is predicated on two assumptions. One is that the jet is in almost constant use. And second is that there is no alternative. While flying coach may not work as an alternative, teleconferencing, for example Cisco's telepresence, may be a lower cost alternative. In which case the saving would be considerably less. But that's a calculation for another day.

A Principle Agent Problem at CNN

Last night I woke to hear John Roberts and Kiran Chetry talking about Oprah and her private jet. In an address to graduating students at Duke University, Oprah said (not unreasonably) that “It’s great to have a private jet. Anyone that tells you that having your own private jet isn’t great is lying to you.”

Chetry, speculated, as news readers are increasingly wont to do, whether this comment might change public opinion - which has been a bit of a downer for private jet industry - and thus go some way to rescure the beleagured small plane makers. This is a lamentable confusion between principals and agents.

There is a distinction that might help here: private jets are fine; corporate jets are another matter. Why? Because what individuals spend their own money on should generally be of no real concern to anyone else. Since Oprah owns her production company, when the company buys (or leases) a jet Oprah, as an officer of the company is spending money that belongs to Oprah, chte company's owner.

Executives of public companies who buy corporate jets are not spending their own money - they spending their shareholders' money. When companies are going broke and shareholders see the looming possibility that they will loose their entire investment in that company, it's understandable that they are unhappy with the people thy have appointed as their agents spending what remains of their money on what they may consider to be unnecessary luxiaries.

There may well be a case to be made that corporate jets do pay their way - but that is cost justification agents must make to their shareholders. Agents should not assume that they have the same rights regarding the way they spend the company's many as Oprah and others who own the companies they run do.

Integrity

After a scandal in the UK concerning MPs' bogus (and apparently fraudulent) expense claims broke in the Daily Telegraph, one MP named in the piece said in an interview that he was paying back the money he had claimed for 'fittings, furniture and household items'; he added "I just want those people I represent to know, whether they vote for me or not, that I have personal integrity".

So let me see if I have this right: if you dip your hand in the public coffers and then return the money after you are caught, this is integrity?

I would have though that integrity would have mean not committing the offense in the first place.