Delphi in Healthcare, Fighting the Corona Pandemic

When a crisis like the coronavirus pandemic hits society, it affects every aspect of human life. It has severely limited our ability to travel and interact with family and loved ones, it has changed how we interact with the community we live in - and last but not least, how we interact with customers and maintain a livelihood. For many people, these are difficult and trying times, personally and professionally.

The Presence of the Past

The topic of business might seem insensitive, if not insignificant in a situation where people might lose a loved one. Yet business is ultimately what funds medical research, provides food, delivers medicine and helps humanity fight back. In terms of sheer destruction, financial or otherwise - I don't think the world has experienced anything like this pandemic; at least not in our lifetime.

The only historical situation of a similar magnitude that springs to mind, is perhaps The Great Depression (1929), which one could argue came about as a direct consequence of the preceding Spanish flu pandemic.

The Spanish flu hit America, Europe and Asia at the onset of 1918, and held sway until 1921 (december 1920 in the US, last reported case in Europe was January 1921).

Camp Funston emergency hospital, Kansas 1919
Above: Camp Funston emergency hospital, Kansas 1919

It has been estimated that roughly fifty million lives were lost to the Spanish flu, and that it affected as many as 500 million in total; a quarter of the world population at the time, making it one of the deadliest pandemics in human history.

Learning from history

What governments and businesses alike are worried about right now, is the recession effect. While the variables that led up to the great depression are vast and complex (let us not forget that the first world war played out between 1914 to 1918, which depleted the European economy), the pattern of cause and effect have similarities that are worth keeping an eye on.

The more people affected by the Corona virus during this pandemic, the heavier the financial burden will be in the aftermath. If debt and interest rates soar and the market is unable to balance itself, what occured in 1929 is a worst-case scenario: a complete collapse of both the national and international economy.

The hero with a thousand faces, our medical professionals

With social media doing more than enough to terrify us with endless streams of apocalyptic worst-case scenarios, it’s easy to lose sight of how blessed we are to be living in 2020. The men and women of 1918 didn't have the luxury of modern medicine, nor did they have at their disposal computers, global communication -or perhaps the most important thing of all, shared international medical research.

Siv Marie Lien (photo used with permission, DIPS AS)
Above: Siv Marie Lien (photo used with permission, DIPS AS) works with customer care at DIPS, but she is also a nurse, working extra shifts during the Corona crisis.

For example, Penicillin, the first antibiotic, was discovered by Alexander Flemming in 1928 in his London laboratory, yet it was not internationally recognized as a therapeutic medicine until the 1940s. In other words, it took 12 years between discovery in the lab -to practical application on a global scale. With modern technology, such timeframes are thankfully a thing of the past.

While the Coronavirus (SARS-CoV-2) is indeed new, it operates in a way that science understands, and we can take simple steps that prevent the virus from spreading. Europe, Asia and India are presently in lock-down mode; people are literally staying home 24/7, which helps fight the virus by refusing it access to new victims (flattening the curve).

At the same time researchers and medical personnel are looking at effective means to heal those that are infected. And we must not lose sight of the fact that the recovery rate is 80% for those who test positive.

A sober perspective

To try and put the present situation into perspective, a total of 193.000 people have lost their lives to the Coronavirus; at the same time the common flu (influenza) has claimed 23000 victims this season. What I am trying to point out is that -left to its own devices, the death toll SARS-CoV-2 is capable of would be horrific. Thankfully, medical professionals and healthcare workers the world over are putting up one hell of a fight! So there is room for sober optimism that we can beat this. We will beat this!

Google live feed
Above: Google has teamed up with the WHO to provide a live feed on the Corona numbers

There is even talk of re-opening economies across the EU starting may 11th, so we are slowly but surely seeing some light in the proverbial tunnel.

The SARS-CoV-2 structure
AboveThe SARS-CoV-2 structure (Source: Creative Commons)

But just to have the facts on the table: It must be understood that Coronavirus is far more aggressive than influenza, and attacks the body in a completely different way (one might even say insidious). These are two very different viruses and the reason Corona has not claimed more lives than it has - is because medical professionals have done, and continue to do, an outstanding job.

With the aid of computers, modern science and global communication, nations have been able to take steps ahead of the curve (of which lock-down is an immediate and highly effective method of protecting the population).

There is much more to learn about the full impact of the Coronavirus, but mankind is making good headway towards defeating it.

Beating a potential recession

As of writing, different parts of the world have been impacted by the Coronavirus in varying degrees (so the relevance of information will differ from place to place). There are hundreds if not thousands of variables at play here, so how long this will last is impossible to say. Based on what our government here in Norway is informing us, I would expect lock-down to last at least through May (we have already had two months of lock-down, with excellent results); Variables change on a weekly basis so we just have to wait and see.

What we can do right now, all of us, is to spend a little time reflecting on past recessions and see if we can find common traits and patterns that are beneficial. A recession can play out in a hundred different ways, but it’s driven first and foremost by human responses (both emotional and not) which tends to be predictable. We should remember that the world was hit by recession quite recently. In fact we had a massive recession in 2000, 1990 and way back in 1980. My memory of the 2000 dot-com crash is quite vivid, because it completely uprooted my life over night.

When the dot-com bubble burst, I spent the next 12 months in total panic because I had no game plan whatsoever.

I went from CTO and lead engineer at a promising tech company, to literally mopping the floors at a local mortuary (talk about radical change). With my life's savings gone and stocks rendered worthless, I had to sell my home at a $50.000 loss. It would take me 10 years to recuperate from the ripple effects of that crash.

And that is the difference: we have seen best case scenarios, and we have seen worst case scenarios. So this time we can use our experiences and aim for a better outcome.

But let’s go back to those traits I mentioned and see if we can extract anything useful from the dot-com crash.

Predictable variables

The reason I was unable to find a job was because I had specialized myself into a niche. When the dot-com bubble burst, my niche fell into a non-essential category, and at the time I did not recognize that my niche and specialization was indeed, non-essential; and thus I was unable to adapt. I was literally blind to the opportunities right there in front of me.

When a society is hit by a crisis like the dot-com incident; and now the Coronavirus pandemic, three things usually  happens:

  1. The market schism into two categories
    1. Essential services
    2. Nonessential services
  2. Adaptive businesses thrives
  3. Monolithic business models suffers

Walter Frick recently published an article in the Harvard Business Review (How to Survive a Recession and Thrive Afterward) which mentions similar observations. Well worth the read!

Essential services

Depending on the situation, what the market deems essential and nonessential will differ. But the common denominator is that everything essential for survival and stability stays, and everything which does not bring immediate benefit or stability is put on pause.

When the dot-com bubble burst, essential services in the context of IT and software development with Delphi, was limited to projects directly involved with day-to-day business (a stark contrast to the cornucopia of schemes, ideas and “spin” that defined the dot-com era). In short, people and companies fall back on the essentials, the basics, what is reliable, what they need to survive. Everything else is deemed nonessential.

In Norway essential businesses were (but not limited to) the oil sector, healthcare services, transport and logistics, agriculture and insurance. In short, focus went from development of new markets to maintenance of fundamental ones (in our case, the market pivoted from creative software development to network administration, big data, security and resource sharing; which would evolve and re-emerge as Cloud Computing 15 years later).

Reflections

If we draw a parallel to our situation today, the pattern is the same but the variables have changed (but this time, we know the pattern and can adapt). With the planet in lock-down it is stores, public transport, outlets, oil and insurance that are hit the hardest. So there will be less work in those categories.

If your business model is monolithic, like owning a store that depends on customers visiting - you fall under the non-essential category (unless you run a pharmacy or sell essential goods, like food). The same is true if you run a software company that lacks the infrastructure to allow your employees to work from home.

If however, you adapt to the situation and expand your online presence, offering home delivery (teaming up with a delivery company), you are by definition operating with an adaptive business model, and your chances of succeeding, thriving even, is exponentially higher.

As a software developer, you have the benefit of working with a medium that is purely digital and that can be rolled out without physical packages being shipped. So your expenses are limited to hosting or on-site infrastructure. Perhaps now is a good time to learn more about virtualization and docker? Making sure your developers can work from home, and perhaps pivot your software to also include the essential-services categories?

Delphi and it’s role in fighting the Coronavirus

If you think that going from a biological virus like Covid-19, through a subjective cause and effect of market changes during a pandemic - to Embarcadero Delphi is a big leap. I can understand why you might think so. But like I have written about in the past, Delphi continues to hold a strong position in the world of medical software. Health services is one of the few essential services that is persistent. It will always be an essential service.

The market for medical software is vast and covers all aspects of modern medicine. From software used by labs for analysis, to more common services like dentistry or ophthalmology (healthcare professionals specializing in eyesight).

Back in February I wrote about a Norwegian company, NorJournal, which builds and retails a complete journaling system for dental companies and surgeons. NorJournal is a client-server based system managing some 300+ dental clinics, treating thousands of patients. And the entire product, right down to the module dealing with x-ray analysis, is written completely in Embarcadero Delphi.

This time I want to look at a larger company, one which is directly involved in supplying software to combat the Coronavirus, namely DIPS AS.

DIPS AS

The DIPS corporation is one of the largest suppliers in Scandinavia of healthcare and medical software. The company employs a staff of more than 300 developers working full time. The DIPS software portfolio covers everything from complete hospital administration and department management - to running special care units and medical research facilities.

FastTrak Covid-19 module
Above: FastTrak, a modular medical application written in Delphi. Here showing the Covid 19 module.

Four out of five medical clinics in Norway are using solutions from DIPS, with a total of 150.000 medical professionals benefitting from their software.

FastTrak Covid-19

One of the programs DIPS produces and that is deployed on the front-lines of the Covid-19 battlefield, is FastTrak. FastTrak is a modular application written in Delphi. It was one of the first applications to offer a Covid-19 pandemic module, focusing on infection tracking, testing and documentation.


Above: FastTrak screening form for Covid 19 patients

Documentation is especially important within the health sector (and must not be confused with text-editing, but rather that the software can provide and work with government issue schemas and XML frameworks, which forms the basis of how information is transmitted between clinics and departments); all of it with a high degree of security and confidentiality.

Delphi roots

FastTrak has roots that go further back than first meets the eye. Having seen the code, it makes use of techniques that are distinctly modern; techniques like dependency injection, clean interface abstraction, generics. The much loved Spring4D Framework frequents the architecture.

The code is clean, polished and well thought out. I have rarely seen code this well organized, and I have worked with some big names over the years. My jaw dropped as I ploughed through the codebase. To say that I am impressed would be an understatement.

FastTrak Infection tracking functionality
Above: FastTrak Infection tracking functionality, being able to warn or inform people that have been in contact with a patient helps reduce response-time and broaden treatment options

-”The oldest ideas in the codebase actually dates back to 1999” Magne Rekdal, the original author of the system says.
Some lines of code were in a product called SmartHeart, launched by Pfizer Norway on the 14th of February that year. The launch date was selected because it was Delphi’s 4th birthday, Valentine’s Day, and the software’s icon was a red heart.

-”In a more recognizable form, it was launched in Copenhagen, Denmark in January 2003.
It was designed to be easily expanded with new modules depending on the customers’ medical documentation needs.
The original back-end was MS SQL Server 6.5 or MSDE 2000”,
 he continues.

Since that time the product has been refactored several times to take advantage of new language features, better organization and modular design. Delphi and Microsoft SQL Server are both products that strive to be as backwards compatible as possible.

Code that was written for older versions of Delphi, like Delphi 7, will happily compile and run on the latest edition. Modernization within the Delphi sphere is not so much about having to re-write large portions of your intellectual property - as choosing to eliminate and replace code with modern constructs.

The introduction of generics is a good example of this. You don't have to use generics, but the amount of boilerplate code it replaces is significant. Maintenance is also a factor. Technological evolution is very tangible in Delphi, where the procedural, object oriented and generics layers co-exist; one building upon the other.

Benefits of using Delphi

One of the key features of Delphi has always been productivity; a productivity rooted in object orientation and Delphi’s signature RAD (Rapid Application Development) strategy. As a consequence, Delphi has a considerably shorter TTM (time to market) since developers can focus more on the task at hand, than building up functional scaffolding and code infrastructure. 

The FastTrak Covid-19 module is a perfect example of this. The DIPS Corporation was among the first to deliver such modules in Scandinavia, helping medical professionals respond quickly and efficiently with minimum delay. As a large corporation DIPS AS operates with several languages and solutions, and has different products in their portfolio. But FastTrak, with its data driven design and modular architecture - is firmly rooted in the award winning Delphi ecosystem.

An ecosystem that has stood the test of time, evolved with changing paradigms and remains as vibrant and productive today as it was a decade ago.

Tools of the trade

A product like FastTrak builds on the rich ecosystem that Embarcadero Delphi has to offer. One of the major strengths of Delphi and C++Builder is the focus on modular design in the form of components. Delphi in particular has always had a rich menu of commercial and non-commercial component vendors; companies that focus on one particular feature, and offer ready to use solutions. 

FastTrak use component packages that is familiar to all Delphi developers.

  • FastReports
  • Konopka VCL Controls (Raize)
  • ODac Database Components
  • Spring 4D Framework
  • BergSoft Components

The infrastructure around the application likewise builds on several Delphi made products, such as:

  • Help & Manual
  • FinalBuilder
  • Beyond Compare
  • Doc-O-Matic
  • Database Workbench Pro

Like so many other successful products in the market -Delphi is a key factor in its success. I look forward to getting to know the software more in the weeks, months and years ahead.

 

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