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How I work

Here's a winning strategy for medical practitioners interested in remote telemedicine
Doctors at the Wolfson Medical Center perform open heart surgery in Holon, Israel, September 12, 2011. (illustrative photo by Nati Shohat/Flash90)
Doctors at the Wolfson Medical Center perform open heart surgery in Holon, Israel, September 12, 2011. (illustrative photo by Nati Shohat/Flash90)

This is an old blog post that I never submitted. I am cleaning up my files. I hope this is of value to my readers.

Almost every day, I will read an article about some new piece of software or phone/tablet app that the writer considers to be very helpful (or even essential) in his/her day-to-day work. There is no question that there is a huge complement of software and hardware that works together to provide a user with nearly a universal front-end, so that time of day and physical location do not interfere with recording an idea, transcribing a blog post, doing online research, sending out a summary email to senior management and so on. There really are people who live on their phones and therefore welcome the larger format six-inch [plus] screens that make viewing and typing much more comfortable.

The question that often gets asked is if a particular piece of hardware or software really is essential. I think it is more appropriate to ask if a combination of software tools come together to make for an essential toolkit that empower the user tremendously. There is also the major factor of portability. These days, so much functionality is available purely through a web browser interface. The well-known Google chrome book is a laptop that is effectively a pure browser interface. As such, from the moment someone starts up a chrome book, they are in a browser and effectively cannot exit it.

This works only because there are sufficient apps with a sufficient range of functionality that can do a tremendous amount of work if backed up by a strong WiFi signal which connects the chrome book to the chrome cloud. It is in this cloud that more apps exist waiting to be used, all of the user data is stored and/or backed up, the option exists to make use of Google massive computing storage and power to run high-end applications off-line, and so on. The wonder of this approach is that one can switch from one chrome book to another, or from a chrome book for a full powered desktop, and then to a smart phone running Android, and maintain the same working environment. 20 years ago, this truly was a dream. Today, Apple and Microsoft are working very hard to create equivalent cloud-based environments and services to compete with Google, and to give the user a true sense of complete portability.

I would like to share with you a description of my personal work environment. This is something that I have built up over many years of working on multiple projects, many of them remotely, i.e. I was working on one of the client machines from home during most stages of development. Therefore, I kept very little of the client’s code on my machine. There are multiple advantages to this and of course possible negatives. But in my case it worked out very well.

So I would set up remote access to a client’s computer. If there is a sudden bug, it is possible to remotely login and see the bug in real time in the real environment. One of the most frustrating things is not being able to duplicate a bug on your test system. But if you can login and observe the bug happening in real time, it changes a great deal. There are a whole range of software options that allow you to remotely connect to another person’s computer. Strictly speaking, you can remotely connect to a server, including the most important and sensitive server, such as the one that is responsible for keeping everyone’s name and the list of their permissions related to how they can access every other computer in the company. So, remote access and remote control software should be something that you immediately implement if you are going to be working with a client or team member who is remotely located.

What is amazing about so much of the software that I will describe is that it is effectively free. Some remote control software does request payment if it is your intent to use it for business purposes. But there are other options that remain free under any conditions.

Once you have your remote connectivity set up, independent of this, you will likely also want some mechanism for communication with the remote site or coworkers. There are so many products on the market for remote video conferencing, it is dizzying. Skype has now been internalized into the Microsoft stack of tools, but still offers a free version for noncommercial use. Google has its own software for remote videoconferencing, which I personally used a few months ago for airing an online webinar. It worked just fine and operated in a manner equivalent to systems that cost many tens of thousands of dollars more just a couple of decades ago.

The fact that you could be a client on this webinar from your mobile phone was a feature that did not exist in the older very expensive versions of this kind of software. Google really is a master of giving away a great deal of very powerful software. I do pay for some of my Google services such as my Google email box which is already coming close to 4 GB in size. But knowing that that mailbox follows me anywhere in the world, along with my pictures, and entire Google Drive truly is a comfort. I have actually begun moving many of my home server files to Google Drive. This way I no longer have to worry whether I have direct access from my phone to any file I previously decided was worth saving. In the past, I had situations where I would have to remotely connect to my home server and then email the file of interest to my phone so that I could share it. Needless to say, the 15 to 20 minutes it took me to get this all running and checked and verified tended to be enough time for the potential client to lose interest.

Another piece of software that I find essential is Evernote. Evernote’s is basically a notepad that you can access from your desktop, tablets and/or smart phone. Any time I come across an interesting article or image or voice file or video, I can save these to Evernote along with some descriptors which help me with searches later on. If I save the PDF, Evernote does an internal OCR so that I should be able to find that PDF more easily in the future. To be fair, I should point out that I sometimes cheat and use Google Drive to save some particular files. For larger files or files that might require special add-on software to play over the Internet, there is an advantage to storing the files in Google Drive. This is admittedly a nuance, but it is a beautiful example of how easy it is to have multiple services for the same issue, that you can flip between as necessary.

Attached to my chrome browser I also have a service that constantly displays how many open emails I have not yet addressed. It’s amazing how easily one can overlook an email that came in with 20 others in the last half-hour. I have another service that links to my Google calendar and allows me to view my calendar from my browser, independent of whatever program is running in the browser at the same time. I have another program that easily allows me to share what I am viewing via Facebook, LinkedIn, Twitter and other services. Once again, this is a small issue, since I can always copy the address of the article I am reading and then simply open a new entry in Facebook and paste it in. But when I am reading multiple articles, it is amazing how much this one feature helps me keep my stride and not lose my focus.

I have another plug-in called MySMS which really excels at one key thing: it allows me to type SMSes from my desktop, and then view received SMSes through my full screen interface. I personally really dislike typing SMSes on my phone and having to pull out my phone whenever a response comes in. So this service, which I paid $10 for, just makes one other regular function that much easier. So I use SMSes much more frequently and benefit from their immediacy. I have yet another service available through my browser that does one clear function – it opens an email to be sent, and automatically records with in the email the address of the page I am presently viewing. Once again, we are not talking about groundbreaking software development. The vast majority of people simply open a new blank email and the webpage they’re presently viewing. But this is once again an example of a simple yet helpful functionality that can really make a difference when in the course of the day you are sending out and reading hundreds of emails and SMSes.

Google released to the public a device called chrome cast a couple of years ago. It is a marvelous device that cost $35 apiece. The device allows you to display whatever is on your laptop/tablet/phone onto your TV screen. I have watched movies, YouTube lectures, personal Skype communications – all via this marvelous combination of hardware and Google software. I have tried to mimic this kind of software many times in the past. Chrome crust, like everything else, isn’t 100% perfect, but it’s pretty close for what it’s meant to do.

There is one program that I presently run directly from my desktop as it is very CPU intensive, relies heavily on a large database and simply would overload most phone and tablet devices. This specific software transforms my speech into text, with amazing accuracy. I am using it at the moment to record this blog post. I have in fact used it for almost every blog post and other emails I have sent out. There are people who are truly masters of this software and can manipulate their entire computer by voice commands. I just use it for dictation. But it saves me a tremendous amount of time and frustration.

Google is now incorporating voice to text into its software. The Google docs feature offers you the option of recording your voice for immediate transcription into text. I have used this feature a couple of times and found it to be less accurate than my desktop software. But this will change in time and I have no doubts that within a few years, Google will be just as accurate and just as reliable as my present software. Strictly speaking, this is really the only software that I personally  use for my day-to-day work and online hobbies, that requires installation on the computer. Everything else I have installed through my browser, and it works just fine.

I obviously have other software packages that I use. One piece of software that I must use on my machine is Microsoft Access which is wholly designed as a local installation package. But the time will come when Microsoft will offer complete virtual machines that allow a user to manage all of his or her development using any software available all through remotes links. This is possible now via remote virtual machines that you could manage via Microsoft Azure or Docker.

Will we eventually cut the cord? Will we eventually be able to place a dime sized device on a surface and have our entire workspace re-created for us wherever we are? I think the answer is pretty much yes. One of the key problems is how to visualize the screens in this totally virtual environment. Needless to say, this is already happening between the VR and AR options that have come to market. So imagine coming in to your office, flipping your wrist to activate your local work environment that of course connects into the corporate environment, then having via virtual glasses your entire workspace appear before your eyes. If you asked the question why is it necessary to come into work if everything is virtualized and you can talk to the guy in the next cubicle via any one of a number of secure chat rooms, I would say you are right.

I will stop here because clearly it is possible to go on forever. I have my important documents all loaded up on Google Drive and I have direct links to folders within Google Drive along my bookmarks bar, which is indistinguishable from having these files on my local computer. I have links to my calendar and my contacts and my photos, as well as Google translate. I personally really like Feedly because it brings together multiple information sources into one place so that I can easily follow them and potentially record them to Evernote.

Last but not least I have a subscription to Marvel Unlimited which allows me to read any comic ever published by Marvel up until the last six months. Fortunately, I am able to limit my enthusiasm such that being up to date to the last six months is sufficient for me. So for $10 a month, I can read my comics from any device, anywhere, anytime.

I think that everyone should take the time to really layout what functionality they need on a regular basis. People should then match up the software they use on their desktop or laptop with the software they are using on their tablets and phones so that they have perfect continuity. Of course, storing everything in the cloud includes automatic backups and very high reliability, something that home systems cannot match. I know that people really like reading from physical books and the idea of a Kindle or reading from any tablet is considered very awkward. I personally have a 9 inch Nexus tablet and it is a beautiful device that is a pleasure to read from. If you can manage to break your physical need to hold yellowing paper in your hand, then you can have a library with thousands of books literally at your fingertips.

I really do believe that people are far more ready to cut the cord than they admit. And truly speaking, once you do so, you offer yourself a whole range of new possibilities that you never even considered beforehand. I know that it has truly reshaped my life. And I would like for other people to enjoy the same benefits.

Thanks for listening.

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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