Development Language

an introduction When looking at any computer system, it is helpful to look at the underlying language that the system was developed in. Though no single language provides all the advantages without some disadvantages, there are trade-offs that assist in determining which language is best for a specific application. The language chosen by a software developer will determine the types of services they can provide, how responsive the product will be to your needs, the speed of the system, the operating systems and computers it will work with, and the cost of the system.

There are many languages that a medical system could be written in. Some of the systems used today have languages that are over 20 years old. Some use 1980-era technology, while others use modern languages designed in the 1990s and which are still evolving today.

The creators of computer languages are continually trying to improve their product to attract more developers. One of the most prominent features to attract developers is the ability to program quickly, thereby reducing cost and allowing the developer to provide new features to their product quickly and inexpensively. This translates into how you, as the software user, are provided software enhancements and at what price.

In a system designed for a multi-user environment, data integrity and speed are driving factors. Modern languages generally provide both of these. This is especially true in client/server technology.

A language is initially written to run on specific a CPU (Central Processing Unit – the ‘brain’ of the computer) and under a specific operating system (e.g. Mac OS). Many development tools are therefore only available for that specific CPU and operating system, while some can be ‘ported’ or adapted to another configuration. The most advanced languages provide the ability for the program to be used by different CPU’s and operating systems all at the same time.

Apple Computer, Inc. was the first company to mass market the Graphical User Interface (GUI). This is now recognized as being a distinct computing advantage. All modern languages on all platforms use a GUI in varying degrees.

Learn about the following in this section:

4th Dimension - a Brief History

JonokeMed™ is written using a 4th generation language. It provides all the advantages of a modern language for a multi-user information system.

4th Dimension (4D) was born in the mid 1980s in France. It is now sold around the world, and is one of the few languages that can be programmed in the native language of the developer. 4D has been used to develop millions of solutions around the world. It uses advanced 32-bit technology; this is a requirement for working under Windows and Mac OS, meaning many of the older medical systems will not run under these modern operating systems.

Though 4D has its own rich language, it provides the ability for ‘plug-ins’ to be added to the language to provide many more features. Therefore, features could be added to any 4D system by writing plug-ins in other languages like C and PASCAL.

As it was first available on Apple’s Macintosh personal computer, 4D has a very rich and mature GUI. Developers using 4D started using a GUI before other medical software developers. Information can be presented more intuitively, in a manner that is similar to other tools you use everyday.

In the early 1990s 4D was enhanced to utilize client/server technology. This permitted solutions using 4D to be used at sites too large for a peer-to-peer system to support. No longer would large sites be restricted to a text-based system. Now the advantages and features of JonokeMed™ can be brought to sites with a need for 100+ workstations.

4D was also enhanced to make it a multi-tasking system for each workstation. In JonokeMed™, this means a user can simultaneously be printing a report, have the appointment scheduler open along with the word processing module, plus any other module they need open. This is a huge advantage as few people work in an environment where their tasks are limited to one for the majority of the day. With a multi-tasking system the user can quickly and easily move between tasks without having to exit one task to access another.

In 1995, 4D was enhanced to run on the Intel 80x86 and Pentium chipset under Microsoft Windows. This greatly expanded the number of users that could choose the JonokeMed™ Solution, simply due to the popularity of Windows computers. More significantly, this resulted in JonokeMed™ becoming the only system that can run on the MacOS and Windows operating systems at the same time. This gives each user the flexibility of using existing hardware, or simply their hardware of choice. This gives Jonoke the advantage of only programming JonokeMed™ once and then running it on several platform combinations.

4D provides a rich set of tools for the programmer. The programmer can make enhancements and modifications in a much shorter time than in other languages, old or new. Older languages like Business Basic or a modern language like C++ cannot compete with 4D for speed of development. This means that JonokeMed™ can be readily enhanced to meet the changing needs of the medical professional.

Development Speed
The creators of computer languages are continually trying to improve their product offerings to attract more developers. One of the most prominent features to attract developers is the ability to program quickly, thereby reducing cost and allowing the developer to provide new features to their product quickly and inexpensively. This translates into how you, as the software user, are provided software enhancements and at what price.

- 4th Dimension -
4th Dimension has won several awards in both the PC and MacOS world as a RAD (Rapid Advanced Development) Tool. This means that those companies that use 4th Dimension can bring to market new features at a lower cost than developers using other tools like C++.

Environment being Enhanced
A big reason to look at what the proposed solution is developed in is to determine if the development language is still being enhanced and developed. Several Medical Software Vendor sell solutions they have developed using tools that are not sold any more.

- 4th Dimension -
This is not the case with Jonoke and it's tool 4th Dimension. 4D Inc is a thriving business that has released new versions with new features every year since it was introduced in the eighties.

Capacity
All development tools are designed to answer specific needs. These include such needs as low cost, and number of concurrent users. An example of this is Microsoft's Access, and FileMaker Pro. These are two modern data base development environments. They are targeted at the low end data base needs. Price of the development tool is a major driving force with these tools. With these tools they are not intended to be used for high transaction, high availability, high data integrity, many concurrent user solutions. They are aimed at the home user, and for small systems. They provide a great solution for these uses, but likely should not be used for a Medical software solution that is used for keeping medical records. Speed, data integrity, and the number of concurrent users are all issues with these types of development environments. It may work for small clinics for a few years, but how does it handle your needs 3 to 5 years from now? Will you need to switch to a more capable system because the development environment just does not have the power to handle your needs?

- 4th Dimension -
4th Dimension is designed to run on a single computer, or with 400 or less concurrent users on a single server. This is not counting web services, or HTTP (web) connections. These are much lighter (less rich) connections. Therefore 4th Dimension is a good tool if your solution requires the number of connected users in this range.

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Graphical Interface
The tool that a solution is developed with will determine to a great degree the resulting user interface. If a user interface is not very graphical, it could be that the development tool used, just does not support a rich environment.

- 4th Dimension -
4th Dimension was born on the Macintosh from Apple Computer Inc. The Macintosh has defined the graphical user interface from day one. To be successful on the Macintosh Platform a solution had to follow the guidelines. Often solutions developed for the Macintosh ended up being the dominant solution on the Windows environment. Examples of this are: Microsoft Word, Excel, PowerPoint, PageMaker, Quark Express to name a few. So starting out on the MacOS has been a good proving ground for many solutions.

Record Locking
This can be a low level problem that will limit what the developer can provide you. Record locking is something that is required of all systems. At some level, a record must be locked to only one person making a change to it. A computer cannot let more than one person change a record at a time. Different development environments handle this differently. An example is how Access handles record locking. It does 'page' locking. On a single 'page' there are multiple records. If a user grabs a record to modify it, all records on the same page are locked to other users as well.
Along the same line, is how the medical software vendor has developed their solution. With some solutions if one user is modifying any part of a patient's record, then no one else can be modifying another part of a patient's whole record. This could be called the locking granularity. It is very frustrating for users to be told they cannot modify information in the system because somebody else is accessing another record in the system.

- 4th Dimension -
4th Dimension does not use page locking, it uses true record locking. Each record in the system can be modified by a user even if they are stored on the same 'page'. This gives you the ability to modify records without having the system telling you have to wait for another users.
As well, Jonoke has developed JonokeMed™ with the smallest granularity. Staff can be modifying letters, billings, payments, appointments, encounters, visit notes, (and more) all at the same time for the same patient.

Platform
A development environment must be written to run on a specific OS (Operating System) and a specific CPU (Central Processing Unit). Together this is called the Platform. Two examples of this are the 'Wintel' platform and the MacOS platform. For this reason many development tools are only available for a single Platform. There is no argument that Windows running on an 'Intel' compatible CPU is the dominant platform in use today. The MacOS platform is the next highest used platform. Linux running on a multitude of CPUs (therefore multitude of platforms) is likely the next highest market. If your group requires a system that runs on a specific platform, or requires or would like a system that runs on multiple platforms then you need to look at this.

- 4th Dimension -
Out of the box, 4th Dimension supports both the 'Wintel' and MacOS platform. This means that on the same data base users can have all the features when using both of these platforms. In addition to this other platforms can have access using thin client, or web connections.

The Personal Computer Advantage

JonokeMed™ makes use of the power of a personal computer for user access to the system. There are several advantages of this approach to an access terminal:

• A personal computer can share the processing workload with the server.
• The workstation can perform data validation as soon as the information is entered. An example of this is the patient’s health care number.
• A graphical user interface (GUI) can be utilized without having to access the central server. This translates into speed and productivity, and makes the system more user-friendly.
• GUI items, programs, workstations preferences, reports, temporary files, and other information can be stored locally when feasible. There is no need to load down the server and network with these items, when the local workstation can accomplish them.
• Other programs can be run on the workstation. CD-ROM’s, access to the Internet, and more can be accomplished at any time while also using the system. This does demand that the software work well with JonokeMed™ Client, however Jonoke is familiar with many other software packages and can provide guidance depending on your intentions.
• A typical dumb terminal system uses specialized terminals and servers. This can often be a costly investment. When upgrading the memory, storage, and speed of these systems you would typically pay 3 to 5 times the cost of a similar upgrade for a system like JonokeMed™ that uses readily available retail technology. • When you replace equipment it is not worthless. It is a personal computer that can be taken home for other uses, or sold. It has value and use beyond the medical application that you initially bought it for.

The cost of personal computers keeps decreasing, even as their processing power increases. Building a JonokeMed™ network consisting of advanced personal computers results in a fast, multi-purpose configuration, and a non-exclusive investment.