With today's limited preview release of a breakthrough health management program, startup SimoSoftware is really proving the "NewRules enterprise." The product, SimoHealth, is a hybrid software combining a desktop client application with an online component. It's also the first client application built on top of the open source Firefox browser.

Download a free preview version from the SimoHealth website (Windows only)

Created by a pair of former AOL executives and with a programming staff of five, SimoHealth is a personal health management app that is interesting both for how it tackles complex health transactions and how the software was built.

Built on Firefox, SimoHealth is equal parts client app and browser

The company was born because Lash found himself "completely bogged down in trying to get the best care and managing expenses" for his son Simon, who suffers from developmental apraxia. "I realized there were no tools out there to help families manage their healthcare and advocate for the best care," Todd told me when I visited him at his Oakland home. He took the idea to Marty Fisher, former AOL president of technology and development. "Marty's reaction was, 'Oh, my god, this is huge. I can't believe this hasn't been done.' " Todd, Marty and Marty's son Todd Fisher, a software architect, joined forces to cofound SimoSoftware, named after young Simon Lash.

Markets don't get much hotter than the elephant-in-the-python aging babyboomer market, and it seems like the health sector is getting lousy with ex-AOLers. Just last month, Steve Case launched Revolution [site | Wash. Post story], a venture firm investing in health-related businesses. And WebMD [site] has brought in longtime AOL product marketing chief David Gang as COO and co-chief exec. As SimoSoftware president Todd Lash says, "The market for healthcare is essentially everybody. People in their 40s and 50s are worrying about their kids and their parents." And there other pressures besides the ravages of time. "Consumer-driven healthcare" is the industry buzzword for pushing costs onto consumers. "But there are no tools to help consumers manage their healthcare," Lash says. Enter SimoHealth.

SimoHealth really is a breakthrough product in this space. It offers what I think is an unparalled ability to break down and track complex medical transactions that goes far beyond the checkbook approach of apps from major players. A medical transaction is a complex affair. "The transaction may take 90 days to transpire - if there are no problems," Lash says. "If there are problems, it could take six months."

SimoHealth tackles this by allowing users to enter data from both the provider invoice and insurance company's explanation of benefits, matching payments, copays and deductible against basic plan information, and alerting users when a bill should be paid and when it's still waiting for insurance payments.

What's really cool from a product development view is that SimoHealth is developed right on top of Firefox, which means that the client app is inherently also a browser. Users can click on web resources or (in the future) download their "continuity of care" records (much like downloading an online bank statement) and the online information will display directly in the app.

SimoHealth calls for a hybrid approach because health information is sensitive data, which should be kept locally, yet there's a need to access online information, both in the form of websites and, soon, XML files that contain patient data. The current app uses the open source database Firebird to handle local data. In the early going, developers struggled to create a UI that would allow seamless integration of patient data with online resources. In the end, they decided to consider the first nine months of work a prototype and to build the actual app on Firefox.

That decision offered numerous advantages, said Fisher, COO of SimoSoftware and the former president of technology and development at AOL. "The architecture allows us to embed networking capabilities seamlessly into the product. We were able to easily customize the look and feel of the browser to make it look like our own application. It's much easier to develop in JavaScript than in C/C++. We had faster development time and more internal component usability."

In other words, the browser, not the operating system, is the platform.

A crucial part of the story is the open source aspect. "We were tapping into a lot of people around the world for help. We were in the IRC channels talking to Mozilla folks. There is a large number of people available to help you. You get scale by using open source," Fisher said.

That's a huge contrast with the old-style development models at AOL, said Fisher, who managed 3,500 people there. "One of the tragedies of AOL was that they refused to move forward from silo-built software. SimoHealth was built by five engineers. At AOL it would have been 40."

Larger companies naturally have bigger management footprints than virtual startups. But the NewRules company is showing that very small teams can write better products with more features, faster and with less complexity than the big guys. To Fisher, this open source approach looks like a major new model in software development. "Outsourcing is one solution to reducing development costs but it's not necessarily the best solution. This just works."