Talk:Main Page
From GPLMedicine
Comments mailed to the oswg list
This is great news!
To do the EHR reviews, the notion of 'criteria for inclusion/exclusion' in the reviewed systems is something that you will be faced with. In essence, what qualifies as "EMR"? The distinction is not always clear when you start looking into these systems. Another issue will be the criteria you will use to determine whether the system is "open source" and thus to be included in your review. Stuart Turner and I scratched the surface on these 'criteria' issues in our AMIA paper last year, but I would be interested to know how this group would draw these lines, or even if lines like these should be drawn. For example, if you use the criteria that to be open source means the software is being made available under one of the many OSI licenses, most of the system we evaluated previously would have been excluded from our research cohort because they lacked such a license (many did not have licenses). Other software was advertised as open source, but the license was not an OSS license and the code not made available -- the company behind the effort called it open source but it would not have passed the standard community criteria for such.
Anyhow, just raising these issues and interested in how the group deals with these distinctions.
Best to all,
Michael Hogarth, MD Associate Professor UC Davis School of Medicine
Response from Tim Cook, long term openhealth contributer
If you are analyzing "open source development" then your approach makes
sense, in some regards.
However, if the ultimate goal is to provide usable EMR/EHR systems then you have to look at the application from a user's point of view. Do they REALLY care how many lines of code are contributed, by how many developers and how often?
I doubt it.
They want a tool that they can use and adapt to their needs. A tool that will improve their ability to service their patient's needs.
In the US there is a great deal of emphasis on getting providers paid. IMHO this should be totally separate from improving patient care.
EMRs and certainly EHRs should be all about improving patient care.
In this context it is important to think about functionality in the hands of the ultimate users. There are also distinct differences between the various (primarily three) levels of patient care.
Though a system of ultimate flexibility would be great. The current crop of patient record applications should be divided into Primary, Secondary and Tertiary care settings. This is ESPECIALLY true in the US.
We could go into further details and as to how the various levels could and should share data. Many people are working on this (though far too often from a myopic perspective). But, I believe that if you select a few frameworks as previously suggested. Then compare your selected applications with those frameworks. You will create something of value for the open source community and the medical community at large.
Kind Regards,
Tim Cook
Section Added on Site/Software Installation
I added the start of a section regarding actual installations of each software. Ultimately, there is very good information in success and failure and everything in between.
I set up semi-structured pages with one page summarizing each installation and lists by software and divided by the general size of the site. I started it for VistA and the clinic installation I work with in Houston.
My thought is that contact information would be very helpful, and at least this site may indicate the induviduals willingness (or not) to email, talk, give tours, etc. Information may be supplied in true wiki spirit by the parties involved, those who know something about or 'reporters' who take it upon themselves to interview involved parties.
Pertinent information includes general typ of configuration, (specific software) and support and/or vendor, dates of various stages of function (all charts, 50% of phys, ...) and generally the feature sets functioning as a function of time. It is much more interesting to me to see a site up 18 months, than one shceduled to start soon.
Some of this information is available on various web sites, but would be most useful here in one place, vetted by those who know and are willing to contribute.
More discussion of the Process:
Review Process Discussion VistA-List VistA-SBCHC-OVR
Kirt Walker --KW 18:30, 10 April 2006 (CDT)
