Re: Question about OIO (was Hello list)
Andrew Ho [EMAIL PROTECTED] wrote: Customizability is the main strength of OIO. It's main weakness is its installation! :-) The problem is the psycopgDA adaptor and the permissions having to be changed to postgres user. Can this compromise security? Zope 3 works with python 2.4 and the psycopgDA 2.x version. This version of psycopgDA is more pythonish and the installation is far more transparent as a result. One day if OIO can migrate to zope 3 as a zxcm file, this may solve the problem! Nandalal On 3/10/06, Brian Bray wrote: Thanks Denny and Aldric for the warm greeting. There have certainly been some interesting discussions while I was gone. (I'm just up to the end of 2003).Hi Brian,Welcome back! I hav e a question for Andrew Ho. In the discussion about Vista/OIO complementarity, you discussed the concept that OIO let's users safely customize forms.Each form has an unique form name and version number within each OIOserver instance:For example, "Psychiatric Progress Note version 1". Customizing a formcould mean 1) creating a new version using the same form name, or 2)copying some of the question items into a new form with a differentform name, or 3) changing an existing form version, which requiressafe migration of existing data. I'm curious how this is done, particularly related to the completeness and semantics of data elements.Completeness can never be assured without significantly restrictingcustomizability. For example, deleting the "Gender" question from anexisting form.Semantic connections between forms (and versions) require"translators" that are separately defined as necessary. I know I should RTFM, but a discussion might be more interesting...especially if some others with flexible systems can chime in.Sounds good!Best regards,Andrew--Andrew P. Ho, M.D.OIO: Open Infrastructure for Outcomeswww.TxOutcome.Org Brings words and photos together (easily) with PhotoMail - it's free and works with Yahoo! Mail.
Re: small practice management programs
Karsten Hilbert [EMAIL PROTECTED] wrote: On Thu, Dec 15, 2005 at 09:47:17PM -0600, Ignacio Valdes wrote: Active projects: FreeMed, ClearHealth, OpenEMR, VistA, OSCAR, SQLclinic I'm sure I've left some out. -- IVYes, GNUmed.Yes and it is apt-gettable. NandalalKarsten-- GPG key ID E4071346 @ wwwkeys.pgp.netE167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: larger FOSS work.
--- Ignacio Valdes [EMAIL PROTECTED] wrote: There's a remarkably good article called: Barriers to Proliferation of Electronic Medical Records by some guy named Valdes. It is a very good article, and I am happy to say I know this guy from a mailing list. Nandalal http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=pubmeddopt=Abstractlist_uids=15140347query_hl=3 -- IV On Thu, 15 Sep 2005 21:23:26 -0500 Bruce Slater [EMAIL PROTECTED] wrote: Thanks Ignacio for those edits and additions. Anyone, Any thoughts on a larger published work either in peer-reviewed or web-published? Bruce __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: Attitudes of hospital workers towards electronic medical records
--- Franklin Valier [EMAIL PROTECTED] wrote: A case study is usually viewed in research circles as just that. Not nearly as valuable as empirical controlled studies. This is generally true. However doing a study of this nature is not so simple and the planning of a controlled study will make things pretty complicated. The lack of similar studies makes it even more difficult. Several simple studies on this nature may give us sufficient information to plan out an empirical controlled study, as you yourself point out. Sometime they lead investigators into areas of further exploration. Nandalal Frank Valier - Original Message - From: J. Antas [EMAIL PROTECTED] To: openhealth-list@minoru-development.com Sent: Friday, May 20, 2005 8:52 AM Subject: Re: Attitudes of hospital workers towards electronic medical records Joseph Dal Molin wrote: This is another example of garbage in = garbage out. I can't understand how studies like this with a sample size of one, are allowed to be published in what appears to be a scholarly journal. I am sure that if you provide a better study with a lot more samples they will be glad to publish it. I have often questioned the quality of peer review in academic medical informatics because of articles like this one... I wonder, were they simply praising and/or glorifying a new EHR/CPOE, would you be so critical? The aeronautical industry only started to get really safe and reliable after they started to exhaustively study all their accidents and/or non-expected events. This combined with the software industry's legacy business model and marketing are the greatest enemies for innovation in health care IT I would rather say that the worst enemy is failing to see the human factor and the social issues as the main causes for Clinical IT failure. In healthcare I tend to agree with the Nicholas G. Carr's IT Doesn't Matter principle. Seen at that light a Clinical IT system is not really different from using a stethoscope or an ultrasonagraph. They are all limited means to reach a common end: to better help other human beings. feel free to add more to the list. Fear not, I guess that my freedom has not being menaced yet. Best regards, J. Antas __ Do you Yahoo!? Yahoo! Mail - Find what you need with new enhanced search. http://info.mail.yahoo.com/mail_250
Re: Attitudes of hospital workers towards electronic medical records
--- Franklin Valier [EMAIL PROTECTED] wrote: However when an individual reads a case study and comes to the conclusion that this is a major contribution to the development of knowledge about the subject in question, it needs to be pointed out that it is just a case study and where case studies fall within the scope of scientific investigations. This is a matter of the critical reading of all literature. There is precious little we can do if the reader is taken up with whatever appears in a journal, irresespective of the quality and standing of the journal in the community. Within the limitations, all observational studies have their uses, and in the abscense of the double blind controlled trials, may indeed be all we can go, alas. Nandalal - Original Message - From: Tim Churches [EMAIL PROTECTED] To: openhealth-list@minoru-development.com Sent: Friday, May 20, 2005 7:22 PM Subject: Re: Attitudes of hospital workers towards electronic medical records Franklin Valier wrote: In science this type of study only has value as to its scientifically agreed upon use. Its ability to be relied upon to make reliable conclusions from the methodology has to be taken into perspective when reading the study. It has value, but in science you don't take it too seriously. We rely on empirical studies for serious evaluation of a phenomena. If they haven't been done, all you can say is this is all have and this is all we know right now. Not much. I wouldn't get too upset about this. I think that you are being overly dismissive of observational studies. Controlled experiments are great, but a) they can be hard to arrange when the thing being tested is a hospital-wide information system which costs tens of millions of dollars to implement and b) controlled trials can introduce their own sets of biases and limit generalisability due to overly tight selection criteria. And how practical is it to randomise whole hospitals to get teh computer system or stay with paper? OPolitically that is rather hard to do. Certainly in the case of evaluations of implementations of hospital and other clinical infromations systems it is best to use a before-and-after study design, in which the hospital acts as its own matched control, and the same survey instruments and methods are used before and after the implementation of the system. It is easy to say that in retrospect, but getting money from management to commission an expensive evaluation study of a new information system BEFORE the system has even begun to be installed can be a challenge, I suspect. Tim C __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: Clinical IT increases documentation time
--- Daniel L. Johnson [EMAIL PROTECTED] wrote: On Sat, 2005-05-07 at 08:34, Jim Stuttard wrote: :-) Thank you Daniel for a historical note of what happens when technology preceeds education and, stupid people are given responsibility to maintain information that the clinician can make any sense of, and will be expected to make sense of the stupid stuff. History will repeat itself no doubt, again and again and regards Nandalal ... The UK Brit Med Assoc (BMA) complained the media that general practice (GP) primary care doctors at ~10 min per appointment resented the displacement of their focus away from the patient represented by concurrent data entry. Once upon a time, 20 years ago, I became a (US) FAA-designated aviation medical examiner. My nurse and I made little scribblings on our FAA form as we worked. A healthy pilot took about 20 minutes of her time and about 20 of mine; when we were done the secretary typed up our notes and the certificate nice and pretty, and the airman trudged off armed for duty. Then the FAA, to reduce their own paperwork burden, created a database. The doctor or the secretary now typed *all* the information on the form into an DOS data entry screen. By *all* I mean that the airman's responses had to by typed in as well. In order to get the airman's certificate out the door in the same time as before, I (a) bought a laptop computer (b) brought it into the exam room (c) typed his responses myself while interviewing him (d) typed my findings after examining him (e) printed the certficate by mounting it on a template and feeding this through my printer. (f) twice a month, I plugged in a modem and batched all the exams to the FAA database. Benefits: The airman had his ticket the moment we were done: no waiting for secretaries. The software knew the certification rules, so I didn't make stupid mistakes or leave out details. Drawbacks: It took 10 more minutes of my own time in the office. (Yes, I tried having the airman enter his own data, but repairing the damage took more time than doing it myself. And some of these pilots are too stupid to understand how to fill out the paper form, never mind the computer. Don't get me started...) It came to pass that the internet became a tool, and so the FAA decided to make this more efficient by having an on-line data entry tool, so that the information would be immediately captured by their database. The AME was now required to have an internet connection and a browser. I will spare you the details; this new software was not well engineered, and the FAA purchased inadequate bandwidth. The error-checking vanished, one had to wade through 8 successive data-entry pages, and (it being a browser) could not print a properly formatted certificate when done. Back to the secretary. With all these advances, it now took an additional 10 minutes of my time to complete a physical for an airman with no medical issues. And meanwhile, computers and word processors flourished, and the secretaries have no typewriters, and the one remaining typewriter in our institution, a fine old IBM Wheelwriter, was bequeathed to me by our administrative secretary, who said, I'll come get if if I need it. The next advance in this system is to have the airman provide his data at home via the internet, directly entering his medical history via an encrypted page. Never mind that half the airman need hand-holding and coaching to get the blanks filled in with the information that actually belongs there. The airman will then be provided a pass code to take to his flight surgeon (that's me). We will pray that he writes it down; that he remembers where he put the note; that he brings it with him. Then, when we have finally obtained the forgotten pass code by telephoning the support specialists in Oklahoma City, we will have to review his data and separately document correction of all his errors (rather than coaching him to do it right the first time). Yes, the efficiencies of IT EHR are indeed wonderful. In this case, the efficiencies are all in the FAA offices. But I'm not complaining. It's fun and entertaining, as these are mostly healthy folk and there's no pressure to do miracles. Dan Johnson md __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: Clinical IT increases the time intensive care nurses spenddocumentingcare.
--- Joseph Dal Molin [EMAIL PROTECTED] wrote: VistA's CPRS works with any Dragon based VR product out of the boxand as I found out quite by accident at the recent American College of Phys. conference it works with hand writing recognition software that comes with the Toshiba Portege tablet computer Is this the proprietary version of VistA CPRS or the free version of Open VistA? Interestingly, the sorts of screen displays and data entry forms best suited to such head-mounted display devices are not complex GUIs, but rather very simple text-mode terminal displays, remarkably like the screens used by VistA The use of a text based browser maybe even more useful. Like Lynx for example The whole thing acts as a voice-activated thin client, communicating with the main hospital systems via wireless networking. Will this not compromise security? What about log-in by voice recognition? I am aware that such systems are being tested and they say a persons voice is almost as good as a fingerprint. Nandalal Nandalal Gunaratne MS FRCS(Eng.) Urological Surgeon __ Do you Yahoo!? Read only the mail you want - Yahoo! Mail SpamGuard. http://promotions.yahoo.com/new_mail
Re: availability/uptake and - automation EMR or parts?
--- David Forslund [EMAIL PROTECTED] wrote: There is a joint effort between HL7 and the OMG to standardize such an RLS. I urge participation by those involved in these standards efforts. There was a lot of work done on a RLS a number of years ago by the OMG and we need to ensure that this RLS service be interoperable as it develops. I couldn't find any significant specification for the RLS in the references you gave. Hi, On the proposed RLS from http://www.connectingforhealth.org/resources/collaborative_response/hie_model/3.php The system supports 1. Linking of records via a registry of information about where records are located and sharing among users participating in the system, but it also allows 2. Linking without sharing, or sharing pursuant only to higher authorization, as well as 3. The ability to choose not to link information in certain sensitive treatment situations determined by users. Should the last of these be determined by patients or professionals? If patients determine what is linked and not, much of the data collected by the doctor will become unavailable to the doctor. Will we need a type of Informed Consent from patients as to 1. If they are willing to have an EMR 2. That they understand the risks (however good security looks)ad that the clinician cannot be responsible for the loss or leak of records. 3. That if they decide not to link parts of the EMR, they will first discuss with the doctor before delinking? That they may be harmed if this information is not available in an emergency situation to the clinician. What about responsibility of problems due to errors in data entry by the patient to his record, or by the health care workers? If a clinician finds an error in the patients own additions, can he correct it? Is he responsible to that records accuracy as well? Nandalal Dave Will Ross wrote: On 23 Apr 2005, at 3:25 AM, Adrian Midgley wrote: I am not convinced we always address the collection of problems and opportunities from the right aspect. I prefer to think about _automation_ rather than just an EMR, and about tools for tasks rather than a whole system. I know that re-usable code and integration of different pieces is harder in practice than in theory, but ... I also believe we have not considered the use of the computer and network as a Knowledge Source for medical/healthcare practice sufficiently, and some distance remains, in England although it is decreasing, to the establishment of an ecology of people making a living, and technical resources aligned to FLOSS. Looking at the opinions published by the US Leapfrog Consortium, and reviewing my memories of the development of UK General Practice software over some decades, the prescribing system seems to be the first clinical tool to be of obvious value. This implies the presence of a register - a list of who is a patient/was a patient (but does not absolutely _require_ it, or require it to be complete). The Connecting for Health group (a fellow traveller to the Leapfrog group) is working as we speak to deliver just this type of index. They call it the Record Locator Service. Their most recent technical overview (Linking Healthcare Information published in February) is available in pdf on the project home page at: http://www.connectingforhealth.org/ The RLS observes a distinction between knowing where a record is located and knowing what is in the record. The OpenHRE project is following the RLS specification. [wr] - - - - - - - - will ross technology project management 216 west perkins street, suite 206 ukiah, california 95482 usa 707.272.7255 [voice] 707.462.5015 [fax] - - - - - - - - begin:vcard fn:David Forslund n:Forslund;David org:Los Alamos National Laboratory;CCS-DO adr;dom:;;MS B265;Los Alamos;NM;87545 email;internet:[EMAIL PROTECTED] title:Laboratory Fellow tel;work:505-665-2633 version:2.1 end:vcard __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: GNUmed taking so long (was Re: )
--- Tim Churches [EMAIL PROTECTED] wrote: Nandalal Gunaratne wrote: I dare say that the GNUmed developers are a little concerned as to why so few people ever bother to help them. :-) I am afraid that there are very few doctors who use EMR. None of them use or want to use Linux. The sons of two of the GPs are in the local LUG and therefore are promoting this. I am using OIO with Zope/Plone as my intention is to use it for research/self audit. Plone is useful for News/Event/discussion, documentation etc. I work in a teaching hospital and have a local LAN. Therefore I cannot really check out the software that I asked about. However, I will encourage the users to give feedback and ideas. I was in a small group which made a HIT policy document to be sent to the government policy planners to begin implementing e-Health. I tried to include the fact that open standards and open source software should be given preference. at this stage itself. But it was turned down by the rest of the committee. It will be considered in the implementing stage. Nandalal If you subscribe to the gnumed-devel mailing list you will see regular calls for people to help test the software. You don't need to be a programmer to contribute. Tim C __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re:
--- Horst Herb [EMAIL PROTECTED] wrote: On Fri, 22 Apr 2005 13:28, David Derauf wrote: Horst: I was not clear enough: We are entertaining the idea of scanning medical records that we are copying for other purposes anyway. Thinking to the future, I thought that we should likely create some sort of meaningful file structure for these scanned records: one that is a) HIPAA compliant b) user friendly c) less likely to become obsolete d) inexpensive e) linkable to future EMR implementation... gnumed has a fully functional scanning + document archival module (one of the few things in gnumed that actually work I am a little concerned a to why GNUMED is taling so long. What is the FOSS that I can recommend to a General Practitioner which actually works and is easy to use. I suggested OpenEMR with the Mandrake installer to a couple of GPs. I have not used it though. OSCAR will be more difficult to cope with i think. tkFP is also something I have heard about. Thanks Nandalal and are already in use in daily practice for some time) Don't know HIPAA compliance requirements though, since I am not in the US Horst __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: Software patents (was Re: Blinkx (was Re: Meditech and GNU/Linux))
--- Tim Churches [EMAIL PROTECTED] wrote: Nandalal Gunaratne wrote: --- Tim Churches [EMAIL PROTECTED] wrote: Hi Tim, Thanks for the detailed answer and the link. I am really concerned about FOSS development/migration in a country with such patent laws. Sri Lanka has not got patent laws yset. Copyrights and IP foor software was brought in recently - two years ago - before that we were a pirate state - well we still are in a much smaller way :-) I hope we never have patent laws, but I doubt it. Regards Nandalal Unfortunately, patents on software algorithms and business methods have been granted here in Australia since 1990, and the courts have upheld some of these patents (but have struck out others). The only saving grace is that the test for novelty was recently made more rigorous - now an invention does not meet the test of novelty if aspects of it have been described previously but in separate published documents, and if the combination of those components is obvious (to someone skilled in the art). In the past, an invention had to have been described in its entirety in one document to have been considered prior art - now the scope of prior art is much wider, which is a good thing, and will hopefully prevent many trivial software, algorithm and business methods patents which are just minor variations on a theme from being granted, or at worst, from being upheld in the courts. However, the whole system is still stacked ridiculously in favour of the patent applicant. I was shocked to learn that as a private citizen, in order to object to the granting of a patent, not only do I need to pay a substantial opposition fee (about $600), if my objection is overruled by the Patents Commissioner, I have to pay the patent applicant's costs, which can run to thousands or tens of thousands of dollars. It seems that the patent system assumes that all patents are for the public good, and that anyone opposing a patent is just a troublemaker. We desperately need an organisation like PUBPAT (see http://www.pubpat.org/ ) here in Australia. In fact, every country needs one! Tim C __ Do you Yahoo!? Yahoo! Small Business - Try our new resources site! http://smallbusiness.yahoo.com/resources/
Re: Blinkx (was Re: Meditech and GNU/Linux)
--- Tim Churches [EMAIL PROTECTED] wrote: Nandalal Gunaratne wrote: Please try out blinkx on your windows machine before you delete it. www.blinkx.com A super new way to search - no linux version yet :-( Yes, some nice ideas there, but it is not open source, and without the source code, no-one can verify that the software does not contain spyware Hi Tim, True! BTW what is the position of Australia regards software patents issue? nandalal (despite the authors claims to the contrary), perhaps using steganographic methods or subliminal channels to leak information about you and your PC to the outside world. Of course, that is true of any closed source software, but one has to be doubly careful with software from a small start-up company which deliberately dredges and indexes everything on your system. The same is true of Google Desktop Search, although Google has so much at stake (as in a entire multi-billion dollar company) and so many staff reveiewing code that it is much, much less likely that spyware functions would be hidden in it. But a small start-up? Who knows? Tim C I am an Endocrinologist in Hagerstown, Maryland who has been lurking on this list for at least four years now and I finally have something useful to report after several years of trying: I am now successfully running Meditech Remote Workstation client version 3.22 on top of CrossOver Office version 4.2 over Debian Unstable using VPNC to connect to my Hospital's network. I shall post a How To once I sort through what are the truly essential steps to do this. It actually works better than under native W2K. I was never able to get pass-through printing working under Windows. I can finally kiss my native windows partition goodbye! __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest
Re: Meditech and GNU/Linux
--- slippman [EMAIL PROTECTED] wrote: Well done! i do not know about Meditech, but will do a search. Please write your HowTo before any goodbye kisses! At least we will have a copy on the list if everything disappears. Please try out blinkx on your windows machine before you delete it. www.blinkx.com A super new way to search - no linux version yet :-( nandalal I am an Endocrinologist in Hagerstown, Maryland who has been lurking on this list for at least four years now and I finally have something useful to report after several years of trying: I am now successfully running Meditech Remote Workstation client version 3.22 on top of CrossOver Office version 4.2 over Debian Unstable using VPNC to connect to my Hospital's network. I shall post a How To once I sort through what are the truly essential steps to do this. It actually works better than under native W2K. I was never able to get pass-through printing working under Windows. I can finally kiss my native windows partition goodbye! __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest
Re: LMN: Windows VistA Client Running on Linux
--- Ignacio Valdes [EMAIL PROTECTED] wrote: I think this is very a very interesting development. I am not clear if we need BOTH WINE and Crossover office or only one of them. 'There are some problems with Report and Lab tabs but most of it works. We would love to have folks chip in and sort out the last few bugs. It is easy to install. You just need the latest version of Wine or Crossover Office' It seems that the word or suggests either However erlier in the article Joseph Dal Molin of WorldVistA reports success in getting the VA Computerized Patient Record System (CPRS) VistA client running on Linux using WINE and Crossover office. and suggests we need both. Please clarify Nandalal Gunaratne As many as 98,000 people die each year as a result of preventable medical errors which Free and Open Source electronic medical records software could reduce. A contender in this area is the Veterans Administration (VA) public domain VistA codebase and large community. In a major advance for FOSS in medicine, Joseph Dal Molin of WorldVistA reports success in getting the VA Computerized Patient Record System (CPRS) VistA client running on Linux using WINE and Crossover office. The CPRS client formerly ran only on the Microsoft Windows operating system and is widely deployed on thousands of workstations within the United States VA system. More details of this development and a screenshot can be found here: http://www.linuxmednews.com/linuxmednews/1112336432/index_html __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest
Re: Linux Medical News is 5 Years Old
--- Ignacio Valdes [EMAIL PROTECTED] wrote: Ignacio, Your work is much appreciated. You deserve amny fishing holidays. Nandalal Gunaratne Linux Medical News is 5 years old as of yesterday. It all began with http://www.linuxmednews.com/linuxmednews/954458835/index_html the first posting. Since that time, there have been 970 posted articles, a great deal of editing, and millions of visitors. Has the landscape changed much since then? Is the work finished? http://www.linuxmednews.com/linuxmednews/1112317813/index_html -- IV __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest
Re: LMN: Windows VistA Client Running on Linux
--- Ignacio Valdes [EMAIL PROTECTED] wrote: Is there a howto anywhere about downloading and installing OpenVista? Thanks Nandalal Gunaratne As many as 98,000 people die each year as a result of preventable medical errors which Free and Open Source electronic medical records software could reduce. A contender in this area is the Veterans Administration (VA) public domain VistA codebase and large community. In a major advance for FOSS in medicine, Joseph Dal Molin of WorldVistA reports success in getting the VA Computerized Patient Record System (CPRS) VistA client running on Linux using WINE and Crossover office. The CPRS client formerly ran only on the Microsoft Windows operating system and is widely deployed on thousands of workstations within the United States VA system. More details of this development and a screenshot can be found here: http://www.linuxmednews.com/linuxmednews/1112336432/index_html __ Yahoo! Messenger Show us what our next emoticon should look like. Join the fun. http://www.advision.webevents.yahoo.com/emoticontest
Re: web based applications - Mozilla
--- Horst Herb (lists) [EMAIL PROTECTED] wrote: On Tuesday October 19 2004 00:09, Calle Hedberg wrote: By the way: One of my collegues - who also is Open Source oriented - this morning warned me against using Firefox, alleging that it is full of spyware. He said he had installed it on a Linux box and intercepted a lot of suspicious traffic. This is plain rubbish. Tell your colleague he is a bloody ignorant and should know better than just spreading FUD. I agree. Calle is also getting unnecessarily involved in this spread? ___ Do you Yahoo!? Declare Yourself - Register online to vote today! http://vote.yahoo.com
Re: web based applications and PRINTING
On Tue, 2004-10-19 at 05:29, Wayne Wilson wrote: I hate to say it, but we gave up on HTML based printing and moved to PDF. For our programmed apps we use the output from the apache FOP project: http://xml.apache.org/fop/ The use of Latex maybe the way to solve this issue. The development of conversion tools allowing single or multiple HTML to Latex conversions will get the files in a format meant for printing. http://html2latex.sourceforge.net Conversion of latex PS to pdf is much better than HTML to PDF. Just to add to the list.a very good FOSS PDF library for Python apps is ReportLab http://www.reportlab.org/ HTH, Tim ___ Do you Yahoo!? Express yourself with Y! Messenger! Free. Download now. http://messenger.yahoo.com
Re: Dasher (was Re: CPOE time studies.)
It is already working in many languages. It has great potential, and kids will love it too! It is like a game, and has potetial as a language teaching application. To make it work in medical application is just a matter of time. i have been using it for some time now, and my speed is pretty good! Your medical words also come up quickly. It is like using the Tab key in Linux! Nandalal --- Bruce Slater [EMAIL PROTECTED] wrote: Haven't tried it yet, but will. It seems from the demo to be a little difficult if you have to navigate the whole universe of a language. Has anyone trained it on their own clinical notes and then tried to write a note? It seems like you could customize the predictive engine by substituting meta-regions that correspond to sections of a progress note or complete health exam. For example instead of an alphabet, present the main headings of a note. Chose a heading like Family History. Within that the universe would be very limited and navigation very obvious and quick. Once an family member was picked, then common familial illness would populate the right side of the screen. Any time a free text was needed a tunnel into classic Dasher could be used to create text. An escape area would take the user back to Family history level to chose another ancestor and then dive back into organized text. When done with Family history the escape would lead to the main level where social history could be chosen. Maybe it is just late at night, but this seems like a potentially revolutionary tool for handhelds and an interesting idea for note creation on desktops. Is someone working on a medical version? Bruce Slater - Original Message - From: Horst Herb [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Thursday, October 14, 2004 10:34 PM Subject: Re: Dasher (was Re: CPOE time studies.) On Fri, 15 Oct 2004 06:59, Tim Churches wrote: I suspect it would be much better that the Graffiti handwritten letter recognition system used on my PalmPilot too. If it is good on a PalmPilot, then it would be good on other PDAs. it's brilliant on my Zaurii Horst __ Do you Yahoo!? Yahoo! Mail Address AutoComplete - You start. We finish. http://promotions.yahoo.com/new_mail
Re: Dasher (was Re: CPOE time studies.)
--- Horst Herb [EMAIL PROTECTED] wrote: it's brilliant on my Zaurii Great! It is fun too isn't it? Nandalal Horst __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: CPOE time studies.
--- Horst Herb [EMAIL PROTECTED] wrote: On Fri, 15 Oct 2004 01:00, Andrew Ho wrote: Nandalal, If I really concentrate, I am faster with Dasher than with the keyboard - but after a while it gives me a headache. It feels like a very fast computer game. True! I think the colours are the problem. I wouldn't use it to write a book :) However it is great for short notes on mobile devices. The trouble is that they have tiny screens and I am over 40 :( Soon we will wear something like the virtual reality glasses on Bluetooth and the mobile device screen will lool like a football field ? Aha! Then Dasher will rise again.. Nandalal Nandalal Gunaratne Urological Surgeon Sri Lanka Horst __ Do you Yahoo!? Take Yahoo! Mail with you! Get it on your mobile phone. http://mobile.yahoo.com/maildemo
Re: CPOE time studies.
Andrew, I want you to look at http://www.dasher.com Nandalal --- Andrew Ho [EMAIL PROTECTED] wrote: On Mon, 4 Oct 2004, Don Grodecki wrote: Sounds to me like a job for Tablet Computers! Don, As far as I know, lack of full-size keyboard dramatically diminishs the utility of tablet computers for applications that require text data entry. Best regards, Andrew --- Andrew P. Ho, M.D. OIO: Open Infrastructure for Outcomes www.TxOutcome.Org ___ Do you Yahoo!? Declare Yourself - Register online to vote today! http://vote.yahoo.com
Re: physician prescribing tool development
--- Adrian Midgley [EMAIL PROTECTED] wrote: On Tuesday 12 October 2004 22:36, Daniel L. Johnson wrote: I believe that the browser is useful for development because it minimises the time spent on developing the presentation layer and can be platform independent. I'm more and more impressed with thin clients - whether VNC or rdesktop or some variant of X over ssh. How secure are VNC and rdesktop compared to SSH? Cna we use SSH with VNC? Nandalal -- Adrian Midgley Open Source software is better GP, Exeter http://www.defoam.net/ ___ Do you Yahoo!? Declare Yourself - Register online to vote today! http://vote.yahoo.com
Fwd: Re: Issue of freedom and migration, Re: CPOE time studies and a word from the other side.
Note: forwarded message attached. __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com ---BeginMessage--- --- Tim Churches [EMAIL PROTECTED] wrote: I am not sure about these arguments. Migration is one issue as it is a possible permanent loss of a skilled person from one country to another. There is a loss of British, Australian, Austrian and others who also move to the USA for example. This is promoted by the USA too. The number of British scientists who have been recruited in such a manner to the US is well known. Do you think the British have not lost? The other problem is that the skilled medical or others in the poorer countries are not given the facilities to work. They can be thoroughly frustrated as a result. Their knowledge and skill is NOT appreciated in their own country. They maybe too qualified and skilled for the country of their origin. They try really hard to do something useful but nobody cares to help - particularly the administrators. They can be lost to their own citizens. What if some other country can make use of them to help their own people, and they want to have a better health care system, and can and will give them the conditions they need to work to the best of their skill and knowledge? Must they be lost to everyone? Take away migration. Many of them do NOT want to migrate, They want to work w few years in another country which will allow them to improve their skills and knowledge and also earn enough to save something and go back to their own country. This is good for both countries. If this is encouraged and made easier to do, but migration is not, then neither side will lose. Nandalal On Wed, 2004-10-13 at 05:41, Andrew Ho wrote: On Tue, 12 Oct 2004, Karsten Hilbert wrote: When the UK, Canada or Australia recruits such a person to work in the UK, Canada or Australia, do they reimburse the South African government for the cost Double standard you use. No. Or rather, yes. Question is WHY a double standard is used. Tim believes applying a double standard is the morally right thing to do in this particular situation. This discussion needs to include consideration of personal freedom and discrimination (or preferential treatment) based on country of origin. Indeed, and our argument is that there should NOT be preferential treatment, through active recruitment and assisted migration, of skilled health care professionals from needy countries to wealthy countries. I think we are in violent agreement. -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0 ___ Do you Yahoo!? Declare Yourself - Register online to vote today! http://vote.yahoo.com ---End Message---
Re: language help
Hi, --- [EMAIL PROTECTED] [EMAIL PROTECTED] wrote: Hi All, When my system has not crashed I make data permanent all the time with a CDRW and DVD-RW device. Actually, I could have someone else do it as well, and I could setup a cron job to do it later. I do not think it is possible to setup a cron job to backup to a CDRW or DVDRW device in Linux systems yet. It maybe possible when Linux supports writing to UDF file systems. Now it just supports reading these file systems. If I am wrong can someone tell me how to do this successfully? Nandalal __ Do you Yahoo!? Yahoo! Small Business $15K Web Design Giveaway http://promotions.yahoo.com/design_giveaway/
Re: From Sweden: Open source in developing countries
Hi Tim, Thanks for the article. I am very much aware of the position of OSS in Sri Lanka, and I feel that it is time to push the concept of FOSS as the e-government and e-Lanka initiatives are to be implemented soon. The SL government has signed an MOU with Microsoft Corporation and the ministry of Education also went for MS solution. However thankfully, the MOU does not bar the use of OSS anywhere. I was the only proponent of OSS for health care in SL, until a few others joined me, after being convinced. It is a difficult task, and I wonder if OSS will be taken seriously by government or even be considered a threat, as little or no money will change hands. I see little support from funding agencies. Sri Lanka also has very lax laws relating to the use of software and therefore has become a paradise for pirated software. One can buy Windows XP and Office XP porfessional for less than US$ 2 and use it! Under such a scenario OSS makes even less sense. Tighter laws and regulations related to pirating (which affects local software produces as well) are expected as this has been one of the demands of Microsoft Corporation. Strangely such regulation and punishment, may give the biggest boost to FOSS over here! The cost of proprietary software even at half the price in USA will be impossibel for majority of uses to afford. Nandalal - Original Message - From: Tim Churches [EMAIL PROTECTED] Date: 19 Feb 2004 09:35:30 +1100 To: openhealth-list @ minoru-development . com [EMAIL PROTECTED] Subject: From Sweden: Open source in developing countries This report, commissioned by the Swedish govt development agency (and referenced by the IOSN site) is useful: http://www.sida.se/Sida/jsp/polopoly.jsp?d=1250a=23955 Nothing startling, but a nice review of the background and an examination of open source business models in poor countries, plus some case studies in Sri Lanka. Nice. One day soon it will be possible to produce a health-specific version of such a report. -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0 signature.asc -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Australia and open source
- Original Message - From: Tim Churches [EMAIL PROTECTED] Date: Wed, 14 Jan 2004 14:36:49 +1100 To: openhealth-list @ minoru-development . com [EMAIL PROTECTED] Subject: Re: Australia and open source All it means is that neither of the major political parties will introduce open source affirmative action legislation or policies - that is, active discrimination in favour of FOSS when software acquisitions are being made. However, that doesn't mean that FOSS won't be considered by government agencies - indeed, govt officials must consider FOSS as part of of their due diligence responsibilities to ensure that the taxpayer gets best value for their tax dollars. The ACT legislation was just reminding them of that fact. I guess this is a good thing. However there are those who are opposed to FOSS who will always try to make government be vary of considering FOSS. The fact often used was that FOSS was insecure and that there is no support. However these are now being proven wrong. The issue that does remain is the licensing issue of FOSS like GPL. With the problems of the law suits involving Linux code, this can be used against FOSS. Maybe someone should make people in government, aware of the GPL and othe FOSS licensing. Using GPL does NOT mean that all products from it have to be GPL. The concerns of governments of making all the products based on FOSS, say the modifications done to make it suitable for use in Australia, will have to be put on the public domain may not be acceptable. From what I know -correct me if I am wrong, there is no absolute that the modifications have to be placed in the public domain. These issues must be worked out or.. http://www.zdnet.com.au/newstech/os/story/0,248630,20282661,00.htm Nandalal Gunaratne -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Australia and open source
http://australianit.news.com.au/articles/0,7204,8381302%5E15441%5E%5Enbv%5E15306-15319,00.html The decision. Was it based on the middle path or the money path? :) -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: openEHR, gnumed, OIO,OpenEMed, FreeMED, SQLClinic, VistA, etc. etc.
Horst, You do write some great stuff! I am seriously worried about these standards, their complexity, the continuous chages, their failure to succeed in getting to be used. I have studied them the best I can, and I feel they are hopeless in the way they are implemented. Just imagine some country starting a EHR and e-health project. To succeed the end usersd must be happy to use them, and must benefit from them immediately. If things are complicated due to the fact that there is conflict in what standards to implement and when, and this affects the speed of implementation, the whole thing may fail. I wonder if standards cannot be implemented to allow communication between systems that already exist, and can be implemented and insinuated into prevailing systems? Will some simple guidelines to the end user software - eg: data should be exportabl;e as XML etc. may not suffice? Excellent end user software in EHR, not having any standards are being used and liked by many clinicians around the world. I feel that end users will go their own way in the prevailing atmosphere relating to standards. Will it really matter to the patient? to the clinician? If so to what extent? Thank you for any enlightenment :) Nandalal Gunaratne - Original Message - From: Horst Herb [EMAIL PROTECTED] Date: Wed, 7 Jan 2004 21:05:33 +1100 To: [EMAIL PROTECTED] Subject: Re: openEHR, gnumed, OIO,OpenEMed, FreeMED, SQLClinic, VistA,etc. etc. On Wed, 07 Jan 2004 20:48, Thomas Beale wrote: I wouldn't know for most of these but it seems reasonable. My only comment is that this classification is fine for a sort of maturity index of software; things like openEHR have a lot of work in the specification space, shared (pioneered) by OMG HDTF, CEN 13606, HL7 and others, which You know that I am all for standards, and you are certainly right in many ways. However, the sad reality is that standards in our domain don't work. Very sad. But in a world where you can't even get the some rogue but very influential countries to agree to most sensible standards with straightforward benefits such as adherence to the metric system, what hope is there for health care standards? Corbamed is sensible and fairly complete in the sense that you can implement it here and now and do something useful with it. I know OpenEMED has implemented some, but honestly: hands up how many world wide installations are there of any Corbamed system? So much for Corbamed as a standard. And HL7? It is still a sad joke. Despite it's (probably entirely unnecessary) complexity it still doesnn't fulfill any expectations. I haven't seen yet any two not-inhouse systems that can talk to each other HL7 without need for a home baken translation level. And even then things can go wrong (see the pathology download tragical comedy in Australia). And CEN standards? I'd love to see them work in our domain, but please point me to any significant installations using them. Standards that work nowadays and make everybodies life easier have arisen out of somebody actually doing something, and the process of becoming a de-facto standard has been helped by either sheer commercial market domination or complete openness. Complex domain specific standards developed on the white board and then imposed onto humanity have not often worked well AFAIK. So, once again: I love standards. I wish standards to penetrate our domain thoroughly. But for standards to have any impact on evaluation of actually existing projects they would need to be more meaningful than what we have, and they definitely would need more acceptance than they currently have. Horst -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: openEHR, gnumed, OIO,OpenEMed, FreeMED, SQLClinic, VistA,etc. etc.
- Original Message - From: Fred Trotter [EMAIL PROTECTED] Date: 06 Jan 2004 10:15:12 -0600 To: OpenHealth [EMAIL PROTECTED] Subject: Re: openEHR, gnumed, OIO,OpenEMed, FreeMED, SQLClinic, VistA,etc. etc. I am emailing them to see if they would add our projects if we did our review in the same format. Did you notice OpenEMR? It is free open source! Is it OpenEHR in disguise? Talk about demonstrating cost effectiveness!!! Fred Trotter On Tue, 2004-01-06 at 10:13, Ignacio Valdes wrote: Interesting site that I've never heard of before. Thanks for the link. Unless I am missing something, I note that there appears to be no FOSS EMR's on the site. Could the usual suspect projects infect the site? Yes, I know I'm supposed to be camping. I haven't left yet. -- IV On 06 Jan 2004 06:32:40 -0800 Tim Cook [EMAIL PROTECTED] wrote: On Mon, 2004-01-05 at 09:26, Kevin Coonan MD wrote: While not an independent study, you may find this comparison matrix helpful. http://www.elmr-electronic-medical-records-emr.com/ Cheers, -- Tim Cook (President, Open Paradigms,LLC) [EMAIL PROTECTED] Public Key - 1024D/9ACDB673 available from: http://www.openparadigms.com/timcook_publickey.asc Key fingerprint = C7BB 675B BDCA B87D 83F0 A002 BBDC C7B8 9ACD B673 -- Fred Trotter [EMAIL PROTECTED] SynSeer signature.asc -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: [Fwd: RE: Dynamic data collection forms in VistA? (was RE: Vistaon the BBC News Web-site)]
I see little exciting: in this development. It is giving a web interface to VistA. But interoperability is a loose term. I think they are thinking of one or two other systems and no further. What is the license under which it is produced? Is it open sourced? Nandalal - Original Message - From: Tim Churches [EMAIL PROTECTED] Date: 30 Dec 2003 12:25:27 +1100 To: openhealth-list @ minoru-development . com [EMAIL PROTECTED] Subject: [Fwd: RE: Dynamic data collection forms in VistA? (was RE: Vistaon the BBC News Web-site)] Thanks to Steven Tomlinson for pointing this out - sounds exciting! http://www.pacifichui.org/media/press_releases/JanusNewsRelease_final.pdf Tim C -Original Message- From: Tim Churches [mailto:[EMAIL PROTECTED] Sent: Sunday, December 21, 2003 11:50 AM To: openhealth-list @ minoru-development . com Subject: Dynamic data collection forms in VistA? (was RE: Vista on the BBC News Web-site) Nandalal Gunaratne wrote: Yes, I have one question. Is it possible to link OIO to VistA in some way. Jim Self wrote: My approach at this point is to take basic web oriented tools from VMACS and combine them with Vista installation on GT.M and Linux with Apache. Then I can expose VistA data and design to the web making it easier for me and others to understand, to potentially reverse engineer, and, of course, that also opens possibilities for re-engineering VistA applications for the web. Hmmm...thinks...one of the features of MUMPS (or rather, M) is its highly flexible and dynamic data storage and retrieval architecture, closely allied to a dynamically interpreted language. Unlike OO-languages and SQL, there is little impedance mismatch between the M language and the M storage system. Given that, I wonder if it would be possible to create an Epi-Info/OIO-style facility for Vista, written in M, with a Web interface, which permits end users to easily create and modify data collection forms which are attached to different parts of the (very extensive) VistA data model? It might be easier to handle issues such as table schema updates with M than it is to handle with SQL data stores. So, rather than link OIO to VistA, it might be possible to re-implement aspects of OIO as part of VistA (and/or other M-based ssytems). That way, end-user data forms and data would be stored with all the other VistA data, and would benefit from being backed-up in the same way, and could be supported by the same infrastructure as the rest of VistA. Obviously such a project would only be of interest to VistA or other sites running M-based systems, but as we have heard, there are a surprising number of these - 140 hospitals in the US VA system alone. That's a fairly large ready-made user base for such a facility, and as Nandalal notes, it would be sure to be popular. Thoughts? -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0 -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0 signature.asc -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: hub, spoke, new Esperanto for healthcare, was Re: form-to-form translator, was Re: Solving the data type problem, was: ODB vs. RDMBS was: OIO-0.9.1 released
Exactly! That's the goal. But to do that, we need to describe a lot of medicine to computers in a way that they can understand. This is one of the things we are trying to do. This does not need a standardization but rather a framework on which to develop, collect, information and to share them. Sharing forms is one simple way, sharing the structure on which a form should be built to allow sharing and comparison is another necessity. A good simple example is the ICD10 Procedure Coding System. The system has developed a structure to facilitate coding which makes a way a computer will understand. This may look strange initially but once learnt makes for a less verbose, simple structured way of collecting data. What do you think? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: OpenEHR vs. OIO semantics infrastructure, was Re: form-to-formtranslator, was Re: Solving the data type problem, was: ODB vs. RDMBS was:OIO-0.9.1 released
This can be handled by OIO Andrew will tell you better :) But the Oncological Surgeon im my hospital does this using OIO - a cancer registry. I will tell him to try and write to me and send me the OIO forms he uses, but he is away at the moment. I too keep records of cancner patients using the forms developed by the UK NHS Oncology Group. OIO allows me to keep complete records of each admission, operation, histology reports in continuity - this is particularly important in bladder cancer patietns in my field of Urological Surgery. Nandalal - Original Message - From: Tim Churches [EMAIL PROTECTED] Date: 28 Dec 2003 09:01:50 +1100 To: openhealth-list @ minoru-development . com [EMAIL PROTECTED] Subject: Re: OpenEHR vs. OIO semantics infrastructure, was Re: form-to-formtranslator, was Re: Solving the data type problem, was: ODB vs. RDMBS was:OIO-0.9.1 released On Sun, 2003-12-28 at 05:11, Andrew Ho wrote: Yes, OIO forms can be adopted for a national database of clinical concepts. For example, the Philippines national cancer registry can create a set of OIO forms - each form describes the initial presentation of a cancer case at the time of first diagnosis. In this example, the top level clinical concept is cancer case at the time of first diagnosis - which is modeled via an OIO form. For example, the Prostate Cancer Detected form, the Ovarian Cancer Detected form, etc. Within each OIO form, there will be multiple concepts (=Question Items) that serve to describe each reported cancer case. Cancer registries are something I know a bit about, having worked in one for a while. So how would OIO handle a cancer registration system? The basic model for a population-based cancer registry is as follows: Each person in the (usually geographically-defined) target population may have zero or more cases of cancer. A person is defined by their demographic details, (name, DOB, sex, address etc) and some of these details may change over time, and these changes need to be recorded. A case of cancer is distinguished by time of diagnosis, tissue of origin (topology) and histology (morphology). There are some additional rules relating to metachronous tumours in paired organs or the same organ (cancer of the left kidney in 1982, and of the right kidney in 1989, or multiple colon cancers appearing over tyhe course of a decade). For each case of cancer, there are zero or more of each of the following: histology reports, treatments, hospital admissions, and various other details, and zero or one date and cause of death. Andrew, perhaps you could sketch out a word picture of how that would be handled in OIO, for our education? Or even a rough sketch of an implementation in OIO? -- Tim C PGP/GnuPG Key 1024D/EAF993D0 available from keyservers everywhere or at http://members.optushome.com.au/tchur/pubkey.asc Key fingerprint = 8C22 BF76 33BA B3B5 1D5B EB37 7891 46A9 EAF9 93D0 signature.asc -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: OpenEHR vs. OIO semantics infrastructure, was Re: form-to-form translator, was Re: Solving the data type problem, was: ODB vs. RDMBS was: OIO-0.9.1 released
The same goes for SNOMED-CT. It is a proprietary standard and very expensive for poorer countries. So how can this become a standard nomenclature? Hopefully ICD-10-CM will see the light of day soon BTW ICD-10 -PCS seems very promising to me - even though not yet implemented. Nandalal - Original Message - From: Horst Herb [EMAIL PROTECTED] Date: Sun, 28 Dec 2003 18:08:53 +1100 To: [EMAIL PROTECTED] Subject: Re: OpenEHR vs. OIO semantics infrastructure, was Re: form-to-form translator, was Re: Solving the data type problem, was: ODB vs. RDMBS was: OIO-0.9.1 released On Sun, 28 Dec 2003 13:12, Thomas Beale wrote: exactly - this is the problem of N^2 translation that HL7v2 has. I was just saying that Andrew's statement that HL7 has failed is not totally correct; and regardless of the shortcomings (of which I can be as critical as anyone else), there are quite a lot of implementations, and there is a measure of success. It's been a step on the path, and a lot of things were learned. A lot has been learned, yes. But Andrew's statement - if we only look at what is actually available AND in use today - is correct: HL7 has been en exteremly expensive failure so far. A failure for more than a decade, that is. Current development looks promising and I wish them wholehearted success - but in one aspect they haven't learned from their past errors, and I consider this non-learning a gloomy sign: that is, they don't publish their work freely. You have to become a member to access their standards. It does not matter that membership is cheap - even a cent a year would not be acceptable fpr the very reason that a standard cannot be a practical and ubiquitously accepted standard (such as POP3, HTTP, HTML) unless the specifications are freely accessible to anybody. Unless they start understanding this crucial issue, I reckon they are doomed. No matter how much more money governments throw after them. The world in general is not very fond of such closed gentlemen's clubs, and end user tolerance for such behaviour is close to zero nowadays. Horst -- On two occasions I have been asked [by members of Parliament!], 'Pray, Mr. Babbage, if you put into the machine wrong figures, will the right answers come out?' I am not able rightly to apprehend the kind of confusion of ideas that could provoke such a question. -- Charles Babbage -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Columbia Presbyterian's Eclipsys experience, was Re: More UK NHSCare Record contracts announced
Dave, Please ask Jim whether he would be willing to go on record and us an email outlining their experience? (via this publicly archived mailing list) Private grumblings won't get any of us anywhere. We need to learn to name names and tell the truth. I agree. Indeed i received an email saying myemails to the list as of some others were being censored? I hope this is untrue. Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: hub, spoke, new Esperanto for healthcare, was Re: form-to-form translator, was Re: Solving the data type problem, was: ODB vs. RDMBS was: OIO-0.9.1 released
Horst, I agree with you completely. To think that the whole of medicine can be standardised is to set forth on a never ending, increasingly frustrating quest. There are too many areas. In a sense let us start with the end user and tell them to collect data, and let them collect data in a way which makes it easy to build communicating portals for sharing information in a flexible way. Let the programmers worry about getting them to communicate rather than trying to tell them HOW they should communicate. regards Nandalal - Original Message - From: Horst Herb [EMAIL PROTECTED] Date: Wed, 24 Dec 2003 14:14:43 +1100 To: [EMAIL PROTECTED] Subject: Re: hub, spoke, new Esperanto for healthcare, was Re: form-to-form translator, was Re: Solving the data type problem, was: ODB vs. RDMBS was: OIO-0.9.1 released On Wed, 24 Dec 2003 12:32, Andrew Ho wrote: 3) My proposal is to build hubs from the bottom-up - based on OIO forms that are in-use. Analagous to building a dictionary - opposite from building an universal language. Let's learn something from the failure of Esperanto, A MAJOR point, and I see this failure happening all over again and again, be it in the domain of coding (where countless professionals have been mucking around for decades in the quest for the ultimate coding system instead of settling for a thesaurus like growing dictionary of terms) or in the domain of health record architectures I'd wish we would settle for small independent modules all communicating via *simple* protocols (like XML-RPC via HTTPS or Jabber), using self-growing terminology dictionaries. I don't believe we need a monolithic architecture. All we need is well defined APIs to extract and submit data. I don't believe these APIs need to be consistent/synchronized/monolithic: - there is no reason why demographic information should be dealt with in the same way as for example vaccination records or a cardiovascular examination or drug interactions. If our systems get too complicated, we will never get there. With all due respect, the ADL of OpenEHR looks to me like a further complication rather than simplification for example - yet another mini language where I believe that using existent versatile markups (like YAML) could have the achieved the same goal with less steep learning curve and the benefit of human readability. Horst -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Options for Argus, Re: Argus correction
Horst, Well said! Kick some butt and more! :) Sickle rather than honey works - unfortunately. The thing to do is to educate the doctors and nurses and other medical staff, get them to use OSS, collect some documents from here and there to the beurocrats and show them that others are using them too, harp on the advantages and refuse to dodge issues. I like that style too. People fought many wars and killeed many people for the sake of religion. We fight for a just cause and kill no one! That is a JUST fight! Nandalal - Original Message - From: Horst Herb [EMAIL PROTECTED] Date: Mon, 22 Dec 2003 08:47:53 +1100 To: [EMAIL PROTECTED] Subject: Re: Options for Argus, Re: Argus correction On Mon, 22 Dec 2003 08:04, Tim Churches wrote: There really isn't any point in being nasty about the civil servants. Thank you Adrian! Bureaucracies can sometimes act in surpringly positive ways in response to encouragement and even well-argued, polite exhortation, but always bunker down or harden their position in the face of outright criticism and dismissive epithets. For four long years I tried with gentle persuasion and providing a continuous flow of easy-to-read educational material. Achievement? Close to zero. The inertia of bureaucracy apparently takes more than just a smile and gentle words to overcome. Recently I started involving taxpayers / consumers association, the press, and direct attacks against particular bureaucrats personally. As soon as they feel their taxpayer funded comfortable nest is shaking, they suddenly spring into action and things actually do happen. Surprise, surprise. I dislike such methods, especially since dealing with the bureaucrats I got to know some in person, and once you establish personal contact you realize we are all humans, with the usual fears and longings and families to feed. OTOH we have a situation where a whole nation suffers, health is more expensive than it needs to be through bureaucratic overload, and positive development either doesn't happen at all or is delayed in a most unacceptable way through the incompetence or inertia or both combined of these same bureaucrats. Furthermore, as a busy full time medical practitioner, I simply haven't got the time to linger around in Canberra and smear honey around the mouths of these sloths. This financial year, I may end up paying a six figure sum in taxes. I can damn well demand some action for that money, and it is my damn right to kick some shins to achieve this. Public servants are employees of the public after all. Horst -- Parkinson's Fifth Law: If there is a way to delay an important decision, the good bureaucracy, public or private, will find it. -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: How VistA inspired OIO, RE: Vista on the BBC News Web-site
An administrative solution would be to hire more MUMPS programmers. A technical solution is to build a system that helps non-programmers to do more. We have barely begun. :-) This is what is necessary if we are to get e-health initiatives going. As a cliniciian I like to do things myself - at least to a great extent. I like systems I can change easiy, create things of my own, share these with others, change it to use for other purposes in the hospital, change it easily to a native language for those who are not too proficient in English. If I have to go looking for a busy programmer and beg for (or pay for indeed, if that brings quick results) help, then wait for a month to be told that it is difficult/unacceptable or that special permisionis needed to do those changes. I will just dump that system :) Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: How VistA inspired OIO, RE: Vista on the BBC News Web-site
Ignacio, Thanks! How exactly does this work I wonder? Anyway this is one point in going with programs like Zope and languages like Python. They are going places and linking to everything :) For exanple not only to almost all database programs but to statistics programs like R as well! Nandalal This is - Original Message - From: Ignacio Valdes [EMAIL PROTECTED] Date: Sun, 21 Dec 2003 18:19:39 -0600 To: [EMAIL PROTECTED] Subject: Re: How VistA inspired OIO, RE: Vista on the BBC News Web-site Some folks at the Houston VA are using Plone for their intranet portal. They have built an interface for the MUMPS based phone directory in DHCP for it. Therefore, the bridge to ZOPE has been done at least once already. -- IV On Sun, 21 Dec 2003 14:24:06 -0800 (PST) Andrew Ho [EMAIL PROTECTED] wrote: On Sun, 21 Dec 2003, Nandalal Gunaratne wrote: ... Is it possible to link OIO to VistA in some way. Nandalal, This has been one of my dreams since 1997. :-) -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Worldvista installation.
Tim, Is is hours, days, weeks, monthsto get a running system of sorts. One or two hours only to install VistA, but yes, days or weeks to configure it. I gather that some VistA experts are working on a demo system, which packages a pre-configured mini-hospital. But bear in mind that VistA could probably run most aspects of, say, RNSH, and hence the fact that configuration of even a minimal system might takes days or weeks is hardly surprising. I was under the impression that we install the basic install of VistA and then add the various applications, which are neither open source nor free :( How easy is it to add these applications? Which of them are FOSS? For end users, this part at least should be easy! I may get a VistA expert (Or get Jim a ticket to fly over) to install the base VistA but if I have to get one for every application I get for VistA, i wouldn't want VistA at all. When I first tried OIO, it was quite difficult to set it up, but wonderfully easy to use. However, with some help across miles ;) I DID set it up on a server in the hospital and got it linked to 16 clients about a year or so ago, to form an embryological FOSS based fibre-optic linked network in my hospital. I have not have to setup the server since, which is amazing!! It runs on RedHat Linux 7.2 and OIO 0.9.9pre. Now an OIO is easy to setup - and everyone likes the LiveOIO CD - it is love at first sight! Oh! except for one thing. It has a whole host of psychiatry related forms for demonstration purposes ;) I have no programming knowledge whatsoever except for a pretty good knowledge of HTML - which is not programming -strictly speaking. My experience with OIO has been, that it is great for clinicians. Many of us, including myself being a specialist surgeon, work in more than one hospital. Thus the beauty of LiveOIO! Indeed purel;y as a clinician, I can happily get along with this, until hospitals are linked! The problem is that I cannot bring this data back and feed it to the main databse in the hospital. If OIO and VistA links in such a manner - we have a near perfect system. A dream..? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Options for Argus, Re: Argus correction
I wish they would have just said - We no longer hold the copyright, its out of our hands. Absolutely! This was what I thought all through the discusssion!! But what have the Argus team of helpless developers done about this? What were their attempts if any which were foiled by the beurocrats. This is what I would like to know next. Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Argus usefulness, was Re: Learning from Argus, Re: How to killopen-source project via funding, was Re: Argus correction
Richard, An advantage of an https approach is that the software (except for the ssl related client) is maintained centrally on a server, and a remotely installed application (such as argus, which looks complex), does not need to be installed and maintained. Just imagine the problems that could occur with ensuring that version of a particular JVM's on the workstations of 12,000 GPs throughout Australia. I tried, but it is too hard :) I would like to know if the hospitals in Australia keep EMRs at all and if so what they use? Is anyone using FOSS? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: How VistA inspired OIO, RE: Vista on the BBC News Web-site
Andrew, It's getting long. I think I should stop here - if anyone is interested, just ask, I will clarify and/or continue. :-) Yes, I have one question. Is it possible to link OIO to VistA in some way. For example clinicians like me are mostly interested in EMR and related data. Can I collect information via OIO and feed this into VistA? I feel that VistA maybe viable if the proposed modifications are made to run in a hospital system, and since it is used in several hospitals, maybe more acceptable for Health officials here who are more interested in administrative, accounting, records etc and these are established in a VistA system. However OIO would be very popular with clinicians, especially as it is a wonderfully flexible and now mobile system. OIO for now do nat have all the various applications that VistA has developed, though one day it well could do so :) Since you know VistA and OIO, what do you think? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Vista on the BBC News Web-site
http://news.bbc.co.uk/1/hi/technology/3331739.stm Interesting. But this is very old software and maybe unsuitable for the purpose. Open source software has gone very far indeed since the days of VistA. It will eventually cost the poorer countries to go in for obsolete software. Nandalal Nandalal Gunaratne Urological Surgeon Colombo South Teaching Hospital Sri Lanka -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: re :Why do health IT projects fail
The flip side of this question, is probably where we should actually be spending our time What makes health IT projects succeed? Gary Kunkel I think failures overshadow success in this field. This is higher in the hospital based clinical IT projects from the literature. It may also be that the way we measure success is flawed. What is success? How do we measure/compare one Health IT project with another? Has there been initial success and then failure? What was this due to? Maybe we should each talk of our own experiences with such projects, and discuss this matter further? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: LiveOIO-1.0.6 released
Andrew, This is tremendous work! Congratulations LiveOIO-1.0.6 provides OIO-1.0.6 with 22 pre-built forms, an example schedule, and several workflows (patient screening and schizophrenia study). I wish there were some of our forms as well, but I am entirely to blame... Thanks to Tim Churches and Adrian Midgley's strong advocacy, we now have single-click, database backup and restore of OIO metadata and data via icons on the Desktop: 1) backup (creates /home/knoppix/publicdb.zip) 2) restore (converts /home/knoppix/publicdb.zip back into publicdb in PostgreSQL) 3) saveToUSB (copies publicdb.zip to USB storage device) 4) readFromUSB (copies publicdb.zip from USB to /home/knoppix). This means we can create custom demo data and save them to USB storage device (USB memory sticks are plug-and-play via Knoppix). Forms, workflows, patient, and other OIO data can be saved and reload back into PostgreSQL for the next demo session. The same mechanism can also be used to simplify backup/restore of PostgreSQL database in production environment (running Knoppix/Debian from hard drive). Ah! It does work in the Hard Drive installation. Good! While LiveOIO-1.0.6 comes configured to use USB device, it is clearly quite simple to slightly modify the saveToUSB and readFromUSB methods to save to and restore from any local (e.g. floppy drive) or remote network drive. True. I am hoping to backup to CDRW media. Once Knoppix supports UDF packet writing this would bw simpler. An interesting implication is that it is now possible to build OIO production servers that run entirely from CD-ROM and RAM - with periodic auto-backup to networked storage or solid state memory, like USB connected flash drives. This is MOST interesting! OIO must be the only EMR system which can do this! If you may remember I wrote to you in an email of this possiblity when we discovered Knoppix. I have been speaking of this to my colleagues and now it has come true! With RAM being cheap, it maybe possible to use an older PC with lots of RAM as a server with USB or CD backup! This has great implications in the developing countries where buying new computers is very expensive. In my country we can buy 5-7 used Pentium II PCs ( DELL/IBM) for one new one. Your criticism and comments are sincerely invited. Criticisms will be reserved for the future if things don't work as expected. Now there is only praise and open moutheed wonderment and a few gasps :) Regards and all the best Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: (Open)VistA and SNOMED/Coding systems
It is unfortunate that SNOMED is a proprietary system, and quite costly to use and maintain. IT is likely that many will stick to ICD coding systems and classifications systems. The recent compltetion of ICD-10-CM and ICD-10-PCS may mean that SNOMED may not catch on in the way it was expected. Nandalal Gunaratne -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: LiveOIO-1.0.0.rc2 released
Andrew, Great going! The entire process of running OIO on any PC now only involves 2 mouse-clicks after booting the CD! Installing to hard-drive still only requires opening a shell-terminal window and typing knx-hdinstall. Maybe you could have a HDinstall icon as well on the KDE desktop to install and avoid opening a shell terminal window at all. Morphix does this. So does Mepis. At the rate OIO is going, I would advice all to write to CDRW and save the world from plastic pollution :) I have also included 1 form (Meeting), 1 schedule, 1 workflow, and 2 patients. I think it is helpful to include more forms on LiveOIO. Please send me forms that you think will be worthwhile including. Anything that I receive by Oct 16, 2003 will have a good chance of becoming part of LiveOIO-1.0.0. My estimate is to include somewhere between 20-30 forms. Current aim is to release LiveOIO-1.0.0.final by Oct 17, 2003 - a week from now. We have time to do .rc3 if someone finds a serious bug. I will send some forms - if I remember to do it that is! Dennis Halladay's new date, date_time, time component should make it into LiveOIO-1.0.0.final. Can Dennis tell us and write a little thing about it? Vadim and Alex's fracture classification wizard may also make it. Our orthopaedic surgeon will be very interested when he returns from the Swiss Alps. Per Mark's strong recommendation, Frozen-Bubble is once again included. Frozen bubble? Can Mark please tell us what is so special about this program/game? Nandalal -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Any open Source clinical trials management systems?
Andrew, It is being used extensively by an Oncological surgeon as well! The OIO software has not been used for oncology, to my knowledge. However, it is being used in Psychiatry, Orthopaedics, and Urology. Gary Kantor prototyped it last year for an Anesthesia outcomes project. Since it supports arbitrary, user-definable forms, there is no reason why it cannot be easily used for oncology studies. Recently, our orthopaedics colleagues submitted code for a multi-step, fracture classification widget. We should be able to integrate that into OIO in the next few weeks. -- __ Check out the latest SMS services @ http://www.linuxmail.org This allows you to send and receive SMS through your mailbox. Powered by Outblaze
Re: Secure HL7 transport?
Maintenance and installs are legitimate issues but I don't see any advantage of any options in this respect. There is and has been a standard for doing all of this cross platform and cross language. It is available fully in open source. The install and maintenance are no worse than any of the other options which don't deal with cross platform and cross language. Currently XML is becoming the favored alternative mechanism to support cross platform and cross language, but is still several years away of equaling the standard solution. Has anyone looked and GNUStep? -- __ http://www.linuxmail.org/ Now with e-mail forwarding for only US$5.95/yr Powered by Outblaze
