In general I agree with David's post, and have only retained the sections on which I feel the need to comment on further.
David Guest wrote: > It is rumoured that HealthConnect or NSW Health.Net will produce a > ?free client for HealthConnect, but there is a dearth of detail. Even if they do fund a free HealthConnect client, my understanding is that HealthConnect in its various State-based incarnations will be a shared summary health record, but without the level of detail or convenience/workflow features that you would seek in software designed for everyday clinical use. I thought the idea was to interface existing and future clinical software to HealthConnect, rather than for HealthConnect to create its own client software. Maybe I have it wrong? > I would suggest that this is sufficient to start but a possibly > separate possibly commercial program for patient and doctor scheduling > and billing is also essential if we are serious about real world take > up of this software. Why should clinical aspects be open source but billing aspects be commercial? I don't understand the logic. Note that there are several open source medical billing software projects for the US - see http://www.freehipaa.net/ and http://www.freeb.org/ Neither are suitable for Australia, BTW, I just mention them by way of illustration that billing and practice manage are not necessarily antithetical to an open source approach. > What would it take to get an EHR up and running. From my observations > it took Richard King and Frank Pyefinch, people who knew what they > were doing, about 8 to 12 months. As a guesstimate a release version > of "Gnumed Professional" should be about the same length of time given > the wealth of experience and existence of core components that are > already available in gnumed. Obviously it also depends on the > experience and skills of the developer. > > How much would this cost? Maybe we should ask Prashanth? $200,000? I think that those estimates are fairly realistic. > What software should we use to build Gnumed Professional? Unlike Tim, > I believe it is essential that we use open source software as the > prime tools. The cost of entry to the project must be essentially zero > for developers in Australia and less developed countries. I said that the use of open source development tools is highly desirable, but that the Vista Office baby should not be thrown out with the bathwater just because the Windows front-end interface is written with a commercial development tool (although the runtimes are all available at no cost). A Linux version of the front-end appears to be possible without a complete re-write by using Borland Kylix, which although it is not open source, is available at no cost, and what's more all the run-time components for applications you build with it are licensed under the GPL - see http://www.borland.com/kylix/open/index.html > I note Horst's very generous offer to take a month off to do some core > work. I would even be prepared to do a week of locum work for him but > this does not seem the right way to go to me. Supporting medical > software is a commercial undertaking and we should take a commercial > approach even if we are using open source software. My feeling is that the value proposition of Horst's offer needs to be cooly and dispassionately assessed, and the only way that assessment can be made is if Horst actually shows the rest of us (including the GnuMed development team) what he is using in his own practice. Just "because its Horst" doesn't mean we should jump at his offer. Nor should we dismiss it. > The best model for > funding Gnumed Professional is not clear but the ideas put forward by > Brendan Scott and Tim are stimulating. It might even be possible to > attract funding from such other diverse sources as Ausaid > (http://www.ausaid.gov.au/) or the Shuttleworth Foundation > (http://www.shuttleworthfoundation.org/). You would need an overseas aid agency as a project partner and a specific project in a recipient country to have an chance of access to AusAID funds. Since most of the priority recipient countries don't use English as their first language, the software would need to support a non-English language from the outset, and would need to be targetted at the very different health care system in the (poor) recipient country. Plus the amount of docmentation AusAID requires for bids is just staggering (my better half used has worked on AusAID applications, and reams of paper are needed to get a few hundred grand out of them for a project). The Shuttleworth Foundation is a possibility but you would need an African partner and a very substantial part of the work would need to be done in Africa, and the end product targetted at the different health system present in most of Africa. > What's next? If two hundred GPs each with a thousand dollars each > thought this was worthwhile, we could make a start on developing a > structure and a business plan. If we cannot find them we need to hunt > around for some money. I'm in for $1000. Anyone else? Yes, me too, although my spouse will kill me... Tim C _______________________________________________ Gnumed-devel mailing list [email protected] http://lists.gnu.org/mailman/listinfo/gnumed-devel
