My 5 ideas
(1) Price/money.
Lets not be too coy about it - we want it cheaper. At the very least cut
out the bit we pay to M$. Current vendors seem unwilling/unable to take
advantage of the potential money to be made here in using open source
systems as the basis of their product. Given the maturity and
functionality of other OSS software, I just cant believe it isnt
possible. For the money we are currently paying, we are getting a pretty
ordinary outcome. This is due to a large number of players in a small
market, who survive only because migration to another product is so
difficult. If migration was easy, then many of the current players would
disappear and we would end up with a much better system. Maybe part of
the GPs reluctance to pay for support stems from the fact that he has
already paid a fair whack in licence fees and (rightly) expects a bit of
support for this. Some of the money paid to M$ and to vendors up front
would be potential income to anyone offering support to an OSS system.
(2) Open system - no artificial restrictions on access. Ability to
srutinize and improve architecture, code and interfaces. Under the
current legal system of IP this is practically impossible with anything
but an open licence. The current closed nature of interfaces and systems
is the single greatest factor holding up progress in health IT IMO. In
fact it is increasingly restricting innovation of all types and is why
we have seen so few "real" new drug innovations in recent years. No
committee or standards organization will be successful when the
interests of the current players are best served by closed systems
(3) Opportunities for public health beyond the individual GP.
I reckon the power of surveillance systems for adverse drug reactions,
sentinel systems for illness etc would be significant if they were based
on good consistent data. Here lies another opportunity to make money for
the smart operator. Govt will be your payer when they save $100M's in
less prescribing costs. OK there are major issues with privacy/security
- but these could be solved with the political will.
I cant see such a system evolving when it is built by a single
commercial vendor - look at the debacle in the UK. Their interests are
best served by locking out others which limits the effort available to
build the system. It will need the power of the OSS community
(4) Better security/long term availability of data.
I have nagging doubts about the safety and long term availability of the
data related to the patients I see using the current systems. Given that
I or my descendants might be sued anytime up to 25 years hence relating
a patient that I have seen today, this is a concern. It is one of the
reasons why I continue to write paper records. OK my medical indemnity
insurer protects me at present but who knows whether they will be there
in the future? I think open systems would give me a better chance of
this data survivng
(5) Better functionality
I find the software in use today quite onerous in terms of overhead for
me or my staff - I am sure we can do better in terms of speed, security
and usability. Sure, interface programs tend to do better under Windows,
but this requires a large market. The power of OSS lies in its ability
to capture more small innovations and not have progress locked up in
some dead software that no-one uses.
R
Geoff Sayer wrote:
Peter Machell wrote:
Unless I am reading the context incorrectly, the current discussion
is all about the desire for an open EHR, not necessarily a better
one. For those willing to pay a bit more than the market leader's
rates, there are already very good products available, that have (I'm
guessing) 95% of users 95% satisfied.
regards,
Peter.
Hi Peter
I started this to capture the essence of what people have been saying on
this list over many years in a manageable way. Doing some of the R of R&D.
Already people had thrown around ideas of not just mimicking the market
leader, different development languages, product requirements, business
models etc. Unless I have misread the context there is opinion that there
are other things as well that needs improvement.
So do you believe that an Open EHR will make an improvement for General
Practice?
Is this more important than say some other IT/IM development for General
Practice in your mind?
What other 4 things would you want?
I am wondering whether everyone is happy with the current products
functionality or wants something else beyond an Open EHR.
Otherwise there is a single item on the list :)
Item 1: Open EHR - we will need to define what that means for wider
consultation of course.
Thanks
Geoff
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