Richard Hosking wrote:
> 
> I agree Tim.
> IF this project were to take off (and it appears to have evolved from a
> few casual comments a week ago - clearly there is a mood to do such a
> thing) then the basic parameters need to be right.
> I have the greatest respect for Horst's abilities.
> However we are not all industry professionals and are possibly easier to
> impress than they would be  :) A second opinion would be useful.
> It is clearly a large undertaking and it is likely that it will founder
> fairly quickly.
> I think we are at the stage in the design process of "feasibility"
> assessment - can/should we do it?

It seems that Horst is self-financing a RoR-based initiative, and I
suspect that others such as Ian may assist with this if it looks
promising. I wish them well and am really interested to see what comes
of it - we may all be pleasantly surprised.

However, I still think that there is a need and role for a GP
information system which meets immediate needs and thus can act as a
practical test-bed for the development and refinement of the next-gen
things which Jon Patrick has mentioned - terminology servers, analytics
and so on.

> It probably doesnt pass the feasibility test in several areas
> Financial/economic
>    on the plus side there is no doubt in my mind that the cost savings
> could be significant to practices if a viable system could be delivered.
> Some of the list members couild be beneficiaries of this. However, on
> the minus side there is no direct link between beneficiaries and those
> who are proposing to do the coding/management. In other words we dont
> have a group of clinicians looking for a better way with money to do so.
> Some money may be available, but it is likely to be well short of what
> is required. Much of the work will be gratis.

My take is that substantial private-sector philanthropic funding is
required - where "philanthropic" may mean "good for public relations and
the corporate image".

> Technical
>    Given enough resources the actual coding is probably not that hard -
> several industry players have delivered systems written by small groups
> of developers.

It is harder than it looks to create a really flexible but really sound
system - and tedious - no-one likes writing thousands of unit test
fixtures, but that is what is needed for a quality system.

> There is a code and experience base in Gnumed and
> previous projects. 

Many lessons to be learnt and ideas to be gleened from GNUmed, but don't
count on being able to re-use the code.

> Open source systems have advanced a lot in recent
> years. To deliver a basic clinical system without any research level
> addons should be technically feasible (there that was easy :))
> However I think there should be a complete practice suite of software

Certainly the open source infrastructure components are now very, very
sound.

> Operational
>    Will the system solve the business problem (what is the business
> problem? Is there a business problem?) I have a vague frustration withe
> current systems, but I guess I can live with them as I am a contractor
> and there is no significant financial penalty to me.
> I guess I would like to do it to scratch an itch and to move things
> forward in the standards area and public health area. I would also learn
> a lot about IT if I was heavily involved. Is that a good enough reason?

Yes, if combined with other good reasons.

> Schedule
>    Will we get it done in a reasonable timeframe? What is the timeframe?

Needs to deliver within two years, max.

> Legal
>    Are there legal barriers to such a project? I cant see any

Nor I.

> Political
>    What will the political effect be? Are there any political
> showstoppers? Will others try to sabotage the project? Could it force
> proprietary vendors to change their approach? Would it open up standards?

Would certainly ginger up the local health IT marketplace.

>     Having said all that I still like the idea

Me too, and I'm prepared to invest some time, starting in Dec, to try to
progress a funding sales pitch. In the meantime, we look to the
Horst-on-Rails locomotive.

Tim C

> Tim Churches wrote:
> 
>> [EMAIL PROTECTED] wrote:
>>  
>>
>>> Quoting Tim Churches <[EMAIL PROTECTED]>:
>>>   
>>>> Horst Herb <[EMAIL PROTECTED]> wrote:
>>>>     
>>>>> Minix and Linux to me illustrate the battle between academia and
>>>>> pragmatic  engineering. Of course the pragmatic engineer will take
>>>>> a leaf
>>>>> out of the  academic book  and benefit from teachings and research,
>>>>> but what they
>>>>> do and how they do it is very, very different from academic
>>>>> "solutions".
>>>>>       
>>>> I suppose we are most interested here in solutions which see the
>>>> light of day
>>>> and can thus be used by many people, not just their genius progenitor -
>>>> regardless of where such solutions come from.
>>>>     
>>> Gentlemen, please! ;-)
>>>   
>>
>> Sorry, but frankly I am still smarting from being accused by Horst of
>> spreading unfounded FUD, just because I dared suggest that it might be
>> worth double checking Horst's take on RoR as the ant's pant's of Web
>> application frameworks.
>>
>>  
>>
>>
>>  
>>
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