it's not that bad, and not much different from the rest of the commonly
used ehr stuff in gp land. My suggestion would be that the academics,
if they are worried about lockin , would be to produce some sort
ehr interface specification, and get people who want to interact
with the academic next-gen stuff, to produce clients to that interface,
and use the prestige of being able to do so as bait.
On Mon Sep 25 22:25 , Tim Churches
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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