[EMAIL PROTECTED] wrote:
> I am not quite sure why Tim has to consistently bag gnumed ;
> it's not that bad, and not much different from the rest of the commonly
> used ehr stuff in gp land. 

Sorry, I didn't mean to bag GNUmed - it incorporates some really good
and innovative ideas and some daring software engineering, and I admire
its commitment to (or perhaps obsession with) sound computer science
principles. It is just that after 6 or 7 years of effort, it is still
far from sufficiently complete or stable enough for everyday use
(although the German side of the project differs on that point - they
seem to be using it in some fashion). And when I look at the underlying
code, my brain hurts - but that probably reflects a problem with my
brain more than a problem with the programme code.

Tim C

> On Mon Sep 25 22:25 , Tim Churches sent:
> 
>     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]
>     <javascript:top.opencompose('[EMAIL PROTECTED]','','','')> wrote:
>     > >
>     > >
>     > >> Quoting Tim Churches <[EMAIL PROTECTED]
>     <javascript:top.opencompose('[EMAIL PROTECTED]','','','')>>:
>     > >>
>     > >>> Horst Herb <[EMAIL PROTECTED]
>     <javascript:top.opencompose('[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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