On Friday 01 December 2006 20:54, Chris Tansell wrote:
> My (I think my first) posting on
> this forum was "Why so many download clients".  While that question is now
> straightforward to me (largely Financial and business motives), I still
> can't see where the benefits lie with open source applications that do not
> hold ANY information.  

This will be along answer coming from many tangents:

In Australia, we do not have any accepted or even widely used data exchange 
formats for medical information.

Every single application, no matter how small or large, has it's own internal 
data format for better or worse.

Not even two pathology companies both claiming to use HL7 of even the same 
version as a wrapper for their information will produce the same "dialect" - 
most can't be bothered applying standards and always seem to find a feeble 
excuse for some proprietary extension or pointless use of unstructured 
appendices.

In that scenario, the government lacks wisdom and doesn't even remotely 
attempt governance. A bloated belly trying hard to digest as many taxpayers 
money as it can farts from time to time, and the resulting shower of money is 
directed at what they call "pilots" - as targeted as a sawed off shotgun.

Whenever we moan and groan about the incompetence and waste and lack of 
solution, the government of the day frantically seeks to employ some 
consultants they can blame afterwards, and the consultants invariably go for 
the glossiest pamphlets to quote in their "reports".

GPs don't even know where to start looking for information. Once upon a time 
there was a rather unproductive organization called GPCG which had at least 
one advantage - a central point of information access for GPs. That was done 
away with at the point where it just started becoming useful and producing 
results (watch out NEHTA - the moment you start delivering, the axe might 
fall ...)

So yes. Practices don't get presented with a solution, vendors don't get 
guidance re standards (which might be a blessing considering the general 
incompetence of government institutions when technology beyond the typewriter 
era is concerned), and nobody knows where to start looking for guidance and 
information.

Not even for simple things like practice IT infrastructure - there are no 
formal checkable qualifications for techies that would tell a non-technical 
customer whether the contracted entity will be any good or not. The blissful 
times of snake oil peddling doctors revisited in IT.

Thus, we try to make do. If our systems are to run reliably, they have to be 
kept simple. Preferably "zero administration". If you believe this is not 
possible, please do come and visit my practice and see for yourself.

Once you have your system running like  well oiled and perfectly maintained 
engine, you don't want to introduce any unknown variables. Especially for 
those suffering from the various Microsoft platforms, installing a single 
download client can destabilize the whole system. Just installing more 
dedicated computers is not the solution either to this stability problem - 
power and space considerations plague us all.

Hence, we want one universal piece of software that we can understand, and 
where we can employ somebody to fix it if needs must (if it doesn't work for 
us for whatever reason but the vendor doesn't care because it seems to work 
for "the majority of customers").

The other advantage of such single gateway would be that it will be much 
simpler to write import/export filters for incoming / outgoing messages - you 
only have to care about one single API instead of dozens

If I have source code access, I can decide - oince everything runs to 
perfection again - that from now on *I* will decide which changes will go 
onto my system. If I am unhappy with the chosen path of the vendor, I simply 
employ a programmer to do my bidding. Or I may join up with a few dozen 
practices, pool resources, and let programmers do my bidding for a share of 
peanuts.

If I use multiple or proprietary messaging software, all these benefits are 
instantly lost. I have to start worrying about system stability, maintenance, 
backups, and the future in general again.

Personally, I am not happy with Argus either. They procrastinate regarding 
proper licensing and source code release, they have funny ideas regarding 
compulsory registration of "free" software, and they don't cooperate well 
with the community either (but at least they communicate). However, they are 
the best we have at present, and hey - it works! And we know if the current 
vendor ever goes belly up, anybody can pick up the pieces and continue from 
there. We also know that we won't depend on proprietary gateways that may or 
may not exist / work tomorrow, and we know that if everything else fails we 
could satill manually decrypt the incoming message with OpenSSL for example, 
and read the HL message in any text editor - our communication woudl not come 
to a sudden halt if Argus ceases to exist.

Even better: one day other vendors might see their chance if users moan and 
groan about one or the other aspect and produce alternative server/client 
software using the same OPEN format - and users can stop moaning and groaning 
because they have a choice, and another vendor can make a honest buck. Can 
you see how HUGE the incentive is for any one vendor of open source software 
to make customers happy? No lock in means that competition can (and will! - 
see example of XFree vs XOrg)  snatch their market share immediately if they 
don't keep customers happy! For a users point of view, paradise. The vendors 
beat each other to satisfy our wishes. Whereas in a lock in situations the 
vendors just belt the money out of us.

Horst - who never again wants to be caught out in upgrade hell
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