Quoting John Mackenzie <[EMAIL PROTECTED]>:

> 1) in UK, their developing EHR has recently admitted
> defeat and given up, so back to the drawing board.
> 
> 2) in Oz, HealthConnect has gone the same way.
> 
> 3) openVista ( http://www.pacifichui.org ) is based on 
> the US Dept of Veteran's Affairs "Vista".
> OSCAR ( http://www.oscarmcmaster.org ) is a Canadian
> open source EHR.
> GnuMed ( http://www.gnumed.org ) is another open source EHR.
> These 3 open source EHRs could potentially be adapted to
> produce an EHR for Australian Hospitals, but a lot of
> coding/ software development would still be required.
The vista client is not open-source, only the server

This is not just an ideological nitpick. Comparing countries gives depressing
insight into how much of a doctor's work, and so the EHR design, is
bureaucratically controlled. However one may view this more optimistically as
one of the main aims of an EHR being to automate the bureaucracy, but this still
means the operational requirements of an EHR vary a lot between countries, so to
use Vista we would need to deeply hack their client, which we can't.

To give an example. In Germany referrals, by law, must be on a specific form,
and must not specify the destination (the patient is free to choose their
specialist) Australian referrals must specify, and are free-form letters, this
in turn means your EHR referral widgets are completely different.

Yanks are different again, in that they have [please correct me if I'm wrong,
I've never worked in the USA] fewer longer consults, as they have NPs and PAs to
do a lot of what would be our briefer consults, and often dictate free-form text
notes, a clerk then enters structured data & codes from the notes to satisfy the
HMO, vista is built around this workflow, which may suit some Aussie
specialists, but not GPs.

An Aussie interface needs to be very cleverly designed, as if we want any
coding, the doc needs to do it themselves, and docs won't do this unless it's
very very slick. 

Ian

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