Maybe if they published their accounting record , showing where their moneys are spent, e.g. programmers' salaries, office staff salaries, management staff salaries, hardware, consulting fees , third party investments, lawyers fees, a better idea could be formed about why it takes $28,000 to do a version accreditation.
On Sun, 2007-02-25 at 10:37 +1100, Tim Churches wrote: > David More wrote: > > Hi Tim, > > > > 3 points: > > > > 1.. The fees go to allow certification to continue - not anywhere else - > > are certification > > bodies not allowed to recover their costs? > > Yes, but only the absolute minimum of costs i.e. they need to do their > business in the most efficient way, with minimal overheads. And thus no > modern offices, no hierarchy of staff, just a Web site and some email > accounts in a small back office hosted by an existing organisation. That > will do. And rely on modern, automated testing methods - see below. > > > Is Standards Australia meant to do it all for > > free? (They a'int! and we are all being ripped off as best I can tell) > > No argument there. > > > Frankly you need to > > recognize this is the way our Government and the US seem to insist things > > are organised > > these days... > > The recognition that Bush and Howard want to screw up the world doesn't > make it right, or that we should just roll over and acquiesce. If > something is wrong or stupid, we have a duty to say so. > > > my preference would have been for a totally government funded body to do > > all > > this...but..when was the last time any government entity did this sort of > > stuff for free > > (think TGA and its fees etc) > > And NGO or QUANGO is fine for accreditation, but an efficient, lean and > mean one, which leverages modern technology and the power of the network > to achieve its ends (which are to ensure software quality, not to build > its own little empire). > > > 2. This, very inexpensive effort in national US terms, is so far ahead of > > what is > > happening here (in OZ) is it grumpifying as far as I am concerned. > > Yes but they spend $450 billion each year on the military in the US, and > everything else there looks cheap by comparison. > > > 3. Note - At least one open-source solution is going for it..sorry it has > > to pay but that > > is the world a majority of us (under Howard and Bush) voted for - so what > > can I do.? I > > sure didn't vote for it! > > > > The CCHIT is happening, its working and there is 'stuff all' happening in > > OZ along the > > same - very important - lines. Ostrich all you like - this is fundamentally > > good stuff > > CCHIT are doing and it is being done on the 'smell or an oily rag' in a > > relative sense. > > I am told that the US govt happily pays Haliburton and other contractors > $5000 each for oily rags to be delivered to Iraq to help with the > reconstruction. > > > Seems you want to have poor quality non-interoperable GP software to go on > > forever in OZ - > > or have I got it wrong and you really would like some decent quality > > control etc? > > No, I am absolutely in favour of formal quality assurance programmes > and/or accreditation for health-related software - more the former than > the latter but they start to merge if done correctly - iff (if and only > if) the process is both effort and financially efficient and completely > transparent. > > Here is how you achieve that: > > a) establish a *small* unit to develop the accreditation standards in a > consultative and transparent fashion, using email and the Internet > (wikis etc), and not endless secretive meetings in capital cities with > people who don't really have much of a clue, or who have a barrow to > push (or both). Allow one year to develop Version 1.0 accreditation > standards. > > b) Design the accreditation standards/tests to be automatable wherever > possible - and this is most places - so the software vendors/producers > can write automated, scripted tests to demonstrate the conformance of > new versions of their code with minimal re-testing overhead. In places > where automation is not possible, then "screencast" movies, made by the > vendor, of the software performing some specified set of actions or > tasks or demonstrating a required feature should be able to be > submitted. software to record screencasts (eg Camtasia) only costs a few > hundred dollars. Any cheating by the vendor in such screencasts will be > obvious, because end users can replicate the steps shown in the > screencast themselves and call teh vendor's bluff. > > c) All automated test scripts, other test code, test data, the test > results and screencasts etc must all be submitted to the accreditation > body, which runs the tests, views the screencasts, checks the > documentation and then publishes the lot on their Web site for public > scrutiny. This allows end users, public interest groups, competitors,, > busy-bodies and do-gooders to independently verify that the tests are > correct and legitimate and that no cheating has occurred. There is a > formal complaints process by which the accreditation body can be asked > to investigate evidence of cheating or anomalies or mistakes given some > prima facie evidence that such has occurred. > > Given the modest size of the Australian health software market, all of > the above should only require a handful of staff to run. It leverages > the power which the Internet brings to consumer groups and end users to > help the accreditation body do its work. > > Of course, software vendors may object to having their testing source > code published on the Internet, but to such an objection the answer has > to be that only test source code is required to be published - there is > *no* requirement to publish the source code of the actual software. If > they object that even such test code may reveal trade secrets, then the > response has to be that we are talking about health and medical software > here, malfunctions of which can have serious impacts on patient's lives, > and thus the public interest must override any commercial concerns over > possible exposure of trade secrets, so tough! > > That's the way to do medical software accreditation. > > Tim C > > > On Sat, 24 Feb 2007 20:32:16 +1100, Tim Churches wrote: > >> David More wrote: > >>> Hi Oliver, > >>> > >>> They are about 2 years into the program. > >>> > >>> They are also about 1 year into certifying hospital systems. > >>> > >>> Now that they have 40+ systems certified (at $US28,000 per time) > >>> > >> There has been much discussion of these fees on the international open > >> health list - fees of such magnitude effectively exclude open source and > >> community-based > > solutions. Not only that, they want the US$28k for every new version > >> to be re-tested. So, if a vendor puts out a minor point release, ka-ching > >> (sound of cash > > register), another $28k please. And their justification is that it > >> takes person-time to re-do the tests. Seems they've never heard of an > >> automated test - > > write the tests once, re-run at the push of a button, which is how all > >> software should be tested as it is built these days. Thus, CCHIT is a > >> farce in practice > > (Horst can supply some suitably colourful epithets here). A bit like > >> accreditation of general practices here in Oz, perhaps? > >> > >> Tim C > >> > >>> On Sat, 24 Feb 2007 17:10:27 +1030, Oliver Frank wrote: > >>>> David More wrote: > >>>>> Hi Oliver, > >>>>> > >>>>> If you want to know how it can be done properly for ambulatory care > >>>>> (i.e. GP and > >>>>> > >>> specialists) I suggest you browse www.cchit.org. They have it sorted for > >>> > >>>>> the US and it is pretty impressive how they plan to move forward I > >>>>> reckon. > >>>>> > >>>>> Pity GP systems is not a focus for NEHTA so this could be replicated > >>>>> here. Imagine if > >>>>> > >>> there was a decent standard for functionality and interoperability > >>>>> that Australian providers had to meet. They might not be all that > >>>>> supportive of such > > a > >>> sensible move I fear as it might cost a few $$ and so on. > >>>> http://www.cchit.org/physicians/overview.htm > >>>> > >>>> tells us: > >>>> > >>>> "CCHIT is the recognized certification authority in the United States > >>>> for EHR products > > - > >>> an independent, private-sector organization that sets the Gold > >>>> Standard for EHRs." > >>>> > >>>> I hope that I never hear that overworked expression 'gold standard' used > >>>> again, > > because > >>> its orginal meaning is no longer known by most people. > >>>> Their PDF: "Physician's Guide: CCHIT Certification for Ambulatory > >>>> Electronic Health > >>>> > >>> Records 2006" > >>>> tells us: > >>>> > >>>> "CCHIT was founded by the American Health > >>>> Information Management Association, > >>>> the Healthcare Information and Management > >>>> Systems Society and the National Alliance > >>>> for Health Information Technology. > >>>> The U.S. Department of Health and Human > >>>> Services (HHS) awarded CCHIT a three-year > >>>> contract to develop and test certification > >>>> criteria and manage an inspection process > >>>> for certifying EHRs. At the end of the > >>>> contract, CCHIT will transition to a selfsustaining > >>>> certification agency." > >>>> > >>>> So they have three years of federal government money to kick start the > >>>> process, then > > it > >>> has to become self-funding. David, do you know when their three > >>>> years of government funding will be up? > >>>> > >>>> "CCHIT works in collaboration with the > >>>> American Health Information Community, > >>>> the Department of Commerce's National > >>>> Institute of Standard and Technology, and > >>>> with several other organizations awarded > >>>> HHS contracts to harmonize standards, > >>>> develop prototypes for a national health > >>>> information network architecture, and assess > >>>> privacy and security laws and practices. > >>>> The work of CCHIT has been endorsed by a > >>>> number of physician professional organizations, > >>>> including: > >>>> - The American Academy of Family Physicians" > >>>> > >>>> OK, so their equivalent of the RACGP is supporting it. Good. > >>>> > >>>> Let's also go for three years of government funding for an organisation > >>>> indepenedent > > of > >>> government, run by the profession and software industry jointly. > >>>> Maybe we can save some time and money by using or adapting some of the > >>>> standards that > >>>> > >>> CCHIT has developed for GP computer systems in the US, keeping in mind > >>> > >>>> the very different way that medical practice is organised and funded > >>>> there. > >>>> > >>> ------------------------------------------------------------------------ > >>> > >>> _______________________________________________ > >>> Gpcg_talk mailing list > >>> [email protected] > >>> http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > >>> > >> _______________________________________________ > >> Gpcg_talk mailing list > >> [email protected] > >> http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > >> > >> __________ NOD32 2078 (20070223) Information __________ > >> > >> This message was checked by NOD32 antivirus system. > >> http://www.eset.com > > > > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
