syan tan wrote: > actually, how about > 20 million people / 300 million people * $US 28,000 * 0.78 exchange > rate = $1460 australian dollars.
Yeah, that sounds more like a reasonable fee. Tim C >> 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 >> > > _______________________________________________ > 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
