David More wrote:
The fact everyone is so worried about $28K shows we don't have a very serious, broad or
deep indigenous Health IT industry - I am sure the price would not worry IBA, HCN and a
few others. In fact I believe (and this may not be popular) that we would do much better
with 4 or 5 large well resouced providers than the status quo. May be the service levels
that people are complaining about could be improved.
David,
One of my deep concerns as a Division IM&T person and as private support
provider is that lots of the stuff out there is crap. The clinical
market has improved somewhat, but the maintenance overheads for
practices, most recently with monthly PBS updates thrown in, has gotten
very silly.
More importantly most 'free' software markets seem to inexorably tend to
near-monopoly, leaving us with the sort of situation of a key player
with its own agenda and everyone wanting them to conform or meet a
particular need, while the little guys live in various degrees of
tenuous resourcing.
The key player is in the luxurious position that it can dictate to
government, knowing its rivals will be hurt trying to keep up anyway. A
bit like Telstra, actually.
I don't see how you can really set up the sort of robust, standardised
environment needed to meet a community's health needs properly that way.
Even the hospital sector struggles with a very imperfect market.
Again the US DVA clinical software comes to mind. One in-house
application used across a whole hospital system and so successful it has
moved outside it's original role. Others, like the Scots, have done
this, as David Gillies explained at 10CC back in 2000.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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