Andrew N. Shrosbree wrote:
> Now that's a great idea. Lets raise a few million dollars so that my team can 
> create a fully open source clinical system for Australian doctors.
> In my dreams.

Well, not sure it should be your team in particular, Andrew - such
funding, if provided from the public purse, should be contestable and
competitively awarded. However, I agree completely that the quantum of
time and money we are talking about is two or three million dollars and
12 to 18 months for a crack team (and yes, they do exist) to create an
open source  "reference implementation" of a next-generation clinical
application for primary care and other ambulatory and community-based
care settings. Web-based, all mod cons, standards-compliant,
application-level ACKS, open plug-in architecture for decision support
and other value-adding modules, fully documented, complete with a really
comprehensive automated testing and validation suite so that people know
they can trust it (even beyond being able to examine the source code).
And licensed under a (small ell) liberal open source license such as the
Mozilla or BSD licenses which allow third parties to create their own
enhanced versions, thus simultaneously providing real competition to the
established players and giving potentially new players in the medical
software supply and support marketplace an immediate leg-up - but also
providing that same leg-up to everyone (including the established
players) on completely equal terms, so no-one could validly complain.

In the context of an $80 plus billion p.a. health sector in Australia,
or even in the context of NEHTA's budget, a few million is a pittance, a
drop in the ocean, yet it would have powerful and far-reaching effects
to the benefit of health professionals and patients everywhere.
Established medical software firms may feel some discomfort due to the
increased (but entire fair and equitable) competitiveness such a
development would bring to the marketplace, but new and emerging health
IT firms would almost certainly benefit enormously, so the overall
economic effects would be positive, not negative.

Perhaps we *are* dreaming, but it is the sort of thing that Health
Minister-in-waiting Gillard might give the nod to. It certainly ties in
with PM-in-waiting Rudd's vision of a proper broadband network for
Australia. Vision! Imagine that, and from Australian politicians too!
But that's what we are finally beginning to see a wee bit of, after a
very long absence of it from any side of politics.

Tim C

> Tim Churches wrote:
>> Andrew N. Shrosbree wrote:
>>   
>>> Tim,
>>>
>>> I agree that it would be great if clinical apps could handle all your
>>> messaging needs. Considering how hard it is (and expensive) to get them
>>> to make the smallest change to their systems, I just don't see how this
>>> can ever be accomplished. Mindful that we should be ever careful of what
>>> we wish for, I advise against wishing the message vendors away...
>>>     
>>
>> Well, I'll continue to wish for one less layer of software providers,
>> but one can add the messaging to the clinical apps, or one can add a
>> clinical app to the messaging. Doesn't bother me which.
>>
>> Tim C
>>
>>   
>>> Tim Churches wrote:
>>>     
>>>> If we had such standards, as well as standards for the
>>>> transport/encryption layer for messaging, then application vendors could
>>>> and would just implement messaging directly in their products and the
>>>> mini-industry of health secure messaging which has sprung up will just
>>>> melt away, and life will be simpler and cheaper for everyone.
>>>>   
>>>>       
>>
>>
>>   
> 
> -- 
> Andrew N. Shrosbree B.Sc, B.Ec
> Technical Architect
> ArgusConnect Pty Ltd
> http://www.argusconnect.com.au
> Mob: +61 (0)415 645 291
> 
> Skype: andrewshroz
> 
> 

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