Jim Glaspole wrote: > I've had some contact with Julia Gillard in the past. Has she been > briefed on this vision? She should be. I will c.c.her office.
Jolly good. I should have added that teh $2-3 million funding quantum is significant not only because it is just sufficient to get the job done, but also because it is not too much money. Once the funding quantum starts to get up towards $10m, the big IT three-letter consultancy companies start to become interested, and once they get involved unnecessary complexity will appear everywhere, the budget will blow out and the end result will be underwhelming and be too hard for anyone else to extend or support. To succeed, such an initiative has to be run in a way that ensures that a lean, hungry and very smart team (or consortium) gets the gig, not one of IT firms that service the big end of town. It could even be presented as an affirmative action or incubator initiative for smart local IT talent, and not as a feeding trough for multinational IT mega-corporations. > My concern is that the private vendors may successfully lobby against > having such worthy competition. I'm sure that some established health software vendors would cry blue murder. But there are several responses to that: a) the amount of money is small, and on par with the annual R&D budgets of publicly-listed companies like HCN (according to their annual financial statements); b) everyone can use the resulting reference implementation, including established players - no preferential access for anyone, a level-playing filed (but the elevation of that field will be several meters higher than the current playing field); c) the expectation is that this will enable many new health IT start-ups to get into the software and/or support market, thus it will have a net growth effect on the local health It industry; d) lots of related services export and partnership opportunities will be created, particularly in our local geographical region where existing Australian health IT companies have been reluctant to engage; e) there is evidence of partial market failure, in that many desirable features which are technically feasible have just not appeared in primary care clinical applications in Australia; f) at the end of the day, governments in general and health departments in particular have a much, much greater duty of care to patients and health professionals than they do to local existing medical software vendors. Minister Abbott may well pay heed to lobbying against such an initiative by existing medical software vendors , but Minister-in-waiting Gillard might be inclined to take a rather broader view. > Perhaps such software will be floated > off. I mused overnight about how HCN was the government's Health > Communications Network once, yet its current incarnation now seems to be > one of the bigger impediments to health communications. Spinning off govt initiatives into privately-held companies is a bad idea - it is anti-competitive. What I am proposing is the creation of a completely level playing field in which *any* company or consortium can pick up, sell, extend, support or otherwise make use of the reference software implementation, but on a non-exclusive basis. > So stuff the > private sector and let them try to do better than our ideal free OS > competitor. Maybe the current vendors will become support providers, or > plug-in developers. Exactly - and they don't even have to do better than it if they can't, they can just use it as is. or they can extend or improve it. or just support it. Almost everyone wins (the vast majority of the population, in fact), and even those who don't (some of the existing software vendors) are provided with a soft landing. Tim C > Tim Churches wrote: >> 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 >>> >>> >>> >> >> _______________________________________________ >> 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
