Wolfgang; I couldn't agree with you more. We need to take a slightly different tactic in starting/reviving the MDC. Let us first take a look at why it faltered so that we understand the pitfalls we must overcome;
1) Deliberation was exhaustively slow in that many of us were working on this effort only sporadically. Many issues got forgotten and had to be recovered. We started to do better in the last couple of years, but more streamlined efforts need to be investigated 2) Loss of funding/support by MUG contributors and member organizations 3) The MDC was looked on as an Ivory Tower. We need to have more eyes on the problems and suggestions added to make the solutions smoother. To these issues, I personally would prefer that we investigate the use of something like the IEEE RFC (Request For Comment) as a model for "airing" the proposals. This allows lots of eyes to examine the issue and a lot of folks thinking about solutions. Each RFC has a champion or a group of champions who are identified as the focus point for considering the solutions and re-issuing the RFC. Each RFC has a period of review by the public which is finite. This gives a bit more timely resolution to the problems and keeps a history of the discoveries and ideas. This approach can be extended to web structure so that all have access to the ideas and progress of these ideas. Progress will be made as individuals get involved and make comment. We need to be inclusive and self-enrolling by participation. The champions make report to the subcommittees of the MDC. The RFC has the deliberation already documented and a specification has been presented, and a sample implementation has been modeled. All issues should have resolved by the time the RFC gets to the Subcommittee and the job of the Subcommittee is to integrate the RFC into the published standard. It will be those changes to the standard which are finally passed to the full MDC to authorize and then release. Much of this work can happen from the web and email without much face to face effort. As such, much of the deliberation has a paper trail and history. The possibilities are numerous and exciting. Best wishes; Chris Richardson ----- Original Message ----- From: "Prof. em. Dr. med. Wolfgang Giere" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, November 25, 2004 8:28 AM Subject: [Hardhats-members] Re: MDC/MUG Revival - Just do it (was) Re: [Hardhats-members] Nov17thinterview [added] Dr. K, MUG, MDC, Goodbye Mumps > This is wonderful. But I would suggest not to raise publicity before it isn't clear that > there will be people and support for a new MDC and which route to take. Better be > coutious now than frustrated later! > > I have been member of the MDC and head of the German ISO delegation for years and could > afford it thanks to my institute, the center of medical informatics of the university in > Frankfurt. I am retired now, my deputy chairman, Wolfgang Kirsten is ill, not available > for quite a while and I am afraid, many of other "old hands" are no more available. .Who > would volunteer do it? > > In my opinion there would be three major activity blocks needed (provided we agree upon > the need!) > : > - one development of the standard itself: Tough and tedious work requiring specialists. > > - one coaching the new standard within the international bodies: Requires contacts, > convincing personalities, comittee meetings, much support, time, and effort > > - one development of the case (probably VistA) in the minds of people, societies, > govenment agencies, ... This needs PR at it's best. > > Probably there should be some few activists coordination the efforts, structuring the > cooperation etc. > > Wolfgang Giere > > > > Wolfgang Giere > > Joseph Dal Molin wrote: > > > I have just returned from Brasil where I gave a worskshop on open source > > in health informatics. I was invited by the Brasilian Health Informatics > > Society and as a result have made some good friends and excellent > > contacts. I will contact both the current and past president of the > > Society as well as colleagues in Sao Paolo to inform them of this > > discussion. > > > > What this will need is a small team of midwives and lots of publicity > > and support. With a team in place I will table a motion at our next > > WorldVistA board meeting to support to this effort. I should think that > > the VSA would want to do the same as well as the Pacific Telehealth Hui. > > We can then use press releases etc. to get the word out.... we have good > > access to reporters several trade journals etc. We can also use other > > medical informatics forums such as the openhealth list....and submit to > > Slashdot. Also all the medical informatics schools should also be contacted. > > > > Unfortunately all I can offer is to help launch this group, I have no > > expertise in M at all....but I do have a great deal of experience > > building communities of this kind in health informatics. > > > > Cheers, > > > > Joseph > > > > Prof. em. Dr. med. Wolfgang Giere wrote: > > > I fully agree with Arden Forrey's remarks. It was a shame that the "Millenium > > > Standard" did not happen. It took us a long march through the institutions to make > > > Mumps an ISO-Standard. > > > > > > To revive MDC as official body can be done either using the old ANSI-affiliation or > > > through a ISO WG (that would be the "normal" way). Both ways reuire international > > > participation. I suppose, MUG Germany would be willing to participate (I cannot ask > > > my successor Wolfgang Kirsten, he is hospitalized right now). Also I guess, Frans > > > Witte (Netherlands) could be reactivated. Ion Diamond in GB? I do not know whether > > > he is still active in the field. But there is a new commercial Mumps available in > > > GB. Finland? I do not know the actual state of M-use there. What about South > > > America? Could George Timson trigger participation? I once visited M-using > > > hospitals in Sao Paulo and might be able to find out. We should get NEW people. > > > > > > I did not follow the ISO-story. Is the standard sustained? I have been asked in > > > Germany and suggested to vote yes, but I did never ask for the results. Does > > > anybody know? > > > > > > Wolfgang Giere > > > > > > "A. Forrey" wrote: > > > > > > > > >>I definitely support Joseph's statement, as Rick and other hard hats > > >>already know. I felt dissolution of both the MTA and the MDC were wrong > > >>following the 1999 meeting and the fact that the "Millenium Standard" was > > >>ready for ballot at that last meeting but never happened was a setback. It > > >>can be reversed. A host organization for the MDC and an organizational > > >>framework for an ANSI-accredited SDO must be written. The NE MUG remains a > > >>viable organization and encompass all the market, not just healthcare or > > >>VistA and this will be important. WV must actively promote getting this > > >>done. Bashkar can offer inputs regarding other market segments and an > > >>initial listing of Suppliers of of M-based products and services must be > > >>compiled quickly to aid in this effort. The HH website can be a mechanmism > > >>of dissemination. Another question of great importance has to do with > > >>building the education infrastructure to which Dick Walters insights will > > >>be important. We must stimulate the creation of programs which feature M > > >>and how it is integrated into the Life Cycle Principles for system design > > >>and implementation as well as how to utilize its unique features to > > >>advantage. This subject was pushed at the Sept 1998 MDC meeting in Seattle > > >>but had not taken off by the 1999 San Diego meeting; the resurrecred MDC > > >>must be structured to address this education issue in this broad context > > >>as it will drive a stake in the heart of the "MUMPS is OLD" saw being used > > >>to rid the market of a powerful component. We must draw on the M vendor > > >>list to be created. We here at UW will contribute to rebuilding the M > > >>Education capabilities. > > >> > > >>On Wed, 24 Nov 2004, Joseph Dal Molin wrote: > > >> > > >> > > >>>It is definitely time to do it....it is not constructive to see this kind of > > >>>press as the VA "hates" MUMPS.... rather it should be seen as "we need help" > > >>>to a) address the deficiencies b) we do not be dependent on a single vendor > > >>>c) we need company. Ironically, a new MDC that leverages an open source > > >>>"business" model, can I believe, without any doubt do what the Red Sox just > > >>>did. More importantly the rest of the planet will need an MDC etc. because > > >>>the will need the same things the VA needs whether or not the VA sticks with > > >>>MUMPS..... > > >>> > > >>>I am not a MUMPSTer...so I say this from a practical strategic > > >>>perspective..... it is indeed a time for revival...a pragmatic one...that > > >>>focuses on improving and leveraging what is good about M and dispelling the > > >>>mythology and misinformation that has bred in the absence of an MDC/MUG. With > > >>>so many vendors still using M, eg. Epic, Meditech, Cerner, McKesson surely > > >>>there is both commercial and user interest. Epic for example, has become one > > >>>of the best systems in the industry....in part it's its management...but one > > >>>cannot ignore its underlying architecture. BTW is there anywhere a commercial > > >>>system that uses the full architecture proposed for 5 years from now?? > > >>> > > >>>joseph > > >>> > > >>>Nancy E. Anthracite wrote: > > >>> > > >>>>This is the article I posted days ago that many of you could not read and > > >>>>that I said I would try to get for you, so here it is and this was the > > >>>>original URL. The original thread was Joseph Conn's interview with Dr. > > >>>>Kolodner. > > >>>> > > >>>> http://www.modernphysician.com/news.cms?newsId=2817 > > >>>> > > >>>>Notice how the lack of a Mumps Users Group and as a corollary, I'm sure, > > >>>>the MDC, is the backbone of his argument that VistA needs to be moved to a > > >>>>SQL database. The MDC desperately needs to be revived. > > >>>> > > >>>>I found this URL interesting last night. This is a company I was not aware > > >>>>of. If their product is good, it would seem to satisfy the VA's burning > > >>>>desire to extract and analyze their data in an SQL database as they do not > > >>>>seem to want to do that straight out of a Mumps database, probably because > > >>>>so many people are trained in making SQL queries but not in how to extract > > >>>>data from VistA. I actually thought that Cache had this capability in it > > >>>>already, but I may be mistaken. > > >>>>I suspect that this company owes its viability to already being used by the > > >>>>VA, but I don't know about that. In fact, maybe some of the folks in the > > >>>>company are on this mailing list or come to WV meetings, I don't know. One > > >>>>would think they are as disappointed as we are that the database is being > > >>>>moved by the VA. > > >>>> > > >>>>http://mde.srs-inc.com/aboutmde.html > > >>>>It is interesting that he mentioned that it will be inexpensive to move the > > >>>>data from one SQL database to another, but the cost of the move from mumps > > >>>>to the SQL database will certainly not be. > > >>>>I wonder what the cost of performing the needed maintenance to a the mumps > > >>>>database would be as compared to the cost of this move. > > >>>> > > >>>> > > >>>>On Wednesday 24 November 2004 01:08 am, Joseph Dal Molin wrote: > > >>>> > > >>>> > > >>>>>Could you please provide the URL for this so it is adequately > > >>>>>referenced....thanks!!! > > >>>>> > > >>>>>Joseph > > >>>>> > > >>>>>[EMAIL PROTECTED] wrote: > > >>>>> > > >>>>> > > >>>>>>Here it is Nancy. > > >>>>>> > > >>>>>>Tom Henderson > > >>>>>> > > >>>>>> > > >>>>>> > > >>>>>>FOIA version of Vista remains available despite recent changes > > >>>>>>/*By Joseph Conn <mailto:[EMAIL PROTECTED]> / *November 17, 2004/ > > >>>>>>// > > >>>>>>Despite plans to overhaul its Vista clinical system, the Veterans > > >>>>>>Health Administration will continue to offer copies of its > > >>>>>>multimillion-dollar software to private-sector users for a nominal fee > > >>>>>>under the Freedom of Information Act, according to the Department of > > >>>>>>Veterans Affairs' top physician informaticist. > > >>>>>> > > >>>>>>"We have the full support of the VHA leadership to continue to keep this > > >>>>>>in the public domain," said Robert Kolodner, M.D., acting chief health > > >>>>>>informatics officer at the VHA and deputy chief information officer for > > >>>>>>health at the VA. > > >>>>>> > > >>>>>>On Nov. 8, the VA published a request for vendors to submit statements > > >>>>>>of their capability to provide the VA with what it called "rehosting > > >>>>>>support." It also called for vendors to provide routine service and > > >>>>>>support for the VA's Vista healthcare information technology system. > > >>>>>> > > >>>>>>Kolodner said the move also would have no immediate impact on an effort > > >>>>>>initiated by the VA and the CMS to develop a version of Vista for the > > >>>>>>physician office practice. That software should be ready by summer 2005, > > >>>>>>according to the CMS. > > >>>>>> > > >>>>>>One goal of the proposed five-year contract is to move the VA's > > >>>>>>healthcare IT system from the programming language and database on which > > >>>>>>it was first written in the late 1970s and where it remains today: from > > >>>>>>MUMPS, or the Massachusetts General Hospital Utility Multi-Programming > > >>>>>>System (now known as M), to, as much as possible, open-source versions > > >>>>>>of the Java programming language and possibly at least two relational > > >>>>>>database systems, Kolodner said. > > >>>>>> > > >>>>>>Kolodner said the VA initially plans to run a national database on > > >>>>>>software from Oracle Corp. and regional databases on the relational > > >>>>>>database portion of Cache, a program by InterSystems Corp., which > > >>>>>>incorporates a proprietary version of M now used by the VA. > > >>>>>> > > >>>>>>"But it could be on (Microsoft's) Sequel Server or SQL or any other > > >>>>>>database," Kolodner said, adding the VA would incur a "relatively small > > >>>>>>cost" to convert Vista from one database to another if need be. > > >>>>>> > > >>>>>>"We've had a history of staying vendor-independent," he said. > > >>>>>> > > >>>>>>Within the VA, M has developed almost a religious following among > > >>>>>>programmers for its speed, dependability, flexibility and scalability, > > >>>>>>and several of today's leading commercial healthcare IT systems have M > > >>>>>>at their core. But Kolodner said it is time to switch. > > >>>>>> > > >>>>>>"MUMPS has served us very well over the last 20 years," he said. "We > > >>>>>>have done a lot with it, and it has supported our needs." > > >>>>>> > > >>>>>>However, many M vendors have been bought by InterSystems and a > > >>>>>>once-thriving MUMPS user group has gone defunct. Today, there are fewer > > >>>>>>programmers skilled in M than in a more modern language, such as Java. > > >>>>>> > > >>>>>>"There are times when it is much too expensive and takes much too long > > >>>>>>to make changes and support the needs that we have," he said. "Java is > > >>>>>>taught in more schools than MUMPS is." > > >>>>>> > > >>>>>>In addition, Java and relational databases are better suited together, > > >>>>>>he said. > > >>>>> > > >>>>>------------------------------------------------------- > > >>>>>SF email is sponsored by - The IT Product Guide > > >>>>>Read honest & candid reviews on hundreds of IT Products from real users. > > >>>>>Discover which products truly live up to the hype. Start reading now. > > >>>>>http://productguide.itmanagersjournal.com/ > > >>>>>_______________________________________________ > > >>>>>Hardhats-members mailing list > > >>>>>[EMAIL PROTECTED] > > >>>>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > > >>>> > > >>>> > > >>> > > >>>------------------------------------------------------- > > >>>SF email is sponsored by - The IT Product Guide > > >>>Read honest & candid reviews on hundreds of IT Products from real users. > > >>>Discover which products truly live up to the hype. Start reading now. > > >>>http://productguide.itmanagersjournal.com/ > > >>>_______________________________________________ > > >>>Hardhats-members mailing list > > >>>[EMAIL PROTECTED] > > >>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > > >>> > > >> > > >>------------------------------------------------------- > > >>SF email is sponsored by - The IT Product Guide > > >>Read honest & candid reviews on hundreds of IT Products from real users. > > >>Discover which products truly live up to the hype. Start reading now. > > >>http://productguide.itmanagersjournal.com/ > > >>_______________________________________________ > > >>Hardhats-members mailing list > > >>[EMAIL PROTECTED] > > >>https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > > > > > > > > > > ------------------------------------------------------- > > > SF email is sponsored by - The IT Product Guide > > > Read honest & candid reviews on hundreds of IT Products from real users. > > > Discover which products truly live up to the hype. Start reading now. > > > http://productguide.itmanagersjournal.com/ > > > _______________________________________________ > > > Hardhats-members mailing list > > > [EMAIL PROTECTED] > > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > > > . > > > > > > > ------------------------------------------------------- > > SF email is sponsored by - The IT Product Guide > > Read honest & candid reviews on hundreds of IT Products from real users. > > Discover which products truly live up to the hype. Start reading now. > > http://productguide.itmanagersjournal.com/ > > _______________________________________________ > > Hardhats-members mailing list > > [EMAIL PROTECTED] > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > ------------------------------------------------------- > SF email is sponsored by - The IT Product Guide > Read honest & candid reviews on hundreds of IT Products from real users. > Discover which products truly live up to the hype. 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