A rational "plan A" might have been to re-engineer Vista such that the clinical packages were lighter, more like front-ends to an underlying clinical repository, which stored all the results and data for lab tests, procedures, prescriptions, problem lists, diagnoses, etc. in a standardized, easily query able format. Instead of in multiple stovepipes, built 30 years ago.
The feeding of the CR could have been message-based, making it possible to substitute best of breed commercial systems for some of the less popular Vista packages, if that's what individual sites wanted to do. The new Vista, would also have been much less tightly integrated so that you don't need the xxx package installed, in order to run Lab, or the yyy package installed in order to run Scheduling. All of this could have been done in M, by re-engineering what is there. Don't get me wrong, Vista is a good system, that has been built by many talented individuals, over many years, and it has served the VA well. But, I think it could have been so much better, had sound software engineering principles been applied, rather than blaming M for any shortcomings that may exist. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Joseph Dal Molin Sent: Wednesday, March 02, 2005 10:51 AM To: [email protected] Subject: A parallel strategy for evolving VistA - Re: [Hardhats-members] MDC Revival One should always have a plan B. What if in parallel to the "rehosting" effort there was a strategy for doing the 20% that will make VistA 80% better in the areas that are most painful....and that as far as I can tell it is not what the user sees but under the covers...the things that affect maintainability etc.. I'll bet there is an 80/20 solution that just needs to be articulated....if we knew what needed to be done those of us that are committed to a commercial open source model can start to tackle some of this work and make the improvements available. BTW, I'll be if you looked under the covers of most of the commercial systems they would be no better....many if not most vendors have added functionality through acquisition and not development....and have the spaghetti code to prove it. Along with this there must be increased training and capacity building capability.....this is beginning to be addressed by a number of folks including Arden's group. Looking down the road a bit this approach would be a win win for all....for the VA...it would provide an alternative strategy that may in fact provide a better ROI and at the very least a fail safe option. For the global VistA community it would result in a better to maintain, improve VistA and capacity building to generate a new generation of experts. It would also create an even more robust open source alternative. Joseph Sowinski, Richard J. wrote: > When did everyone get so dumb ? You learned M. I learned M. When did it > all of a sudden get so difficult to learn it ? > Are you saying we were smarter than the upcoming generation ? I don't > think so. > > The real problem with Vista right now is not the language. It is the > shear size of it, and the rat's nest of poorly documented code > under the hood, which is the result of years of patching already patched > code. I liken it to a huge wad of gum. > > A redesign in M is as valid as a redesign in any other language. In > fact, it would be much simpler. VA already has the installed base, > and the in-house expertise. > > We'll find out 10 years from now (maybe) when the current redesign is > finished, how well it works , and how many people it takes to > support it. > > Oh yeah, by the way, outsourcing has worked really well. CoreFLS was a > grand success. > > > -----Original Message----- > *From:* [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] Behalf Of > *steven mcphelan > *Sent:* Tuesday, March 01, 2005 8:06 AM > *To:* [email protected] > *Subject:* Re: [Hardhats-members] MDC Revival > > I believe Cameron's statement about the VA management not being able > to back off of migrating to a newer platform is probably very close > to the truth. However, I am sure that there were some real business > management decisions made (or at least I hope so). I saw an article > recently that estimated that 40-50% of the current VA IT staff will > be retiring in the next 5 years. If I was a manager of VA IT I > would be very concerned about that. I would seriously consider > moving my technology to a platform that enables me to recruit > competent IT staff without having to rely on in-house training for > the next generation of VA IT support. I would even consider > technology that is inferior to my current technology as long as the > new technology meets my needs and gives me greater flexibilty in > personnel matters or provide me the opportunity to competitively > outsource some IT functions. ------------------------------------------------------- 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://ads.osdn.com/?ad_id=6595&alloc_id=14396&op=click _______________________________________________ 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://ads.osdn.com/?ad_id=6595&alloc_id=14396&op=click _______________________________________________ Hardhats-members mailing list [email protected] https://lists.sourceforge.net/lists/listinfo/hardhats-members
