Hey,
        As is often the case, what was meant to be an aside has cause quite a
thread.

        I want to reply in summary to all of the emails, but i feel that Kevins
comments, below are particularly pointed..
> 
> I just went to the ClearHealth and ran the Demo.  It seems mostly like
> a practice management system (i.e. calendars, encounters, billing),
> but I found it hard to find the "chart", i.e. progress notes etc.

ClearHealth has most of its EHR system undefined, we allow arbitrary
extension of data. We are going to be working with the OIO project to
get some good default data someday and then there should be more "to
see" of the EHR capabilities on ClearHealth.

However your practice management system point is very valid. ClearHealth
does have that as its primary base. I think the VistA crowd focus alot
on extending and improving high-level functionality of the EHR compnents
of VistA, and as a result lose sight of the fact that the reason they
can have those discussions is that VistA became, a long time ago, a
really good way to run a VA hospital. 

Running a practice is pretty complex and practice management is more
important than EHR functionality to about 90% of the people in private
practices. ClearHealth is the first open source application to seriously
address practice management functionality. This is not to knock other
projects, we are so far along precisely because we started by studying
them.

The reason why the "hub and spoke" model is valid is because the spokes
need practice management and the hub does not. Thats what makes the
ClearHealth/VistA or the VistAOffice/VistA team such a winner, they are
addressing different parts of the same issue. 

As for the validity of PHP vs Perl vs Python and the super-thin-client
web browser model, these are all discussions that have taken place on
the old openhealth list. For this concerned with those issues, that is a
good place to discuss them. Here I would prefer to discuss ClearHealth
only in as much as it applies to VistA and GTM. 

Regards,
Fred Trotter



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