Fred;
I would just like to reply to your perspective. It will be important to
work with
component suppliers (such as those who deal with "Practice Management"
functions. Your statement that PM "is more important than EHR
functionality to 90% of the people in private practices" may be a
historical reality (I was told 40 yrs ago by a Cardiologist who set up
the Seattle "Medic One" EMS system that the Primary procedure in
healthcare is the Wallet Biopsy and every thing else is secondary) but
the coming transformation in healthcare must recognize that Patient Care
is first and it is enabled and supported by Resource Management ( a noted
economist also noted 6 yrs ago that until healthcare recognizes that the
business model is not that of a suppermarket it will not progress to meet
society's needs (note Katrina). The VistA and HH folks are a step ahead of
many others so we must look at "Enterprise View, Life Cycle Principles" in
concert with the VA and federal healthcare agencies and work it showing
how this fundamental complementarity works in the VistA architecture. IHS
has been part of the VOE effort and it has been active in utilizing
non-VistA components; most recently for EOHR (Dental) functions as just
one example. We need to directly find out how they have interacted with
these component Suppliers and how their experience might be useful. We
also need strong interaction with other professional disciplines -
particulalry the Health Record Administrators who have strong roles in in
standards for EHR Conceptual Content. This will be relevant to the dialog
threads about VistA use in disaster emergency care and VistA configurations
that might serve those situations. Also reports are needed about how the
VAMC's that were affected by Katrina were able to carry out the
transition that they did using the full national architecture that they
have. This will suggest ways that private practice configurations might do
the same under NHIN of Brailer's ONCHIT office. The expertise is in the HH
if the dialog get seriously into these issues and doesnt just reamin
chit-chat. We have those who can comment; I look forward to waht thye may
say.
Arden
On Mon, 12 Sep 2005, Fred Trotter wrote:
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
-------------------------------------------------------
SF.Net email is Sponsored by the Better Software Conference & EXPO
September 19-22, 2005 * San Francisco, CA * Development Lifecycle Practices
Agile & Plan-Driven Development * Managing Projects & Teams * Testing & QA
Security * Process Improvement & Measurement * http://www.sqe.com/bsce5sf
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members
-------------------------------------------------------
SF.Net email is Sponsored by the Better Software Conference & EXPO
September 19-22, 2005 * San Francisco, CA * Development Lifecycle Practices
Agile & Plan-Driven Development * Managing Projects & Teams * Testing & QA
Security * Process Improvement & Measurement * http://www.sqe.com/bsce5sf
_______________________________________________
Hardhats-members mailing list
Hardhats-members@lists.sourceforge.net
https://lists.sourceforge.net/lists/listinfo/hardhats-members
