> > 2. What should the alliance's stance be on "purity" of components? Should
> > we consider an open source project (like the GEHR API) based on a non-open
> > source programming language (like Eiffel) -- "open source"?
Well, this is the $64,000 question. If we are willing to include proprietary
elements, then I think the discussion is over. The Vista system is an
enormously useful, up-to-date EMR that is widely used (more widely used than
any other EMR) and extraordinarily easy to contribute to. Go see it. There's
nothing missing. I'd deploy it in a flash, if our hospital hadn't just spent
millions on an ancient retread from the 3270 (sp?) days. If we want to
negotiate with the owners of a proprietary piece of software, then I think
that negotiating with Intersystems is the way to go. It's just that
idealistic projects that wish to deploy in underserved areas are going to have
a problem.
I realize that Vista is, in a sense, not a model of anything. But, in another
sense, it is very definitely a model of a complex medical care delivery
system, and it is very easy to manipulate. Or, put another way, it is the
embodiment of a model that doesn't exist.
I'm not advocating Vista. But if there were a powerful, open source M/Mumps
interpreter out there, and a representative of a third world country (such as
Long Island, New York) came to ask me about EMR, I would say to them, "Get the
interpreter and install Vista and use it. Something better may come along,
but, while you're waiting, use Vista".
John Gage
