Hence, there are two sorts of models that can be used: existing systems
and de novo specifications. It is in favor of existing systems that
they have to some extent solved many of the problems needing to be
solved and that they are accepted by the people using them. Shakespeare
was not limited by his use of Holinshed when he wrote Henry IV (1 and
2). As great a playwright as he was, he did not (like some modern
playwrights) feel that he had to make up new rules. Pedantic enough for
the new millenium?
John Gage
Jim Self wrote:
>
> Danl Johnson wrote:
> >"Gregory J. Woodhouse" wrote:
> >>
> >> On Fri, 31 Dec 1999, John S. Gage wrote:
> >>
> >> > There is a philosophy ... that major software applications ...were
> >> > written without much in the way of specifications and, second, that
> that
> >> > is the way to do things. I do not advocate this.
>
> This resonates with my own experience in working to develop a hospital
> information system with limited resources. It seems to me that in the
> absence of prior working models/implementations there is simply no other way
> to proceed.
>
> The problems are simply too large and poorly understood to analyze fully and
> the solutions, not to mention the rapid pace of technological change,
> fundamentally alter basic assumptions about the costs of technology, the
> knowledge level (and expectations) of clinicians and staff, and the basic
> operations of the health care organization being served.
>
> The trick is in finding a practical balance with enough specification to set
> a stable direction then move ahead a little bit before the rules change. ;-)
>
> >> Part of the problem is that many of us know what an operating system is
> >> and what a web server is, but EMR systems are another matter. In
> addition,
> >> most of have enough experience with EMR systems tht we could do a fairly
> >> decent job with much of it, but I ... I don't have the expertise to
> design this kind
> >> of software on my own. ... We need to find a way to bring our various
> >> specialties together in developing a design, and then implementing that
> design.
> >>
> >This resonates with me. I know what on OS is, and what a web server is,
> and
> >what EMR systems try to be; but I am not a real hacker, I am a physician.
> >I have had a long interest in the ergonomics of the medical office,
> including
> >both manual and intellectual work tasks. I could, if it seemed worth the
> >time, write operational specifications for software (end-user)
> functionality
> >so that the user interfaces would comfortable and usable. But my technical
> >knowledge of database, interfacing, and data exchange is deficient.
> >
> >And it's personally daunting to look in on these erudite technical
> discussions,
> >to view the knowledge and experience that each of you brings. Maybe others
> >on this list feel as inadequate as we about our "incompleteness."
>
> This last statement resonates strongly with me who is coming at this from a
> completely different direction. Each of us is much less complete, in the
> sense of being able to individually span a given area of expertise than when
> I started working in this area. There is so much more to know about and so
> much has changed that it is simply overwhelming at times.
>
> This list and the fact that so many people with different viewpoints and
> areas of expertise are participating in this discussion is the best antidote
> to the isolation of specialization that I have come across in a long time.
> Thank you all for being here.
>
> >Perhaps our first important documentation is a personnel-resource page that
> >lists and coordinates the experience, knowledge, interests, and possible
> >time commitment of those who want to participate in design (as distinct
> from
> >chat).
> >
> >Merry Millenium to all!
> >Danl Johnson
> >
>
> ---------------------------------------
> Jim Self
> Manager and Chief Developer
> VMTH Computer Services, UC Davis
> (http://www.vmth.ucdavis.edu/us/jaself)
