Hi,

Tim & Jim are both pointing out what I think is a fundamental truth about
Health Information Systems: The Health Sector is to an extreme extent an
OPEN system, where it is next to impossible to pre-specify all components
and solutions on beforehand. Diseases, treatments, organisations,
professions, health infrastructures - they are all in constant change as the
world is striving to cope with everything from spiralling costs of medical
inputs to ageing populations to virus mutations.

So system developments MUST incorporate strong elements of learning and
prototyping - development methodologies that fit Big IT and their Wall
Street masters very poorly.

It does not mean that long-term specification & standardisation work is a
waste of time - but it DOES mean that such long-term  "deepthought" projects
run a risk of being incompatible with the installed base when they finally
arrive. Intermediate products emanating from such long-term projects might
also "open up" the project to developers that have a more practical approach
or those that need something NOW to satisfy immediate needs. This creates
new alliances, and as we all know political/professional alliances are as or
more important than technical excellence in determining winners and losers.

Best regards
Calle

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Calle Hedberg
3 Pillans Road,
7700 Rosebank, SOUTH AFRICA
Tel/fax (home): +27-21-685-6472;  Cell: +27-82-853-5352
Email: [EMAIL PROTECTED]
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