On Sat, 2003-06-07 at 21:22, David Forslund wrote:
> ...what I keep hearing from hospitals that have purchased
> a large system (usually for billing).  They tell me that despite the
> fact that they've paid the vendor some $10+M, the vendor owns them
> rather than the other way around.  They believe they can only do what
> the vendor tells them they can do.  They've totally lost control of their
> resources.   This is a big and recurring problem as far as I can see.
> This is where open source can help.  But it only helps.  I find that there
> isn't enough expertise in the hospital for them to understand what they 
> really need.
> They are dependent on the vendor for that knowledge.  This is where the 
> danger lies.
> The same situation could happen with an open source installation.   I don't 
> have
> a good solution for this problem.
> 
> Does this sound familiar to anyone else?

This is a ubiquitous and inevitable problem when expert systems or
expert-dependent systems are deployed for the benefit of inexperts.  We
will never get away from it; we merely modify the competitive mileau
over time to hinder unfair exploitation (which is essentially what open
source is beginning to do for the technically savvy).

But... I am a physician; non-physicians are at our mercy.  How do *you*
know your doctor is actually up to date, diligent, prudent, and
skilled?  Not very easily.  The readily available "second opinion" is
the main fall-back.  There will come from open source, I believe, a
consultant class that is in fact expert, which will help.

But... I own a couple of automobiles.  I am totally at the mercy of the
vendor regarding maintenance and repair; I am saved by the
commoditization of the automobile; this is one of the things that open
source is beginning to do.

Dan Johnson

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