I am a full-time Family Practitioner (we call them General Medial Practitioners or GPs). I make all my notes, and keep all my letters outward electronically. I receive a load of paper and this is handled partly by abstracting into the EMR, and partly by filing the paper. Sometimes we scan images of all or part of a paper record in and hold that loosely associated with the patient's record.
Of the bytes of code we use, I wrote perhaps 20%. > FreeMed (http://www.FreeMed.Org) This one I am not sufficiently acquainted with to comment on. > TkFP (http://sourceforge.net/projects/tkfp) I am deeply impressed with lex's work. It is usable with close support and development in his practice, and in at least another which is a failry quiet one. It is getting better and more comprehensive all the time and has elements which I believe to be absent form some commercial systems. It is suitable at present for around 1% of General/Family Practices. Buses are to be considered harmful[1], although being FLOSS the demise of the developer does not stop anyone using or developing the software. > OSCAR (http://67.69.12.117/) David Chan is a superb example of the egoless programmer exalted and given credit for progress by ESR. His software is supported and developed by a team and at a major centre of persistent scholarship and interestingly integrates some elements of the Knowledge Service I bang on about from time to time. It has major and significant elements which seem to me to make it far more fit for the purpose of training GPs than any of the commercial GP systems in use in the UK, which don't actually seem to me to have any adaptations for that purpose, nor to have a recognition (or to be less prejudicial, an opinion in favour ) of the great desirability of such adaptations. It is suitable, I think, and an ex-English colleague seems likely to concur, for a considerable proportion of Canadian Practices. I'm not quite sure about the Canadiennes. Lets say it is suitable for 50%, and could cross the border with some hard work to adapt it, taking the HIPAA and claim elements from another project which is in mid-develoipment and coming along, and from TKFP, in a year or so and end up suitable for say 25%... The support arrangements of either or both system would need constructing, which involves banks and recuriting and the glacial pace which business often moves at when the economics (despite Martin Fink's excellent book on them( are not entirely clear to everyone. These are not today solutions to problems that the owners and directors of AAFP wish and need to solve. We can improve this, but acting as if a problem is not there is not a solution either. > Where have you (and AAFP's so called "experts") been? I think the AAFP - of whom there are a lot - have grown old and wise and spread themselves over many many areas of practice and examples of human endeavour, as have the Fellows of our medical Colleges. That they know less about Cardiology than a Cardiologist, Informatics than an informatician, FLOSS than a {whatever we are} is unsurprising, but does not extend to the rest of that matrix. I would really hesitate before presenting my sense of the proportionality of things against theirs as being clearly superior. And I regard myself as clever, knowledgeable, clear thinking, proud and egotistical. > Wrong. There were several public offers from FreeMed et al. Their > ignorance was and continues to be totally intentional. David Kibbe knows > about the OpenHealth List; he knows where to find open soure > collaborators. Hmm. Collaborators. Partners. People to work with. I count myself to be abrupt and direct, and I do not address my intended partners and those with whom I believe common cause will lead to common good so abruptly. I went on a course about it once. > Where is there? Free software solutions are already useful and more than > adequate for most family physicians. Bollux, actually. Sorry. I deeply regret that this is as yet the case, and I am quite clear about where to best apply development effort and what model is best for me if others follow it and I hope best for them in the long-run. But as of now, in this time and in these places that is bollux. Uttering it does not help the process we are engaged in. > They sold out to Microsoft before David Kibbe. I think that actually is "bought" or possibly, although not this side of the ocean, "bought into". Adopted. Used. Settled for. Grasped, as a drowning man a straw. Perforce accepted. Met charming and personable salesmen for, and were persuaded that the things they wanted to do, there and then, could be done to a reasonable degree using these tools and at a price which was affordable. How do people make decisions? How are people persuaded, or come to believe things which they did not learn at school? > to MedPlexus et al after David Kibbe. If they are "pragmatic", they > would have at least looked into some of the free software projects and > made a public statement of why existing projects do not fit their needs, > if that's their conclusion. I'm less sure. Sometimes people don't like to blast the hopes or reputation of others who are attempting a task, although they do not choose to join in with it as of yet. Such politeness and reticence can be carried to excess, but is rarely complained of. [1] A Python reference... Google will have it. -- From the Linux desktops of Dr Adrian Midgley http://www.defoam.net/
