On Sat, 15 Nov 2003, Horst Herb wrote:

> On Sat, 15 Nov 2003 08:31, Kantor, Gary wrote:
> > The open-source approach has worked best for tools, and there
> > is no example that we are aware of in which something as
> > complex as an EHR has succeeded.
>
> With all due respect, I don't think you have though this through before you
> wrote.

Horst,
  Gary did not write the original JAMIA position paper "A Proposal for
Electronic Medical Records in U.S. Primary Care":
(http://www.jamia.org/cgi/content/abstract/10/1/1). Gary wrote a response
to it, which generated a reply (copied to this list) from 3 of the 5
original authors.

The three authors who wrote the illuminating reply to Gary's letter are:

 In the lead -
 David W. Bates, M.D., MSc,
        American College of Medical Informatics Fellow,

        Medical Director of Clinical and Quality Analysis,
        Partners HealthCare System,

        Chief, Division of General Internal Medicine
        Brigham and Women's Hospital
        Boston, MA

        Associate Professor of Medicine, Harvard Medical School

        according to http://www.amia.org/acmi/fellows/fellows/bates.html
            and http://aging.senate.gov/events/hr65db.htm

 H.C. Mullins, M.D., Professor Emeritus, University of South Alabama
    He is the original chairman and founder of the Department of Family
       Practice at the University of South Alabama.
   "He has been an active leader in many medical societies and
       associations including the AMA, AAFP, Medical Association of
       Alabama, STFM, AMIA, and IMIA."
  according to http://www.fammed.usouthal.edu/Residency/FacultyPages/Moon.htm
    and http://www.ncvhs.hhs.gov/970415t7.htm

 John A. Zapp, M.D.
    Director of Residency Training, Redding Program, UC Davis Family
      Medicine.
http://famcommed.ucdmc.ucdavis.edu/network_residency/programs/redding/faculty.htm
and http://www.acgme.org/Site/template.asp?StaffID=27

> Complexity has nothing to do with stages of this evolutionary creative
> process - compexity is dealt with whenever need arises. GCC is extremely
> complex, and so is the KDE project - both far more complax than any EHR
> ever will be.

  I agree. These people gave a non-sense reply.

...
> It is *NOW* feasible to create free EHR systems.

  You are too modest. Many free / open source EHR systems have already
been created and in daily use. They are not perfect - None of the
closed-source EHR systems are perfect either.

...

Best regards,

Andrew
---
Andrew P. Ho, M.D.
OIO: Open Infrastructure for Outcomes
www.TxOutcome.Org

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