I have no problem with your comments, with one exception. The state of IT
in public health in the US, despite the efforts of the CDC, NEDSS, and PHIN is
pretty abysmal. I can't compare it to Australia, but on any scale, they are
in the dark ages here in the US and need all the help they can get.
I suspect that reflects decades of very low levels of investment in public health infrastructure (especially personnel) in the US prior to 2001. No matter how much money is thrown at the problem, it just takes time to build infrastructure, especially organisational infrastructure and trained, experienced personnel.
It certainly
isn't your job to do so, but it would be nice to provide them better capability
(and more efforts and true interoperability). They keep asking for better
case management tools, and this isn't really in the purview of the CDC.
CDC has something called the Outbreak Management System (OMS), I understand, which I think has recently been re-written in Java? Not really sure - very hard for people outside US public health circles to find out what is going on inside CDC, beyond is published on the CDC web site, and all our email enquiries go unanswered. CDC is so big that I don't think people inside teh organisation know what everyone else is working on, either, particularly in teh last few years with all the funds flowing in for public health informatics.
Tim C
------------Original Message------------ From: Tim Churches <[EMAIL PROTECTED]> To: "David Forslund" <[EMAIL PROTECTED]>, "Andrew McNamara" <[EMAIL PROTECTED]> Cc: [email protected] Date: Fri, Dec-24-2004 1:40 PM Subject: Re: Open source tools for population health epidemiology and public health
David Forslund wrote:
This sounds reasonable and certainly is, but there are some more
complications. I try
to be database independent, too, letting the deployment of a
particular database to be
site specific. The problem I also ran into at our state is the
required use of MSSql
on an Windows platform. Something like PostgresSQL was beyond their
willingness to move.
Sure, but again, there is nothing fundamental which ties NetEpi Case Manager to PostgreSQL - it was just that PostgreSQL was (and is) our database server of choice for development purposes. We use the Python DB-API 2.0, which abstracts away most of the database server-specific characteristics, but of course, every SQL database has its own set of extensions, and there are a few "Postgresisms" which we have used out of expediency (we were under considerable self-imposed pressure to get something working in the midst of the SARS outbreak of 2003)- this use of Postgresisms also needs to be abstracted out in order to support a wider range of back-ends (including embedded databases such as SQLite) - that is a task we plan to do, but again it is not the highest priority (of course if someone wants to sponsor the work or do it themselves, the priority would be changed).
Also, the system would have to meet CDC reporting requirements, for
which much of their
software is used, not because they find it useful, but because it is
required to meet
their reporting requirements.
Yes, if use of the tools in the US is a goal, then meeting CDC requirements is a necessity. However, in developing the tools, the US did not even enter our thoughts - simply because so much money has been
poured into public health informatics over the last two or three years in the US that it doesn't need any help from us. Frankly, when we started developing NetEpi Case Manager, the data collection tool, in early 2003, we had Australian needs primarily in mind, but were also mindful of its potential utility in developing and transitional countries, especially those to our north and north-west (where, incidentally, Linux and other open source infrastructure tends to have a much greater mindshare within government departments and NGOs than it does in richer countries, although MS Windows is still probably the dominant OS - and hence does need to be supported by the NetEpi tools, in due course).
They will be using NEDSS because it is supported by CDC and reduces
their exposure to
responsiblity of software risk. Thus an open source solution also
needs to be NEDSS-compliant
or PHIN compatible in the US these days.
Yes, I agree. However, we currently have no plans to make the NetEpi tools NEDSS or PHINS compatible, primarily because the US is already well-provided for in publc health informatics. We are more interested in maximising the utility of the NetEpi tools for use in Australia and other parts of the world. That said, we have borrowed (and will continue to borrow) ideas from NEDSS and PHINS where they are valuable and not overly complex (the NEDSS data model in particular tends towards the baroque, in my opinion, but it is trying to address a very wide range of problems, far more ambitious in scope than what teh NetEpi tools hope to address) - and of course not encumbered by patents, but as far as I know, none of the material in the NEDSS or PHINS design documents is patented or likely to be patented.
Something better isn't the only driving force these days.
Again, I agree entirely. But we don't claim that the NetEpi tools are better than anything else - we only strive to make them as useful as possible to the target audience, which is public health practictioners in countries which do not already have well-funded and strongly organised public health informatics programmes (like most developed countries, there is some funding for public health informatics in Australia, but compared to the US on a per-capita basis, it is still an
order of magnitude less, and on an absolute basis, absolutely miniscule
- the same is true of most OECD countries, I think, with teh exception perhaps of Canada in the last 18 months, for obvious reasons). Nor do we hope that the NetEpi tools drive out "competitors" - if they do no more
than catalyse other open source development projects in public health informatics, then they will have served their purpose (although we do of course hope that they are used).
Cheers,
Tim C
------------Original Message------------
From: Tim Churches <[EMAIL PROTECTED]>
To: [email protected]
Date: Fri, Dec-24-2004 8:01 AM
Subject: Re: Open source tools for population health epidemiology and
public health
David Forslund wrote:
I know a number of folks who would be interested, but the inability
to
run the software on Win platforms removes them
from consideration at this time.
All of the tools and infrastructure used are cross-platform, with the
exception of PostgreSQL - but that will soon be also with the
imminent
release of Version 8.0, which will run natively under MS-Windows as well. It's just that MS-Windows is not our primary development platform, and we haven't had time to recompile, test and package various components for it - but we will, in due course (or someone else might
volunteer to take on that task).
Tim C
