On Sat, 2005-04-23 at 01:52, Nandalal Gunaratne wrote: > I am a little concerned a to why GNUMED is taling so > long. What is the FOSS that I can recommend to a > General Practitioner which actually works and is easy > to use.
I have a load of code that amounts to a largely complete system, for English general practice, however it is written in Visual Basic and therefore is far from Free (Libre) in its underpinnings. GNUMED is being developed, I understand, on the basis that it will be released when it is ready, not to a deadline. THis is from one POV good. I am not convinced we always address the collection of problems and opportunities from the right aspect. I prefer to think about _automation_ rather than just an EMR, and about tools for tasks rather than a whole system. I know that re-usable code and integration of different pieces is harder in practice than in theory, but ... I also believe we have not considered the use of the computer and network as a Knowledge Source for medical/healthcare practice sufficiently, and some distance remains, in England although it is decreasing, to the establishment of an ecology of people making a living, and technical resources aligned to FLOSS. Looking at the opinions published by the US Leapfrog Consortium, and reviewing my memories of the development of UK General Practice software over some decades, the prescribing system seems to be the first clinical tool to be of obvious value. This implies the presence of a register - a list of who is a patient/was a patient (but does not absolutely _require_ it, or require it to be complete). It would be tempting to any designer or even tinkerer to add in a record of what was prescribed to whom as well, IE a drug history. In theory all developments should proceed and derive from a proper philosophy and appreciation of the likely future developments. In practice however almost none do, instead solving problems in the easiest possible way for the moment. Thus each community automating or computerising will repeat (sometimes with a degree of vehemence that it must be so) the mistakes of all previous ones, and for the same reasons. The development we are engaged in is subtle and slow but over a wide front, and at some point it will become the obvious thing to do to adopt a FLOSS solution set, supplied and supported by people who also think it is obvious. Meanwhile, vendors of closed source tend to offer exactly waht I tend to see as bad about it - that they take all the worries away from the administrators - but which is exquisitely tuned to their market. Anyway... Having a loose prescribing system with a layer that adapts it to the prescription forms in use in the country of use, and linked in an easy way to as many other pieces as are easily separable seems a useful part of advancing. I wish my Python were better. -- Adrian Midgley FLOSS regularly
