Before I contributed to the opinions raised I would like to point out
several things that my recent investigations have pointed out. First, the
proposed fees are "straw man" fees CCHIT wants feedback on these prices.
They are not at all set in stone.

They also have some mechanisms in place to handle version issues. That is
why the certification only lasts three years and is associated with a
particular version.

Now for the sake of argument, lets assume that these mechanisms work and the
rapidly changing versions that Rod has pointed out will not be a problem.

Rods other point is very signifigant. He sees no benifit for himself as a
developer. In fact Rod is a case study in what I consider to be the heart of
this and several other problems in "open source medicine". That is the
freeloader problem. Most of the people who use OSS do not pay anything for
it. RedHat and other companies do very well but their income is trivial
compared to Microsofts because Microsofts customers either pay or break the
law.

Lets imageine that 100 practices use Epic. How many of the paid epic for it?
probably 100. Say 100 people use OpenEMR how many people would pay Rod. My
guess is 5. Rods ok with that, and so am I. But that does mean that there is
a substantive difference between Rod and Epic. Linus does pretty well except
when you compare him to Bill. That does not mean that OpenEMR is not as
ligitimate as Epic, all it means is that EPIC business model is well-suited
towards paying for certifications.

My personal opinion is that using proprietary licenses is a kind of
profiteering. It seems trivial to me that no software for medical purposes
should be published without an opensource license. After all, is not a
source code review the most telling examination of a codebase? The idea of
certification seems to be a way to get around openess.

Now many of you would view the opinions stated there as very radical. (Thats
the rsponse that I get when I say things like this on emrupdate.com) but
this is just the counter position to the current CCHIT pricing scheme which
only a proprietary business model can afford. They are essentially saying
that unless you profit from a proprietary license then your product is not
legitimate. This is not the first time this has happend...

Take a close look at the HIMSS EHRVA effort. At first it looks like a worthy
effort for vendors to work towards interoperability. But a close read of the
application shows that only proprietary vendors can apply.

http://www.himssehrva.org/ASP/index.asp


--
Fred Trotter
SynSeer, Consultant
http://www.fredtrotter.com
http://www.synseer.com
phone: (480)290-8109
email: [EMAIL PROTECTED]


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