> On Fri, 13 May 2011, Keith Lofstrom wrote: > > >OpenEMR is a web app based on php, with a mysql back end. On Fri, May 13, 2011 at 12:09:06PM -0700, Rich Shepard wrote: > This approach of allowing choices of database back ends and browser front > ends seems much more rational to me, particularly for open source > applications, than the approach of requiring MySQL (or at least not actively > supporting any other). Is this lock-in to one specific dbms back end due to > a single connecting layer, ADOdb-lite, that does not equally support all > open source back ends?
EMR systems are certified for particular configurations, and the certification process is very expensive ( around $100K ) and slow ( months to years ). I'm not sure what level of modularity and reconfiguration the "modular ONC meaningful use certification" allows (see http://onc-chpl.force.com/ehrcert ) but swapping the database engine probably means "back to square one". Right now, the focus for OpenEMR is to achieve complete 100% certification for all the modules, which they expect to complete within the next few months. Progress info at: http://wiki.oemr.org/wiki/OpenEMR_Certification They already have certified CCR (Continuity of Care Record) data interchange support and will have CCD (Continuity of Care Document) support by 2012. See: http://en.wikipedia.org/wiki/Continuity_of_Care_Document The doctors, hospitals, and government agencies are very cautious about this stuff. Lives are at stake, and there are myriad opportunities for lethal errors. Agility and customizability are valued, but are much less important. So "open source" will not always translate to "easily modified with modifications sharable" in the GNU sense. The free software community's development processes will be vital and active, but big changes will funnel through certification agencies before full deployment. Still, I would rather trust my life to readable source code. rather than closed source code, even if I can't tweak the code quickly. Usually, it is more important to know where the bugs are, and avoid triggering them, rather than patch them immediately (possibly introducing more bugs). Perhaps someday, with exhaustive regression testing and complete code test coverage, we can certify the meta processes which produce FLOSS medical software. Then we can go at warp speed. But the remaining hurdles for complete deployments are small. OpenEMR is partially deployed in clinics in North Carolina and Texas and elsewhere, and some of us are helping some local Portland clinics evaluate the software. By the time these clinics are ready to deploy, the code will be fully certified. With more software talent, and more savvy open source folks evangelizing their physicians, both processes will move forward faster. Keith -- Keith Lofstrom [email protected] Voice (503)-520-1993 KLIC --- Keith Lofstrom Integrated Circuits --- "Your Ideas in Silicon" Design Contracting in Bipolar and CMOS - Analog, Digital, and Scan ICs _______________________________________________ PLUG mailing list [email protected] http://lists.pdxlinux.org/mailman/listinfo/plug
