[openhealth] Yet more UK health IT programme woes

[Tim.Churches]

Noticed on the UK RadStats (radical statisticians) mailing list. An
object lesson in what not to do.

Tim C

  NHS trusts pay millions in fines
  to suppliers of delayed IT system

  John Carvel, social affairs editor
  Tuesday June 6, 2006
  The Guardian

  NHS trusts are being made to pay multimillion-pound
  penalties to computer suppliers because of a clause
  in contracts for the health service's £20bn IT scheme.

Read on at:

http://www.guardian.co.uk/uk_news/story/0,,1790952,00.html

where, towards the end, the situation is summed up:

  Mr Bacon [Conservative MP Richard Bacon] said: "At a time
  when hard-pressed NHS trusts are having to make painful
  choices to reduce deficits, they are being forced to pay
  money they don't have and release staff they can't spare,
  for something they don't want and which doesn't work ...
  the NHS is being hit with fines running into tens of
  millions of pounds, which it simply cannot afford".


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Re: [openhealth] Sustainable technology?

[Tim.Churches]

Wayne WIlson wrote:
> Molly sent us this data., which is important enough to restate:
> 
> To support our focus on developing countries, the biggest challenge is
> equity and the data found in this presentation says it all.
> High-income countries:
>    16%   population
>    7%  burden of disease
>    89% health spending
>    94%    Internet hosts
> Low-income countries:
>   84% population
>   93% burden of disease
>   11% health spending
>   6% Internet hosts
> 
> 
> To make some other points obvious:
> 
>   1) Any solution which involves 'upgrading' the low-income countries to the 
> state of resource consumption which the high-income countries use to support 
> these numbers will only have limited success!
> 
>   2) If you didn't understand point #1, the US has roughly 5% of the worlds 
> population and consumes roughly 25% of the worlds oil production.  Most of this 
> consumption is split between the transportation sector, electrical generation 
> and food production.  Electrical generation is crucial in the IT industry.
> 
>    2a) I am 'embedded' in the US health care delivery system, managing computer 
> servers.  Our current trend is to obsolete computers every 3 to 5 years, 
> replacing them with ever more powerful and power consuming models.  I have been 
> on the 'bleeding' edge of trying to conserve power, but in less than three years 
> of growth, we have exhausted the capacity of our power feeds coming in ~ 30KW 
> and our cooling capacity for that power load. 

Yes. I had cause to visit one of the data centres for the govt health
organisation for which I work a few weeks ago, to inspect our population
health servers (which occupy just one rack). I was surprised to notice
several new racks of servers, each absolutely full of "blade" servers
each with 20 or 30 CPUs in each unit i.e. hundreds of CPUs per rack, and
there were several such racks. Drooling at all that computational power,
I asked what they were for. The answer: "They are Citrix servers for the
XYZ application." For those unfamiliar with it, Citrix is a (closed
source) technology which allows Windows desktop sessions running on
central servers (the huge bank of blade servers) to be remotely
controlled from Windows desktops via a thin client. Rather like VNC for
Windows, but a bit more sophisticated. The XYZ application was a Windows
GUI app which needed to be accessed from wards in hundreds of public
sector hospitals, and the use of Citrix and the centralised virtual
Windows desktops very appropriately avoided the hassle and expense and
difficulties of installing the application in so many locations.
However, knowing that the GUI application in question did not have a
terribly complex interface, I could not help but reflect that had the
software been implemented as a Web application, then only a handful of
central servers would have been needed to service it. The (valid)
arguments were that redeveloping the application in question as a Web
app would have cost more than the banks of Citrix servers etc needed to
deploy it as a Windows GUI application, and that the Citrix servers
could be used for other Windows apps in the future. All true. But there
is a lesson there for software developers who wish their code to be
deployed in places where there are not the funds available to purchase
large banks of Citrix servers...

In the more local clinic settings, there is a great deal to be said for
the use of robust, low-power discless workstations (eg IBM NetVista - no
longer sold but available second-hand - or NeoWare Capio - see for
example http://www.itreviews.co.uk/hardware/h611.htm ) served from a
Linux (or even Windows) server. Alternatively, a multi-headed Linux
server is worth considering if all the screens and keyboards can be
positioned close to the server.

And then there is power supply technology. Solar and wind power are
increasingly affordable for remote locations, but they demand very low
power hardware eg machines based on the VIA chipsets - which are slower
but use only a fraction of the power of desktop Intel or AMD CPUs and
chipsets. The use of cheaper laptops as servers is also worth
considering. Modern laptops can be fairly reliable as long as they are
left in one physical place and are not moved around while running eg
treat the laptop like a server and leave it in a (ventilated) cupboard.

Also uninterruptable powers supply technology is important, possibly
with generators (yuck!) to fill in for longer outages of mains power.
During the power failures ("brown outs") in Manila in 2000 I saw all
sorts of ingenious (and sometimes hair-raising) battery-backed power
supplies for computers cobbled together from car batteries and inverters
(or in some cases the batteries were supplying 12V and 5V DC current
direct to the computers, which is more efficient).

Then there are issues of dust, moisture and humidity protection -
computers designed for nice, clean environments common in rich countries
of

Re: [openhealth] Re: OSHCA

[Tim.Churches]

rld, just that it will not takes sides on any political question. But
health and the need for healthcare is universal, and computers are also
remarkably non-partisan, so we don't expect to have to deal with a lot
of political issues in the normal business of OSHCA.

Tim C

> Tim.Churches a écrit :
> 
>  >David Forslund wrote:
>  > 
>  >
>  >>I apologize for bringing this up, but it does affect my relationship
>  >>with OSHCA
>  >>since it is being incorporated in Malaysia.  I will be unable to support
>  >>OSHCA
>  >>in Malaysia because of the politics/human rights issues I see happening
>  >>in that country.
>  >>   
>  >>
>  >
>  >I am sorry that you feel that way, Dave. However, it is your call and I
>  >don't think it is productive or wise to try to change your mind.
>  >
>  >We will have a separate OSHCA mailing list established very shortly
>  >which will handle all OSHCA business, and this openhealth list can be
>  >devoted purely to more general health informatics issues. I hope you
>  >will continue to participate in the openhealth list, because your
>  >technical expertise is greatly valued.
>  >
>  >Tim C
>  >
>  > 
>  >
>  >>K.S. Bhaskar wrote:
>  >> > Please, let's keep the discussion on this mailing list focused on
>  >> > Free/Libré and Open Source Software (with a broad interpretation of
>  >> > software, so discussion of ICD codes and OSHCA incorporation are within
>  >> > the scope of the group) as it pertains to healthcare.  There are plenty
>  >> > of other forums for other topics.
>  >> >
>  >> > Thank you very much.
>  >> >
>  >> > Regards
>  >> > -- Bhaskar
>  >> >
>  >>   
>  >>
>  >
>  >
>  >
>  >
>  >
>  >
>  >Yahoo! Groups Links
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  > 
>  >
> 
> 
> 
> SPONSORED LINKS
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Re: [openhealth] Re: OSHCA

[Tim.Churches]

David Forslund wrote:
> I apologize for bringing this up, but it does affect my relationship
> with OSHCA
> since it is being incorporated in Malaysia.  I will be unable to support
> OSHCA
> in Malaysia because of the politics/human rights issues I see happening
> in that country.

I am sorry that you feel that way, Dave. However, it is your call and I
don't think it is productive or wise to try to change your mind.

We will have a separate OSHCA mailing list established very shortly
which will handle all OSHCA business, and this openhealth list can be
devoted purely to more general health informatics issues. I hope you
will continue to participate in the openhealth list, because your
technical expertise is greatly valued.

Tim C

> K.S. Bhaskar wrote:
>  > Please, let's keep the discussion on this mailing list focused on
>  > Free/Libré and Open Source Software (with a broad interpretation of
>  > software, so discussion of ICD codes and OSHCA incorporation are within
>  > the scope of the group) as it pertains to healthcare.  There are plenty
>  > of other forums for other topics.
>  >
>  > Thank you very much.
>  >
>  > Regards
>  > -- Bhaskar
>  >







  
  
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Re: [openhealth] Re: OSHCA

[Tim.Churches]

David Forslund wrote:
> Tim.Churches wrote:
>  > David Forslund wrote:
>  > > What is happening with the setting up of OSHCA in Malaysia?  It has been
>  > > quiet for some time now.
>  >
>  > My understanding is that the papers have been filed with the relevant
>  > authority and presumably they are being or will soon be assessed and
>  > processed. Meanwhile arrangements are being made to establish a new
>  > OSHCA web site - hopefully we'll have something working in a week or
>  > three. Is there anyone familar with Plone who could assist?
>  >
>  > > It is disturbing to see the Prime Minister of Malaysia shaking hands
>  > > with the Hamas terrorist Mahmoud Zahar.   What
>  > > possible good can come from that?  How are we supposed to interpret this
>  > > action?
>  >
>  > That question is rather off-topic, but anyway: Mahmoud Zahar is the
>  > Foreign Minister of a democratically and popularly elected government,
>  > visiting Malaysia. Thus it would be rather surprising for the Malaysian
>  > Prime Minister not to shake his hand. As to whether Zahar is a
>  > terrorist, well, one person's terrorist is another person's freedom
>  > fighter. I am not defending the actions of Hamas or its supporters, but
>  > it is worth remembering that it is well documented and undisputed that
>  > numerous Zionist groups engaged in terrorist campaigns before and
>  > shortly after the declaration of the state of Israel in 1948. Violence,
>  > both unofficial and state-sanctioned, breeds more violence.
>  >
>  > Tim C
>  >
> I respectfully disagree with your assessment, when the "official"
> position of a government
> is to seek the destruction of their "neighbor" and to disavow any
> participation in an
> internationally agreed to peace process.  They should be treated no
> better than
> South Africa was during apartheid.

Have you ever been to the West Bank or Gaza, Dave? My memory of the West
Bank is of one of the most oppressive places I have visited. I never
visited South Africa during the apartheid decades, but I am told by
people who have visited both places that there were striking
similarities. My point is that there are almost always two sides to any
story, and what you read in the US newspapers and see on US TV may not
provide the full picture, and may conveniently elide a lot of bitter
historical conflict, with mistakes and atrocities on all sides. However,
we stray way, way off topic here, so I will say no more.

Tim C





  
  
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Re: [openhealth] Re: OSHCA

[Tim.Churches]

David Forslund wrote:
> What is happening with the setting up of OSHCA in Malaysia?  It has been
> quiet for some time now.

My understanding is that the papers have been filed with the relevant
authority and presumably they are being or will soon be assessed and
processed. Meanwhile arrangements are being made to establish a new
OSHCA web site - hopefully we'll have something working in a week or
three. Is there anyone familar with Plone who could assist?

> It is disturbing to see the Prime Minister of Malaysia shaking hands
> with the Hamas terrorist Mahmoud Zahar.   What
> possible good can come from that?  How are we supposed to interpret this
> action?

That question is rather off-topic, but anyway: Mahmoud Zahar is the
Foreign Minister of a democratically and popularly elected government,
visiting Malaysia. Thus it would be rather surprising for the Malaysian
Prime Minister not to shake his hand. As to whether Zahar is a
terrorist, well, one person's terrorist is another person's freedom
fighter. I am not defending the actions of Hamas or its supporters, but
it is worth remembering that it is well documented and undisputed that
numerous Zionist groups engaged in terrorist campaigns before and
shortly after the declaration of the state of Israel in 1948. Violence,
both unofficial and state-sanctioned, breeds more violence.

Tim C





  
  
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Re: [openhealth] Beyond standards.

[Tim.Churches]

K.S. Bhaskar wrote:
> Thomas Beale wrote:
> [KSB] <...snip...>
>> contracts (as a software vendor) where the software is FOSS (my company,
>> Ocean Informatics is offering a GPL or commercial licence choice to
>> buyers). Anyway, recently we had a conversation during the negotiation
>>
> [KSB] I have a minor bone to pick with the above.  Why do you consider 
> GPL to not be a commercial license?  For GT.M, our business model treats 
> the GPL as a commercial license.  The license is free but we charge for 
> support.

KS has a valid point, and may I commend to all and sundry a really
excellent paper by Brendan Scott of Open Source Law. The paper, titled
"The Open Source Legal Landscape", is full of clear thinking and can be
found on Brendan's firm's web site at http://www.opensourcelaw.biz/ Here
is a quote from it relevant to the above issue:


4. Open Source as a New Model

4.1 Open source licensing is a customer driven market reaction to the
high transaction costs and anticompetitive effects that the old model
has produced. It effectively says that, through judicious use of
copyright, customers can acquire software with rights analogous to
ownership. In the example above, if the software is open source
software, the person acquiring the software would have property-like
rights over the use of the software in a manner analogous to the rights
they have over the screwdriver.

4.2 The fundamental difference therefore between the old, closed source,
model and the new, open source, model is that under a closed source
licence, a customer acquires very restricted rights in relation to the
software, whereas under an open source licence, a customer acquires very
broad rights analogous to ownership of the copy they acquire.

4.3 Another way of looking at this is that open source licensing
attempts to treat software as a form of property, while the old model of
licensing attempts to prevent such treatment. That is, open source is a
form of deregulation of the software industry. Open source uses
copyright to effect that deregulation.

Open Source is Pro-Copyright
5.1 An open source licence is a licence over copyright granted by the
copyright owner of a work which has certain characteristics (discussed
further below). As a licence, it is only meaningful in the presence of
the copyright regime. Open source licences are explicitly dependent upon
the continued existence of copyright for their efficacy. As open source
would not exist without copyright it is incorrect to assert that open
source is opposed to copyright.

Complement of Commercial is Non Commercial, not Open Source
5.2 A corollary of section 4 above is that open source is a particular
model for the commercialisation of software. It is a different model,
but not a non commercial one. That said, there exists open source
software which is made available on a non-commercial basis, just as
there is closed source software which is made available on a
non-commercial basis.

Complement of Open is Closed, not Proprietary
5.3 A corollary of paragraph 5.1 above is that the copyright in open
source software is owned by someone, otherwise there is no basis on
which a licence can be granted. As such to oppose the terms
"proprietary" and "open source" software implies that the copyright in
open source software is not owned by someone. This is incorrect. That
said, this use of "proprietary software" is, unfortunately, widespread.
If anything, the complement of proprietary software is public domain
software. That is, software over which copyright does not exist or is
not asserted.


Tim C


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Re: [openhealth] Standards -- more questions

[Tim.Churches]

Thomas Beale wrote:
> Tim.Churches wrote:
>  > Thomas Beale wrote:
>  > > Alvin B. Marcelo wrote:
>  > >  > I agree with Heitzso. ICD-10 suffers from 'usability' issues. Yet
>  > >  > unlike the better systems (ie,
>  > >  > SNOMED) it is freely accessible.
>  > >  >
>  > >  > Perhaps OSHCA can make a statement making ICD-10 the 'least common
>  > >  > denominator' together with the
>  > >  > caveats and recommendations as cited by Heitzso?
>  > > one of the major reasons we designed archetypes in the first place was
>  > > not to have to be stuck with any coding system, but to be able to use
>  > > any and all of them as needed.
>  > >
>  > > I know people here are probably bored of hearing about archetypes - but
>  > > we have them in a number of implementations now, and the data created
>  > > are very usable for querying, CRUD functions etc - without any prior
>  > > coding.
>  >
>  > Thomas, I suspect that I am not entirely alone in experiencing a slight
>  > degree of exasperation every time I hear about the wonders of openEHR
> Tim,
> 
> you are missing the point. What we were talking about in this thread is:
> should OSHCA have a line on terminology use for its members? 

No, my little rant was purely in response to your assertion:

"I know people here are probably bored of hearing about archetypes - but
we have them in a number of implementations now, and the data created
are very usable for querying, CRUD functions etc - without any prior
coding."

I should have changed the subject of my post to make that clear - it was
not relating to the topic of the thread.

> I am
> proposing that rather than legislate or otherwise recommend a particular
> coding system, that instead, a framework approach be adopted. I have
> described the framework elements - very simple as you can see from a
> couple of posts ago. What we need to discuss here is whether the
> community sees it as useful. If they do, then we need to work out if
> people want to use archetypes or something else that achieves the same
> thing as far as terminology use goes. If it is archetypes then we can
> start working with them.

Sure, I don't have any problem with that - I agree that a mapping
framework is a good idea. However whether the archetypes framework and
ADL is overkill for such a purpose of mapping codes and concept to one
another really depends on additional utility of the archetypes framework
and ADL, which goes back to my rant - currently the real-life utility is
somewhat constrained. It is a bit like writing computer programmes in a
programming language for which there is no compiler or interpreter, and
thus no way to run the programmes on a computer (except on the
biological computer in your head). That's still useful (Knuth!), but
rather, err, cerebral, and not as useful or as satisfying or as
convincing as running the programme code on an actual electronic computer.

> The tools are already there - there are two editors, and two parsers.
> Final testing for ADL 1.4 in all of these tools is underway at the
> moment. There is also an online archetype repository. Could all these
> things be better? Of course. If the funding situation from various
> government e-Health programmes was even vaguely sensible, it would have
> all been there a long time ago. But at least now the authoring tools are
> there and they work.

No complaints about the quality of the any of these things.

> There are openEHR kernels in C# and Java (being upgraded to Release 1.0)
> and Eiffel (still being built). The latter two have been online in
> subversion for over a year.
>
> The first (probably the most complete) will
> end up being open source when Ocean Informatics can afford to do so -
> which means getting some buy-in from large customers. This is happening.
> These components are incomplete today for two reasons: a) funding and b)
> the fact of openEHR making the effort to work with international
> standards bodies. If more people here want to work on any of the
> software projects, they can join a team and start working. We encourage
> that. What is there today is what has been possible in the current
> economic climate.

OK, perhaps I misunderstood the situation. So in fact you don't have any
complete, working but unreleased openEHR kernels yet? Is that correct?

> Back to my original point: this discussion is not about software, it is
> about what principle OSHCA wants to adopt re: terminology. 

As I said above, my rant was not about the proposed mapping approach to
terminology.

> If you (not
> you personally Tim;-) don't want to engage in such a conversation until
> you have th

Re: [openhealth] Standards -- more questions

[Tim.Churches]

Tim.Churches wrote:
> Thomas Beale wrote:
>  > Alvin B. Marcelo wrote:
>  >  > I agree with Heitzso. ICD-10 suffers from 'usability' issues. Yet
>  >  > unlike the better systems (ie,
>  >  > SNOMED) it is freely accessible.
>  >  >
>  >  > Perhaps OSHCA can make a statement making ICD-10 the 'least common
>  >  > denominator' together with the
>  >  > caveats and recommendations as cited by Heitzso?
>  > one of the major reasons we designed archetypes in the first place was
>  > not to have to be stuck with any coding system, but to be able to use
>  > any and all of them as needed.
>  >
>  > I know people here are probably bored of hearing about archetypes - but
>  > we have them in a number of implementations now, and the data created
>  > are very usable for querying, CRUD functions etc - without any prior
>  > coding.
> 
> Thomas, I suspect that I am not entirely alone in experiencing a slight
> degree of exasperation every time I hear about the wonders of openEHR
> archetypes. Why? Because we are not able to try it out ourselves, simply
> because there is no complete, documented and usable implementation of an
> openEHR archetypes storage/retrieval engine which the average developer
> or interested person can use - not an open source implementation, nor a
> commercial one. None. Yes I know there is an open source implementation
> in Java by a Swedish company, but it is not yet complete (the README and
> CHANGELOG files indicate that there are large chunks of the openEHR
> framework yet to be tackled by it) and there is no usable deployment
> documentation (or much other documentation) that I could find. And yes I
> know that you have implementations written in Eiffel and C#, but you
> have not released them, neither commercially nor as open source. And
> yes, the private company that was formerly DSTC (which was an Australian
> govt-funded IT research consortium) does have commercial health
> information management products which use an openEHR engine, but they
> only sell them as complete suites, and don't sell just an openEHR engine
> (or kernel as you refer to it) for incorporation into other products or
> projects. In the 1st quarter of 2003, as we were about to embark on our
> NetEpi public health data collection project, I asked you about
> implementations of an openEHR storage/retrieval engine (thinking that
> openEHR, which you had been actively promoting for 3 or 4 years at that
> stage, was the way to go to solve our data management issues), and the
> (disappointing) answer was "we have implementations working but we
> haven't released them yet". About 4 months ago, before embarking on
> further round of development on the NetEpi project, I asked you the same
> question again - very nearly 3 years after the first time I asked - and
> the answer was basically the same. So yes, a small degree of boredom is
> setting in. But by all means keep posting to this list (and elsewhere)
> about openEHR, but please don't be offended if some of us (or at least
> me) seem less and less enthused about it as the years go by. Please note
> that none of the foregoing is intended as a criticism of the fact that
> there is currently no openEHR engine/kernel to be had for love nor money
> - neither you nor the openEHR Foundation nor anyone is under any obligation 
> to release or provide an openEHR engine/kernel to any particular timetable,
> or even at all. I am just pointing out that that absence of available
> implementations necessarily has some impact on the level of enthusiasm
> for and interest in the openEHR concept.

I realise the foregoing rant probably seems rather harsh, or just plain
mean and nasty. However, it is born of frustration, because I think that
openEHR is potentially a much better solution to a whole raft of health
informatics problems than HL7 v3.x is ever likely to be. But HL7 V3.x
has a large number of people and organisations behind it. openEHR
doesn't, and the only way it will get a firm foothold (or mindshare)
before the HL7 V3.x steamroller flattens it (just as SOAP flattened the
technically far superior CORBA, or HL7 V2.x flattened the almost
infinitely technically more superior CORBAmed/HDTF specs) is if people
can see openEHR in action, rather than just read the documents and run
thought experiments with the ideas behind it in their head. Systems for
managing EHR data will, due to the nature of the problem domain of
shared health data, exhibit very strong network effects (
http://en.wikipedia.org/wiki/Network_effect ) - in other words, once the
steamroller gets moving... Exposure to openEHR in-use would also, IMHO,
do a great deal to enhance interest in it by health informatics
standards 

Re: [openhealth] Beyond standards.

[Tim.Churches]

Thomas Beale wrote:
> David Forslund wrote:
>> I am familiar with this problem. It seems to me to stem from negotiating
>> the wrong kind of contract. I don't think FOSS helps that much because
>> the contracts seem to me to be negotiated from ignorance. If the local
>> organization demands interoperability BEFORE they sign a contract they
>> will have more power over the provider. If they don't understand the 
>> technology
>>   
> this is a little bit off the topic, but Dave's comments here just 
> reminded me to post something we have been finding useful in negotiating 
> contracts (as a software vendor) where the software is FOSS (my company, 
> Ocean Informatics is offering a GPL or commercial licence choice to 
> buyers). Anyway, recently we had a conversation during the negotiation 
> phase with one very large (typically skeptical) company that wanted our 
> software development expertise but of course wanted to own all the 
> software we developed for them. We on the other hand try to build things 
> very generically, and don't want to go around having to rewrite all the 
> time due to not having access to the IP. We took a pretty strong stance 
> in the negotiation on open source. In the end it came down to them 
> saying: why should we pay you to develop your product? Well, of course 
> we said the obvious things like:
> - it's your product too. You set the requirements, not us
> - you'll get the benefit of maintenance and bugfixing due to wider use 
> than just you
> - etc
> 
> But in the end the argument that they understood was this:
> - every piece of software has a total cost over its lifetime. It is 
> commonly accepted that the build cost to first deployment is roughly 30% 
> and that the cost of maintenance and enhancement over the remaining life 
> of the product is 70% (obviously this varies but it's a pretty common 
> figure given in the literature).
> - so you (the customer) are paying for 30% of the total cost, upfront 
> for a generic component.
> - we (the builder) pick up 70% of the cost, in an incremental ongoing 
> fashion.
> - You get free access for the life of the product.
> 
> Now, if we just charge reasonable contracting rates to get the thing 
> built, the price the customer pays is the price of building it. But what 
> they get is a lifetime of use, including all updates, upgrades etc etc.
> 
> This is all obvious to people on this list, but not to most corporate 
> customers. I don't know if this particular way of justifying open source 
> in contracts is commonly used or described in the open source 
> literature, but for convincing hard-nosed businesses who are most 
> interested in monetary arguments, it works quite well.

That's an excellent way of putting the argument, and I'll squirrel that
away and trot it out when necessary if I may. I would have thought that
the arguments needed to convince software vendors (who are typically in
competition with each other) need to be stronger (as yours is) than the
arguments needed to convince healthcare providers or health authorities
(which tend not to be in competition with each other, at least not in
many countries). However, I am still often asked the question 'Why
should we (meaning a health authority for jurisdiction A) pay for
software which jurisdiction B can also use?' As you say, the answer is
obvious to us, but a large number of people have never considered the
fact that software, like most "intellectual property" (a horribly
misleading term), is not depleted by more widespread use, but rather is
enhanced (in every respect) by it.

Tim C



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Re: [openhealth] Re: Nationalized Medicine was: article re IBM and others contributing open source epi and other

[Tim.Churches]

David Forslund wrote:
> Tim Churches wrote:
>  > Despite having one of the highest per-capita spends on healthcare in the
>  > world, the US ranks in the bottom half (and often right at the bottom)
>  > of all OECD countries on just about every health and health outcome
>  > measure, on a population basis. Sure, for wealthier people in the US who
>  > can afford good health insurance, health outcomes are excellent, but
>  > those people represent about 50% of the total population. The rest of
>  > the population have really very bad outcomes, so the overall results are
>  > remarkably poor given the overall expenditure. And even amongst the
>  > insured, the quality and nature of the care is very patchy, due to the
>  > incredibly fragmented nature of the US healthcare system.
> Where do you get your numbers?   The percentage that isn't covered is
> much smaller, I believe, particularly since people who haven't applied
> and thus don't show up on a list are, in fact, covered.  The quality
> of healthcare is patchy, but not necessarily based on income, but on
> locality.

The healthcare insurance coverage is a figure I recall from a CDC Health
People report, probably 5 years old or so - but it is at work. I'll look
it up on Monday. The population-based health outcomes are documented in
many places - again I'll look for a summary in some OECD reports on  Monday.

> But most people I know would much rather have their
> operation in the US rather than going to another country for the same
> or similar procedure.

I'm just guessing, but could that be because most people you know are
Americans?

> The IT problem of rigid stove pipes of proprietary systems contributes
> to the problem but
> probably isn't the biggest contributing factor, in my opinion.   I'm not
> sure how FOSS
> works in countries that have nationalized healthcare.  Aren't their
> requirements that
> one use the "national IT system"?

Or at least a small number of approved systems. That is certainly the
way the UK NHS is heading, for better or worse. None (or very few) of
those systems are FOSS, though. But typically even if health care is
funded centrally by govt, administration is done on a regional basis and
that often permits (for better or for worse) quite a lot of IT
diversity. Even completely centrlist administrations try to avoid
complete monocultures in IT, especially where commercial suppliers are
involved, for fear of being price-gouged.

Tim C





  
  
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Re: [openhealth] Standards -- more questions

[Tim.Churches]

Thomas Beale wrote:
> Alvin B. Marcelo wrote:
>  > I agree with Heitzso. ICD-10 suffers from 'usability' issues. Yet
>  > unlike the better systems (ie,
>  > SNOMED) it is freely accessible.
>  >
>  > Perhaps OSHCA can make a statement making ICD-10 the 'least common
>  > denominator' together with the
>  > caveats and recommendations as cited by Heitzso?
> one of the major reasons we designed archetypes in the first place was
> not to have to be stuck with any coding system, but to be able to use
> any and all of them as needed.
> 
> I know people here are probably bored of hearing about archetypes - but
> we have them in a number of implementations now, and the data created
> are very usable for querying, CRUD functions etc - without any prior
> coding.

Thomas, I suspect that I am not entirely alone in experiencing a slight
degree of exasperation every time I hear about the wonders of openEHR
archetypes. Why? Because we are not able to try it out ourselves, simply
because there is no complete, documented and usable implementation of an
openEHR archetypes storage/retrieval engine which the average developer
or interested person can use - not an open source implementation, nor a
commercial one. None. Yes I know there is an open source implementation
in Java by a Swedish company, but it is not yet complete (the README and
CHANGELOG files indicate that there are large chunks of the openEHR
framework yet to be tackled by it) and there is no usable deployment
documentation (or much other documentation) that I could find. And yes I
know that you have implementations written in Eiffel and C#, but you
have not released them, neither commercially nor as open source. And
yes, the private company that was formerly DSTC (which was an Australian
govt-funded IT research consortium) does have commercial health
information management products which use an openEHR engine, but they
only sell them as complete suites, and don't sell just an openEHR engine
(or kernel as you refer to it) for incorporation into other products or
projects. In the 1st quarter of 2003, as we were about to embark on our
NetEpi public health data collection project, I asked you about
implementations of an openEHR storage/retrieval engine (thinking that
openEHR, which you had been actively promoting for 3 or 4 years at that
stage, was the way to go to solve our data management issues), and the
(disappointing) answer was "we have implementations working but we
haven't released them yet". About 4 months ago, before embarking on
further round of development on the NetEpi project, I asked you the same
question again - very nearly 3 years after the first time I asked - and
the answer was basically the same. So yes, a small degree of boredom is
setting in. But by all means keep posting to this list (and elsewhere)
about openEHR, but please don't be offended if some of us (or at least
me) seem less and less enthused about it as the years go by. Please note
that none of the foregoing is intended as a criticism of the fact that
there is currently no openEHR engine/kernel to be had for love nor money
- you nor the openEHR Foundation nor anyone is under any obligation to
release or provide an openEHR engine/kernel to any particular timetable,
or even at all. I am just pointing out that that absence of available
implementations necessarily has some impact on the level of enthusiasm
for and interest in the openEHR concept.

Tim C






  
  
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Re: [openhealth] Re: article re IBM and others contributing open source epi and other

[Tim.Churches]

ivhalpc wrote:
> I wonder how this is all going to end and I fear it will end badly as
> in Nationalized medicine in the US when costs continue to climb out of
> control because of this kind of insanity.

A bit off-topic, but huh? Why would "Nationalised medicine" be a bad
ending? No system is perfect, but countries with such systems have
demonstrably better health outcomes on a population basis at much lower
overall cost to society - both rich countries and especially
transitional and developing countries. Surely it is US model of
privatised medicine which represents the "bad ending" which so many
countries are heading towards?

Tim C

> --- In openhealth@yahoogroups.com, David Forslund <[EMAIL PROTECTED]> wrote:
>  >
>  > IBM is part of one of the ONCHIT "winners". Also IBM is
> participating in
>  > the HSSP effort. Sounds like normal operations for IBM.
>  > I've not found a technical reference to the IHII yet, although the
>  > ONCHIT required at least some of the response to be open source.
>  >
>  > Dave Forslund
>  > Nandalal Gunaratne wrote:
>  > > This is another interesting paragraph
>  > >
>  > > "A statement from IBM said the company will engage with industry
>  > > leaders. But it did not mention whether it will coordinate efforts
>  > > with the so-called Interoperability Consortium—a group of large IT
>  > > vendors including IBM, Cisco Systems Inc., Microsoft Corp. and Oracle
>  > > Corp.—who banded together to call for open standards to be used in
> any
>  > > national health information network."
>  > >
> 
> 
> 
> 
> 
> 
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> 
> 
> 



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Re: [openhealth] Standards -- more questions

[Tim.Churches]

Alvin B. Marcelo wrote:
> First thread:
> 
> I propose we standardize on ICD-10 (as a minimum). It's an international 
> standard anyway (albeit
> difficult to use). This of course does not preclude the others from using SNOMED 
> if they can
> afford to do so.

ICD-10 and SNOMED-CT are different kettles of fish. ICD-10 (and its
predecessors) are, as their names suggest, classifications of diseases
and injuries i.e. they are designed to group disease/injury entities
with certain characteristics in common (typically based on the
underlying pathophysiology, such as neoplasia, combined with the
anatomical site or organ system involved, plus sometimes the acuity of
the disease or the cause of the injury) for the purposes of statistical
analysis and reporting. However, ICD classifications do not capture
everything of clinical (or other) relevance about a particular case of
disease or instance of injury - that is not their purpose. Put another
way, ICD classification is deliberately "lossy".

By contrast, SNOMED-CT is a terminology, which aims to provide a unique
identifier (a Concept ID) for every (or at least most) concepts used in
the health and related domains, even if there are multiple ways to refer
to that concept (eg in different languages, or different countries eg
"epinephrine" and "adrenaline" have the same SNOMED-CT Concept ID, as do
 "paracetamol" and "acetaminophen".

The aim of SNOMED-CT is to be able to capture every last bit of detail
in and every aspect of a medical or health record in an unambiguous and
computable manner, using Concept IDs (or groups of them). Tus SNOMED-CT
aims to provide teh basis of a "lossless" coding system for halth and
medical information. However, by itself, SNOMED-CT is not very useful
for producing statistical summaries or other aggregate information
(which is what ICD is designed for) - SNOME-CT is far too detailed for that.

SNOMED-CT is supplied with an overarching ontology - a way of
structuring and organising all those concepts - but that is not the only
possible set of structures or organisation which can be used with
SNOMED-CT. Indeed, "mapping' ICD-10 to SNOMED-CT is really imposing an
alternative ontology on top of SNOMED-CT - a way of indicating which
sets of SNOMED-CT concepts are equivalent to or cognate with a
particular ICD-10 classification code.

Tim C


  




  
  
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Re: [openhealth] Code Breakers on BBC World TV

[Tim.Churches]

Molly Cheah wrote:
> http://www.apdip.net/news/fossdoc
> A two-part documentary, “Code Breakers” will be aired on BBC World TV 
> starting on 10 May 2006. Code Breakers investigates how poor countries 
> are using FOSS applications for development, and includes stories and 
> interviews from around the world.
> 
> Free/Open Source Software (FOSS) contains ‘codes’ that can be used, 
> copied, studied, modified and redistributed without restriction. These 
> freedoms that are for all – developers and users – are highly 
> significant to the developing world as FOSS increases access, ownership 
> and control of information and communication technologies.
> 
> A two-part documentary, “Code Breakers” will be aired on BBC World TV 
> starting from 10 May 2006. Code Breakers investigates how poor countries 
> are using FOSS applications for development, and includes stories and 
> interviews from around the world.

I caught part 1 of this programme, and found it very good and
well-balanced and factually rather accurate (which is rare). Lots of
airtime was given to a spokesperson from Microsoft Europe - he was made
to seem warm and cuddly at first but as the programme progressed the
makes skilfully revealed more and more of what Microsoft (and many other
closed-source software companies) are really like. Part 2, next week,
will focus on the real-life capabilities and real-life costs associated
with FOSS.

I hope that BBC chose to make this programme freely downloadable in teh
near future.

Tim C


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Re: [openhealth] Standards

[Tim.Churches]

Molly Cheah wrote:
> There doesn't seem to be control of its use. Information (unofficial) of
> its copy rights by WONCA is here
> http://www.ulb.ac.be/esp/wicc/copyright-en.html
> 
> You can download the electronic version of ICPC2 from here.
> http://www.ulb.ac.be/esp/wicc/ceo.html
> 
> When we started using it 6 years ago, we were told it can be freely used
> in "research" i.e. if you're developing your software. Then I was told
> by a former member of the WONCA Int'l Classification Committee to go
> ahead and use it. Frankly I don't think WONCA is concerned about
> charging for its use. The people who seem to want to charge is
> University of Sydney Family Medicine Research Centre (BEACH project) and
> the resultant extensions developed called  ICPC2-Plus
> http://www.fmrc.org.au/
> 
> The ICPC-L mailing list is inactive and there is very little news from
> WONCA itself except for the BEACH project. I haven't been following the
> progress of the project but I know they've been very active. However,
> there doesn't seem to be a breakthrough in the use of ICPC2 even in
> Australian general practice which is a pity.

Following is some more information on ICPC-2 and ICPC-2-Plus posted a
while ago on the Australian general practice computing group mailing
list by various people

Tim C

-Original Message-
From: Tim Churches [mailto:[EMAIL PROTECTED]
Sent: Monday, July 11, 2005 3:21 PM
To: Tolentino, Herman
Subject: ICPC-2 Plus use in Australia

I asked on the GPCG mailing list which systems used it here in Oz:

Richard Hosking wrote:
> It is used in Medical Spectrum as far as I know

Les Ferguson wrote:
> MedTech32 is using it in Australia, although their own website only
> names 5 products using it:
> http://www.fmrc.org.au/icpc2plus/origins.htm)

Tony Lembke wrote:
> Genie is one. That's a start.

Peter Machell wrote:
> 1. Totalcare

Tim C

 Original Message 
Subject: Re: [GPCG_TALK] ICPC-2 Plus in use?
Date: Tue, 12 Jul 2005 10:45:13 +1000
From: Graeme Miller <[EMAIL PROTECTED]>
Reply-To: Graeme Miller <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
References: <[EMAIL PROTECTED]>

There are currently 25 EHR software developers holding licenses to
include ICPC-2 Plus in their software products. There are installations
at 400+ sites involving 1,600+GPs. Some are small with bespoke software
in one or two sites. Some larger ones are listed on our website as
mentioned by Les Ferguson. There are also an additional 10 licenses for
research and administrative software and 5 development evaluation
licenses to a total of 40 licenses. Off shore, Plus is being used in Sri
Lanka and Macao and negotiations are proceeding in Fiji and the Philippines.

We charge a one off fee for ICPC-2 which is remitted to Wonca to support
international development of ICPC-2. We charge a small annual fee for
ICPC-2 Plus to cover our support costs. Plus is a dynamic interface
terminology with a 3 to 6 month update cycle with end users being
updated in synchrony with the MIMS database updates. Wonca is currently
negotiating a national licence for ICPC-2 with DoHA [Australian Govt
Dept of Health and Ageing] which will cover the cost of ICPC-2. If the
government provided ongoing support for supply and distribution, as it
does does ICD10AM [AM=Australian Modification] (=$1M+ PA)then end user
costs would be nil. If they supported open source then perhaps EHR
software would also be free BUT someone would have to supply the support
(as with Argus [open source secure medical comms software]).

The University of Sydney is non profit and a registered charity with ATO
tax exempt donation status.

--
Dr Graeme Miller MB BS PhD FRACGP
Medical Director
Family Medicine Research Centre
(A Collaborating Centre of the World Organisation of Family Doctors)
University of Sydney
Acacia House
Westmead Hospital
Westmead NSW 2145
Australia

Medical Director
General Practice Statistics and Classification Unit
Australian Institute of Health and Welfare/
University of Sydney

Phone  +61 2 9845 8156
Mobile 0412 465 585
Fax    +61 2 9845 8155
Fax (Home)  +61 2 9890 1174
Email  [EMAIL PROTECTED]
Web http://www.fmrc.org.au

Quoting Tim Churches <[EMAIL PROTECTED]>:

> It says here
>
http://www.generalpractice.adelaideuni.org/content/res_content/current/vocab/2_02_4.pdf
> that "ICPC-2 Plus is used in 38 clinical computing systems that are
> intended for General Practice and Community Health. It is also used
> for
> coding data in the BEACH Study and by the Australian Bureau of
> Statistics (National Health Survey)."
>
> Its use in BEACH comes as no surprise, but its use in so many clinical
> software packages comes as a surprise.
>
> Can anyone on this list name any of those 38 clinical computing
> systems?
> Presumably that means 38 different clinical software packages, as
> opposed to 38 installations of a particular clinical software package?
>
> Tim C
>



  




  
  
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Re: [openhealth] What to Call the OpenEMR/ClearHealth/FreeMed/MirrorMed Universe?

[Tim.Churches]

Ignacio Valdes wrote:
> Linux Apache MySQL PHP server setups are so common that they have
> their own designation, collectively called 'LAMP' applications. It
> seems that in the United States, the hotbeds of FOSS Electronic
> Medical Records (EMR)'s activity are falling into two universes: that
> based upon the VA's VistA and a consortium of groups using a
> combination of OpenEMR, ClearHealth, FreeMed, FreeB and MirrorMed
> which also happen to be LAMP applications. Might there be a term
> currently to call the latter? Could this apparently thriving community
> invent one?

We use Linux, apache, Python and PostgreSQL for our NetEpi applications.
Does that make us LAPPlanders, or LAPPis (Wikipedia tells me that
"Lappi" is the Finnish name for Lapland).

Tim C


  




  
  
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Re: [openhealth] [ FW: [Eval] Extended IT Evaluation Database at http://evaldb.umit.at]

[Tim.Churches]

Tim Cook wrote:
> 
> FYI
> 
> A good source for discovering what works and what doesn't in various
> healthcare settings.

Fantastic! Thanks to N&T for pointing this out - I think I'll be using
this a lot.

Tim C

> FYI
> 
> This database has been developed by a colleague and co-author of mine
> and is well worth remembering... 
> 
> Nikki
> 
> Dr. Nicola Shaw
> Research Chair, Health Informatics
> iCARE; University of Alberta &
> Capital Health. Edmonton.
> E-Mail: [EMAIL PROTECTED]
> Tel: +1 780 492 3185
> WWW: http://www.pathgroup.ca
> 
> 
>  >-Original Message-
>  >From: [EMAIL PROTECTED]
>  >[mailto:[EMAIL PROTECTED] On Behalf Of Elske Ammenwerth
>  >Sent: May 12, 2006 4:06 AM
>  >To: [EMAIL PROTECTED]
>  >Subject: [Eval] Extended IT Evaluation Database at
>  >http://evaldb.umit.at
> 
>  >Dear all,
> 
>  >in 2003, the IT Evaluation Database (http://evaldb.umit.at)
>  >was developed to present papers on IT evaluation studies in
>  >health care.
>  >In addition, all studies are classified with regard to e.g.
>  >evaluation approach, clinical domain or evaluation criteria to
>  >support a quick search for specific papers.
> 
>  >You may be interested to learn that the Evaluation Database
>  >has now been largely extended to include evaluation studies
>  >from 1982 up to 2006 (before, it stopped in 2002).
>  >The database now contains around 1.250 papers on evaluation studies.
> 
>  >In addition, we now added the PubMed ID that allows a direct
>  >link to PubMed with all the service available there (direct
>  >link to the full paper, address of authors etc.).
> 
>  >I hope you can make use of this resource that is offered for
>  >free by UMIT (University for Health Sciences, Medical
>  >Informatics and Technology in Tyrol) and the AMC (Academic
>  >Medical Center in Amsterdam).
> 
>  >Please feel free to pass this information to anybody interested.
> 
>  >Please note that such a database can never be "complete", so
>  >if you miss important paper please let me know so that we can
>  >include it.
> 
>  >Thanks a lot,
>  >Elske
> 
>  >__
>  >Univ.-Prof. Dr. Elske Ammenwerth
>  >Institut für Informationssysteme des Gesundheitswesens
>  >Institute for Health Information Systems UMIT - Universität
>  >für Gesundheitswissenschaften, Med. Informatik und Technik
>  >UMIT - University for Health Sciences, Medical Informatics and
>  >Technology Eduard Wallnöfer-Zentrum 1 A - 6060 Hall in Tirol,
>  >Tel. +43 50 8648 3809 Fax +43 50 8648 3850
> 
>  >___
>  >Eval mailing list
>  >[EMAIL PROTECTED]
>  >http://listman.umit.at/mailman/listinfo/eval
> 
> 
> 
> 

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Re: [openhealth] request for advice re electronic medical record

[Tim.Churches]

Tim Cook wrote:
> As soon as you start embedding complex data into relational structours
> you start losing the ability to recover "information".
> 
> In the SPECIFIC instance of OSCAR, the act of creating PDF's as data
> stores means there is no way to report back out of them so that data
> quality/ data integrity can be verified.

Tim (or anyone else familiar with OSCAR),

Can you elaborate on this? What sort of data is being stored solely in
PDFs, presumably as BLOBs in a table, or in the filesystem with pointers
to them in a table? I can conceive of several circumstances in which
storage of PDFs would be quite OK eg scanned copies of paper
correspondence, given that paper is still by far the most common
modality for health communication, and copies of outgoing reports and
correspondence. Even if such reports were generated entirely from data
in the database, there may be a business or legal requirement to keep a
snapshot of the data as it was when used to generate the report - and
just storing a PDF of the generated report might be a convenient way of
doing that.

I've heard good reports about how functional OSCAR is in real-life
practice from a person whose opinion I trust, although he did mention
that the user interface wasn't entirely to his taste, but admitted that
was a matter of personal preference. Thus your assertion that OSCAR may
contain an FDF (Fundamental Design Flaw) is the source of some surprise.
More details would be useful. I suspect that OSCAR may instead contain
an FDDO (Fundamental Design Difference of Opinion), also known as an
INDILT (I'd Never Design/Do It Like That). However, if it really is an
FDF as you assert, then you need to provide more details and evidence to
 convince us and to help the OSCAR people and others to correct or avoid
such design mistakes - if they are in fact mistakes. Tell us more about
the circumstances in which OSCAR is using embedded PDFs as a primary
data store.

Tim C





  
  
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Re: Openhealth Archives? (was) Re: RES: [openhealth] OSHCA - Notion of "founding members"

[Tim.Churches]

Bhaskar, KS wrote:
> The archive is in the Openhealth group Files area at Yahoogroups:
> http://groups.yahoo.com/group/openhealth/files/openhealth-list.tar.gz
> 
> You will need a Yahoo id attached to the e-mail address with which you
> are subscribed to the openhealth list in order to access the archives.
> Of the 204 current members, 13 do not yet have Yahoo ids attached to
> their e-mail addresses.
> 
> Caveat: the archived e-mail has not been scanned for malware.  You
> should know how to protect yourself if you decide to download and access
> the archive.

One of the first tasks post-registration of OSHCA will be refurbishment
of the OSHCA Web site, and I think that a sub-task of that should be to
create a (Google etc) searchable archive of the openhealth list based on
the contents of the tarball to which Bhaskar refers. I volunteer to do
that. The openhealth archive contains a lot of wisdom, as well as a lot
of unfortunate and sometimes childish disputation (mea culpa), but there
is no easy way to separate one from the other, alas. Putting the mailing
list archives up can be a subproject of the OSHCA Web site project.

Of course, all of the foregoing assumes that the openhealth list, or
whomever the owner of the openhealth list archives is deemed to be,
assents to this - OSHCA does not equal the openhealth lists nor
vice-versa, although OSHCA business has historically be conducted on the
openhealth list, so the two are closely related. But given that the
mailing list archives are currently downloadable, I don't see any
objection. An alternative strategy would be to make the archives
searchable online but only by subscribers to the openhealth mailing
list. That would add a lot of technical overhead and not achieve very
much, IMO.

Tim C

> On Fri, 2006-04-28 at 08:31 -0500, Joseph Dal Molin wrote:
> 
> [KSB] <...snip...>
> 
>  >   Which brings to mindis there a copy of the mail archives
>  > dating 
>  > back to the formation of the openhealth list.I recall an earlier 
>  > message asking Brian if the archive could be downloaded...did this
>  > come 
>  > to pass? It will be very helpful to have the archive for many
>  > reasons, 
>  > not to mention documenting the history of this community.





  
  
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Re: [openhealth] OSHCA Inaugural Meeting - Closing remarks

[Tim.Churches]

David Forslund wrote:
> ( I've been curious why "protem" was used for the committee name instead
> of "protemp"?)

It is an abbreviation for "pro tempore". I have always said "pro temp"
too, but I gather that "pro tem" and "pro tem." are also widely used. I
think that "protem" is rather more pomo (post-Modern), although I think
that CamelCase ought to be used (I'm old-fashioned when it comes to
post-Modernism): "ProTem" - however I have refrained from commenting on
this until now.

Tim C


  




  
  
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Re: [openhealth] Re: oshca inaugural meeting - constitution

[Tim.Churches]

Will Ross wrote:
> nandalal,
> 
> from the perspective of a simple discussion at a face to face  
> meeting, this is what is happening:
> 
> "we have a motion and a second to approve the 1.0 draft of the  
> constitution.   is there any further discussion?"

Although there was at least a two week opportunity to comment on the
draft constitution prior to the meeting, with several messages from
Molly reminding us of this fact.

> as a responsible member of the community i first evaluate whether or  
> not it makes sense to initiate further discussion.   deciding that it  
> makes sense to raise the objection, i ask for the floor and state my  
> concern so that my concern is noted as part of the process, even if i  
> have every confidence that the motion will pass over my further  
> discussion.

Will, what *is* your concern with the constitution? I don't recall
seeing it set out in any of your various posts in the last few days on
the process for the inaugural meeting?

> then, the chair receives a motion to close the discussion, which is  
> seconded and passed.
> 
> does this "disrupt the process" or is it a legitimate part of the  
> process?   you decide.

No, you have not done anything wrong. I agree that the process may be a
bit confusing. In retrospect, I think the problem has been that the act
of voting for the resolutions and the act of applying for foundation
membership have been rolled into a single process. Arguably it would
have been better to separate them.

In a face-to-face Inaugural Meeting:

(0) Prior to the inaugural meeting, some form of discussion forum would
be convened to draft a proposed constitution and nominate initial protem
office bearers.

(1) At the inaugural meeting, some speeches would be made and some
time-limited discussion of the resolutions and constitution would be
allowed, then votes would be taken on the resolutions to form the
organisation with the proposed constitution and officers, and if there
were sufficient yeah votes, formation of the organisation could then
proceed. I understand that at least seven people are required before an
organisation can be registered in Malaysia.

(2) If the resolutions were successful (that is the minimum number of
yeah votes were received), then an invitation is issued to join the
nascent organisation as founding members. An absolutely typical
requirement for membership is that the prospective member; a) agrees
with the goals of the organisation; and b) that the member agrees to
abide by the constitution, rules and regulations of the organisation (in
the case of OSHCA, there is only a constitution). Note that members do
NOT have to agree with every last word of the constitution, but they
must agree to abide by it. That is analogous with national or state law
- I don't agree with many of the laws of Australia, but I accept that as
a citizen and resident of Australia I must abide by them (often
grudgingly, but I still do so). I also accept that I can try to change
those laws with which I don't agree through a range of activities, from
lobbying political representatives through to direct participation in
the political process.

The proposed OSHCA constitutions says:

"5.1 Membership
shall be open to persons interested in furthering the objects of
OSHCA and shall consist of anyone who has accepted the premise of
OSHCA’s Vision, Mission Statements and Principles by indicating such
acceptance via OSHCA’s Internet Registration process."

Also implicit in Section 7.4 are the provisions that members must
*abide* by the constitution and not bring the organisation into disrepute.

Nowhere does it say that members must agree with every last provision or
letter of the constitution, just that they must abide by it. Members
must, however, accept the OSHCA vision, mission statement and principles.

(3) The minutes of the inaugural meeting, the constitution and other
documents, the details of the initial office bearers and protem
committee, and the details of all the founding members would then be
submitted to the relevant national or state authority to allow the
organisation to be formally registered.

(4) Subsequent meetings would be called to organise elections after as
suitable brief delay (to allow more members to join after some promotion
and publicity about the organisation) for committee/board members and
office bearers, and if members desire it, for modifications to the
constitution. Non-members can lobby members to initiate or vote for
motions to change the constitution, but can't do so themselves.

It is fairly easy to see how the steps taken to found OSHCA as a formal
organisation are analogous to the steps set out above, with the
exception that the process of voting for or against the resolutions and
the process of applying for membership have been conflated.

I think that this collective mistake can be easily remedied by inviting
a second round of founding membership applications using a form which
makes the conditions for membership cr

Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Will Ross wrote:
> On Apr 22, 2006, at 5:13 PM, Tim.Churches wrote:
> 
>  > Will Ross wrote:
>  >> ARTICLE 5 - MEMBERSHIP
>  >>
>  >> 5.2  -  The Committee when rejecting an application SHALL provide a
>  >> reason.
>  >
>  > Strictly speaking, "shall" should be used only for the first person
>  > singular or plural. The use of "should" (as the text currently 
>  > reads) to
>  > convey obligation is acceptable and common usage - see
>  > http://www.bbc.co.uk/worldservice/learningenglish/grammar/learnit/
>  > learnitv43.shtml
>  > - although I note that "shall" has a specific meaning of obligation in
>  > American formal usage, which it doesn't have in the formal English 
>  > usage
>  > in most Commonwealth countries, although I note that teh use of 
>  > "shall"
>  > throughout the proposed constitution doesn't adhere to strict formal
>  > English usage.
>  >
>  > However, I think we are splitting hairs (but not infinitives) here.
>  > Shall we leave it as is?
> 
> tim,
> 
> i am fine either way.   but as a matter of reference, i was thinking 
> of "should, shall, may" in the "sob" sense:
> 
> http://www.ietf.org/rfc/rfc2119.txt

OK, interesting. Here in Australia, "shall" tends to denote
indefiniteness, compared to "should" or "will", which indicate
obligation and definiteness respectively. That is quite different to the
sense of "shall" proposed in the above RFC, which is of North American
origin.

Isn't English a wonderful language?

>  >> ARTICLE 16 - PROHIBITIONS
>  >>
>  >> 16.4  -  I don't understand this.   Are Malaysian students who are
>  >> over 21 prohibited from joining OSHCA unless they have prior written
>  >> approval from the University?
>  >
>  > Presumably all the rules in this section are required to meet some
>  > slightly idiosyncratic Malayasian legal requirements - every 
>  > country has
>  > its own peculiarities (for example, the gambling game of "two-up" is
>  > illegal in Australia except on 25th April - true! - see
>  > http://en.wikipedia.org/wiki/Two-up
>  >
> 
> excellent!    shall we schedule a game three days hence?

Two days hence. It is already 23rd April here.
> 
> ;-)

Which raises another issue. The times for the first meeting need to
specified with respect to GMT/UMT. Otherwise "25th April" for us here in
Oz only overlaps with "25th April" for Americans by six hours, and
Americans are quite likely to be asleep for those six hours...

Tim C



  




  
  
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Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Will Ross wrote:
> Some last minute suggestions.
> 
> ARTICLE 1 - NAME
> 
> The Organisation shall be known as Open Source Health Care Alliance, 
> hereafter referred to as "OSCHA", and shall be registered in Malaysia.

That is better wording but not really a substantial change - not an
essential modification from my perspective - but I doubt there would be
objection to it.

> ARTICLE 3 - CHAPTERS
> 
> Why is South America omitted?   This collection of regions seems 
> complex.   The boundaries between regions is not obvious from the 
> text.  Why not use the same 6 global regions as FIFA?

Latin America and the Carribean is on the current list. "Latin America"
includes all of South America, doesn't it, together with Central America
and Mexico? I suspect that Mexico has more in common with respect to
opens source software in health with its neighbours to the south than it
does with El Norte.

> ARTICLE 5 - MEMBERSHIP
> 
> 5.2  -  The Committee when rejecting an application SHALL provide a 
> reason.

Strictly speaking, "shall" should be used only for the first person
singular or plural. The use of "should" (as the text currently reads) to
convey obligation is acceptable and common usage - see
http://www.bbc.co.uk/worldservice/learningenglish/grammar/learnit/learnitv43.shtml
- although I note that "shall" has a specific meaning of obligation in
American formal usage, which it doesn't have in the formal English usage
in most Commonwealth countries, although I note that teh use of "shall"
throughout the proposed constitution doesn't adhere to strict formal
English usage.

However, I think we are splitting hairs (but not infinitives) here.
Shall we leave it as is?

> ARTICLE 8 -  COMMITTEE
> 
> 9.8  -  In the event of the death or resignation of a member of the 
> Committee, the Committee shall have the power to APPOINT any other 
> member of OSHCA to fill the vacancy until the next annual general 
> meeting, but the member shall have the right to decline to be 
> appointed to the Committee without resigning from OSHCA.

I think that "co-opt" (in the current text) is being used to mean
"summary appointment". However there is no suggestion of coercion in any
of the senses of co-option (or co-optation), are there? See
http://www.answers.com/main/ntquery?s=co-opt&gwp=13 Thus I feel that
"co-opt" is quite acceptable.

> ARTICLE 11 - FINANCIAL PROVISIONS
> 
> 11.2  -  change "any officer or servant of OSHCA" to "any officer of 
> OSHCA or other volunteer"

Yes, "servant" is slightly archaic, but hey, I am still employed as a
public servant (touch forelock, genuflect). Perhaps we might leave it as
is, m'lud?

> ARTICLE 14 - INTERPRETATION
> 
> 14.2  --  (improved wording)  Except when contrary to or inconsistent 
> with a policy previously established by a general meeting,  decisions 
> of the Committee shall be binding on all members of OSHCA unless or 
> until countermanded by a resolution at a general meeting.

Yes, that's better. There is a typo in the version 7 draft to me by
Molly on 20/4 - "there" should be "they". When fixing that, might as
well change to Will's suggested text above.

> ARTICLE 16 - PROHIBITIONS
> 
> 16.4  -  I don't understand this.   Are Malaysian students who are 
> over 21 prohibited from joining OSHCA unless they have prior written 
> approval from the University?

Presumably all the rules in this section are required to meet some
slightly idiosyncratic Malayasian legal requirements - every country has
its own peculiarities (for example, the gambling game of "two-up" is
illegal in Australia except on 25th April - true! - see
http://en.wikipedia.org/wiki/Two-up

However, paragraph 16.1 does prohibit the playing of all video games on
OSHCA premises. Molly, that means you can't play mahjong on your laptop.

> ARTICLE 17 - AMENDMENTS
> 
> I would like to see a requirement that the exact wording of any 
> constitutional amendment must circulated ahead of a meeting.   I fear 
> the opportunity for the general meeting to compose and pass a 
> constitutional amendment without prior circulation to the larger 
> membership.

Paragraphs 8.4 and 8.7 both require that agenda for annual and
extraordinary general meetings be circulated 14 days prior to each
meeting. Thus it would not be possible to effect a change to the
constitution without two weeks notice of it being placed on the agenda.
I don't think that it necessary to specify that the exact wording be
circulated beforehand - that would be usual in any case, and would be
demanded by members if it were not. The main thing is that completely ad
hoc, spur-of-the-moment changes to the constitution will not be
possible. Clearly, the Chair of the general meetings should not permit
something as fundamental as a constitutional change to be conducted as
unannounced "Any other business".

Tim C

> On Apr 21, 2006, at 10:07 AM, Molly Cheah wrote:
> 
>  > Hi everyone,
>  >
>  > I would like to announce the following:
>  > 1) 25th April 2006 will be the 

Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Tim.Churches wrote:
> OK. Sorry for suggesting membership fees rather higher than those which
> Molly proposes. I have forgotten the password for the Yahoo username
> which I used to subscribe to this list, so I have been unable to examine
> the draft constitution documents as yet - I have re-applied to join the
> list with a fresh username (no, there is no way to recover my password,
> since I used fake details to register which I no longer recall - I
> wouldn't trust Yahoo with any real personal details).

Ignore that - Molly has distributed copies of the draft constitution via
direct mail to protem committee members - I'll read it now and stop
making uninfomed comments serves me right for catching up on a
week's worth of email in reverse order - always a mistake.

Tim C


 
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Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Dr Molly Cheah wrote:
> What Tim's response is what I was eluding to. Here's the relevant 
> article in the constitution.
> 
> 
> *6.1 - * The Committee shall prescribe a list of equitable membership 
> entrance fee for different countries based on the UNDP’s 2005 Human 
> Development Index (HDI) of the country. The entrance fee payable for 
> membership shall be as follows (refer to List of Countries by HDI):-
> 
> *6.1.1 - Ordinary member*
> 
> Countries with High HDI USD10.00
> 
> Countries with Medium HDI USD5.00
> 
> Countries with Low HDI USD2.50
> 
> 
> *6.1.2. - Associate member*
> 
>  1.
> 
> *- Civil Societies & Professional bodies*
> 
> Countries with High HDI USD20.00
> 
> Countries with Medium HDI USD10.00
> 
> Countries with Low HDI USD5.00
> 
>  2.
> 
> *- Corporations*
> 
> Countries with High HDI USD100.00
> 
> Countries with Medium HDI USD50.00
> 
> Countries with Low HDI USD25.00
> 
> 
> *6.2 - * There shall be no monthly subscription payable. However, 
> members are encouraged to donate to specific projects as and when necessary.
> 
> 
> We've actually made the entrance fees very very affordable. These 
> figures can be increased in subsequent amendments. However, as there is 
> provision for donations and also special levies for projects, we can use 
> those provisions for increasing contributions.

OK. Sorry for suggesting membership fees rather higher than those which
Molly proposes. I have forgotten the password for the Yahoo username
which I used to subscribe to this list, so I have been unable to examine
the draft constitution documents as yet - I have re-applied to join the
list with a fresh username (no, there is no way to recover my password,
since I used fake details to register which I no longer recall - I
wouldn't trust Yahoo with any real personal details).

Anyway, we can discuss the level of the fees further at the inaugural
meeting - I think Molly's proposed fees are a bit too low.

Tim C

> Tim.Churches wrote:
> 
>> Thomas Beale wrote:
>>  
>>
>>> doesn't the fact of paying the same number but in your own currency fix
>>> this? E.g. 50AUD, 50M$, 50Euro, 50rupiah, 50USD, 50yuan etc?
>>>
>>>
>> Not really, because the granularity of currency units varies greatly
>> between countries - consider, for example:
>>
>> 50 Japanese Yen is only US$0.42
>> 50 Philippine pesos is US$0.96
>> 50 Mexican pesos is US$4.53
>> 50 Indonesian rupiah is US$0.00562895
>>
>>
>>  
>>
>>> But Tim
>>> seems to be saying start with e.g. 50AUD and convert this to all the
>>> other currencies?
>>>
>>>
>> And then apply the HDI-based factor to reduce the amount for
>> transitional and developing countries.
>>
>>  
>>
>>> My early concern (either way) would be the cost & resources of
>>> accounting, $ transfer & processing etc. Even if the supposed income
>>> covers the $-cost, will it realistically cover the human cost? Who will
>>> do all this?
>>>
>>>
>> No, the membership fee for each of the three HDI classes which Molly
>> proposes should be specified in only US dollars and Euros, or perhaps
>> only in Malaysian ringgit (that would make a refreshing change!).
>> Conversion of each member's local currency to the prescribed membership
>> fee would be the responsibility of the member and/or the payment
>> mechanism eg Paypal, or your credit/debit card provider. If I buy
>> something on the Internet from a vendor in a foreign country, my
>> expectation is that prices will be quoted in US dollars, Euros or in the
>> vendor's local currency, not in Australian dollars.
>>
>> Tim C
>>
>>
>>
>> Yahoo! Groups Links
>>
>>
>>
>>
>>
>>
>>
>>
>>  
>>
> 
> 
> 
>  
> Yahoo! Groups Links
> 
> 
> 
>  
> 
> 
> 
> 



 
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Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Thomas Beale wrote:
> doesn't the fact of paying the same number but in your own currency fix
> this? E.g. 50AUD, 50M$, 50Euro, 50rupiah, 50USD, 50yuan etc?

Not really, because the granularity of currency units varies greatly
between countries - consider, for example:

50 Japanese Yen is only US$0.42
50 Philippine pesos is US$0.96
50 Mexican pesos is US$4.53
50 Indonesian rupiah is US$0.00562895


> But Tim
> seems to be saying start with e.g. 50AUD and convert this to all the
> other currencies?

And then apply the HDI-based factor to reduce the amount for
transitional and developing countries.

> My early concern (either way) would be the cost & resources of
> accounting, $ transfer & processing etc. Even if the supposed income
> covers the $-cost, will it realistically cover the human cost? Who will
> do all this?

No, the membership fee for each of the three HDI classes which Molly
proposes should be specified in only US dollars and Euros, or perhaps
only in Malaysian ringgit (that would make a refreshing change!).
Conversion of each member's local currency to the prescribed membership
fee would be the responsibility of the member and/or the payment
mechanism eg Paypal, or your credit/debit card provider. If I buy
something on the Internet from a vendor in a foreign country, my
expectation is that prices will be quoted in US dollars, Euros or in the
vendor's local currency, not in Australian dollars.

Tim C


  




  
  
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Re: [openhealth] OSHCA inaugural meeting - important announcement

[Tim.Churches]

Dr Molly Cheah wrote:
> I believe that OSHCA should be a not-for-profit but not a charitable
> organisation. "Free" sometimes attract the wrong type of people who
> "may" make up the numbers but do not show commitment to OSHCA's cause.
> Besides there is a cost in servicing these free riders and I don't think
> we want OSHCA to be just a free riders' organisation. If there are
> people who are genuinely interested in becoming members and contributing
> towards OSHCA's objectives, but cannot afford the entrance fees, perhaps
> we can set up a donation fund to help them. This is what we did for the
> Malaysian Council for Tobacco Control (MCTC) and we got funds from
> Rockefeller Foundation to assist the poorer NGOs to be members. Our
> entrance fees was MYR200.00.
> 
> The amount to be collected should be such that it will offset the
> financial cost associated with the collection process, but yet
> affordable and equitable.

I agree. Memberships fees are means for members to signify that they
care enough about the goals of the organisation to make a small
financial sacrifice and a small effort to effect the membership payment.
Potential sponsoring organisations will look at the membership fees as
in indication of the commitment of members to the organisation's goals.
It is also a good way to distinguish real people from virtual people,
which is very important for an international organisation which will be
using the Internet as its primary means of communication, rather than
face-to-face meetings. It doesn't confirm identity, but that's not so
important - but membership fees will weed out trolls and people who just
want to amuse themselves by making trouble.

How large should that financial sacrifice be? As Molly says, it has to
outweigh the cost of collection. My feeling is that pitching the annual
membership fee at about the price of a single meal for one person in a
medium-priced restaurant in the capital cities of any of the rich
nations. There may be some debate over how much that actually is, but
here in Sydney between AUD$30 and AUD$50 buys a pretty nice meal
(AUD$1.00 = US$0.75) - yes, I am aware that in some cities that barely
buys you a hamburger. The HDI index should then be applied to make this
proportionally less for transitional and developing countries, and a
full-time student/unemployed discount should be available. Those sort of
amounts seem fair to me - if individuals wish to give more, then they
can make donations. Organisational membership fees should be higher,
perhaps in a series of steps depending on the size of the organisation,
starting at perhaps three times the individual fee.

Tim C


> Christian Heller wrote:
> 
>  >Hi,
>  >
>  >[..]
>  > 
>  >
>  >>look for non-profit foundation support rather than dues.  If the goals
>  >>of OSHCA
>  >>are worthwhile, it shouldn't be hard to find grant support of some kind.
>  >>   
>  >>
>  >
>  >I've thought about this comment of Dave Forslund once more.
>  >
>  >Perhaps he's right and we should permit any private person to become
>  >a member of OSHCA, FOR FREE. Otherwise, there is always a barrier to
>  >enter, even with lowest fees.
>  >Companies, on the other hand, should be obliged to pay a certain amount,
>  >to thereby contribute to financing OSHCA.
>  >
>  >However, perhaps it is too late now to change that in the documents?
>  >We can still talk about it at the inaugural meeting, I guess.
>  >
>  >Christian
>  >
>  >
>  >
>  >Yahoo! Groups Links
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  > 
>  >
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth "
>   on the web.
>    
> *  To unsubscribe from this group, send an email to:
>    [EMAIL PROTECTED]
>   
>    
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>   . 
> 
> 
> 
> 






  
  
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Re: [openhealth] Areas for cooperation and collaboration for OpenHealth

[Tim.Churches]

David Forslund wrote:
> Tim.Churches wrote:
>  > David Forslund wrote:
>  > > OMG HDTF:  PIDS, COAS, RAD, LQS
>  >
>  > In case anyone else is looking for these, this message provides pointers
>  > to them - they are nigh-on impossible to find just be navigating around
>  > the OMG Web site: http://www.omg.org/archives/healthcare/msg01716.html
> Of course they are also all on our site: http://OpenEMed.org
> 
> SOAP and WSDL interfaces didn't exist when these specs were written. :-)
> 
> The specs do have UML models behind them.  It is relatively
> easy to translate the interfaces to WSDL (and can be done automatically
> and even dynamically).  The unfortunate feature of WSDL is that it
> is almost impossible to read by a human and has no good representation
> of objects.   We've implemented HL7's CTS WSDL interface on a server
> that also implements the OMG LQS (in OpenCTS on OpenEMed.org).
> 
> It may not be obvious, but the importance of those interfaces aren't
> that they are in CORBA (really IDL, which is not the same as CORBA).
> It is that they are examples of important abstractions of value to
> healthcare (and other domains)

Sure, no argument there - the abstractions are potentially useful.
However, for a project like, say, CHITS (which is where this thread
started), considerable extra work involving considerable expertise is
required to convert the OMG HDTF specs from IDL form into SOAP/WSDL.
That is yet another reason why these interfaces are hardly ever
implemented.

>  > However, the documents all refer to CORBA interfaces. Are there
>  > equivalent SOAP and WSDL interface definitions? CORBA might be superior
>  > to SOAP and WSDL, but it nevertheless lost the marketing battle. CORBA
>  > interface libraries for popular open source languages are also far less
>  > well supported and maintained than SOAP libraries eg SOAP libraries for
>  > PHP, Python, Ruby, Java etc are all available as standard, installable
>  > packages for the popular Linux distributions. Not so with CORBA
>  > libraries. That is a big consideration when it comes to deployment and
>  > support of systems.
> Mature robust CORBA libraries are delivered with every version of Java.
> I can't speak for PHP, etc.   C++ CORBA libraries are also delivered on
> every Linux platform, to my knowledge. (Orbit?)
>  >
>  > And then there is the patent threat which Tim Cook points out. It is
>  > pretty blatant: the OMG specification document says that readers are
>  > granted perpetual, royalty-free copyright licenses to implement the
>  > specifications described in software, but the very next paragraph warns
>  > that the companies contributing to the specifications might sue your
>  > socks off for breach of unspecified patents if you do implement the
>  > specifications. If I asked our legals about this, I am sure they would
>  > say that there is no way we should implement such specs due to the legal
>  > risk involved, evinced by the thinly veiled threat in the preface to
>  > each of the documents.
> Have you spoken to the OMG folks about this issue?  I still think this
> is the usual legaleze that seems to be ubiquitous in products and services
> these days. The OMG doesn't want to be responsible for things that it has
> no control over.   I think this is a empty excuse for not using these
> specifications

If the companies involved in formulating the OMG HDTF specs had no
intention of suing anyone for patent infringement over ideas in the
specs, then frankly they should have said so in the pre-able to the
specs, instead of inserting this kind of legal threat, standard though
it may be (although I am not so sure - for example, the Open Geospatial
Consortium specs contain no such threat of patent infringement - see
http://www.opengeospatial.org/specs/?page=specs ). It is not an empty
excuse for not implementing the specs. The presence of that warning
means that anyone implementing the specs could find themselves landed,
with no warning and completely out of the blue, with a patent
infringement law suit which may cost tens of thousands to defend, and
maybe tens of thousands of dollars just to evaluate - and you may still
lose the suit, in which case you need to pay royalties, damages and
their legal costs. That is the stuff of ruination for small companies
and small project groups. Why on earth would anyone risk it? Better to
peruse the specs, gleen some general ideas, and the start afresh
creating a new set of unencumbered interface specs (perhaps using
XML-RPC). That's the sad reality of the software/algorithm/business
process patenting regime in the countries which are silly enough to
allow it (eg US, Japan, India, Australia).

> even as some kind of examp

Re: [openhealth] Areas for cooperation and collaboration for OpenHealth

[Tim.Churches]

David Forslund wrote:
> OMG HDTF:  PIDS, COAS, RAD, LQS

In case anyone else is looking for these, this message provides pointers
to them - they are nigh-on impossible to find just be navigating around
the OMG Web site: http://www.omg.org/archives/healthcare/msg01716.html

However, the documents all refer to CORBA interfaces. Are there
equivalent SOAP and WSDL interface definitions? CORBA might be superior
to SOAP and WSDL, but it nevertheless lost the marketing battle. CORBA
interface libraries for popular open source languages are also far less
well supported and maintained than SOAP libraries eg SOAP libraries for
PHP, Python, Ruby, Java etc are all available as standard, installable
packages for the popular Linux distributions. Not so with CORBA
libraries. That is a big consideration when it comes to deployment and
support of systems.

And then there is the patent threat which Tim Cook points out. It is
pretty blatant: the OMG specification document says that readers are
granted perpetual, royalty-free copyright licenses to implement the
specifications described in software, but the very next paragraph warns
that the companies contributing to the specifications might sue your
socks off for breach of unspecified patents if you do implement the
specifications. If I asked our legals about this, I am sure they would
say that there is no way we should implement such specs due to the legal
risk involved, evinced by the thinly veiled threat in the preface to
each of the documents.

Back to square one.

Tim C

> Tim.Churches wrote:
>  > David Forslund wrote:
>  > > What we have done shouldn't be the issue at all.  What is important is
>  > > that there has been standards
>  > > in this area for some time (98-00).  I've heard people complain that
>  > > they were too complex, but I've not heard
>  > > people complain that they are incomplete (although I believe they are).
>  > > I claim the specs aren't
>  > > too complex for the task that is required of them.  Almost all the
>  > > things in the spec (particularly
>  > > taking into account differing conformance criteria) have to be done
>  > anyway.
>  >
>  > Which specs are you referring to, Dave?
>  >
>  > Tim C
>  >
> 
> 
> 
> 
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Re: [openhealth] Areas for cooperation and collaboration for OpenHealth

[Tim.Churches]

David Forslund wrote:
> What we have done shouldn't be the issue at all.  What is important is
> that there has been standards
> in this area for some time (98-00).  I've heard people complain that
> they were too complex, but I've not heard
> people complain that they are incomplete (although I believe they are). 
> I claim the specs aren't
> too complex for the task that is required of them.  Almost all the
> things in the spec (particularly
> taking into account differing conformance criteria) have to be done anyway.

Which specs are you referring to, Dave?

Tim C


  




  
  
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Re: [openhealth] Re: Community Health Information Tracking System www.chits.info

[Tim.Churches]

David Forslund wrote:
> Alvin,
> 
> We had exactly this approach with the OMG HDTF (aka corbamed) in the
> late 90's.   There are standards there which do exactly this (long
> before people thought about doing web services).  In addition, this is
> now being revisited with the HSSP joint effort of HL7 and the OMG
> (hssp.wikispaces.org).   Since there are specifications for this type of
> integration, I would hope people would pay attention to at least learn
> from them in later versions of such standards.   The HSSP effort is and
> all are invited to participate.   The only open source system I'm aware
> of that has tried to follow this pattern is the OpenEMed software :-)  
> What is the "glue" that is used in CHITS?
> 
> If all open source systems "glue" stuff together differently, it isn't
> all that much better than proprietary systems although it might be more
> "discoverable".   Our entire philosophy with OpenEMed is to have well
> defined interfaces that define component behavior so that systems can
> interoperate easily.  This was proven to work very well at HIMSS in
> 1998, where a number of commercial products worked out of the box
> without any prior configuration.

Alvin and Herman can give far more informed answers on CHITS, but lack
of information has never stopped me from venturing an opinion...

Looking at the documentation for CHITS, it seems that the "glue" in
CHITS is a set of specifications for writing plug-in modules in PHP.
Although that gets one only so far, I think it is a very appropriate
place to start given the immediate goals of CHITS - it is intended for
deployment in community health clinics in developing countries. Note the
list of pre-requisites for a CHITS installation in a clinic:

"...a telephone connection is desirable but optional..."

(that's a telephone for voice communications, not computer communications).

That doesn't mean that attention should not be paid to interoperability,
but worrying about which standard to use for a network-based
service-oriented architecture (SOA) comes a fair way down the list when
writing software intended for such settings.

Of more relevance is interoperability between applications on the same
server (which is likely to be the only server in the clinic, without any
persistent network connections to any other server anywhere else - at
best an intermittent dial-up connection). Thus starting with a plug-in
framework for the software implementation language, as the CHITS people
have done,  seems a reasonable place to start. Interoperability with
other software on the same server can then be achieved in a myriad of
ways, such as passing around data extracts in CSV files, or directly
reading data from the MySQL database which CHITS uses. Sure, proper APIs
and other callable interfaces are desirable, and XML-RPC can be used for
this, but the reality is that the interfaces are likely to be ad hoc and
app-to-app within the confines of a single server. Not perfect or ideal,
but surprisingly effective and easy to do. The effort of quickly
creating an app-to-app ad hoc interface using XML-RPC within the
confines of a single server is often a lot less than trying to read and
comply with far more complex interface specifications and standards.

None of that is to say that interoperability standards are not
important, but when you only have a single server working in isolation
in a single clinic, or at best having a dial-up modem link to the
Internet now-and-then (eg when it is not raining, when moisture causes
so much noise in the lines due to "battery" effetcts in the telephone
terminal connections that a modem connections are impossible...), then
it is highly localised interoperability that really counts.

Tim C

> alvinbmarcelo wrote:
>  > Thanks Nandalal.
>  >
>  > I was wondering: whatever happened to the old discussions about making
>  > interchangeable health software objects (rather than large bulky
>  > applications). That was at a time when XML was just revving up and web
>  > services was in its infancy. Tom Beale had a lot to share about GEHR,
>  > artifacts and the like. I thought that was interesting. To some
>  > extent, we implemented the same concept in CHITS but we would hardly
>  > call it standard. (It takes a global community to create a standard?)
>  >
>  > Does OSHCA have a framework of some sort for this kind of health
>  > software object interchange? That's where gap is most felt in the
>  > industry and where openness would be of most value.
>  >
>  > I admire MirrorMed's 'gluing' stuff together. That was the kind of
>  > cooperation I had expected from OSHCA 'products' before. And that's
>  > where FOSS is strong and gains an edge over proprietary products.
>  >
>  >
>  > --- In openhealth@yahoogroups.com, Nandalal Gunaratne <[EMAIL PROTECTED]>
>  > wrote:
>  > >
>  > >
>  > >
>  > > alvinbmarcelo <[EMAIL PROTECTED]> wrote:
>  > >
>  > >  This looks like a very good system. Congratulations!
>  > >
>  > >  I will try this

Re: [openhealth] MirrorMed Highlights FOSS in Action

[Tim.Churches]

Tim.Churches wrote:
> Nandalal Gunaratne wrote:
>  >
>  > "Tim.Churches" <[EMAIL PROTECTED]> wrote:
>  >
>  > Tim,
>  >
>  > All the following work with Firefox - in that i am taken to the correct 
> URL!
>  > What were you trying to point out here?
> 
> I was pointing out that all of the following work in Firefox, and that
> you are taken to the correct Web sites. None of the following are, in
> fact, valid URLs eg "mirrormed" is NOT a domain name. Thus it is
> unexpected behaviour, but explicable because Firefox just sends invalid
> URLs to Google and redirects to the the top link which  Google returns.
> 
> Thus, these also work as pseudo-URLs in Firefox:
> 
> mirrormed
> 
> gnumed
> 
> oshca
> 
> nandalal
> 
> and so on.

Since it is Easter, you should also try typing about:mozilla as a URL in
Firefox (or Mozilla).

Tim C

>  > That leads to a whole genre of single word, non-deterministic URLS in
>  > Firefox. Try these (in Firefox, results will be disappointing elsewhere):
>  >
>  > http://mirrormed
>  >
>  > http://gnumed
>  >
>  > http://oshca
>  >
>  > http://linuxmednews
>  >
>  > http://netepi
>  >
>  > Tim C
> 
> 
> 
> SPONSORED LINKS
> Software distribution 
> <http://groups.yahoo.com/gads?t=ms&k=Software+distribution&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=XcuzZXUhhqAa4nls1QYuCg>
>  
>   Salon software 
> <http://groups.yahoo.com/gads?t=ms&k=Salon+software&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=CW98GQRF3_rWnTxU62jsdA>
>  
>   Medical software 
> <http://groups.yahoo.com/gads?t=ms&k=Medical+software&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=86bMQqtlpuDBvFzrRcQApw>
>  
> 
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> <http://groups.yahoo.com/gads?t=ms&k=Software+association&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=YhKUbszKHqjPXh21AbTSwg>
>  
>   Software jewelry 
> <http://groups.yahoo.com/gads?t=ms&k=Software+jewelry&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=9EWe0V3gtVyQaCqOgchvlw>
>  
>   Software deployment 
> <http://groups.yahoo.com/gads?t=ms&k=Software+deployment&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=VNvgzp250z70B2EFV3JYqg>
>  
> 
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
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> <http://groups.yahoo.com/group/openhealth>"
>   on the web.
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Re: [openhealth] MirrorMed Highlights FOSS in Action

[Tim.Churches]

Nandalal Gunaratne wrote:
> 
> "Tim.Churches" <[EMAIL PROTECTED]> wrote:
> 
> Tim,
> 
> All the following work with Firefox - in that i am taken to the correct URL! 
> What were you trying to point out here?

I was pointing out that all of the following work in Firefox, and that
you are taken to the correct Web sites. None of the following are, in
fact, valid URLs eg "mirrormed" is NOT a domain name. Thus it is
unexpected behaviour, but explicable because Firefox just sends invalid
URLs to Google and redirects to the the top link which  Google returns.

Thus, these also work as pseudo-URLs in Firefox:

mirrormed

gnumed

oshca

nandalal

and so on.

Tim C

> That leads to a whole genre of single word, non-deterministic URLS in
> Firefox. Try these (in Firefox, results will be disappointing elsewhere):
> 
> http://mirrormed
> 
> http://gnumed
> 
> http://oshca
> 
> http://linuxmednews
> 
> http://netepi
> 
> Tim C



 
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Re: [openhealth] MirrorMed Highlights FOSS in Action

[Tim.Churches]

James Busser wrote:
> A solution I came across:
>   http://www.mathcs.emory.edu/~jpheale/help_spam_google.html

Cool! One doesn't even need to prepend http:// to the term to the looked
up. Just type oshca into Firefox as a URL and you'll end up at the OSHCA
web site (unless Google finds a more popular use of the acronym OSHCA
somewhere).

Tim C

> On Apr 16, 2006, at 2:50 AM, Tim.Churches wrote:
> 
>  > Tim.Churches wrote:
>  >> Nandalal Gunaratne wrote:
>  >>> It is indeed most encouraging to see such developments. When I 
>  >>> clicked the
>  >>> "screenshots" i was taken to the Microsoft web site!!!
>  >>> Your link should be
>  >>> http://www.mirrormed.org/fb/
>  >>> Not
>  >>> http://http//www.mirrormed.org/fb/
>  >>
>  >> This seems to be a peculiarity of Firefox. Other browsers (correctly)
>  >> report an error with the above URL, whereas Firefox does indeed 
>  >> take you
>  >> to the Microsoft Web site. Why, I wonder?
>  >
>  > Here is the explanation: http://www.oreillynet.com/cs/user/view/
>  > cs_msg/43360
>  >
>  > That leads to a whole genre of single word, non-deterministic URLS in
>  > Firefox. Try these (in Firefox, results will be disappointing 
>  > elsewhere):
>  >
>  > http://mirrormed
>  >
>  > http://gnumed
>  >
>  > http://oshca
>  >
>  > http://linuxmednews
>  >
>  > http://netepi
>  >
>  > Tim C


 
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Re: [openhealth] MirrorMed Highlights FOSS in Action

[Tim.Churches]

Tim.Churches wrote:
> Nandalal Gunaratne wrote:
>  > It is indeed most encouraging to see such developments. When I clicked the
>  > "screenshots" i was taken to the Microsoft web site!!!
>  > Your link should be
>  > http://www.mirrormed.org/fb/
>  > Not
>  > http://http//www.mirrormed.org/fb/
> 
> This seems to be a peculiarity of Firefox. Other browsers (correctly)
> report an error with the above URL, whereas Firefox does indeed take you
> to the Microsoft Web site. Why, I wonder?

Here is the explanation: http://www.oreillynet.com/cs/user/view/cs_msg/43360

That leads to a whole genre of single word, non-deterministic URLS in
Firefox. Try these (in Firefox, results will be disappointing elsewhere):

http://mirrormed

http://gnumed

http://oshca

http://linuxmednews

http://netepi

Tim C


 
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Re: [openhealth] MirrorMed Highlights FOSS in Action

[Tim.Churches]

Nandalal Gunaratne wrote:
> It is indeed most encouraging to see such developments. When I clicked the 
> "screenshots" i was taken to the Microsoft web site!!!
> Your link should be
> http://www.mirrormed.org/fb/
> Not
> http://http//www.mirrormed.org/fb/

This seems to be a peculiarity of Firefox. Other browsers (correctly)
report an error with the above URL, whereas Firefox does indeed take you
to the Microsoft Web site. Why, I wonder?

Tim C



 
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Re: [openhealth] sumultaneous registrations and registration form

[Tim.Churches]

Richard Schilling wrote:
> I cannot believe that there's no desire for a U.S. component!  You all 
> are taking advantage of U.S. developed open source.  We're creating more 
> open source on this continent than any other country!

Damn it, you're right! Molly, stop wasting your time incorporating OSHCA
in tin-pot dictatorships and get yourself on the first flight to the US
of A and register OSHCA there. That's the least you can do to thank
Americans for their selflessness and self-sacrifice in writing all that
open source code, with no help whatsoever from anyone else, for the
benefit of the ungrateful rest of the world!

> I have enough open source software on my server to build the entire IT 
> infrastructure of a small country - including Biosurveillance!  And if 
> 3rd world countries aren't able to get to it it's probably because 
> groups like this haven't chosen to ally with U.S. based efforts.

If that ain't the truth, Richard! Hell, I'm gonna propose this as the
OSHCA theme song:

Oh, say can you see, by the screen's eerie light,
What so proudly we hailed at the twilight's last demo?
Whose hard disk stripes and bright aster, through the perilous fight,
O'er the RAM parts we watched, were so gallantly streaming media?
And the rockets' red glare, the logic bombs bursting in air,
Gave proof through the night that our compile flag was still there.
O say, does that star-spangled banner yet wave
O'er the land of the free and open source software?

Tim C

> Will Ross wrote:
>> Richard,
>>
>> As a newcomer to this list you have no basis for your observation.
>> I've been participating since 2002, and I am a great admirer of  
>> Molly's efforts.   Far from being undermined, I think Molly's Protem  
>> Committee is rather clearly the only game in town.
>>
>> Please figure out how to be a bit more constructive.   There is a lot  
>> of real work to be done.
>>
>> [wr]
>>
>> - - - - - - - -
>>
>> On Mar 29, 2006, at 2:02 AM, Richard Schilling wrote:
>>
>>
>>> The protem committee taking four years to get this far is a pretty  
>>> clear
>>> indication that they've undermined themselves.
>>>
>>>
>>> Richard
>>>
>>>
>>>
>>> Molly Cheah wrote:
>>>
 Richard,
 I would appreciate it if you allow the protem committee to make the
 decisions on OSHCA since the community has given us the mandate to
 resurrect OSHCA. Otherwise I feel that you're undermining our  
 efforts. I
 don't understand why suddenly you're in such a hurry. Like many  
 others,
 Tim Cook, Bhaskar etc had expressed earlier there can be
 chapters/branches etc formed later.

 The discussions and sentiments expressed here will certainly be taken
 into consideration by the protem committee. I would like to appeal to
 you not to complicate the matter further otherwise your intentions  
 may
 be misconstrued. Please let me complete my job and my  
 responsibility to
 the community.

 I did not think that my intention to update the community with
 information would lead to a kind of upstaging the protem committee's
 efforts. If you proceed to register OSHCA it will be tantamount to
 acting in bad faith, as I had been negotiating with Brian on  
 behalf of
 the community.

 Molly
 Richard Schilling wrote:



> Since OSCHA is an internationl body we can register  
> siultaneously, and
> choose the base to be anywhere.
>
> Is the incorporation in Malaysia going to be doing business or just
> representing FOSS industry interests?  Depending on the answer to  
> that
> here are our choices here in the U.S. that I can pursue now:
>
> Trade association — Definition.
>
>   trade associations don't "do business" but exist to exert
>   influence on a market.  This seems to me the best fit for OSCHA
>   if the organization does not intend to own things like
>   copyrighted software.  Gets around the  international
>   intellectual property issues on software for OSCHA
>   as well.
>
>   "Trade association," as that term is used here
>   means a membership organization of persons engaging in a similar
>   or related line of commerce, organized to promote and improve
>   business conditions in that line of commerce and not to engage
>   in a regular business of a kind ordinarily carried on for profit
>   and for which no part of net earnings inures to the benefit of
>   any member.
>
>
> Non-Profit Corporation - Definition.
>
>   Non-Profit Corporations conduct business (e.g. provide products
>   and services) and can also have an influencing effect.
>
>   A nonprofit corporation is an organization formed as a
>   corporation for purposes other than generating a profit, and in
>   which no part of the organization's income is distributed to its
>   directors or officers. Nonprofits are formed pursuant to

Re: [openhealth] Digest Number 176

[Tim.Churches]

Irving Buchbinder wrote:
> A thought about storage for Minoru or upcomming back storage needs:
> 
> I can't speak for each project, however, the FreeMED Software Foundation
> would be willing to MIRROR such archives, indeed host that sort of activity.
> I'm sure we can find groups/Open Source works who will also be willing to
> put forward some server/disk time to keep the list operational.

Horst herb has also indicated his willingness to host mail archives on
his servers. Adhering to the LOCKSS (lots of copies keeps stuff safe)
principle, I see no objection to there being online multiple archives.
Although there is a lot of embarrassing disputation in the openhealth
archives, there is also a great deal of high quality and interesting
discussion of both technical and sociopolitical matters.

The key matter is to sanitise the email addresses so as to render the
archives less of a magnet for spam address harvesters. It's too later
for such concerns with respect to my email addresses - I get an
avalanche of spam, and rely on spam filters (which work well enough that
I hardly bothered by it). However, I can appreciate why others might not
want their email addresses easily harvestable in the archive.

Transforming email addresses is rather easy - a simple regular
expression with find them. The question is, should they be removed
entirely or just changed to something like "tim [dot] churches {at}
gmail [dot] com"? If they are removed entirely, many messages will then
be rendered effectively anonymous in the archive, because not everyone's
email client supplies a name when sending mail.

The popular MHonArc mail archiving programme has options for email
address obfuscation built-in, I think - http://www.mhonarc.org/

> Although I monitor the lists regularly, I'm not a big contributor. I've many
> times thanked Brian for his efforts when FreeMED was still a fledgling
> project, helping us to get our wings.

Yes. Brian, what is involved in packaging up the openhealth mail
archives and sending them to a one or more alternative archive hosts?
Can a compressed tarball be made easily?

> Please let us/me know what we can do to make this happen. I've never been a
> fan of Yahoo mailing because of its twitchy policies regarding back storage
> and such. Its not at ALL open source nor does its corporate nature seem
> disposed in that way.

Yes, if the current list is to remain on Yahoo, there is a good case for
setting up an independent searchable archive of it. Am I correct in
thinking that you need to actually sign in to Yahoo to be able to search
and browse the archives of the *current* openhealth mailing list? If so,
that is, I think, unfortunate and some form of openly accessible mirror
archive needs to be established.

Tim C



 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

David Forslund wrote:
> Tim.Churches wrote:
>  > David Forslund wrote:
>  > > Molly,
>  > >
>  > > Incorporating OSHCA in the US doesn't necessarily imply US domination.
>  >
>  > No, but US citizens need to be sensitive to the negative feelings
>  > towards the US which are present and growing in many countries around
>  > the world. Whether this antipathy towards the US is justified depends a
>  > great deal on one's standpoint - and I don't think we should debate it
>  > here - but it definitely exists and is remarkably pervasive - in some
>  > countries it is the dominant attitude, in others, it is present in a
>  > sizeable minority of the population.
> This certainly is too bad as the characterization of things in the US by
> the press outside the US is certainly not very factual or unbiased.

This is a bit off-topic, but anyway... I don't think attitudes to the US
are informed primarily by press reports of the internal situation in the
US. I think that attitudes to the US are informed more by reports or
direct experience of the actions and policies of the US govt and of US
businesses outside the US.

>  > Given these attitudes to the US, incorporation of an international
>  > organisation in the US may be perceived negatively by some would-be
>  > participants in OSHCA, and certainly by many potential funding or
>  > collaborating bodies, such as the WSIS. Thus it *is* a practical
>  > consideration.
> What about unwarranted bias against the US that some organizations might
> have?

Whether the biases are warranted or unwarranted depends a great deal on
one's point of view - but either way, it is not OSHCA's role to fight
against anti-US sentiment. It does need to be mindful of it when dealing
with other agencies and individuals, but should certainly not pander or
play up to it. OSHCA needs to be seen to be non-aligned. Incorporation
in Malaysia is a good basis for such a stance, I feel.

>  > > I did not hear an
>  > > answer to my question about the possible necessity of incorporating
>  > > OSHCA in multiple countries.
>  >
>  > Yes, that may be necessary, but OSHCA should cross that bridge if and
>  > when it comes to it. There is no need for immediate, simultaneous
>  > incorporation in many countries in the first instance. If the need for
>  > incorporation elsewhere becomes apparent, then the necessary steps can
>  > be taken. But let OSHCA walk before forcing it to run a cross-country
>  > race.
> It wasn't clear why it needs to be incorporated anywhere.  I thought
> Molly talked about "registration".

Incorporation is needed in order to handle funds in an accountable
manner from just about any source.

>  > > I didn't understand Tim C.'s comment about there not being freedom of
>  > > political expression in Malaysia.
>  >
>  > I was alluding to the case of Anwar Ibrahim - see
>  > http://en.wikipedia.org/wiki/Anwar_Ibrahim - amongst others. But that
>  > was a while ago now, and Mahathir has retired. This happens in many
>  > democracies from time to time - see for example
>  > http://en.wikipedia.org/wiki/Mccarthyism
>  >
>  > > How does that fit with a form of democracy?  I just read this week in a
>  > > Australian paper about a government
>  > > official threatening to jail non-Muslims if they were "perceived" as
>  > > insulting Islam.  These types of things concern
>  > > me if an international body is to be organized in such a country.
>  > > Perhaps this information is totally erroneous?
>  >
>  > Such things are often misreported. However, OSHCA is unlikely to ever
>  > make insulting comments about Islam or any other religion for that
>  > matter. In fact, the only religious topics which might be discussed are
>  > emacs vs vi or Java vs Python or Ruby. Thus I can't see why such things
>  > are of concern with respect to where OSHCA is incorporated. Note that
>  > incorporation of OSHCA in Malaysia or anywhere else has no impact on
>  > your freedom of speech as an individual, even if you are also a member
>  > of OSHCA.
>  >
>  > Tim C
>  >
>  >
> It isn't that OSHCA would deliberately do such things, but when the
> interpretation is by a government official
> and an action is perceived to be offensive, it could run into trouble
> and have no recourse.

I think that the likelihood that OSHCA will offend anyone's religious
sensibilities is vanishingly small, provided that it sticks to its
business of promoting and advocating for free, open source software in
health. OK, it would not be a good idea for 

Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

Thomas Beale wrote:
> Tim.Churches wrote:
>  > David Forslund wrote:
>  > > Molly,
>  > >
>  > > Incorporating OSHCA in the US doesn't necessarily imply US domination.
>  >
>  > No, but US citizens need to be sensitive to the negative feelings
>  > towards the US which are present and growing in many countries around
>  > the world. Whether this antipathy towards the US is justified depends a
>  > great deal on one's standpoint - and I don't think we should debate it
>  > here - but it definitely exists and is remarkably pervasive - in some
>  > countries it is the dominant attitude, in others, it is present in a
>  > sizeable minority of the population.
> Come on everyone, we need action not endless debate... There are some
> relatively simple things to be done, someone who currently has the
> energy and wherewithall to do it (Molly); we should be looking at the
> "least pain" route to getting the organisation going (which as far as I
> can tell is: set it up in Malaysia, in the first instance). We can't
> base that thinking on the complexities of geopolitics (and I am the
> first to agree that the world situation is a concern of the first order)...

Thomas, I think that it important to discuss this issue (where OSHCA is
to be incorporated in the first instance), up to a point. I don't think
that the debate that has occurred has delayed Molly's work on
incorporation - it is, to use a much abused term, orthogonal to that.

Also, OSHCA will, as an advocacy group with international scope, need to
interact with many different organisations, and here geo[socio]political
considerations do play a part. Far from merely being a convenient and
relatively cheap location to do business, incorporation of OSHCA in
Malaysia sends strong, positive signals to a wide range of people and
organisations in a way that incorporation in the US, Australia, Canada,
or the EU would not. The fact is that there is genuine concern in many
countries about US (and to a lesser but real extent, EU) cultural,
economic and technological (and, um, military) hegemony, influence or
encroachment. Thus there are strong benefits in OSHCA, as an
international organisation, having its incorporated base in Malaysia,
which: a) is a developing/transitional country: b) has a long history of
and reputation for non-alignment; c) has a reputation for promoting and
fostering the use and development of technology, especially information
technology, as a means of accelerating appropriate economic and social
development; d) is a secular, religiously-tolerant and -moderate state
which has an association with the Islamic faith. Some or all of these
these attributes are likely to matter to the people with whom OSHCA
wishes to engage (or ought to wish to engage) in developing and
transitional countries. Wayne is absolutely correct: the main game for
free open source health software is in the poorer majority of the world.
In rich, developed countries, open source software in health is
important, but realistically it is not going to become the dominant
source of deployed health information systems in those countries in the
next decade or two. But that is not the case in developing and
transitional countries, where FLOSS has the real potential to become a
or the major provider of health informatics infrastructure and systems.

So, Malaysia does matter, but yes, let's let Molly get on with it.

> However, OSHCA has a much more focussed agenda, a reasonably clear
> mission, and we need to be thinking about what comes after the
> organisation is running (hopefully a matter of weeks, not years!), not
> obsessing about where it should be incorporated, or the relative evils
> of Malaysian injustices v US injustices.

I think the point that I was attempting to make is that no country is
beyond criticism in some important respect, and thus there is no
"perfect" home base for OSHCA.

> The latter may be relevant to
> how we live our lives, but I really doubt that it has any practical
> impact on just getting the horse called "OSCHA" out the gate.

I disagree - as expounded above, I feel that place of incorporation will
have a bearing on teh success of OSHCA as an international adovocy body
for FLOSS in health.

> Our main
> strengths are the individuals here, not the countries they come from.

Sure, but external perceptions of OSHCA will not primarily based on the
personal characteristics of its members or Board. Perceptions will be
based on published documents and statements of principal, on the
countries of origin of its Board/steering committee and its members
(hence the desire to have one Board member of steering committee member
from each continent/region), and on the location of its home base.

> Many of us here have worked in some kind of advocate or champion mode i

Re: [openhealth] sumultaneous registrations and registration form

[Tim.Churches]

Richard Schilling wrote:
> The protem committee taking four years to get this far is a pretty clear 
> indication that they've undermined themselves.

No, Richard. There have been two, quite distinct pro tempore OSHCA
committees. The first one, of which I was a member, was working towards
incorporation of OSHCA in Canada, then Australia, then Canada again,
over the course of about 18 months or two years. Various people, whom I
shall not name, started to complain (probably with some justification)
about the slow progress (for part of which I was responsible), and
others began to see conspiracies and dictatorial tendencies in the way
OSHCA was being organised. Suffice to say that the barrage of criticism
resulted in a large proportion of the first pro temporore organising
committee resigning. Nothing then happened for at least a year, perhaps
18 months - there was no further discussion of OSHCA or its
incorporation. Then Molly, to her immense credit, decided to start
afresh - and that was only a month or two ago. So things are moving
pretty quickly for a disparate, international group of people in
different time zones and communicating only by email.

Tim C

> Molly Cheah wrote:
>> Richard,
>> I would appreciate it if you allow the protem committee to make the 
>> decisions on OSHCA since the community has given us the mandate to 
>> resurrect OSHCA. Otherwise I feel that you're undermining our efforts. I 
>> don't understand why suddenly you're in such a hurry. Like many others, 
>> Tim Cook, Bhaskar etc had expressed earlier there can be 
>> chapters/branches etc formed later.
>>
>> The discussions and sentiments expressed here will certainly be taken 
>> into consideration by the protem committee. I would like to appeal to 
>> you not to complicate the matter further otherwise your intentions may 
>> be misconstrued. Please let me complete my job and my responsibility to 
>> the community.
>>
>> I did not think that my intention to update the community with 
>> information would lead to a kind of upstaging the protem committee's 
>> efforts. If you proceed to register OSHCA it will be tantamount to 
>> acting in bad faith, as I had been negotiating with Brian on behalf of 
>> the community.
>>
>> Molly
>> Richard Schilling wrote:
>>
>>
>>> Since OSCHA is an internationl body we can register siultaneously, and 
>>> choose the base to be anywhere.
>>>
>>> Is the incorporation in Malaysia going to be doing business or just 
>>> representing FOSS industry interests?  Depending on the answer to that 
>>> here are our choices here in the U.S. that I can pursue now:
>>>
>>> Trade association — Definition.
>>>
>>> trade associations don't "do business" but exist to exert
>>> influence on a market.  This seems to me the best fit for OSCHA
>>> if the organization does not intend to own things like
>>> copyrighted software.  Gets around the  international
>>> intellectual property issues on software for OSCHA
>>> as well.
>>>
>>> "Trade association," as that term is used here
>>> means a membership organization of persons engaging in a similar
>>> or related line of commerce, organized to promote and improve
>>> business conditions in that line of commerce and not to engage
>>> in a regular business of a kind ordinarily carried on for profit
>>> and for which no part of net earnings inures to the benefit of
>>> any member.
>>>
>>>
>>> Non-Profit Corporation - Definition.
>>>
>>> Non-Profit Corporations conduct business (e.g. provide products
>>> and services) and can also have an influencing effect.
>>>
>>> A nonprofit corporation is an organization formed as a
>>> corporation for purposes other than generating a profit, and in
>>> which no part of the organization's income is distributed to its
>>> directors or officers. Nonprofits are formed pursuant to state
>>> law, often under the Revised Model Non-Profit Corporation Act
>>> (1986). A nonprofit can be a church or church association,
>>> school, charity, medical provider, legal aid society, volunteer
>>> service organization, professional association, research
>>> institute, museum, or in some cases a sports association. Being
>>> formed with the state as a nonprofit corporation does not
>>> automatically provide an organization with tax-exempt status.
>>> Nonprofits must apply for tax-exempt status at the federal and
>>> sometimes at the state level.
>>>
>>>
>>>
>>>
>>>
>>> Yahoo! Groups Links
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>
>>
>>
>>  
>> Yahoo! Groups Links
>>
>>
>>
>>  
>>
>>
>>
> 
> 
> 
>  
> Yahoo! Groups Links
> 
> 
> 
>  
> 
> 
> 



 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

David Forslund wrote:
> Molly,
> 
> Incorporating OSHCA in the US doesn't necessarily imply US domination.  

No, but US citizens need to be sensitive to the negative feelings
towards the US which are present and growing in many countries around
the world. Whether this antipathy towards the US is justified depends a
great deal on one's standpoint - and I don't think we should debate it
here - but it definitely exists and is remarkably pervasive - in some
countries it is the dominant attitude, in others, it is present in a
sizeable minority of the population.

Given these attitudes to the US, incorporation of an international
organisation in the US may be perceived negatively by some would-be
participants in OSHCA, and certainly by many potential funding or
collaborating bodies, such as the WSIS. Thus it *is* a practical
consideration.

> I did not hear an
> answer to my question about the possible necessity of incorporating
> OSHCA in multiple countries.

Yes, that may be necessary, but OSHCA should cross that bridge if and
when it comes to it. There is no need for immediate, simultaneous
incorporation in many countries in the first instance. If the need for
incorporation elsewhere becomes apparent, then the necessary steps can
be taken. But let OSHCA walk before forcing it to run a cross-country race.

> I didn't understand Tim C.'s comment about there not being freedom of
> political expression in Malaysia.

I was alluding to the case of Anwar Ibrahim - see
http://en.wikipedia.org/wiki/Anwar_Ibrahim - amongst others. But that
was a while ago now, and Mahathir has retired. This happens in many
democracies from time to time - see for example
http://en.wikipedia.org/wiki/Mccarthyism

> How does that fit with a form of democracy?  I just read this week in a
> Australian paper about a government
> official threatening to jail non-Muslims if they were "perceived" as
> insulting Islam.  These types of things concern
> me if an international body is to be organized in such a country. 
> Perhaps this information is totally erroneous?

Such things are often misreported. However, OSHCA is unlikely to ever
make insulting comments about Islam or any other religion for that
matter. In fact, the only religious topics which might be discussed are
emacs vs vi or Java vs Python or Ruby. Thus I can't see why such things
are of concern with respect to where OSHCA is incorporated. Note that
incorporation of OSHCA in Malaysia or anywhere else has no impact on
your freedom of speech as an individual, even if you are also a member
of OSHCA.

Tim C



 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

Dr Molly Cheah wrote:
>  >Is OSCHA a religious organization or an independent world-wide
>  >technological organization accessible to everyone regardless of
>  >religious conviction?  (Tim, you're not making any sense with your "star
>  >and crescent" comment).
>  > 
>  >
> I think Tim was just being cheeky :).

Yes, just stirring the pot... sorry, it is my nature to do so.

>  >And, what I'm suggesting is that you start with a U.S. incorporation.
>  >Then incorporate elsewhere.  What is below is point/counter-point.  And,
>  >it's not talking about suitability based on religion, "the people" or
>  >any other facet other than legal.
>  >
> But why start of with a US incorporation? Past discussions clearly
> indicate that the membership "do not" want a US dominated OSHCA.
> 
>  >So, let me boil this down to simple terms:
>  >
>  >1. Legal protections: U.S. incorporation means that as a U.S. company,
>  >OSHCA has the same rights as an individual.  Intellectual property
>  >rights and agreements are upheld.  In other countries, especially ones
>  >with new regimes, this might not be the case.  U.S. subsidiaries running
>  >in non-U.S. countries would work just fine and be stabilized by the U.S.
>  >based parent.
>  > 
>  >
> I don't agree that US incorporation offers more legal protection than
> Malaysia which are also signatories to International Conventions and
> legal frameworks and taking them seriously. Under the law OSHCA will be
> a legal entity with rights to all provisions under the relevent acts.
> Incidently Malaysia is not a new regime and we got our independence from
> the British in 1957. Before that we were colonized by the Portugese,
> then the Dutch and then the British.
> Stabilized by US based parent? How so?
> 
>  >2. Repatriation of capital: As OSCHA earns fees, receives donations,
>  >pays taxes, etc... it's much more straightforward in the U.S. I believe.
>  >  The tax burden on a non-profit like OSHCA would be minimal or
>  >non-existent.
>  > 
>  >
> I plan to apply for tax-exempt status, in addition to the non-profit
> status which will automatically be given. That means that donors to
> OSHCA do not pay taxation on their donations to OSHCA and OSHCA does not
> have to pay tax on the donations received. There is no control on the
> repatriation of monies earned in Malaysia.
> 
>  >3. Political stability: In politically less-stable countries (e.g.
>  >Malaysia, Taiwan, Mexico, South Africa, Haiti, etc..) when regimes
>  >change so does the law - you can find your corporation and all its
>  >assets suddenly owned by someone else.
>  > 
>  >
> I didn't know that Malaysia is politically unstable and I don't know of
> any assets that had been suddenly owned by someone else. But I'm amazed
> by your perceptions of Malaysia. I would be happy to play host and
> invite you to come and see Malaysia.

If anything, the political system in Malaysia might be a little bit too
stable... Um, no.

>  >4. Government funding: incorporating in a country because "it looks like
>  >there's government funding" is a bad idea. You need a much harder offer
>  >than that.  What are the incentive programs, specifically that the other
>  >government offers?  Who, specifically in the government, is offering them?
>  > 
>  >
> I've not mentioned about Govt funding. I did say that it would be easier
> to get funding for OSHCA activities from the likes of organisations like
> UNDP, IDRC, CIDA, SIDA etc. Maybe I failed to "market" or "hard sell"
> Malaysia for our purpose. As for incentive programmes and other Govt
> offers, it is obvious that you are not aware of the Malaysian Govt's
> Policy on Open Source, incentives related to ICT companies and projects.
> There are too many to enumerate here. I did a google search on
> Malaysia's incentives for ICT and they're all there. However, after all
> these efforts I wonder if the members of OSHCA are capable to make a
> difference to push the open source agenda in health care especially in
> the developing world. I must quality that this is my main interest - the
> developing world that needs help.

I think it is fair to say that Molly has comprehensively demolished
Richard's arguments and hopefully dispelled a little of Richard's
ignorance about Malaysia (and the world in general beyond the US).

Richard, feel free to incorporate whatever organisation that you like in
the US, as long as you don't call it OSHCA, because that name and meme
has been well and truly claimed by a long-standing international group
of like-minded people who are now about to embark on a second (and
certain to be successful this time) attempt at incorporation - in
Malaysia in the first instances, through the good offices of Molly, and
elsewhere if and when the need arises. But baby steps first: incorporate
in Malaysia.

Please proceed as planned, Molly.

Tim C

>  >Molly Cheah wrote:
>  > 
>  >
>  >>I was born in Malaysia and lived through the period where we obtained
>  >>independance from t

Re: [openhealth] Openhealth mailing list

[Tim.Churches]

Brian Bray wrote:
> Thanks for the welcome, Bhaskar, and also the warm welcome (in every
> sense of the word) I've received from many others.
> 
> Also, thank you for creating this list. The list software at
> minoru-development.com was and is broken- you took the right step to
> keep this incredible community conversation going.
> 
> I have no intention of fixing the "old list." Having two lists is
> confusing and creates the appearance of division where none exists.
> Accordingly, I'll be closing down the openhealth mailing list on the
> minoru site in about a week.

Are there any archives of the old list which need to be preserved for
posterity? Are they all available elsewhere? If not, I am sure Horst
herb would be happy to host teh archives on his servers.

Tim C


 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

Molly Cheah wrote:
> Though this is out of context here, Malaysia has a secular constitution
> and therefore it is "not" an islamic country, though majority of the
> population are muslims. Unfortunately the media especially in the US
> says we  are an islamic state and most people rely on the media for
> information and believes them. But this (muslim or secular) should not
> be of concern to anyone.

Indeed. But I still think it is refreshing to have OSHCA incorporated in
a country with the crescent and star on its flag, although I would draw
the line at incorporation in a theocracy (of any flavour). But as Molly
points out, Malaysia has a completely secular system of government, and
complete freedom of religious expression (err, won't mention freedom of
political expression here... but even there it is still better than so
many other countries).

Tim C

> David Forslund wrote:
> 
>  >There may be legal protection, etc in Malaysia.  We are more familiar
>  >with the situation in the US.
>  >It is more of a question of comparing what is required and what you can
>  >do with a corporation
>  >in Malaysia than in the US.  The decision shouldn't be made on political
>  >grounds but on technical grounds,
>  >in my opinion.
>  >
>  >Dave
>  >Molly Cheah wrote:
>  > 
>  >
>  >>I was born in Malaysia and lived through the period where we obtained
>  >>independance from the British and from whom our legal framework was
>  >>adopted. Just wondering what are the concerns of Richard and David on
>  >>the legal protection for OSHCA. Can you elaborate rather than make a
>  >>comment that imply there isn't legal protection. Incidently we don't
>  >>have the equivalence of Guantanano Bay in Malaysia.
>  >>Molly
>  >>Joseph Dal Molin wrote:
>  >>
>  >>   
>  >>
>  >>>Legal protection in the context of an organization like OSHCA is IMHO
>  >>>not a major concern. What is more important is how the countries laws
>  >>>influence governance.
>  >>>
>  >>>David Forslund wrote:
>  >>>
>  >>>
>  >>> 
>  >>>
>  I don't understand why this is good or even relevant.  What should
>  matter is the legal protection
>  provided by the incorporation in the various countries participating,
>  which I think was Richard's point.
>  
>  Dave Forslund
>   
>  
>     
>  
>  >>>
>  >>>Yahoo! Groups Links
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>>
>  >>> 
>  >>>
>  >>   
>  >>
>  >
>  >
>  >
>  >
>  >
>  >Yahoo! Groups Links
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  >
>  > 
>  >
> 
> 
> 
> SPONSORED LINKS
> Software distribution 
> 
>  
>   Salon software 
> 
>  
>   Medical software 
> 
>  
> 
> Software association 
> 
>  
>   Software jewelry 
> 
>  
>   Software deployment 
> 
>  
> 
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth 
> "
>   on the web.
>
> *  To unsubscribe from this group, send an email to:
>[EMAIL PROTECTED]
>   
>
> *  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service
>   . 
> 
> 
> 
> 



 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

David Forslund wrote:
> There may be legal protection, etc in Malaysia.

Not may be, there definitely is. As Molly said, Malaysian law was
originally based on British law - it is now distinct from it, but rest
assured that there is rule of civil law in Malaysia. There is also
corruption and political influence over the courts, but I would not like
to have to say whether there is more or less such corruption in Malaysia
than in the US or other countries. However, for a tiny, nascent
organisation like OSHCA, none of this is relevant. Suffice to say that
Malaysian corporate law should be more than adequate for OSHCA's
purposes. That's correct, isn't it Molly?

>  We are more familiar
> with the situation in the US.

Well, yes. I am more familiar with Australian law. But that doesn't mean
that I regard the legal regimes in every other country with suspicion.

> It is more of a question of comparing what is required and what you can
> do with a corporation
> in Malaysia than in the US.  The decision shouldn't be made on political
> grounds but on technical grounds,
> in my opinion.

Given what OSHCA hopes to achieve - things like engaging with
UN-sponsored initiatives such as WSIS and perhaps with national and
international development agencies -  I think that incorporation in
Malaysia (or some other "non-aligned" developing or transitional
country) is a *much* more sound choice, from a political perspective,
than incorporation in the US (or other G8 or other rich nations, but
particularly the US, particularly at the moment).

Tim C

> Molly Cheah wrote:
>  > I was born in Malaysia and lived through the period where we obtained
>  > independance from the British and from whom our legal framework was
>  > adopted. Just wondering what are the concerns of Richard and David on
>  > the legal protection for OSHCA. Can you elaborate rather than make a
>  > comment that imply there isn't legal protection. Incidently we don't
>  > have the equivalence of Guantanano Bay in Malaysia.
>  > Molly
>  > Joseph Dal Molin wrote:
>  >
>  > >Legal protection in the context of an organization like OSHCA is IMHO
>  > >not a major concern. What is more important is how the countries laws
>  > >influence governance.
>  > >
>  > >David Forslund wrote:
>  > >
>  > >
>  > >>I don't understand why this is good or even relevant.  What should
>  > >>matter is the legal protection
>  > >>provided by the incorporation in the various countries participating,
>  > >>which I think was Richard's point.
>  > >>
>  > >>Dave Forslund
>  > >>  
>  > >>
>  > >
>  > >
>  > >
>  > >Yahoo! Groups Links
>  > >
>  > >
>  > >
>  > >
>  > >
>  > >
>  > >
>  > >
>  > >
>  > >
>  >
>  >
> 
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth 
> "
>   on the web.
>
> *  To unsubscribe from this group, send an email to:
>[EMAIL PROTECTED]
>   
>
> *  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service
>   . 
> 
> 
> 
> 



 
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Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

David Forslund wrote:
> I don't understand why this is good or even relevant.  What should
> matter is the legal protection
> provided by the incorporation in the various countries participating,
> which I think was Richard's point.

Joseph and I (and Molly) were thinking of the political dimensions of
the choice of country for incorporation, rather than the engineering
excellence of each country's corporation API.

I remain unconvinced that US corporate law offers any advantages with
respect to an organisation like OSHCA over Malaysian corporate law. If
the discussion were about the incorporation of an Enron, then that's a
different matter...

Tim C

> Dave Forslund
> Tim.Churches wrote:
>  > Richard Schilling wrote:
>  > > If I were involved in the incorporation (which I can do, by the way in a
>  > > day) I would object to doing it in Malaysia.  I would do it in the U.S.
>  > > first.  The protections offered a U.S. corporation might be much greater
>  > > than in Malaysia.
>  >
>  > Glad that you have compared US and Malaysian corporate law. Personally I
>  > think it is great that OSHCA will finally be incorporated, and given the
>  > current Zeitgeist in many rich countries, that it will be incorporated
>  > under a flag bearing the crescent and star.
>  >
>  > Tim C
>  >
>  > > Molly Cheah wrote:
>  > >  > Dear all,
>  > >  >
>  > >  > I am happy to annouce that the transfer of the domain name oshca.org
>  > >  > from Brian had been completed. Brian is in the process of
>  > creating and
>  > >  > signing a document disclaiming rights to the OSHCA trademark.
>  > Thank you
>  > >  > Brian for these initiatives.
>  > >  >
>  > >  > I understand that Brian will also make a decision with regards to the
>  > >  > fate of the openhealth lists on Minoru and Yahoo by this weekend.
>  > I'll
>  > >  > leave that to Brian to make that annoucement.
>  > >  >
>  > >  > As for the status of OSHCA, the protem committee members (volunteers
>  > >  > expressed on the list as well as those agreed to serve when
>  > requested)
>  > >  > are as follows:
>  > >  > Joseph dal Molin (Canada/US)
>  > >  > Adrian Midgley (UK/Europe)
>  > >  > Thomas Beale (Australia/Pacific islands)
>  > >  > Nandalal Gunaratne (Sri Lanka/Asia)
>  > >  > Molly Cheah (Malaysia/Asia)
>  > >  >
>  > >  > I hope to keep the protem committee small for quick decision
>  > making but
>  > >  > hope to add 2 more names, preferably from South America and
>  > >  > Africa/Middle East by the time we submit the incorporation
>  > documents for
>  > >  > registration. Please volunteer. These numbers and representation
>  > >  > structure can change after incorporation if members wish so. I don't
>  > >  > know how much discussion should go into the incorporation process
>  > or how
>  > >  > much time should be alotted. My proposed timeline for completion of
>  > >  > incorporation is 3 months from 15th April 2006 - tentative date for
>  > >  > submission of papers. We should have OSHCA ressurrected by 15th July
>  > >  > 2006, barring unforseen circumstances. Here are my assumptions in
>  > order
>  > >  > to realise this initiative:
>  > >  > 1. Provisions in the constitution/M&A of OSHCA is a living
>  > document and
>  > >  > can be changed by members' majority wishes. For purpose of
>  > >  > incorporation, we will take into consideration past discussions
>  > >  > (2002-2004) and make the provisions as general and flexible as
>  > possible
>  > >  > to meet incorporation requirements.
>  > >  > 2. There is no objection to incorporate ina developing country like
>  > >  > Malaysia. There will be provisions for setting up geographical
>  > >  > sections/branches etc with as much de-centralization as possible.
>  > >  > 3.The Vision, Mission Statements, Principles and Activities as
>  > discussed
>  > >  > earlier this year will be included in the incorporation papers. Any
>  > >  > suggestion of changes posted on the Yahoo list by 15th April will be
>  > >  > taken into consideration by the protem committee for incorporation.
>  > >  > Procedures will be provided for amendments to be made after
>  > incorporation.
>  > >  > 4. Elections for new committee members can take place immedi

Re: [openhealth] Important announcement and oshca update

[Tim.Churches]

Richard Schilling wrote:
 > If I were involved in the incorporation (which I can do, by the way in a
> day) I would object to doing it in Malaysia.  I would do it in the U.S.
> first.  The protections offered a U.S. corporation might be much greater
> than in Malaysia.

Glad that you have compared US and Malaysian corporate law. Personally I
think it is great that OSHCA will finally be incorporated, and given the
current Zeitgeist in many rich countries, that it will be incorporated
under a flag bearing the crescent and star.

Tim C

> Molly Cheah wrote:
>  > Dear all,
>  >
>  > I am happy to annouce that the transfer of the domain name oshca.org
>  > from Brian had been completed. Brian is in the process of creating and
>  > signing a document disclaiming rights to the OSHCA trademark. Thank you
>  > Brian for these initiatives.
>  >
>  > I understand that Brian will also make a decision with regards to the
>  > fate of the openhealth lists on Minoru and Yahoo by this weekend. I'll
>  > leave that to Brian to make that annoucement.
>  >
>  > As for the status of OSHCA, the protem committee members (volunteers
>  > expressed on the list as well as those agreed to serve when requested)
>  > are as follows:
>  > Joseph dal Molin (Canada/US)
>  > Adrian Midgley (UK/Europe)
>  > Thomas Beale (Australia/Pacific islands)
>  > Nandalal Gunaratne (Sri Lanka/Asia)
>  > Molly Cheah (Malaysia/Asia)
>  >
>  > I hope to keep the protem committee small for quick decision making but
>  > hope to add 2 more names, preferably from South America and
>  > Africa/Middle East by the time we submit the incorporation documents for
>  > registration. Please volunteer. These numbers and representation
>  > structure can change after incorporation if members wish so. I don't
>  > know how much discussion should go into the incorporation process or how
>  > much time should be alotted. My proposed timeline for completion of
>  > incorporation is 3 months from 15th April 2006 - tentative date for
>  > submission of papers. We should have OSHCA ressurrected by 15th July
>  > 2006, barring unforseen circumstances. Here are my assumptions in order
>  > to realise this initiative:
>  > 1. Provisions in the constitution/M&A of OSHCA is a living document and
>  > can be changed by members' majority wishes. For purpose of
>  > incorporation, we will take into consideration past discussions
>  > (2002-2004) and make the provisions as general and flexible as possible
>  > to meet incorporation requirements.
>  > 2. There is no objection to incorporate ina developing country like
>  > Malaysia. There will be provisions for setting up geographical
>  > sections/branches etc with as much de-centralization as possible.
>  > 3.The Vision, Mission Statements, Principles and Activities as discussed
>  > earlier this year will be included in the incorporation papers. Any
>  > suggestion of changes posted on the Yahoo list by 15th April will be
>  > taken into consideration by the protem committee for incorporation.
>  > Procedures will be provided for amendments to be made after incorporation.
>  > 4. Elections for new committee members can take place immediately after
>  > incorporation. Provision will be made for the protem committee to stay
>  > on for a defined number of months to attend to "teething" issues that
>  > may arise.
>  > 5. The yahoo list will continue to discuss organising the 1st
>  > post-incorporation OSHCA meeting scheduled for later part of 2006 to
>  > kick-start/launch OSHCA. This may not be in the form of a full
>  > conference. I would like to see presentations of current status of open
>  > source healthcare solutions/applicaions. It should also provide the
>  > opportunity to include indepth discussions on planning for the future of
>  > OSHCA so that its resurrection becomes meaningful - reflecting more than
>  > just a community of open source enthusiasts in health care. If there are
>  > no other bidders, I plan to get funding to do this in Malaysia.
>  > Naturally it may be on a modest scale.
>  >
>  > Please feel free to propose ideas.The protem committee will work on an
>  > action plan and invite volunteers to help.
>  >
>  > Molly
>  >
>  >
>  >
>  >
>  > 
>  > Yahoo! Groups Links
>  >
>  >
>  >
>  > 
>  >
>  >
>  >
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth 
> "
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Re: [openhealth] Re: CCHIT biased towards proprietary software?

[Tim.Churches]

Greg Woodhouse wrote:
> Every software developer writes unit tests, 

In your dreams!

> but the unit test typically
> end up being files on their hard drives at some point. Making unit
> tests into artifacts is a relatively recent phenomenon,

Agreed, but I had recent releases of open source software in mind.

> and even more
> so is the idea of writing test cases before you code (one of the tents
> of XP). If unit tests are included in the distribution, so much the
> better! But I wouldn't overstate the value of these tests. They might
> tell you that the nails were driven in all the way, or that current
> flows to the electric lights, but they're not going to tell you whether
> or not a building is structurally sound.

Hence your reference to "the tents of eXtreme Programming"?

Tim C

> --- "Tim.Churches" <[EMAIL PROTECTED]> wrote:
> 
> 
> -
> Wayne Wilson wrote:
>  > Finally if software is developed with unit test capabilities, it is
>  > quite easy to repeat unit tests upon software modification, so this
> does
>  > not become much of a burden either.
> 
> Indeed. My approach these days when considering open source software
> components for serious use is to look for the unit tests (and for
> functional and integration tests too). If there are no unit tests, it
> indicates that the code was written on a wing-and-a-prayer basis and is
> best avoided.
> 
> Tim C
> 
> 
> ===
> Gregory Woodhouse  <[EMAIL PROTECTED]>
> 
> "It is foolish to answer a question that
> you do not understand."
> --G. Polya ("How to Solve It")
> 
> 
> SPONSORED LINKS
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>   Salon software 
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>   Medical software 
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> 
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>  
>   Software deployment 
> <http://groups.yahoo.com/gads?t=ms&k=Software+deployment&w1=Software+distribution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+jewelry&w6=Software+deployment&c=6&s=142&.sig=VNvgzp250z70B2EFV3JYqg>
>  
> 
> 
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Re: [openhealth] CCHIT biased towards proprietary software??

[Tim.Churches]

Will Ross wrote:
> Fred,
> 
> I oppose the creation of a separate open source certification 
> process.   I think it compromises the opportunity for open source 
> solutions to displace commercial solutions, and it distracts open 
> source projects from leveraging the collaborative process to create 
> seriously superior solutions.

This is a US matter, but as I set out, my position would be to argue for
a reduced-cost certification process of any software which makes all the
necessary documentation, source code, unit tests, functional test
scripts etc needed to satisfy the certification criteria publicly
available for scrutiny by anyone.

But the actual criteria to be met should be the same.

Tim C

> On Mar 27, 2006, at 10:16 AM, Fred Trotter wrote:
> 
>  > This is an interesting discussion. However we do have some 
>  > decisions to
>  > make.
>  >
>  > 1. Does the different nature free and open source medical software 
>  > warrant
>  > different consideration than proprietary models for CCHIT 
>  > certification
>  > pricing. (If a large number of people feel this way then we should 
>  > draft our
>  > own letter.)
>  > Yes/No
>  >
>  > 2. In NOT should the pricing generally be lowered for everyone so 
>  > that small
>  > and open source projects will have the opportunity to get 
>  > certified. (If you
>  > feel this way then you should just sign the emrupdate.com letter)
>  > Yes/No
>  >
>  > Feel free to continue the substance of the discussion by saying why 
>  > or why
>  > not for your answers. In any case if you feel that a letter should be
>  > written or signed... now is the time to do so the review window is 
>  > closing.
>  > --
>  > Fred Trotter
>  > SynSeer, Consultant
>  > http://www.fredtrotter.com
>  > http://www.synseer.com
>  > phone: (480)290-8109
>  > email: [EMAIL PROTECTED]
>  >
>  >
>  > [Non-text portions of this message have been removed]
>  >
>  >
>  >
>  >
>  > Yahoo! Groups Links
>  >
>  >
>  >
>  >
>  >
>  >
>  >
> 
> 
> [wr]
> 
> - - - - - - - -
> 
> will ross
> project manager
> mendocino informatics
> 216 west perkins street, suite 206
> ukiah, california  95482  usa
> 707.272.7255 [voice]
> 707.462.5015 [fax]
> www.minformatics.com
> 
> - - - - - - - -
> 
> "Getting people to adopt common standards is impeded by patents."
>  Sir Tim Berners-Lee
> 
> - - - - - - - -
> 
> 
> 
> 
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Re: [openhealth] Re: CCHIT biased towards proprietary software?

[Tim.Churches]

Wayne Wilson wrote:
> Finally if software is developed with unit test capabilities, it is
> quite easy to repeat unit tests upon software modification, so this does
> not become much of a burden either.

Indeed. My approach these days when considering open source software
components for serious use is to look for the unit tests (and for
functional and integration tests too). If there are no unit tests, it
indicates that the code was written on a wing-and-a-prayer basis and is
best avoided.

Tim C


 
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Re: [openhealth] Re: [Amazon S3

[Tim.Churches]

Wayne Wilson wrote:
>  >   From: "Tim.Churches" <[EMAIL PROTECTED]>
>  >
>  >
>  >Any other ideas for S3?
>  >
> 1) Wait for Google to offer it for free :)
> 
> Seriously, Google already offers 2GB of free web 'mail' space.  Someone
> has already figured out how to make a file system like interface to that.

Yeah, I mentioned that in my post:

TC> I suspect that Google will follow suit, as they, like Amazon,
TC> already have the required infrastructure to host this sort of thing,
TC> and their Gmail service is already being used by many as an
TC> unofficial Internet file store (see, for example,
TC>
http://richard.jones.name/google-hacks/gmail-filesystem/gmail-filesystem.html
TC>

However, such use of GMail is unsanctioned and, if you read it
carefully, in conflict with the spirit of the usage agreement. Thus,
Google could pull the plug on such (ab)use of GMail at any time. The
difference with the Amazon S3 facility is that it is designed from the
outset for bulk data storage and access, and they do not dredge the data
to try to match advertisements against it (encryption prevents that
anyway). In fcat, there is no user interface to S3 - it is just an API
which you build into your application.

Google are rumoured to offer something similar quite soon, working name
"GDrive", but in the absence of a way to obtain revenue from it via
adverts, they will probably charge for it - but Amazon has set the bar
for such charges at a remarkable low level.

> This is the tip of an iceberg in the developed countries that further
> widens the gap between the 'Netties' and network impoverished.
> What if storage on the net is free and unlimited? What if all electronic
> information is indexed on the net?  How would one design distributed
> systems when the storage and retrieval of data became decoupled (and
> replaced with a web service)  from the systems you use to manipulate
> that data?
> 
> What are the issues?
>   Who is in control of the data?  Where are the boundaries of control?
>How can I trust them to do what they say they will do with the data?

You can't, as I pointed out in my post:
TC> I wouldn't trust the Amazon assurances of privacy for the data (as
TC> Amazon are still subject to US search warrants and court orders for
TC> example, as well as simple security blunders - so any patient data
TC> would need to be strongly encrypted before sending it to S3 for
TC> off-site backup storage - but that should be routine practice for
TC> any off-site back-ups [or any other storage] of patient data on
TC> removable or transportable media anyway).

> Just so you don't think these are abstract issues, where I work we just
> promulagated policy that strongly suggested that google desktop be
> uninstalled or otherwise disabled on all organizational owned workstations.

Sure - the issue Wayne is referring to is the ability for the latest
version of Google Desktop to send copies of your local documents to the
Google servers for retrieval from a different computer - but that is
orthogonal to the uses of Amazon S3 which I suggested in my post, which
all involve the archival, back-up or temporary storage of *encrypted*
data - I suppose I should have spelt it out more clearly - things like
Amazon S3 are not useful for storage, even temporary or transient
storage - of confidential data unless it is strongly encrypted. Nor can
their reliability be absolutely relied on - it is likely to be very
good, but they provide no guarantees that they won't lose your data or
that it won't be inaccessible. Thus, I think that they should only be
used for back-ups or transient storage. Until Google brings out a
competing service. Then if you store your data on *both* Amazon S3 *and*
Google Gdrive, the risk of your data disappearing is vanishingly small.
But the data that your store on them still needs to be strongly
encrypted, OK?

Tim C



 
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Re: [openhealth] Of potential interest: Amazon S3

[Tim.Churches]

Tim.Churches wrote:
> Amazon S3 is not strictly open source software but may be of interest to
> open source software developers and end-users.
...
> So what could S3 be used for?
...
> 2) As a store-and-forward facility for the exchange of lab results or
> other health messages (in encrypted form, of course). By using strong
> encryption for the data being stored-and-forwarded, the fact that the
> "secret" access key for an S3 account would need to be shared between
> multiple parties is not an impediment. Billing for the usage of S3 for
> such shared data interchange might be an issue, but I think that the S3
> billing records are in machine-readable format, so some additional
> mechanism for apportioning costs could be built - if the costs warranted
> that.

Actually, Amazon offer another, free service directed at that: the
Amazon Simple Queue Service - see the left-hand panel at
http://aws.amazon.com - however, the Queue Service can only handle
messages up to 4kb, which means it is not much use. Amazon S3, by
contrast, can handle individual files up to 5GB, and as many of them as
you want, which means it could be used for heavy-duty store-and-forward
delivery of messages containing large payloads such as high-quality
digitised radiographs and MRI scans and echocardiography or endoscopy
movies and so on.

Tim C


 
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Re: [openhealth] CCHIT biased towards proprietary software??

[Tim.Churches]

Gregory Woodhouse wrote:
> On Mar 25, 2006, at 5:01 PM, Joseph Dal Molin wrote:
> 
>  > and...at the risk of stating the obvious there should be some
>  > mechanism for evaluating the certification authority and the 
>  > criteria...
>  >
> 
> Sadly, I don't know how many people are even thinking in those terms. 
> What we are discussing here is software quality (meaning fitness for 
> a particular purpose), and it may well be that people with the 
> appropriate expertise are not well represented in this process. 
> Worse, the current standard (in medicine, one might say "standard of 
> care") in this area is heavily biased towards testing and informal 
> (if any) requirements definition. Formal methods, automated proof 
> systems, rigorous specifications, and so forth are all thought of as 
> rather esoteric or "academic" (purposely using what Guy L. Steele 
> perceptively called horror quotes in his thesis!) I know I've written 
> correctness proofs for no reason but to satisfy myself that an 
> algorithm I developed was correct. It's not such a terrible thing. 
> Perhaps medicine is an area where we ought to start thinking about 
> setting aside industry standard practice and thinking in terms of 
> more rigorous methods of validating softwares -- which, after all is 
> used in patient care!

Certainly formal quality assurance mechanisms for health-related
software should be used where possible and reasonable, but it must also
be remembered that the practice of medicine itself is, at worst, guided
by a tradition of what seems to work as recorded in textbooks and handed
down by traditional teaching, and at best by "evidence based practice"
which relies on meta-analyses of observational studies which have all
sorts of design and execution flaws, or on (hopefully double-blind) RCTs
(randomised controlled trials) which typically have very limited
generalisability to wider populations.

Tim C



 
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[openhealth] Of potential interest: Amazon S3

[Tim.Churches]

Amazon S3 is not strictly open source software but may be of interest to
open source software developers and end-users.

Here is the blurb from the S3 Web page at
http://www.amazon.com/gp/browse.html/104-1570532-7764752?node=16427261



Amazon S3 is storage for the Internet. It is designed to make web-scale
computing easier for developers.

Amazon S3 provides a simple web services interface that can be used to
store and retrieve any amount of data, at any time, from anywhere on the
web. It gives any developer access to the same highly scalable,
reliable, fast, inexpensive data storage infrastructure that Amazon uses
to run its own global network of web sites. The service aims to maximize
benefits of scale and to pass those benefits on to developers.

Amazon S3 Functionality
Amazon S3 is intentionally built with a minimal feature set.
* Write, read, and delete objects containing from 1 byte to 5
gigabytes of data each. The number of objects you can store is unlimited.
* Each object is stored and retrieved via a unique,
developer-assigned key.
* Authentication mechanisms are provided to ensure that data is kept
secure from unauthorized access. Objects can be made private or public,
and rights can be granted to specific users.
* Uses standards-based REST and SOAP interfaces designed to work
with any Internet-development toolkit.
* Built to be flexible so that protocol or functional layers can
easily be added.  Default download protocol is HTTP.  A BitTorrent™
protocol interface is provided to lower costs for high-scale
distribution.  Additional interfaces will be added in the future.

Pricing
* Pay only for what you use. There is no minimum fee, and no
start-up cost.
* $0.15 per GB-Month of storage used.
* $0.20 per GB of data transferred.



Amazon provide API libraries or sample code for S3 in most of the
popular programming languages (including C#, Java, Ruby and Python) and
a search of the blogosphere on Google will reveal a lot of activity to
build all sorts of better and more elaborate interfaces to it.

I suspect that Google will follow suit, as they, like Amazon,  already
have the required infrastructure to host this sort of thing, and their
Gmail service is already being used by many as an unofficial Internet
file store (see, for example,
http://richard.jones.name/google-hacks/gmail-filesystem/gmail-filesystem.html

So what could S3 be used for?

Lots of things, but a few things spring immediately to mind.

1) Off-site secondary storage of back-up files for practices or clinics
running their own EMR systems or other clinical applications on
locally-hosted servers. The advantage of the simple API provided by S3
is that the EMR/clinical application for a practice/clinic could
automate the back-up-and-copy-to-S3 cycle, and could even automate
periodic test retrievals and restores (to a separate test database or
file system on the clinic's EMR server). I wouldn't trust the Amazon
assurances of privacy for the data (as Amazon are still subject to US
search warrants and court orders for example, as well as simple security
blunders - so any patient data would need to be strongly encrypted
before sending it to S3 for off-site backup storage - but that should be
routine practice for any off-site back-ups of patient data on removable
or transportable media anyway). The cost structure for the S3 service
would make such use very cheap, since the back-up data are sent once and
would be rarely accessed, so the bandwidth charges should be quite
modest, and the per-month storage charges are very cheap. Cheap enough
for even small clinics in developing and transitional countries to
afford, assuming they have broadband Internet access to enable the
upload of back-ups to S3 in the first place. Certainly cheap enough for
even small practices/clinics in rich countries - no more than $10-$20
per month I would think, maybe much less.

2) As a store-and-forward facility for the exchange of lab results or
other health messages (in encrypted form, of course). By using strong
encryption for the data being stored-and-forwarded, the fact that the
"secret" access key for an S3 account would need to be shared between
multiple parties is not an impediment. Billing for the usage of S3 for
such shared data interchange might be an issue, but I think that the S3
billing records are in machine-readable format, so some additional
mechanism for apportioning costs could be built - if the costs warranted
that.

3) As the basis of a shared EHR. As someone commented on a blog
somewhere, what S3 offers is a huge, distributed hashed storage system.
This makes it rather suitable as an object store, particularly good for
things like openEHR data. The really interesting thing is that because
there is no up-front capital cost involved, it means that that
individuals or families could have their *own* EHR stored, in encrypted
form, on S3, 

Re: [openhealth] CCHIT biased towards proprietary software??

[Tim.Churches]

Will Ross wrote:
> On Mar 24, 2006, at 9:44 PM, Rod Roark wrote:
> 
>  > I repeat: NOBODY will pay thousands for certification of Free
>  > Software.  They will use it because they already believe in it.
> 
> Rod,
> 
> I have been following the CCHIT process.   I do not consider CCHIT to 
> be biased against open source.   I think competing on a level playing 
> field for a fair, tough, industry standard certification is good 
> idea.   The cost is trivial.   If an open source project cannot 
> produce a coherent release candidate and collectively finance its 
> certification by CCHIT, then that open source project has not scaled 
> up to be a credible package for real clinical situations where lives 
> may hang in the balance.
> 
> I also think it is a disservice to the open source definition to 
> propose a dumbed down parallel open source certification process.   I 
> have no plans to pitch physicians on on software they can "believe" 
> in.   I want solid open source code that can be equally certified by 
> CCHIT alongside NextGen, Centricity, Allscripts, et. al.   I see a 
> huge marketing advantage for open source to stand up, get certified, 
> and start taking business away from the proprietary vendors.

I agree, but certifying authorities such as CCHIT (is CCHIT a govt
certification authority or is it a certifying business set up to make
money or is it an "industry" non-profit set up to perform a service?)
need to to be told to concentrate on making their validation criteria as
automatable and repeatable as possible. Not all criteria can be
automated, but those that can't still need to be specified in a manner
which maximises re-usability - in particular, the form of the vendor's
response. Having a human validator with a clipboard and a tick list,
laboriously working through each test script on each occasion of testing
is not the way it ought to be done. Automated testing tools are the way
to go, and organisations like CCHIT should be prepared to accept scripts
for such testing tools as evidence that criteria are met. Sure they
still need to validate that the test script actually demonstrates that
the criterion in question is met - but they need only do that once.
Repeat testing is then a) check the script is the same as last time b)
click a button. The mantra for testing of all types - unit tests,
regression tests, functional and integration tests - is automate and
then do it often. I can't see why certification criteria can't be guided
by that same principle.

Tim C



 
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Re: [openhealth] CCHIT biased towards proprietary software??

[Tim.Churches]

Thomas Beale wrote:
> Rod Roark wrote:
>  >
>  >
>  > The point is, open source (as in Free Software) is NOT a business
>  > model.  It's a method and end result of collaboration among users.
>  > I make good money at it only because some of those users are willing
>  > to pay me to do the techie work for them.
> if someone is paying you something, then there is a business model. It's
> better to be aware of what it is than pretend that it isn't there
>  >
>  > I repeat: NOBODY will pay thousands for certification of Free
>  > Software.  They will use it because they already believe in it.
> If the accreditation process and procedures are transparent and do
> indeed show that anyone claiming to have an XYZ-compliant product really
> does have such, then it is in the interests of the users. Put yourself
> in the shoes of a purchaser (especially a health authority or
> government). Let's say you are interested in DICOM software. Let's say
> there are two products on the market that do what you want, but only one
> is certified. You find out about the certification process, you discover
> that the test cases are published as are the procedures for doing the
> certification. You know that the certified product correctly processes
> say 50 published test files, and does 65 other things described in the
> process. Finally, let's say that the prices are within 30% of each
> other. Which one do you buy?

Test files?In fact, there is no reason why automated test scripts
couldn't be used to demonstrate compliance with the criteria described
by CCHIT - see http://www.cchit.org/publiccomment4.htm - but I get the
feeling that those framing the criteria had human actors in mind with
respect to their test scripts. I might be wrong.

Either way, it would seem quite feasible for an open source project to
publish documentation of how it meets the certification criteria in the
documents on the above Web page. Tedious to compile such documentation,
but still only person-weeks (or at worst one- o r two-person months)of
work, I suspect, not person years. Split it up between five or six
people and its doable without danger of inducing madness. If a project
did that, then the CCHIT charge for certification ought to be minimal,
if anything at all.

Tim C


 
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Re: [openhealth] CCHIT biased towards proprietary software??

[Tim.Churches]

Fred Trotter wrote:
> The current CCHIT pricing module seems biased against any GPL based system.

Fred, you don't think that the CCHIT pricing is biased against software
released under other types of free, open source licenses?

> Joseph has already written about this, but I would like for us to consider
> group action in the issue.
> 
> The first issue is pricing. It will cost a $25,000 to $35,000 one-time fee
> to perform the test. After certification, an annual fee based on sales will
> be required which will be at least $5,000 a year. According to...
> 
> http://www.healthcareitnews.com/story.cms?id=4639
> 
> This pricing assumes a proprietary business model. The "seal of approval"
> model is also problematic. Suppose I pay the fee to have MirrorMed (my
> project of choice) certified. There is no way for me to guarentee that only
> I benifit from the "seal". My competitors which have full access to the code
> that I would have certified would be able to correctly claim that the code
> had been certified, and would benifit with me. As with the original pricing
> there is no way to fairly spread these kinds of costs across a community. As
> a result, FOSS medical software could face an environment where there
> products could not compete against "certified" proprietary products.

This is of interest because certification of medical and health software
is a debate which we are about to have here in Australia.

I think that the key question is: what does certification involve? How
is it done? Is the $25000 certification fee required in order to employ
a team of High Priests who use magical incantations and crystal balls to
determine whether a particular software product should be certified, or
is there an objective list of criteria which products must meet or
fulfil? Hopefully the latter. Clearly these criteria should be
published, and publishers of medical software should be encouraged to
document how their product meets these criteria. The cost of certifying
a product for which its vendor/publisher has done all the hard work for
the certifying agency by documenting how it meets the certification
criteria should cost a lot less to have certified than system without
such documentation. The vendor/publisher-provided certification
documentation might comprise things like reference to design documents,
automated tests to demonstrate compliance with certain prescribed or
proscribed behaviours, or reference to the source code for the product.

Now, one can see why vendors of proprietary medical software would not
want to make such certification documentation publicly available - it
would reveal a great deal to their competitors about the engineering of
their product and would probably require access to source code and a
working copy of the product in order to be useful anyway - neither of
which would be publicly available - so there would be little point.
Hence, the certification documentation would need to be checked in
secret by the certification authority or a trusted agent appointed or
engaged by it. Secrecy costs money, hence the proposed certification
charges.

But there are no such impediments to publication of the certification
documentation for open source health and medical software. Thus, in the
case of open source software, the certifying authority could just
require the publication of the certification documentation, and publicly
call for objections to it. If no objections are received, the
certification should be issued. This would be predicated on two (valid,
I think) assumptions: a) that there are extremely strong disincentives
for open source projects to cheat with respect to this certification
documentation; and b) competitors to an open source product have an
incentive to check the adequacy of the documentation and complain to the
certification authority if they can show that the certification criteria
are not met, or that the certification documentation is wrong in some way.

Obviously there is still a high cost to certification for proprietary
vendors and open source projects alike, but at least with the model
described above, or variations on it, those costs can be distributed
across a community of users and developers, and the certification can
evolve and be maintained alongside the open source software itself,
rather than having to be redone from scratch by behind-doors certifiers
for each new release or version.

And it is transparent. Transparency of certification and other quality
assurance mechanisms is crucial for all health and medical software, I feel.

> Free and Open Source EMR vendors are not the only one effected by this. This
> will target any small vendor, open source or otherwise. www.emrupdate.com is
> writing a group letter for the CCHIT feedback process which points this out.
> 
> http://www.emrupdate.com/forums/thread/46564.aspx
> 
> I think that we should consider also writing a group letter. I would be
> willing to author this, if I knew that once it was written and 

Re: [openhealth] [Fwd: Re: [n-gaa] Is Open Source Good for Innovation?]

[Tim.Churches]

Thomas Beale wrote:
> Tim.Churches wrote:
>  >
>  > >
>  > > Why Wikipedia doesn't have one is a mystery to me. Why it is as good as
>  > > it is (however good you think it is) is also a mystery.
>  >
>  > It is wrong to think of wikipedia as an open source/open content
>  > project. In fact, it is about 1 million separate open source/open
>  > content projects (that is, articles), each with their own project team.
>  > All the good projects (articles) have a small "editorial" team, often
>  > just one person, which really cares about them. If someone else makes a
>  > worthwhile contribution, it is allowed to stand. If someone else
>  > degrades the content, then the editorial team changes it back to its
>  > former state. Often content goes through many cycles of degradation and
>  > restoration, but the editorial team usually wins through sheer
>  > doggedness. And the overall, average direction of change across the 1
>  > million articles is towards the better, although it is easy to find
>  > examples of articles which spiral down. But most get better.
>
> but as far as I know there is not even a signalling mechanism for the
> editor (how does she know she's the only one) to know about changes?

See http://en.wikipedia.org/wiki/Help:Watching_pages

> Where is the editorial group proclaimed? I made some additions once and
> never ran into any editorial mechanism.

There is no proclaimed editorial group - but as I said, most good
articles do have at least one person who really cares about the content
of the article - often the person who wrote it originally. This
"editorial team" is, as I said, self-appointed, unproclaimed and
entirely de facto - it exerts influence by persistence and doggedness in
correcting what it feels are retrograde changes to each article. And
yes, it is not uncommon for there to be multiple "editorial teams"
(often just different individuals) at war over an article - hence the
conflict resolution procedures:
http://en.wikipedia.org/wiki/Wikipedia:Conflict_resolution

>  > However, if wikipedia articles were not based on the wiki-wiki roll-back
>  > paradigm, the whole thing would collapse. As it is, the self-appointed
>  > editorial team for each article can roll back changes with a few clicks
>  > of the mouse. Self-appointed? Yes, just like the way in which leaders of
>  > almost all open source software projects are self-appointed. Both OSS
>  > and wikipedia are meritocracies in which power and position is gained by
>  > doing things - writing software or writing articles.
>
> Of course I agree with the sentiment, but I don't see where the
> editorial groups are constituted.

They are not constituted, they are de facto. Perhaps "team" was the
wrong word - more often there are de facto, self-appointed editorial
guardians for articles. But quite often these guardians get together to
back one another up. And yes, sometimes they fight.

Tim C



 
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Re: [openhealth] [Fwd: Re: [n-gaa] Is Open Source Good for Innovation?]

[Tim.Churches]

Thomas Beale wrote:
> David Forslund wrote:
>  > http://www.economist.com/business/displaystory.cfm?story_id=5624944
>  >
>  > is the link to the article I intended to post.
>  > David Forslund wrote:
>  > > I thought folks might like to see this article.   Any comments?
>  > >
>  > > -Dave
>  > >
> this brings back a big debate about among this group where I was
> lambasted by some for suggesting that you still had to do engineering
> and have some control to make open source software work. In the words of
> the article, what you always need is a focussed editorial group and
> change management policy to make sure the thing being built isn't just a
> wall covered in grafitti - there has to be a gatekeeper.  The reason why
> Linux works so well is that Torvalds is himself the iron fist of control
> over the whole thing - he is the gateway, the editorial board and the
> change manager (I think he has a couple of workers above the
> lieutenant's level).
> 
> Why Wikipedia doesn't have one is a mystery to me. Why it is as good as
> it is (however good you think it is) is also a mystery.

It is wrong to think of wikipedia as an open source/open content
project. In fact, it is about 1 million separate open source/open
content projects (that is, articles), each with their own project team.
All the good projects (articles) have a small "editorial" team, often
just one person, which really cares about them. If someone else makes a
worthwhile contribution, it is allowed to stand. If someone else
degrades the content, then the editorial team changes it back to its
former state. Often content goes through many cycles of degradation and
restoration, but the editorial team usually wins through sheer
doggedness. And the overall, average direction of change across the 1
million articles is towards the better, although it is easy to find
examples of articles which spiral down. But most get better.

However, if wikipedia articles were not based on the wiki-wiki roll-back
paradigm, the whole thing would collapse. As it is, the self-appointed
editorial team for each article can roll back changes with a few clicks
of the mouse. Self-appointed? Yes, just like the way in which leaders of
almost all open source software projects are self-appointed. Both OSS
and wikipedia are meritocracies in which power and position is gained by
doing things - writing software or writing articles.

Tim C



 
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Re: [openhealth] Demonstrations & Standards.

[Tim.Churches]

Thomas Beale wrote:
> Tim.Churches wrote:
>  > Thomas Beale wrote:
>  >
>  > >
>  > > I agree with Dave that this area is interesting and important to sort
>  > > out. I'll put the PhD thesis links on openEHR.org - they are all a
>  > > great read.
>  > >
>  > > my 5c
>  >
>  > Any opinion on YAWL ( http://www.yawl.fit.qut.edu.au/ )?
> I'll warn you that I am a relative beginner in this workflow area, so my
> opinion won't count for much. YAWL is another "object model" approach to
> the workflow formalism problem. It's a modified Petri-net approach,
> which means it may have some inherent limitations (see Robert Müller's
> comments below). I have not studied it enough to know. Both Müller and
> Eric Browne did work on adaptive workflows (based on the real concern
> that what you planned to be done might have to be changed partway
> through due to unexpected events); they both imply that Petri-nets are
> too limited in this area.
> 
>  From my point of view, YAWL looks like good work; the graphical
> language contains many of the operators that seem to be needed (and
> there are a lot of similarities with Müller's own graphical workflow
> language, AgentWork). My issue with it is only what I stated before -
> these graphical languages look great (they really do - I have spent days
> playing with them; thay have a lot of expressive power and are very
> enticing) - it is only when you have a look at 3+ experts' ideas on what
> the language should be that you realise that there is no common (i.e.
> interoperable) language for this purpose, and that none of the languages
> has exactly the same semantics (making the development of a shared
> language a real challenge).
> 
> See http://www.yawl.fit.qut.edu.au/about/tour/diagram.jsp for an example
> YAWL diagram; you can get a feel for some of the operators (various
> kinds of splitters and joiners etc). On page 14 of
> http://www.yawl.fit.qut.edu.au/yawldocs/yawl.pdf you can see the
> elements of the language. We do need a language like this; but each
> research group has their own version, and it is not just a case of minor
> syntax/naming differences. This tells me that it is too soon in the
> research history of this subject to commit to a graphical language. The
> reason is this: when you have a graphical language, any particular
> workflow that you write has to be a serialised expression of these
> graphical elements. If you decide for any reason to change the semantics
> or naming of the elements, all previous workflows risk being
> invalidated; they probably have to be converted. Whereas if you start
> from a parsable language, it is much easier to ensure that previously
> written instances still not only compile, but have the correct semantics
> according to later thinking. That is because the parser contains the
> transformation rules from the language expression into the objects.
> Starting with the objects locks you in, at least to some extent in my
> mind. The syntax approach also means that workflows are just text files;
> in the object form, they will typically be serilialised to XML files
> whose contents must conform to a particular schema (they might conform
> to a different one, but the differences can't be great). The flexibility
> of the parsing approach is what is needed when a domain is working out
> its solutions.
> 
> I don't know how big this problem is, but I do know that attempts to
> have universal graphical languages so far have only succeeded in
> specialist areas after many years. They haven't worked in programming -
> else we would all be using UML to program with.

Thanks Thomas - good points which we will consider. We were attracted to
YAWL by its relative simplicity and the fact that end users may be able
to get to grips with it to design new workflows. But a bit more thought
needed before we start implementing anything.

Tim C

> ** Comments by R Müller on petri-net approaches to workflow, in
> his 2003 PhD thesis.
> 
> [AALST 1997, VOORHOEVE & AALST 1997] describe an approach where - in
> contrast to [ELLIS ET
> AL. 1995] - every workflow instance is controlled by exactly one
> so-called workflow net, which is
> a workflow-oriented petri net subtype. Thus, ad hoc adaptation of single
> instances becomes possible.
> For this, a number of predefined transformation rules is provided, e.g.,
> to refine an activity with
> a subworkflow, or to split up sequences to several paths executed in
> parallel or conditional, and to
> join them again. However, the limitation of this approach is that data
> flow aspects are neglected,
> and that the handling of loops remains unclear.
> Fu

Re: [openhealth] Demonstrations & Standards.

[Tim.Churches]

David Forslund wrote:
> I've been quite impressed by the YAWL work of van der Alst at
> Eindhoven.   It is probably technically superior to
> some of the other workflow systems out their, particularly in its
> richness and accuracy of expressing workflow, but I don't
> believe it supports any of the standards out there.  Thus exchanging
> workflow models and interoperability would
> appear to be sacrificed which was the origin of this discussion.   I
> know that XPDL isn't expressive enough
> for everything, but that might not be needed to get workflow out and in
> use.  Shark currently has a longer history
> of stable releases, too.

OK, thanks, good to know. We're mainly interested in the adequacy of the
 YAWL workflow calculus rather than their Java implementation - we plan
to implement a workflow engine which will be built into our public
health data collection app (in Python). I don't think that
interoperability is important in our case either, but will search for a
counter-case to that position before embarking on it in the next few weeks.

Cheers,

Tim C

> Tim.Churches wrote:
>  > Thomas Beale wrote:
>  > > David Forslund wrote:
>  > >  >
>  > >  > We have been using workflow engines for a while.  The one I happen to
>  > >  > prefer is Shark (http://shark.objectweb.org)
>  > <http://shark.objectweb.org%29>
>  > >  > <http://shark.objectweb.org%29> which is quite robust and
>  > >  > uses standard WfMC's XPDL for the workflow representation and that it
>  > >  > supports both Web Services and the OMG CORBA workflow standard.  The
>  > >  > lack of interoperability in workflow models is a major
>  > impediment.  We
>  > >  > worked with the City of Hope for three years to try to come up
>  > with the
>  > >  > fundamental generic workflow for clinical trials, but didn't
>  > finish the
>  > >  > task. My main interest in XPDL is that it separates out the workflow
>  > >  > definitions from the implementation of workflow.  The popular
>  > BPEL seems
>  > >  > to confuse this issue, at least as I see it.   Getting some
>  > agreement on
>  > >  > the basic workflow elements for healthcare that might be shared
>  > would be
>  > >  > quite interesting and valuable, in my opinion.
>  > >
>  > > During last last year I read 3 clinical workflow PhD dissertations, and
>  > > spent a fair bit of time looking at BPEL, XPDL etc. My conclusions when
>  > > struggling to see what was "the" workflow model to use to represent
>  > > workflow were:
>  > > a) none of the models I reviewed did everything needed
>  > > b) I realised one day that the right way to represent such semantics is
>  > > in a programming language-like syntax, rather than the object model
>  > > form. The reason for this is that a syntax and parser approach are far
>  > > more amenable to understanding a problem domain; it is only when it is
>  > > completely sorted that you can afford to publish object models.
>  > > c) such a language needs to have all the temporal operators required by
>  > > workflow, including all the synchronous/asynchronous branching, split &
>  > > join operators and so on. I can imagine a modified version of current
>  > > programming language syntax might go close to this. The advantage is
>  > > that the language can be improved over time, but previous workflows will
>  > > still compile (if the compiler builders take care); whereas object model
>  > > representations are usually left out in the cold because they are the
>  > > equivalent of what the compiler generates (the parse tree), not the
>  > > input, whose syntax might not change, but whose meaning might.
>  > > d) the XML-based attempts really suffer from not having an abstract
>  > > language. XML is just a transfer syntax. When will people start getting
>  > > this? (do you read OWL in XML-RDF? Of course not, you read it in
>  > > OWL-abstract; do you read .class files or .java files? etc). Worse,
>  > > XML models are actually direct serialisations of structural object
>  > > models, they are not any kind of syntax. It is too early in the learning
>  > > curve of this area to be committing to object models.
>  > >
>  > > I agree with Dave that this area is interesting and important to sort
>  > > out. I'll put the PhD thesis links on openEHR.org  - they are all a
>  > > great read.
&

Re: [openhealth] Demonstrations & Standards.

[Tim.Churches]

Thomas Beale wrote:
> David Forslund wrote:
>  >
>  > We have been using workflow engines for a while.  The one I happen to
>  > prefer is Shark (http://shark.objectweb.org)
>  >  which is quite robust and
>  > uses standard WfMC's XPDL for the workflow representation and that it
>  > supports both Web Services and the OMG CORBA workflow standard.  The
>  > lack of interoperability in workflow models is a major impediment.  We
>  > worked with the City of Hope for three years to try to come up with the
>  > fundamental generic workflow for clinical trials, but didn't finish the
>  > task. My main interest in XPDL is that it separates out the workflow
>  > definitions from the implementation of workflow.  The popular BPEL seems
>  > to confuse this issue, at least as I see it.   Getting some agreement on
>  > the basic workflow elements for healthcare that might be shared would be
>  > quite interesting and valuable, in my opinion.
> 
> During last last year I read 3 clinical workflow PhD dissertations, and
> spent a fair bit of time looking at BPEL, XPDL etc. My conclusions when
> struggling to see what was "the" workflow model to use to represent
> workflow were:
> a) none of the models I reviewed did everything needed
> b) I realised one day that the right way to represent such semantics is
> in a programming language-like syntax, rather than the object model
> form. The reason for this is that a syntax and parser approach are far
> more amenable to understanding a problem domain; it is only when it is
> completely sorted that you can afford to publish object models.
> c) such a language needs to have all the temporal operators required by
> workflow, including all the synchronous/asynchronous branching, split &
> join operators and so on. I can imagine a modified version of current
> programming language syntax might go close to this. The advantage is
> that the language can be improved over time, but previous workflows will
> still compile (if the compiler builders take care); whereas object model
> representations are usually left out in the cold because they are the
> equivalent of what the compiler generates (the parse tree), not the
> input, whose syntax might not change, but whose meaning might.
> d) the XML-based attempts really suffer from not having an abstract
> language. XML is just a transfer syntax. When will people start getting
> this? (do you read OWL in XML-RDF? Of course not, you read it in
> OWL-abstract; do you read .class files or .java files? etc). Worse,
> XML models are actually direct serialisations of structural object
> models, they are not any kind of syntax. It is too early in the learning
> curve of this area to be committing to object models.
> 
> I agree with Dave that this area is interesting and important to sort
> out. I'll put the PhD thesis links on openEHR.org  - they are all a
> great read.
> 
> my 5c

Any opinion on YAWL ( http://www.yawl.fit.qut.edu.au/ )?

Tim C



 
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Re: [openhealth] Demonstrations & Standards.

[Tim.Churches]

Wayne Wilson wrote:
> Boy, is this discussion bringing back old memories, Dave Forslund reminds me 
> exactly how old later on and I have some inline comments.
> 
> Just below, Tom Beale suggests interoperability built on engineering 
> principles.  Some discussion follows about the difficulty of connecting 
> systems 
> with different models, etc.

Um, is some of this discussion occurring on a different list, or
privately - no problem if so, but just curious because I haven't seen
all the messages which you quote below from the openhealth list on Yahoo.

> So, I agree with Tom about what experience tells us about standards and de 
> facto 
> momentum. 

Also agree that de facto engineering standards, rather than ones nutted
out by small, select technical committees, tend to be much better.
However, de facto engineering standards only develop when one company or
group comes up with a very good implementation way ahead of everyone
else. I don't think that is the case in much of health informatics -
typically engineering solutions which might become standards take so
long to develop that competing or alternative solutions inevitably
spring up during the development period. Unless one solution is so
vastly superior on all counts to the others (which hardly  ever happens
in health informatics), we end up with a plurality of engineering
solutions and national authorities or standards committees then have to
decide between them and anoint one or the other, or at least a few.

>  > David Forslund wrote:
>  >  The vendor lock-in was the
>  >biggest factor that worked against
>  >the adoption of the fairly reasonable OMG specifications we worked on
>  >from 96-01.
>  >
> Gosh, was it that long ago?  I have come to believe that alongside vendor 
> lock-in, high complexity played a significant role.

I agree. Complexity + lack-of-Internet in the mid-1990s -> lack of CORBA
take-up. If you look at all the SOAP, WSDL and other current WS-*
standards, they are just as complex as CORBA (but mostly not as good) -
but the social network effects of the Internet mean that the complexity
can be conquered, even by a small start-up software company.

> I am not as sold on multi-source components as I once was.  I believe that 
> nearly all the value lies in process (workflow in it's generic sense) and how 
> various 'natural' groupings of functions (Things that people do in a patient 
> care setting)  need to hand off to each other.

Absolutely. We have recently realised, with respect to public health
information systems, that workflow management is just as important as
semantic and syntactic information management, if not more so. We're
busily reading up everything we can on various workflow engines and
their underlying calculus and theoretical bases. I think the same
applies to hospital-based clinical medicine, and to primary care. In
fact, some form of workflow engine are vital to any human enterprise
which can't be done or isn't typically done by a small group who can all
talk to one-another face-to-face in order to co-ordinate their actions.

> Clearly many people 'sense' this value and find all encompassing suites 
> attractive.  Before Health care IT trys to build the PeopleSoft or SAP of 
> clinical care I think we need to absorb the lesson of those big suites:  
> Change 
> in operations is constant and loosely coupled systems change faster than 
> tightly 
> coupled systems.

Yup.

Tim C


 
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Re: [openhealth] Re: OS at MedInfo 2007

[Tim.Churches]

Thomas Beale wrote:
> I think (and I may be wrong) that OS as a theme in and of itself is not
> that interesting;

I agree. I hope to submit some papers for presentation at MedInfo2007
which describe systems both built on and released as open source, but I
don't want those papers "ghettoed" in an open source conference track.
The open source aspects of the projects are positive features, but are
not their main features or purpose.

> the point is: how does the OS approach in health
> improve things? Positive consequences that spring to mind:
> 
> * OS software it is potentially a better means of achieving
>   interoperability, since open source developments are more like
>   than closed ones to want to reuse rather than reinvent due to more
>   limited resources (however, the evidence is that all modes of
>   software development are trapped largely in reinvention mode)
> * OS software is accordingly more likely to be a better vector for
>   standards, since there is not the commercial motivation to lock in
>   customers (but how do we know there isn't another kind of
>   motivation in the OS area to do the same thing - based e.g. on pride?)
> * OS software is more likely to be componentised, and delivered in
>   components, due to more limited resources and the inability to
>   financially sustain gigantic new build efforts.
> * It should be cheaper to own and run
> * It might even be more innovative, due to the need to find smart
>   solutions that work on cheap technology. I have no evidence at all
>   for this, but it could well be true for the sectors of the market
>   that are not pursued by big companies (e.g. small systems for
>   developing countries).
> * being a vector of systemic change - i..e not just serving
>   individual customers but offering alternatives for widespread
>   change across entire sectors of health. This is also related to
>   not locking in users.
> 
> All obvious? I don't think it is. I think these are all potentials, and
> I think that OS development efforts owe it to themselves and the
> community they aspire to serve to be more interested in
> interoperability, (good) standards, and thinking in terms of attractive
> long-term options for users. I think we all run the risk of being just
> as inward-looking and non-customer focussed as any commercial
> development effort. The record of commercial products for
> interoperability and lock-in has been mostly poor, so the opportunity is
> there, but in my mind, it is definitely not a given that OS efforts will
> do any better at exploiting it than commercial ones.
> 
> These are the kinds of themes I would find more interesting in a
> conference or other forum; not endless debates about free/libre,
> licenses or other details. In other words the interest in OS must be
> about better outcomes.

Excellent suggestions for themes and questions to be tackled - perhaps
in a workshop under MedInfo2007 auspices, or as a one-day satellite
mini-conference? Could either of these be organised under IMIA OSWG
auspices? I am happy to help.

Tim C

> Tim.Churches wrote:
>  > Forwarded message from Peter Murray.
>  >
>  > ---- Original Message 
>  > Subject: Re: OS at MedInfo 2007
>  > Date: Sun, 19 Mar 2006 09:54:15 +
>  > From: Peter Murray <[EMAIL PROTECTED]>
>  > To: Tim.Churches <[EMAIL PROTECTED]>
>  > CC: [EMAIL PROTECTED]
>  >
>  > Hi, Tim -
>  >
>  > good question on OS activities at medinfo2007. (Could you copy the
>  > substance of this reply to the openhealth list, as I am not on it -
>  > thought I was going to be added after the AMIA OSWG meeting in November,
>  > but does not seem to have happened yet - I will copy this to AMIA OSWG
>  > list).
>  >
>  > I think we should aim for something substantial at medinfo2007 in the
>  > free/libre open source area - we can at least get an IMIA OSWG activity
>  > of some kind, which we can open to any medinfo2007 attendees, but it
>  > might be useful to see if we can get enough momentum and interest to
>  > maybe have a full day or so 'in conjunction with medinfo2007' or similar
>  > phrasing for as many groups and individuals as are interested.
>  >
>  > I have to confess that the IMIA OSWG has not been as active in
>  > organising events and things as I had hoped we might be - for various
>  > reasons, but when I did try and pull together a 'critical mass' of
>  > things for MIE2005, I did not get much response from people.
>  >
>  > I will be seeing Joan Edgcumbe from HISA here at our UK health
>  > informatics

Re: OSHCA Meetings (was) Re: [openhealth] Re: List future [was: Why are you here?]

[Tim.Churches]

Joseph Dal Molin wrote:
> Tim,
> 
> Sorry didn't mean to dampen enthusiasm and imply that a satellite
> conference in 2007 was impossible to pull offwhat I meant was that
> in general you need operating capital to be able to pick where you want
> to hold a meeting. In fact a satellite conference is preferable to
> imbedding a meeting in Medinfo because of the cost of registration. A
> low risk strategy is to find a willing host that can provide the space
> to meet and ideally food services that are within walking distance -  a
> university or something like that.

No, I agree completely.

> BTWthe London meeting shadowed MedInfo and OSHCA was able to
> collaborate with  the Medinfo organizers advertise our meeting on the
> Medinfo website and vice versa which generated a great turn out.

I think that those interested in OSHCA should organise a satellite mtg
if they wish, but that an open source workshop or some other meeting
under the auspices of MedInfo2007 should also be pursued. Let's not put
all our eggs in one basket...

Tim C

> Tim.Churches wrote:
>  > Joseph Dal Molin wrote:
>  >  > While it makes sense to shadow MedInfo it may be difficult to do
>  >  > anything more than a "birds of a feather" meeting initially without
>  >  > first establishing self sustainabilitythe critical success factors
>  >  > for successful OSHCA meetings so far have been:
>  >  >
>  >  > - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los Angles
>  >  > and London)
>  >  > - champion(s) and well connected organizing committee in OSCHA
>  >  >
>  >  > The first one was always the most important because it allowed OSHCA to
>  >  > stage a meeting without any financial risk or commitment.something
>  >  > that is absolutely necessary when you don't have operating capital. This
>  >  > also meant that OSHCA had to be opportunistic and "follow the money" in
>  >  > deciding where meetings would take place. I think it makes sense to seek
>  >  > some seed money for an initial meeting with the goal of
>  >  > self-sustainability through a combination of attendance fees, and
>  >  > sponsorship.
>  >
>  > OK, no OSHCA satellite conference around MedInfo 2007 then. Anyway, is
>  > anyone interested in an open source workshop or BOF meeting as part of
>  > MedInfo in Brisbane in 2007?
>  >
>  > Tim C
>  >
>  >  >
>  >  > IMHO meeting every 3 years is setting the bar too lowOSHCA was able
>  >  > to meet every year for four years in a row and clearly was gaining
>  >  > momentum. With the OSHCA.org issue resolved, the integration of the
>  >  > discussion lists and most importantly the renewed spirit of harmony a
>  >  > more ambitious agenda is quite realistic.
>  >  >
>  >  > Joseph
>  >  >
>  >  > Will Ross wrote:
>  >  >  > On Sat, 18 Mar 2006 01:48:46 -0800 Horst Herb wrote:
>  >  >  >
>  >  >  >  > On Sat, 18 Mar 2006 03:34, Joseph Dal Molin wrote:
>  >  >  >  >> Adrian, thanks for the smile and words of wisdom.hopefully it
>  >  >  >  >> won't
>  >  >  >  >> be long before we have an opportunity to meet again. One of
>  > the first
>  >  >  >  >> things on the OSHCA agenda IMHO should be a conference. Every one
>  >  >  >  >> we had
>  >  >  >  >> was unique and inspiring event and essential to community
>  >  >  >  >> building
>  >  >  >  >
>  >  >  >  > I would volunteer to organize it in Australia - sure, it's a long
>  >  >  >  > way from
>  >  >  >  > anywhere else, but it can be damn nice, it's safe, and it can be
>  >  >  >  > very cheap
>  >  >  >  > too once the flight has been paid.
>  >  >  >  >
>  >  >  >  > Horst
>  >  >  >
>  >  >  > I propose we meet Brisbane in August 2007
>  >  >  >
>  >  >  > http://www.medinfo2007.org/
>  >  >  >
>  >  >  > Meeting in 2006 would also be nice, but may be more difficult to pull
>  >  >  > off.   I have the sense that the scale of our collaboration would be
>  >  >  > stretched by attempting to meet too often.   If we shadow MedInfo's
>  >  >  > pattern, once every three years, could be a good fit for now, and we
>  >  >  > can follow MedInfo as it hops about the globe.
>  >  >  >
>  >  >  > [wr]
>  >  >  >

Re: [openhealth] Re: [os-wg] OS at MedInfo 2007

[Tim.Churches]

Will Ross wrote:
> Peter,
> 
> Does the OSWG have a budget for invited presentations?   One of the 
> first on my list would be Prof. von Hippel of MIT to present a recent 
> paper in his investigations into "Democratizing Innovation."A lot 
> of his work is based on close observations of the Apache Project, but 
> he also does a good job generalizing the open source effect beyond 
> software, which I think is a potent part f the open source message:   
> it is not just software, it is a disruptive form of rapid and 
> comprehensive collaboration.   We also have a lot of depth on the 
> bench directly within in the AMIA OSWG  --  Bill Lober, Mike Hogarth, 
> etc.
> 
> I think an OS track gives us the opportunity to stretch the 
> discussion to attract mainstream informatics attendees.   If we have 
> a bit of funding we may be able to offer slate of fairly provocative 
> presentations.

I think that a separate OSS workshop, before the main conference,
perhaps with an invited keynote speaker to open it, would be better than
an open source track in the main conference. Not the least, I don't want
to miss too many of the other presentations...

If there is no budget to bring  an international keynote speaker for
such a workshop, I think we can find some local talent who will have
some things of interest to say - but I agree that von Hippel would be great.

Tim C

> On Mar 19, 2006, at 1:54 AM, Peter wrote:
> 
>  > The following is part of reply to a mesage Tim Churches sent me - I
>  > thought it would be useful to discuss on the AMIA OSWG list too.
>  >
>  > Peter
>  >
>  >
>  > Hi, Tim -
>  >
>  > good question on OS activities at medinfo2007. .
>  >
>  > I think we should aim for something substantial at medinfo2007 in the
>  > free/libre open source area - we can at least get an IMIA OSWG 
>  > activity
>  > of some kind, which we can open to any medinfo2007 attendees, but it
>  > might be useful to see if we can get enough momentum and interest to
>  > maybe have a full day or so 'in conjunction with medinfo2007' or 
>  > similar
>  > phrasing for as many groups and individuals as are interested.
>  >
>  > I have to confess that the IMIA OSWG has not been as active in
>  > organising events and things as I had hoped we might be - for various
>  > reasons, but when I did try and pull together a 'critical mass' of
>  > things for MIE2005, I did not get much response from people.
>  >
>  > I will be seeing Joan Edgcumbe from HISA here at our UK health
>  > informatics event over the next few days - if I get the chance, I will
>  > sound out with her possibilities and processes.
>  >
>  > So - I am all for trying to get something together - we need, at a
>  > minimun, to encourage FLOSS submissions (papers, panels, tutorials,
>  > workshops, etc) as part of the normal processes of papers etc for a
>  > scientific event; that way, we may be able to get a clearly 
>  > identifiable
>  > track/stream. We should be able to get some. I am keen to try and do
>  > more than this as well.
>  >
>  > Let's see what interest we can generate by getting a message out to 
>  > the
>  > various OS/FLOSS group lists and then see where we can take things 
>  > - we
>  > will probably need a 'loose coalition' of people to push things among
>  > the various groups.
>  >
>  > Cheers, Peter Murray
>  > Chair, IMIA OSWG
>  >
>  >
>  >
>  >
>  >
>  > Tim.Churches wrote:
>  >
>  > Will Ross wrote:
>  >
>  >> HISA
>  >>
>  >> http://www.medinfo2007.org/100049.php
>  >>
>  >>
>  >
>  > Yeah, I'm a member of HISA (hmmm, better pay my dues...), but does
>  > anyone know of anyone organising or planning to organise an open 
>  > source
>  > event in the context of MedInfo 2007? I suppose I should ask Peter
>  > Murray, Graham Wright and Jan Vejvalka directly - in May 2005 Peter
>  > Murray noted on the IMIA Open Source Working Group Web site (see
>  > http://www.chirad.info/imiaoswg/ ):
>  >
>  > "3. It is not too early to start thinking about IMIA OSWG 
>  > activities for
>  > MIE2006, medinfo2007, and other conferences. We would like to hold
>  > OSWG/OSNI activities at other conferences/events and have been 
>  > exploring
>  > various possibilities; more news when we have anything to report. "
>  >
>  > Peter, Jan or Graham: any open sourcery planned for MedInfo 2007 in
>  > Brisbane?
>  >
>  > Tim C
>  >

[openhealth] Re: OS at MedInfo 2007

[Tim.Churches]

Forwarded message from Peter Murray.

 Original Message 
Subject: Re: OS at MedInfo 2007
Date: Sun, 19 Mar 2006 09:54:15 +
From: Peter Murray <[EMAIL PROTECTED]>
To: Tim.Churches <[EMAIL PROTECTED]>
CC: [EMAIL PROTECTED]

Hi, Tim -

good question on OS activities at medinfo2007. (Could you copy the
substance of this reply to the openhealth list, as I am not on it -
thought I was going to be added after the AMIA OSWG meeting in November,
but does not seem to have happened yet - I will copy this to AMIA OSWG
list).

I think we should aim for something substantial at medinfo2007 in the
free/libre open source area - we can at least get an IMIA OSWG activity
of some kind, which we can open to any medinfo2007 attendees, but it
might be useful to see if we can get enough momentum and interest to
maybe have a full day or so 'in conjunction with medinfo2007' or similar
phrasing for as many groups and individuals as are interested.

I have to confess that the IMIA OSWG has not been as active in
organising events and things as I had hoped we might be - for various
reasons, but when I did try and pull together a 'critical mass' of
things for MIE2005, I did not get much response from people.

I will be seeing Joan Edgcumbe from HISA here at our UK health
informatics event over the next few days - if I get the chance, I will
sound out with her possibilities and processes.

So - I am all for trying to get something together - we need, at a
minimun, to encourage FLOSS submissions (papers, panels, tutorials,
workshops, etc) as part of the normal processes of papers etc for a
scientific event; that way, we may be able to get a clearly identifiable
track/stream. We should be able to get some. I am keen to try and do
more than this as well.

Let's see what interest we can generate by getting a message out to the
various OS/FLOSS group lists and then see where we can take things - we
will probably need a 'loose coalition' of people to push things among
the various groups.

Cheers, Peter Murray
Chair, IMIA OSWG





Tim.Churches wrote:

>Will Ross wrote:
>  
>
>>HISA
>>
>>http://www.medinfo2007.org/100049.php
>>
>>
>
>Yeah, I'm a member of HISA (hmmm, better pay my dues...), but does
>anyone know of anyone organising or planning to organise an open source
>event in the context of MedInfo 2007? I suppose I should ask Peter
>Murray, Graham Wright and Jan Vejvalka directly - in May 2005 Peter
>Murray noted on the IMIA Open Source Working Group Web site (see
>http://www.chirad.info/imiaoswg/ ):
>
>"3. It is not too early to start thinking about IMIA OSWG activities for
>MIE2006, medinfo2007, and other conferences. We would like to hold
>OSWG/OSNI activities at other conferences/events and have been exploring
>various possibilities; more news when we have anything to report. "
>
>Peter, Jan or Graham: any open sourcery planned for MedInfo 2007 in
>Brisbane?
>
>Tim C
>
>  
>
>>On Mar 18, 2006, at 4:07 PM, Tim.Churches wrote:
>>
>> > Will Ross wrote:
>> >> Tim,
>> >>
>> >> I'm confident there will be an OS track at MedInfo 2007 in
>> >> Brisbane.   We had an OS track at MedInfo 2004 in San Francisco.
>> >
>> > Does anyone know who is organising it?
>> >
>> > Tim C
>> >
>> >> - - - - - - - -
>> >>
>> >> On Mar 18, 2006, at 3:13 PM, Tim.Churches wrote:
>> >>
>> >>> Joseph Dal Molin wrote:
>> >>>> While it makes sense to shadow MedInfo it may be difficult to do
>> >>>> anything more than a "birds of a feather" meeting initially without
>> >>>> first establishing self sustainabilitythe critical success
>> >>>> factors
>> >>>> for successful OSHCA meetings so far have been:
>> >>>>
>> >>>> - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los 
>> >>>> Angles
>> >>>> and London)
>> >>>> - champion(s) and well connected organizing committee in OSCHA
>> >>>>
>> >>>> The first one was always the most important because it allowed
>> >>>> OSHCA to
>> >>>> stage a meeting without any financial risk or
>> >>>> commitment.something
>> >>>> that is absolutely necessary when you don't have operating
>> >>>> capital. This
>> >>>> also meant that OSHCA had to be opportunistic and "follow the
>> >>>> money" in
>> >>>> deciding where meetings would take place. I think it makes sense
>

OS at MedInfo 2007 (was Re: OSHCA Meetings (was) Re: [openhealth] Re: List future [was: Why are you here?])

[Tim.Churches]

Will Ross wrote:
> HISA
> 
> http://www.medinfo2007.org/100049.php

Yeah, I'm a member of HISA (hmmm, better pay my dues...), but does
anyone know of anyone organising or planning to organise an open source
event in the context of MedInfo 2007? I suppose I should ask Peter
Murray, Graham Wright and Jan Vejvalka directly - in May 2005 Peter
Murray noted on the IMIA Open Source Working Group Web site (see
http://www.chirad.info/imiaoswg/ ):

"3. It is not too early to start thinking about IMIA OSWG activities for
MIE2006, medinfo2007, and other conferences. We would like to hold
OSWG/OSNI activities at other conferences/events and have been exploring
various possibilities; more news when we have anything to report. "

Peter, Jan or Graham: any open sourcery planned for MedInfo 2007 in
Brisbane?

Tim C

> On Mar 18, 2006, at 4:07 PM, Tim.Churches wrote:
> 
>  > Will Ross wrote:
>  >> Tim,
>  >>
>  >> I'm confident there will be an OS track at MedInfo 2007 in
>  >> Brisbane.   We had an OS track at MedInfo 2004 in San Francisco.
>  >
>  > Does anyone know who is organising it?
>  >
>  > Tim C
>  >
>  >> - - - - - - - -
>  >>
>  >> On Mar 18, 2006, at 3:13 PM, Tim.Churches wrote:
>  >>
>  >>> Joseph Dal Molin wrote:
>  >>>> While it makes sense to shadow MedInfo it may be difficult to do
>  >>>> anything more than a "birds of a feather" meeting initially without
>  >>>> first establishing self sustainabilitythe critical success
>  >>>> factors
>  >>>> for successful OSHCA meetings so far have been:
>  >>>>
>  >>>> - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los 
>  >>>> Angles
>  >>>> and London)
>  >>>> - champion(s) and well connected organizing committee in OSCHA
>  >>>>
>  >>>> The first one was always the most important because it allowed
>  >>>> OSHCA to
>  >>>> stage a meeting without any financial risk or
>  >>>> commitment.something
>  >>>> that is absolutely necessary when you don't have operating
>  >>>> capital. This
>  >>>> also meant that OSHCA had to be opportunistic and "follow the
>  >>>> money" in
>  >>>> deciding where meetings would take place. I think it makes sense
>  >>>> to seek
>  >>>> some seed money for an initial meeting with the goal of
>  >>>> self-sustainability through a combination of attendance fees, and
>  >>>> sponsorship.
>  >>>
>  >>> OK, no OSHCA satellite conference around MedInfo 2007 then. 
>  >>> Anyway, is
>  >>> anyone interested in an open source workshop or BOF meeting as 
>  >>> part of
>  >>> MedInfo in Brisbane in 2007?
>  >>>
>  >>> Tim C
>  >>>
>  >>>>
>  >>>> IMHO meeting every 3 years is setting the bar too lowOSHCA was
>  >>>> able
>  >>>> to meet every year for four years in a row and clearly was gaining
>  >>>> momentum. With the OSHCA.org issue resolved, the integration of the
>  >>>> discussion lists and most importantly the renewed spirit of 
>  >>>> harmony a
>  >>>> more ambitious agenda is quite realistic.
>  >>>>
>  >>>> Joseph
>  >>>>
>  >>>> Will Ross wrote:
>  >>>>> On Sat, 18 Mar 2006 01:48:46 -0800 Horst Herb wrote:
>  >>>>>
>  >>>>>> On Sat, 18 Mar 2006 03:34, Joseph Dal Molin wrote:
>  >>>>>>> Adrian, thanks for the smile and words of 
>  >>>>>>> wisdom.hopefully it
>  >>>>>>> won't
>  >>>>>>> be long before we have an opportunity to meet again. One of the
>  >>>>>>> first
>  >>>>>>> things on the OSHCA agenda IMHO should be a conference. Every 
>  >>>>>>> one
>  >>>>>>> we had
>  >>>>>>> was unique and inspiring event and essential to community
>  >>>>>>> building
>  >>>>>>
>  >>>>>> I would volunteer to organize it in Australia - sure, it's a long
>  >>>>>> way from
>  >>>>>> anywhere else, but it can be damn nice, it's safe, and it can be
>  >>>>>> very cheap
>

Re: OSHCA Meetings (was) Re: [openhealth] Re: List future [was: Why are you here?]

[Tim.Churches]

Will Ross wrote:
> Tim,
> 
> I'm confident there will be an OS track at MedInfo 2007 in 
> Brisbane.   We had an OS track at MedInfo 2004 in San Francisco.

Does anyone know who is organising it?

Tim C

> - - - - - - - -
> 
> On Mar 18, 2006, at 3:13 PM, Tim.Churches wrote:
> 
>  > Joseph Dal Molin wrote:
>  >> While it makes sense to shadow MedInfo it may be difficult to do
>  >> anything more than a "birds of a feather" meeting initially without
>  >> first establishing self sustainabilitythe critical success 
>  >> factors
>  >> for successful OSHCA meetings so far have been:
>  >>
>  >> - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los Angles
>  >> and London)
>  >> - champion(s) and well connected organizing committee in OSCHA
>  >>
>  >> The first one was always the most important because it allowed 
>  >> OSHCA to
>  >> stage a meeting without any financial risk or 
>  >> commitment.something
>  >> that is absolutely necessary when you don't have operating 
>  >> capital. This
>  >> also meant that OSHCA had to be opportunistic and "follow the 
>  >> money" in
>  >> deciding where meetings would take place. I think it makes sense 
>  >> to seek
>  >> some seed money for an initial meeting with the goal of
>  >> self-sustainability through a combination of attendance fees, and
>  >> sponsorship.
>  >
>  > OK, no OSHCA satellite conference around MedInfo 2007 then. Anyway, is
>  > anyone interested in an open source workshop or BOF meeting as part of
>  > MedInfo in Brisbane in 2007?
>  >
>  > Tim C
>  >
>  >>
>  >> IMHO meeting every 3 years is setting the bar too lowOSHCA was 
>  >> able
>  >> to meet every year for four years in a row and clearly was gaining
>  >> momentum. With the OSHCA.org issue resolved, the integration of the
>  >> discussion lists and most importantly the renewed spirit of harmony a
>  >> more ambitious agenda is quite realistic.
>  >>
>  >> Joseph
>  >>
>  >> Will Ross wrote:
>  >>> On Sat, 18 Mar 2006 01:48:46 -0800 Horst Herb wrote:
>  >>>
>  >>>> On Sat, 18 Mar 2006 03:34, Joseph Dal Molin wrote:
>  >>>>> Adrian, thanks for the smile and words of wisdom.hopefully it
>  >>>>> won't
>  >>>>> be long before we have an opportunity to meet again. One of the 
>  >>>>> first
>  >>>>> things on the OSHCA agenda IMHO should be a conference. Every one
>  >>>>> we had
>  >>>>> was unique and inspiring event and essential to community
>  >>>>> building
>  >>>>
>  >>>> I would volunteer to organize it in Australia - sure, it's a long
>  >>>> way from
>  >>>> anywhere else, but it can be damn nice, it's safe, and it can be
>  >>>> very cheap
>  >>>> too once the flight has been paid.
>  >>>>
>  >>>> Horst
>  >>>
>  >>> I propose we meet Brisbane in August 2007
>  >>>
>  >>> http://www.medinfo2007.org/
>  >>>
>  >>> Meeting in 2006 would also be nice, but may be more difficult to 
>  >>> pull
>  >>> off.   I have the sense that the scale of our collaboration would be
>  >>> stretched by attempting to meet too often.   If we shadow MedInfo's
>  >>> pattern, once every three years, could be a good fit for now, and we
>  >>> can follow MedInfo as it hops about the globe.
>  >>>
>  >>> [wr]
>  >>>
>  >>> - - - - - - - -
>  >>>
>  >>> will ross
>  >>> project manager
>  >>> mendocino informatics
>  >>> 216 west perkins street, suite 206
>  >>> ukiah, california  95482  usa
>  >>> 707.272.7255 [voice]
>  >>> 707.462.5015 [fax]
>  >>> www.minformatics.com
>  >>>
>  >>> - - - - - - - -
>  >>>
>  >>>
>  >>>
>  >>>
>  >>> SPONSORED LINKS
>  >>> Software distribution
>  >>>
>  >> <http://groups.yahoo.com/gads?t=ms&k=Software 
> <http://groups.yahoo.com/gads?t=ms&k=Software>
>  >> +distribution&w1=Software+distribution&w2=Salon+software&w3=Medical
>  >> +software&w4=Software+association&

Re: OSHCA Meetings (was) Re: [openhealth] Re: List future [was: Why are you here?]

[Tim.Churches]

Joseph Dal Molin wrote:
> While it makes sense to shadow MedInfo it may be difficult to do
> anything more than a "birds of a feather" meeting initially without
> first establishing self sustainabilitythe critical success factors
> for successful OSHCA meetings so far have been:
> 
> - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los Angles
> and London)
> - champion(s) and well connected organizing committee in OSCHA
>
> The first one was always the most important because it allowed OSHCA to
> stage a meeting without any financial risk or commitment.something
> that is absolutely necessary when you don't have operating capital. This
> also meant that OSHCA had to be opportunistic and "follow the money" in
> deciding where meetings would take place. I think it makes sense to seek
> some seed money for an initial meeting with the goal of
> self-sustainability through a combination of attendance fees, and
> sponsorship.

OK, no OSHCA satellite conference around MedInfo 2007 then. Anyway, is
anyone interested in an open source workshop or BOF meeting as part of
MedInfo in Brisbane in 2007?

Tim C

> 
> IMHO meeting every 3 years is setting the bar too lowOSHCA was able
> to meet every year for four years in a row and clearly was gaining
> momentum. With the OSHCA.org issue resolved, the integration of the
> discussion lists and most importantly the renewed spirit of harmony a
> more ambitious agenda is quite realistic.
> 
> Joseph
> 
> Will Ross wrote:
>  > On Sat, 18 Mar 2006 01:48:46 -0800 Horst Herb wrote:
>  >
>  >  > On Sat, 18 Mar 2006 03:34, Joseph Dal Molin wrote:
>  >  >> Adrian, thanks for the smile and words of wisdom.hopefully it
>  >  >> won't
>  >  >> be long before we have an opportunity to meet again. One of the first
>  >  >> things on the OSHCA agenda IMHO should be a conference. Every one
>  >  >> we had
>  >  >> was unique and inspiring event and essential to community
>  >  >> building
>  >  >
>  >  > I would volunteer to organize it in Australia - sure, it's a long
>  >  > way from
>  >  > anywhere else, but it can be damn nice, it's safe, and it can be
>  >  > very cheap
>  >  > too once the flight has been paid.
>  >  >
>  >  > Horst
>  >
>  > I propose we meet Brisbane in August 2007
>  >
>  > http://www.medinfo2007.org/
>  >
>  > Meeting in 2006 would also be nice, but may be more difficult to pull
>  > off.   I have the sense that the scale of our collaboration would be
>  > stretched by attempting to meet too often.   If we shadow MedInfo's
>  > pattern, once every three years, could be a good fit for now, and we
>  > can follow MedInfo as it hops about the globe.
>  >
>  > [wr]
>  >
>  > - - - - - - - -
>  >
>  > will ross
>  > project manager
>  > mendocino informatics
>  > 216 west perkins street, suite 206
>  > ukiah, california  95482  usa
>  > 707.272.7255 [voice]
>  > 707.462.5015 [fax]
>  > www.minformatics.com
>  >
>  > - - - - - - - -
>  >
>  >
>  >
>  >
>  > SPONSORED LINKS
>  > Software distribution
>  > 
>   
> >
>  
> 
>  >   Salon software
>  > 
>   
> >
>  
> 
>  >   Medical software
>  > 
>   
> >
>  
> 
>  >
>  > Software association
>  > 
>   
> >
>  
> 
>  >  

Re: OSHCA Meetings (was) Re: [openhealth] Re: List future [was: Why are you here?]

[Tim.Churches]

James Busser wrote:
> On Mar 18, 2006, at 8:56 AM, Joseph Dal Molin wrote:
> 
>  > the critical success factors
>  > for successful OSHCA meetings so far have been:
>  >
>  > - a local sponsor/champion eg. Mike McCoy and Colin Smith (Los Angles
>  > and London)
>  > - champion(s) and well connected organizing committee in OSCHA
> 
> Anyone have contacts/ideas for potential sponsor/champions in Brisbane?

I am keen to organise (or help organise) an open source workshop and/or
satellite conference as part of or around MedInfo in Brisbane in 2007. I
live in Sydney but at least its the same country (more or less...).
However, it is now March 2006, so I had better, as we say, extract the
digit and start doing something. I'll ask around to see who else is
interested in helping to organise same, and also enquire of the MedInfo
organisers to find out if anyone else is planning open source workshops.
I thought that the IMIA open source working group was. Could OSHCA
combine with that or is a separate mini-conference desired? How many
days? In Brisbane? But maybe at a cheaper venue (eg a university campus)?

Tim C

> 
> To what can we credit the past sponsorship/championing of Mike McCoy 
> and Colin Smith?
> 
> Maybe if we understand that, it will help to sustain & reproduce it.
> 
> 
> SPONSORED LINKS
> Software distribution 
> 
>  
>   Salon software 
> 
>  
>   Medical software 
> 
>  
> 
> Software association 
> 
>  
>   Software jewelry 
> 
>  
>   Software deployment 
> 
>  
> 
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth 
> "
>   on the web.
>
> *  To unsubscribe from this group, send an email to:
>[EMAIL PROTECTED]
>   
>
> *  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service
>   . 
> 
> 
> 
> 



 
Yahoo! Groups Links

<*> To visit your group on the web, go to:
http://groups.yahoo.com/group/openhealth/

<*> To unsubscribe from this group, send an email to:
[EMAIL PROTECTED]

<*> Your use of Yahoo! Groups is subject to:
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Re: [openhealth] Openhealth mailing list

[Tim.Churches]

Will Ross wrote:
> I agree with Bhaskar's proposal.   The openhealth@yahoogroups.com 
> list is not broken, so there is no need to "fix" it.   Rather than 
> dissipate community resources in an unnecessary technology migration 
> task, let's concentrate instead on the governance and planning tasks 
> needed for a cohesive re-launch of OSHCA.

OK, no problem. However, Horst's kind offer stands in case OSHCA does
ever need a server.

Tim C

> On Mar 17, 2006, at 7:40 AM, Peter Holt Hoffman wrote:
> 
>  > I agree with Bhaskar for all the reasons he enumerated in his email 
>  > below (I
>  > edited it to just the relevant portion).  I would also like to take 
>  > this
>  > opportunity to thank him for having started this group.
>  >
>  > -- Peter.
>  >
>  >
>  > -Original Message-
>  > From: openhealth@yahoogroups.com 
>  > [mailto:[EMAIL PROTECTED] On
>  > Behalf Of Bhaskar, KS
>  > Sent: Friday, March 17, 2006 10:32 AM
>  > To: openhealth@yahoogroups.com
>  > Subject: [openhealth] Openhealth mailing list
>  > 
>  >
>  > In my role as moderator, I see myself as serving the wishes of the 
>  > free
>  > and open source software for healthcare community.  One suggestion I
>  > would make, however, is simply to leave the list at Yahoogroups.  Yes,
>  > we can create our own list on our own server, but then we would be
>  > responsible for things like the list below for a server that will 
>  > sit on
>  > the Internet:
>  >
>  > 1. Backups.
>  > 2. Indexing and searching.
>  > 3. Anti-virus and spam filtering.
>  > 4. Security, including keeping up to date with patches.
>  > 5. Network access, bandwidth, data center operations.
>  >
>  > I recently had an opportunity to observe the need to respond to a 
>  > server
>  > that was found to have the t0rn root kit installed on it, and it was
>  > very disruptive on the lives of those who managed it.
>  >
>  > Yahoogroups does all of this for us, and the price is some advertising
>  > appended to each message (and if you opt for text messages rather than
>  > HTML messages, the advertising is at the bottom and quite innocuous).
>  > All the group moderators have to do is to approve requests to join the
>  > group.
>  >
>  > We already have several moderators from the community who are 
>  > members of
>  > the group, and there is redundancy should I, or any of the other
>  > moderators, have something untoward happen to us and be unable to 
>  > serve.
>  > I am also happy to accept others who would like to volunteer to serve
>  > the community as moderator.
>  > 
>  >
>  >
>  > [Non-text portions of this message have been removed]
>  >
>  >
>  >
>  >
>  > Yahoo! Groups Links
>  >
>  >
>  >
>  >
>  >
>  >
>  >
> 
> 
> [wr]
> 
> - - - - - - - -
> 
> will ross
> project manager
> mendocino informatics
> 216 west perkins street, suite 206
> ukiah, california  95482  usa
> 707.272.7255 [voice]
> 707.462.5015 [fax]
> www.minformatics.com
> 
> - - - - - - - -
> 
> 
> 
> 
> YAHOO! GROUPS LINKS
> 
> *  Visit your group "openhealth 
> "
>   on the web.
>
> *  To unsubscribe from this group, send an email to:
>[EMAIL PROTECTED]
>   
>
> *  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service
>   . 
> 
> 
> 
> 



 
Yahoo! Groups Links

<*> To visit your group on the web, go to:
http://groups.yahoo.com/group/openhealth/

<*> To unsubscribe from this group, send an email to:
[EMAIL PROTECTED]

<*> Your use of Yahoo! Groups is subject to:
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[openhealth] News story about an OpenVista implementation

[Tim.Churches]

See
http://computerworld.co.nz/news.nsf/mgmt/830C9682243AB990CC25712C0075BA53

They are using the proprietary Cache implementation of MUMPS on RedHat
Enterprise Linux as the back-end platform (not open source GT.M on
Linux), but the main thing is that they are deploying VistA, and claim
substantial savings over commercial solutions as well as apparent
benefits in care and efficiency.

Tim C


 
Yahoo! Groups Links

<*> To visit your group on the web, go to:
http://groups.yahoo.com/group/openhealth/

<*> To unsubscribe from this group, send an email to:
[EMAIL PROTECTED]

<*> Your use of Yahoo! Groups is subject to:
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Re: [openhealth] Post from Brian Bray of MInoru Development regarding the openhealth list name

[Tim.Churches]

Bhaskar, KS wrote:
> I am forwarding an e-mail from Brian Bray of Minoru Development, where
> he evidently expects this list to change its name.  I am not a lawyer -
> I do not know whether the name of a mailing list can conflict with a
> trademark, but I would like to bring his message to the attention of the
> members of the list openhealth@yahoogroups.com in order for you to
> express your opinions.

Good question. It also depends on whether Minoru has protected
"openhealth" through an International Trade Mark application under the
Madrid Protocol, and in which countries it applied for protection (and
whether registration of the application was granted and has been
maintained in those countries).

However, I suspect that none of this will matter to Yahoo - just the
merest hint of possible infringement of a trade mark registered in just
one country is probably enough to cause it to remove the list or require
a change of name.

But there are always Horst's servers as an alternative home, as I
mentioned previously.

> Please, no flames - let's keep the discussion moderate and professional.

Seconded.

Tim C

>  Forwarded Message 
>  > From: Brian Bray <[EMAIL PROTECTED]>
>  > Reply-To: openhealth-list@minoru-development.com
>  > To: [EMAIL PROTECTED], openhealth-list@minoru-development.com
>  > Subject: Why are you here? (was Re: Hello list)
>  > Date: Sun, 12 Mar 2006 21:01:17 -0600
>  >
>  >
>  > Tim Churches a écrit :
>  > > Hmmm, does Minoru plan to assert its trade mark against the
>  > Openhealth
>  > > list on Yahoo (see http://groups.yahoo.com/group/openhealth/ )?
>  > >   
>  > I'm not expecting that I'll have to. It depends on the the other
>  > list 
>  > and my decisions over the next few weeks.
>  >
>  > The way I see it, there are two possibilities for the motivations of
>  > the 
>  > creators of the other list:
>  >
>  > 1) It really is a question of the technical capabilities of the list
>  > and 
>  > the lack of support.
>  >
>  > In this case, the folks running the yahoo list will have no problem 
>  > changing the name to avoid confusion. The two lists will either merge
>  > at 
>  > some point or specialize to meet different needs of the community.
>  > The 
>  > yahoo list has critical mass, so a name change is unlikely to cause
>  > its 
>  > members to leave.
>  >
>  > 2) The motivation is to profit from the goodwill that Minoru has in
>  > the 
>  > community on an ongoing basis.
>  >
>  > In this case, the folks running the yahoo list will resist changing
>  > the 
>  > name and it will be necessary to assert the trademark to protect 
>  > Minoru's interests and reputation.
>  >
>  > But, as I said, I'm not expecting this to be necessary. I believe
>  > that 
>  > we can come to some understanding that is best for everyone.
>  >
>  > 
>  > In any event, the needs of the community have substantially changed 
>  > since the Openhealth list was created. When we started, there were
>  > just 
>  > a small number of open source projects. They were duplicating each 
>  > others work, the creators had never met or communicated, and the
>  > level 
>  > of competition was preventing collaboration to move ahead more
>  > quickly.
>  >
>  > Thanks to you and the other members of the Openhealth list, there is 
>  > much more understanding and appreciation of the merits of different 
>  > approaches to solve different problems. There is also much more 
>  > collaboration as projects exchange not only ideas, but modules (such
>  > as 
>  > FreeB for example).  Ongoing communication between projects is still 
>  > important, but there are now many mechanisms and places where that
>  > happens.
>  >
>  > The question I asked in my first reponse to your note "Why are you 
>  > here?" This is a serious question we should address to determine the 
>  > future of the list and whether it still has a value in the
>  > community. 
>  > The increasing number of open source healthcare projects creates a
>  > need 
>  > to objective comparative reviews and critiques to help refine their 
>  > work. There is also a need for greater communication and
>  > colllaboration 
>  > between physicians and engineers one the one hand, and open source 
>  > developers and medical informatics research on the other. Can this
>  > list 
>  > help meet these needs?
>  >
>  > --
>  > In terms of the technical capabilities of the list, the reason for
>  > the 
>  > long delay in upgrading the list is that my internet service
>  > provider 
>  > was not ready. I considered hosting the list on an open source
>  > product 
>  > or moving it to a free service in the past, but both these options
>  > had 
>  > drawbacks.
>  >
>  > It is just a fact of life that Minoru's sites are subject to attack.
>  > My 
>  > ISPs report that our sites are subject to more security incidents
>  > than 
>  > other sites they host, including e-commerce sites. I have hosted
>  > other 
>  > lists directly, and came to th

Re: [openhealth] Open Source Software: A Primer for Health Care Leaders

[Tim.Churches]

Tim.Churches wrote:
> Nandalal Gunaratne wrote:
>> Will Ross <[EMAIL PROTECTED]> wrote:
>>
>> Tim has done a good job of analysing this report.
> 
> I only covered 5 paragraphs in one small section of the report - that's
> all I have read. There are another 30 pages of it...

I skimmed through some more of it - their hearts are in the right place
and the overall thrust of the report is OK, but it is riddled with
annoying technical inaccuracies. For example, on page 14, they say:

"Each open source software program comes with a license that grants
royalty-free copyrights to the user."

Nope, that's just wrong guys - particularly annoying when just 4 pages
later they get it right:

"An open source project owns the software copyright. Licenses grant
certain nonexclusive rights to licensees."

However, I don't have the time or energy to review it all in detail. The
irony is that they could have leveraged an open source model for the
report itself, by a) inviting a group of people who knew something about
open source (eg those on this list...) to provide editorial feedback to
them so that the more egregious of their technical errors could be
corrected before publication and b) publish it under a Creative Commons
or GNU FDL (free documentation) license.

Tim C

>> I do not think anyone whould 
>> have the freedom to create their own versions of what FOSS means and the 
>> licences mean as well!
>>
>> There is however a subtle difference between "open source software" and 
>> "Free 
>> Libre Open Source Software..
>>
>> Nandalal
>>   Tim,
>>
>> I agree with your take on the report.   To me it falls into the 
>> category of "any publicity is better than no publicity."   I winced 
>> when reading it, knowing that the intended audience is inherently 
>> unfamiliar with open source as a license category.   The muddled idea 
>> that the level of restriction on a license has any causal 
>> relationship in the world with project forking is nonsensical, but 
>> unfortunately it seems coherent to outsiders seriously describing 
>> open source to their fellow outsiders.
>>
>> The up side of the report is that as wrong as it is on the details, 
>> it still opens the door for more expansive adoption of open source.   
>> I encourage non-technical executive decision makers to read it 
>> because the net effect is more legitimacy for open source solutions 
>> in the enterprise.
>>
>> [wr]
>>
>> - - - - - - - -
>>
>> On Mar 11, 2006, at 12:44 AM, Tim.Churches wrote:
>>
>>  > Maury Pepper wrote:
>>  >> Tim,
>>  >>  I'd be interested to hear why you feel that way about
>>  >>  the report. I have read comments by others praising
>>  >>  it.  Perhaps they have missed something.
>>  >
>>  > As I said, I have not read the entire report, and my observation that
>>  > teh authors did not understand what they were talking about was
>>  > restricted, as I indicated, to the section titled "Licensing for Open
>>  > Source". Here is what they say (numbers in square brackets refer to my
>>  > commentary which follows):
>>  >
>>  >
>>  > There are two basic types of open source licenses: unrestricted and
>>  > restricted.[1] Each applies in certain circumstances.[2] Unrestricted
>>  > licenses are a great way to promote broad use of a new technology very
>>  > quickly, such as implementing an important new privacy standard. 
>>  > They do
>>  > not limit the distribution of derivative works or the use of open 
>>  > source
>>  > software in commercial software.[3] The Apache and BSD licenses are
>>  > examples.
>>  >
>>  > Restricted licenses are ideal for maintaining the integrity of 
>>  > software
>>  > code and preventing splinter efforts.[4] The restrictions ensure that
>>  > the code will always be freely available.[5] This enables integrators
>>  > and the hospitals, clinics and practices they support to have a 
>>  > reliable
>>  > code base.[6] The Free Software Foundation has coined the term 
>>  > copyleft
>>  > (vs. copyright) to refer to restrictive licenses, like the GNU general
>>  > public license (GPL), which requires that modified versions of a GPL
>>  > program be free software as well.[7]
>>  >
>>  >
>>  > [1] This would appear to be a brand new classification or
>>  > characterisation of open source licenses which the authors have dreamt
>>  > up. I find it mislea

Re: [openhealth] [Fwd: [GPCG_TALK] Open Source Software: A Primer for Health Care Leaders]

[Tim.Churches]

Nandalal Gunaratne wrote:
> 
> Will Ross <[EMAIL PROTECTED]> wrote:
> 
> Tim has done a good job of analysing this report.

I only covered 5 paragraphs in one small section of the report - that's
all I have read. There are another 30 pages of it...

Tim C

> I do not think anyone whould 
> have the freedom to create their own versions of what FOSS means and the 
> licences mean as well!
> 
> There is however a subtle difference between "open source software" and "Free 
> Libre Open Source Software..
> 
> Nandalal
>   Tim,
> 
> I agree with your take on the report.   To me it falls into the 
> category of "any publicity is better than no publicity."   I winced 
> when reading it, knowing that the intended audience is inherently 
> unfamiliar with open source as a license category.   The muddled idea 
> that the level of restriction on a license has any causal 
> relationship in the world with project forking is nonsensical, but 
> unfortunately it seems coherent to outsiders seriously describing 
> open source to their fellow outsiders.
> 
> The up side of the report is that as wrong as it is on the details, 
> it still opens the door for more expansive adoption of open source.   
> I encourage non-technical executive decision makers to read it 
> because the net effect is more legitimacy for open source solutions 
> in the enterprise.
> 
> [wr]
> 
> - - - - - - - -
> 
> On Mar 11, 2006, at 12:44 AM, Tim.Churches wrote:
> 
>  > Maury Pepper wrote:
>  >> Tim,
>  >>  I'd be interested to hear why you feel that way about
>  >>  the report. I have read comments by others praising
>  >>  it.  Perhaps they have missed something.
>  >
>  > As I said, I have not read the entire report, and my observation that
>  > teh authors did not understand what they were talking about was
>  > restricted, as I indicated, to the section titled "Licensing for Open
>  > Source". Here is what they say (numbers in square brackets refer to my
>  > commentary which follows):
>  >
>  >
>  > There are two basic types of open source licenses: unrestricted and
>  > restricted.[1] Each applies in certain circumstances.[2] Unrestricted
>  > licenses are a great way to promote broad use of a new technology very
>  > quickly, such as implementing an important new privacy standard. 
>  > They do
>  > not limit the distribution of derivative works or the use of open 
>  > source
>  > software in commercial software.[3] The Apache and BSD licenses are
>  > examples.
>  >
>  > Restricted licenses are ideal for maintaining the integrity of 
>  > software
>  > code and preventing splinter efforts.[4] The restrictions ensure that
>  > the code will always be freely available.[5] This enables integrators
>  > and the hospitals, clinics and practices they support to have a 
>  > reliable
>  > code base.[6] The Free Software Foundation has coined the term 
>  > copyleft
>  > (vs. copyright) to refer to restrictive licenses, like the GNU general
>  > public license (GPL), which requires that modified versions of a GPL
>  > program be free software as well.[7]
>  >
>  >
>  > [1] This would appear to be a brand new classification or
>  > characterisation of open source licenses which the authors have dreamt
>  > up. I find it misleading at worst, unhelpful at best.
>  >
>  > [2] No, each type of license might best be applied in certain
>  > circumstances (or for certain purposes or projects). But circumstances
>  > rarely dictate that a "restricted" (i.e copyleft) or 
>  > "unrestricted" (i.e
>  > non-copyleft) license *has* to be applied, except of course for
>  > derivative works.
>  >
>  > [3] No, but nor do "restricted" licenses (such as the GPL) limit the
>  > *distribution* of derivative works.
>  >
>  > [4] Really? How? Forking of projects and code bases is just as easy 
>  > with
>  > GPLed code as it is with BSD licensed code, as is independent
>  > distribution of modified versions of that forked code.
>  >
>  > [5] The "restrictions" imposed by the GPL don't ensure that code will
>  > always be freely available - BSD-licensed code is just as likely to
>  > remain freely available as GPLed code - once released, BSD or GPL code
>  > will always remain freely available (as long as someone archives it 
>  > and
>  > makes copies of those archives freely available in perpetuity, but 
>  > with
>  > facilities such as SourceForge and Savannah, that almost always 
&

Re: [openhealth] [Fwd: [GPCG_TALK] Open Source Software: A Primer for Health Care Leaders]

[Tim.Churches]

Maury Pepper wrote:
> Tim,
>  I'd be interested to hear why you feel that way about 
>  the report. I have read comments by others praising
>  it.  Perhaps they have missed something.

As I said, I have not read the entire report, and my observation that
teh authors did not understand what they were talking about was
restricted, as I indicated, to the section titled "Licensing for Open
Source". Here is what they say (numbers in square brackets refer to my
commentary which follows):


There are two basic types of open source licenses: unrestricted and
restricted.[1] Each applies in certain circumstances.[2] Unrestricted
licenses are a great way to promote broad use of a new technology very
quickly, such as implementing an important new privacy standard. They do
not limit the distribution of derivative works or the use of open source
software in commercial software.[3] The Apache and BSD licenses are
examples.

Restricted licenses are ideal for maintaining the integrity of software
code and preventing splinter efforts.[4] The restrictions ensure that
the code will always be freely available.[5] This enables integrators
and the hospitals, clinics and practices they support to have a reliable
code base.[6] The Free Software Foundation has coined the term copyleft
(vs. copyright) to refer to restrictive licenses, like the GNU general
public license (GPL), which requires that modified versions of a GPL
program be free software as well.[7]


[1] This would appear to be a brand new classification or
characterisation of open source licenses which the authors have dreamt
up. I find it misleading at worst, unhelpful at best.

[2] No, each type of license might best be applied in certain
circumstances (or for certain purposes or projects). But circumstances
rarely dictate that a "restricted" (i.e copyleft) or "unrestricted" (i.e
non-copyleft) license *has* to be applied, except of course for
derivative works.

[3] No, but nor do "restricted" licenses (such as the GPL) limit the
*distribution* of derivative works.

[4] Really? How? Forking of projects and code bases is just as easy with
GPLed code as it is with BSD licensed code, as is independent
distribution of modified versions of that forked code.

[5] The "restrictions" imposed by the GPL don't ensure that code will
always be freely available - BSD-licensed code is just as likely to
remain freely available as GPLed code - once released, BSD or GPL code
will always remain freely available (as long as someone archives it and
makes copies of those archives freely available in perpetuity, but with
facilities such as SourceForge and Savannah, that almost always happens
these days).

[6] This is ambiguous: do they mean "access to a body of reliable code"
or "reliable access to a body of code (of variable reliability)"? If the
former, then I'm afraid that free availability of code does not
necessarily mean that it will be reliable.

[7] Wrong. The GPL requires that modified versions which are distributed
to third parties or otherwise published also be distributed under the
GPL. However, a hospital or clinic or practice may modify a GPLed
program as much as it likes, but as long as it does not distribute or
publish that modified version (and the GPL puts it under no obligation
to do so), it does not have to apply the GPL to the modified code - see
section 2.b of the GPL V2.

I am not sure if the authors misunderstand how various open source
licenses work, or whether the problem is their terribly sloppy use of
language, but either way, I feel that these foregoing paragraphs would
misinform a naive reader. What do others think? I hope the rest of the
report is better researched and/or more carefully written.

Tim C

> - Original Message - 
> From: "Tim Churches" <[EMAIL PROTECTED]>
> To: 
> Sent: Friday, March 10, 2006 11:15 PM
> Subject: [openhealth] [Fwd: [GPCG_TALK] Open Source Software: A Primer for 
> Health Care Leaders]
> 
> 
>> This report (see below for URL) may be of interest to subscribers of
>> this list. I haven't read the entire document, but a glance at the
>> section titled "Licensing for Open Source" reveals that the authors
>> don't understand what they are talking about. Sigh.
>>
>> Nice cover art, though.
>>
>> Tim C
>>
>>
>> Open Source Software: A Primer for Health Care Leaders
>>
>> Forrester Research
>>
>> March 2006
>>
>> As information technology in the health care industry evolves from an
>> administrative tool for billing and bookkeeping to a clinical tool for
>> improving the quality and efficiency of health care, the scope of
>> information sharing is expanding beyond the walls of individual
>> institutions. Achieving this level of integration will require that
>> software models overcome a host of technical obstacles, and that they
>> are accessible, affordable, and widely supported.
>>
>> This report examines the development and distribution of open source
>> software, a well-established software development model—and a potential
>> s

Re: [openhealth] OSS collections

[Tim.Churches]

Benjamin Jung wrote:
> Hello,
> 
> I was trying to find a website that lists Open Source Applications used
> in Healthcare and their status, e.g. obsolete, beta, stable,... A quick
> Google search returned some pages that list applications, but they do
> not go into more details. Additionally, most of these 'link collection
> pages' have been updated only "a couple of years ago".
> 
> Are you aware of any such websites that give up-to-date information?
> If not:
> Do you think such a site would be beneficial to market OSS in healthcare
> in one single place?
> Anybody interested in some initial email brain storming?
> 
> Imagine a physician/hospital/lab that is looking for an Open Source
> application for a specific purpose. Where do they get comprehensive,
> comparable information? Some applications are hosted on sites such as
> sourceforge and freshmeat; others aren't. Some applications are
> mentioned regularly in News and Blogs; others aren't. Some applications
> are being taught and introduced at university; others aren't.

As other people have already mentioned, there are several sites with
such catalogues and lists, with various degrees of currency.

However, all of these sites focus primarily on open source applications,
and to a lesser extent, open source infrastructure software (operating
systems, Web servers, database servers, programming environments etc etc).

Joseph dal Molin has correctly pointed out that pointers to evaluations
of health-related open source applications would also be valuable. The
problem is that there are, to my knowledge, very few such evaluations.
Indeed, they are rather thin on the ground for closed-source health
software applications as well.

However, there are an increasing number of descriptions or mentions of
open source software in health care and health research, and it may be
valuable to catalogue these.

For example, we have recently published a peer-reviewed paper which
describes a public health surveillance system based on data collected
from hospital emergency departments (aka emergency rooms, casualties),
which primarily uses open source software components, from the server
operating system up  - see
http://www.biomedcentral.com/1471-2458/5/141/abstract

(OK, I'll admit that SAS is used in a few places in the system, but
we'll replace that with Python and R code eventually.)

A wiki or simple online database could be used to collect links to
scientific papers and even web sites and blog entries which similarly
make reference to the use of open source in health. It would even be
possible to do some data mining to find these references, using Google
Scholar ( http://scholar.google.com/ ) or directly using the full-text
corpus now available for many open access journals (see for example
http://www.biomedcentral.com/info/about/datamining/ ).

However, I think that some sort of editorial oversight of such a
catalogue would be needed, to prevent accumulation of junk and off-topic
unsuitable references. Alas, at this stage, I am not volunteering for
such an editorial role, but would be happy to contribute items (and even
do some data mining to find candidate references). Perhaps one or more
of the existing open source software catalogues might like to expand
their scope to include references to or descriptions of OSS in health,
rather than just open source applications.

Tim C


 
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Re: [openhealth] Dangerous idea -- quality

[Tim.Churches]

Gregory Woodhouse wrote:
> I suppose you could call it an adjunct. I'm not suggesting we abandon 
> testing, only that to the extent that we are content (and that's 
> really the key) to rely on testing, we have admitted defeat.

Ok, thanks, now I understand what you meant. And incidentally I don't
altogether disagree.

Tim C


 
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Re: [openhealth] Takin' it serious...

[Tim.Churches]

Koray Atalag wrote:
> but what bothers me
> with your recent post though is how this challenge/criticism is made: I am
> perfectly happy with criticism in a constructive/respectful and not
> neccesarily professional way...This was unfortunately not what happened with
> that message :-(

Sorry if I offended you - it's these annoying cultural differences, you
know. It'll be so much easier in another decade or so when we all think
and act like Americans. Until then...

Tim C


 
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Re: [openhealth] RE: The Question

[Tim.Churches]

Koray Atalag wrote:
> Oops...Sorry, I thought this was a free discussion listNever mind my
> thoughts and keep goin...

OK. It's just that some of us treat open source healthcare software as a
serious matter, and thus we can't leave expressed thoughts such as yours
unchallenged, particularly when expressed on an publically archived
mailing list which is indexed by search engines, even when signposted as
"dangerous". Well, I can't. Everyone is free to think and express their
thoughts on this mailing list, but they must also be prepared to have
them challenged and questioned (in a polite, professional manner, of
course).

Tim C

> From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
> Behalf Of Tim.Churches
> Sent: Sunday, January 08, 2006 10:00 AM
> To: openhealth@yahoogroups.com
> Subject: Re: [openhealth] RE: The Question
> 
> 
> 
> Koray Atalag wrote:
>  > Q4: When we stop talking about security in healthcare information systems
>  > and start doing something that makes sense instead of inhibiting the
>  > innovation?
> 
> Golden rule of medicine: first do no harm.
> 
>  > Q6: When we start using skype (or some other free
>  > communication/collaboration tools) instead of making already giant telecom
>  > companies even stronger?
> 
> Note that Skype is definitely not open source.
> 
>  > P.S. Also regarding QA and Testing in SW I want to ask the question: Has
> the
>  > nature made any testing before releasing Homo Sapiens V1.0 on earth?
> 
> Yes, a few millions of years of hominid evolution to get the bugs out,
> but the basic subroutines initially appeared nearly a billion years
> earlier than that (archaebacteria are that old, aren't they?). At least
> 500 million years.
> 
>  > So why
>  > we bother? Just release and see if it survives...
> 
> You mean see if the patient survives the incorrect or absent information
> provided by the untested healthcare software? That's why it is necessary
> to bother, you see.
> 
>  > (of course not the
>  > embedded SW of some pacemaker or ICU devices! That's another story
> 
> Actually its not another story. And you were trying to organise a bid
> for tens of million of Euros to develop open source healthcare software?
> 
> Tim C
> 
>  > From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
>  > Behalf Of John Norris
>  > Sent: Sunday, January 08, 2006 7:27 AM
>  > To: openhealth@yahoogroups.com
>  > Subject: [openhealth] RE: The Question
>  >
>  >
>  >
>  > Great topic!  Here's one-
>  >
>  > When will more not-for-profit medical organizations band together and
> share
>  > in the development of open source software for their common interests?
>  >
>  > Dangerous in that I think it is disruptive and inevitable.
>  >
>  > John
>  > *
>  > Art, Information, and Ceramics.
>  > http://www.john-norris.net
>  > *
>  >
>  >
>  >
>  >
>  >   _
>  >
>  > YAHOO! GROUPS LINKS
>  >
>  >
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>  > 
>  > *  To unsubscribe from this group, send an email to:
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>  >
>  >
>  >
>  >   _
>  >
>  >
>  >
>  > [Non-text portions of this message have been removed]
>  >
>  >
>  >
> 
> 
>  > YAHOO! GROUPS LINKS
>  >
>  > *  Visit your group "openhealth
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> 
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Re: [openhealth] RE: The Question

[Tim.Churches]

Koray Atalag wrote:
> Q4: When we stop talking about security in healthcare information systems
> and start doing something that makes sense instead of inhibiting the
> innovation?

Golden rule of medicine: first do no harm.

> Q6: When we start using skype (or some other free
> communication/collaboration tools) instead of making already giant telecom
> companies even stronger?

Note that Skype is definitely not open source.

> P.S. Also regarding QA and Testing in SW I want to ask the question: Has the
> nature made any testing before releasing Homo Sapiens V1.0 on earth?

Yes, a few millions of years of hominid evolution to get the bugs out,
but the basic subroutines initially appeared nearly a billion years
earlier than that (archaebacteria are that old, aren't they?). At least
500 million years.

> So why
> we bother? Just release and see if it survives...

You mean see if the patient survives the incorrect or absent information
provided by the untested healthcare software? That's why it is necessary
to bother, you see.

> (of course not the
> embedded SW of some pacemaker or ICU devices! That's another story

Actually its not another story. And you were trying to organise a bid
for tens of million of Euros to develop open source healthcare software?

Tim C

> From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
> Behalf Of John Norris
> Sent: Sunday, January 08, 2006 7:27 AM
> To: openhealth@yahoogroups.com
> Subject: [openhealth] RE: The Question
> 
> 
> 
> Great topic!  Here's one-
> 
> When will more not-for-profit medical organizations band together and share
> in the development of open source software for their common interests?
> 
> Dangerous in that I think it is disruptive and inevitable.
> 
> John
> *
> Art, Information, and Ceramics.
> http://www.john-norris.net
> *
> 
> 
> 
> 
>   _ 
> 
> YAHOO! GROUPS LINKS
> 
> 
> 
> *  Visit your group "openhealth
>  " on the web.
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> *  Your use of Yahoo! Groups is subject to the Yahoo!
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> 
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> 
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Re: [openhealth] Dangerous idea -- quality

[Tim.Churches]

Gregory Woodhouse wrote:
> On Jan 7, 2006, at 3:41 PM, Tim.Churches wrote:
> 
>  > Gregory Woodhouse wrote:
>  > > Relying on process and testing as a means of achieving software
>  > > quality is an admission of defeat
>  >
>  > Um, are you suggesting that the undefeated write software which is
>  > always completely defect-free, without the need for any form of 
>  > process
>  > and testing?
> 
> No, that's not quite what I said,

OK, fair enough, I'm just trying to work out exactly what you meant.

> but I think the undefeated would 
> not be content relying on testing to determine whether or not their 
> software worked correctly.

Um, if you don't rely on testing, then how do you determine that your
software works correctly or not? I thought that provably correct
software was still in the research labs? ADA makes a stab at it, which
is why the US Dept of Defence loves it (they never make mistakes like
bombing innocent families in Baghdad, right?), but geez, look at the
costs. Similarly languages like Eiffel go to pains to make it hard (but
not impossible) to make mistakes due to extensive use of
programming-by-contract and pre- and post-conditions etc. But even then,
such languages do nothing to check that the higher-level design of
software is correct.

>  > I agree that slavish, mindless adherence to process is not a 
>  > substitute
>  > for putting one's brain in gear and really thinking through the issues
>  > of software quality. But I can't conceive of any approach to software
>  > quality that doesn't involve testing.
>  >
>  > No testing? Now that IS a dangerous idea!
> 
> Thank you.   :-)

I'm still curious as to what you suggest as an alternative or adjunct to
testing, if anything? Or are you just an extreme optimist?

Tim C


 
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Re: [openhealth] Dangerous idea -- quality

[Tim.Churches]

Gregory Woodhouse wrote:
> Relying on process and testing as a means of achieving software 
> quality is an admission of defeat

Um, are you suggesting that the undefeated write software which is
always completely defect-free, without the need for any form of process
and testing?

I agree that slavish, mindless adherence to process is not a substitute
for putting one's brain in gear and really thinking through the issues
of software quality. But I can't conceive of any approach to software
quality that doesn't involve testing.

No testing? Now that IS a dangerous idea!

Tim C


 
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Dangerous Idea 2 (was Re: [openhealth] The Question)

[Tim.Churches]

Tim Cook wrote:
> If any of you read The Edge ( http://www.edge.org/ ) you'll be familiar
> with John Brockman's annual big question to a chosen group of leading
> thinkers.
> 
> Many on this mailing list have been working together since 1999 or
> before in some cases. I am wondering..in the context of open source
> healthcare IT lessons learned so far.
> 
> "What is your dangerous idea?"

Sticking once again to Tim's brief of open source healthcare IT lessons
learned so far, my second dangerous idea is as follows (it is one which
I have voiced previously):

Large, expensive and important health IT projects have a rather high
chance of failing (or of being only very partial successes) - estimates
vary, but over 50% chance. Given that inescapable fact,
it is sensible for every large, expensive and important health IT
project (say any project with budget of over $1 million) to have a risk
management strategy in anticipation of such failure or very partial
success. So why not decide, from the outset, that 10% of the total
project budget be devoted from the outset to a "Plan B", which becomes
the major risk management strategy for the main project ("Plan A")?
Furthermore, why not mandate that Plan B, which should be as independent
as possible from the main project (Plan A), be done as an open source
project - with the results to be open sourced and the underlying
components to be, as far as possible, themselves open source. If Plan A
succeeds, then Plan B is still released to the world as open source, and
it is quite likely that someone somewhere will pick it and run with it,
so the money and effort spent on risk management for Plan A will not
have been wasted from the wider perspective. It may also be that Plan B
acts as ongoing competition to a successful Plan A solution,
thus preventing price-gouging for long-term support costs from the Plan
A vendor/developer, and giving them cause to stay on their toes. Open
source is a much better way to encourage such competition than simply
splitting investment between two conventional closed-source vendors,
since it is simple for small numbers of vendors to form a cartel. Open
source mitigates against such collusion.

Furthermore, if Plan A starts to look like it is going pear-shaped, then
the existence of Plan B means that the overall project management or
sponsors are far less likely to fall into the very common Fallacy of
Sunk Costs - see http://en.wikipedia.org/wiki/Sunk_cost - which causes a
vast amount of good money to be thrown after bad.

Of course, if Plan A fails spectacularly (as they so often do) or if
Plan A "succeeds" in a dysfunctional and very partial manner (even more
common), then Plan B can be life-safer (perhaps literally, since we are
talking about health care here).

The only counter-argument against the 10% open source Plan B
approach is that taking funding away from Plan A may precipitate its
failure. I doubt that this is often - or ever - the case: I have yet to
see a failing large health IT project which was rescued by injecting
only 10% more funding. Typically supplementary injections of 50-100% of
the initial funding are needed to salvage such projects.

Tim C


 
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Dangerous Idea 1 (was Re: [openhealth] The Question)

[Tim.Churches]

Tim Cook wrote:
> If any of you read The Edge ( http://www.edge.org/ ) you'll be familiar
> with John Brockman's annual big question to a chosen group of leading
> thinkers.
> 
> Many on this mailing list have been working together since 1999 or
> before in some cases. I am wondering..in the context of open source
> healthcare IT lessons learned so far.
> 
> "What is your dangerous idea?"

Sticking to Tim's brief of open source healthcare IT lessons learned so
far, my idea is, I suspect, not so much dangerous as unpopular, and that is:

In order to see an open source healthcare IT project through to the
stage where it can be installed and used on a routine basis, a huge
amount of  attention to detail, testing and final "polishing" effort is
required. Pulling all the threads together, crossing the tees and
dotting the eyes (and whatever other metaphors you can think of) almost
always requires a team of at least several people working on the project
on a full-time basis for at least several months - in other words, a
person-year or more of concentrated effort (and the larger or more
ambitious the project, the greater the final concentration of effort
need to get it to production-ready stage, particularly with respect to
testing).

The corollary is that many of the more ambitious open source projects
which are undertaken on a purely voluntary, spare-time basis produce
excellent proofs-of-concept, but so many then fail to make the jump from
there to a production-quality product, and rather get caught in a cycle
or endless elaboration or refinement of a prototype, which is a great pity.

Of course, exactly the same is true for nascent closed-source software
projects which fail to make the leap to proper resourcing, but a) we
tend not to hear about or be aware of those failures and b) they tend
not to have so many ideological and personal issues with external
funding, although the Faustian pacts demanded by venture capitalists are
often the source of much grief for the progenitors of many software
start-ups.

So what is solution? Well, the world desperately needs more
open-source-friendly venture non-capitalists. In other words,
organisations (or even wealthy individuals) who are prepared to fund
open source health projects through to completion - so we are talking
about sums in the range of several hundred thousand dollars to several
million, but not tens or hundreds of millions of dollars (which are sums
which large traditional health IT projects regularly consume).

Traditionally such benefactors have been philanthropic individuals or
organisations, such as the Shuttleworth Foundation (see
http://www.tsf.org.za/, although it focuses mainly on open source in
education, not in health). But large supra-national organisations
(particular WHO, but there are many others) need to adopt a policy of
*only* funding open source software projects, unless there are
overwhelming reasons to go with closed-source software (which is
currently their usual software development, although they fund
remarkably little health IT development in general). The same applies to
the World Bank, Asian Development Bank and many other similar
organisations. Finally, national and regional governments also have an
enormous role to play in providing open source funding, as an investment
in leveraging the skills and expertise of their own constituencies as
much as a way of achieving particular health IT ends (but they can do
that too).

Tim C



 
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Re: [openhealth] The Question

[Tim.Churches]

Koray Atalag wrote:
> I was crazy enough to put my personal funds and run
> after an R&D project to realize this approach; but as
> you might guess I failed! Now I do not have a car:(
> The World is not ready yetIf you are interested it
> is also at SourceForge.Net:
> 
> http://cerebrus-fp6.sourceforge.net

I had a look at the above site, but it was very difficult to divine what
the Cerebrus project was intended to be about - except that the idea was
to seek funding for it under the European 6th Framework. However, after
a bit of poking around, I found this document, which gives some clues:

http://cerebrus-fp6.sourceforge.net/docs/CEREBRUS_InitialProposal_Final.pdf

Um, very ambitious indeed. I think that even had you owned a fleet of
Rolls-Royces, you would still have to had sold them all!

Tim C


 
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Re: [openhealth] Reflexions on Knowledge Modelling

[Tim.Churches]

Tim Cook wrote:
> On Wed, 2006-01-04 at 10:33 +0100, Christian Heller wrote:
>  > However, I think it is time to accept a citation of Wikipedia,
>  > for example. Many profs claim that it were not "scientific" enough.
> 
> Wikipedia is not peer-reviewed in any formal process.  "All" professors
> should claim it is not scientific enough.  That said, I do think most of
> the information there is quite accuratebut I still use caution and
> NEVER use it for reference.
> 
>  > > Don't you (ALL) think we badly need an Open Source and
>  > > Free Journal in our domain. I strongly feel this must
>  > [..]
>  >
>  > There is one: http://www.josmc.org/
> 
> There is an online, peer-reviewed, free medical/health journal that is
> indexed and carries an (estimated) 2.0 impact factor:
> http://www.jmir.org/?JMIR_Home:Why_choose_JMIR%3F
> 
> They are also offering to provide support for a new journal if you are
> ready to start one.  See the website above for details.
> 
> You can also submit relevant research information to OpenClinical for
> publication; http://www.openclinical.org/home.html Though I doubt it
> will count for your publication requirements for your degree???

What is wrong with BioMed Central medical Informatics and Decision
Making? It is peer-reviewed and indexed in Medline. Fully open access.
If your university is a member then you won't have to pay any author
fees. If not, the charges are about teh same as for JMIR, I think.

See http://www.biomedcentral.com/bmcmedinformdecismak/

Tim C


 
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Re: [openhealth] Framework for interoperability between existing softwares

[Tim.Churches]

Nandalal Gunaratne wrote:
> 
> Koray Atalag <[EMAIL PROTECTED]> wrote:
> 
> namely CEN TC251, is centered around openEHR metholodologies and 
> artifacts...Also as far as I
>   know it is selected as a national standard in Australia -
>   
> What is? OpenEHR or CEN TC251?

Neither, unless something has been announced by Standards Australia or
some other national standards body recently.

>   as you might know
> Australia and New Zealand are two locomotive
> countries for implementation of
> good HIS technologies in all aspects of health informatics.

Are we really? I never realised...

> Is Australia using OpenEHR standards at all?

Not that I am aware of.

> Where can i find more info on Australian implementations?

I gather it is being used in a  HealthConnect EHR trial in Queensland -
but HealthConnect never publishes the details or results of its trials,
so it is hard to know how it is being used, really. No production
installations of which I am aware, but there is much of which I am not
aware.

Tim C


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Re: [openhealth] GPLMedicine.org

[Tim.Churches]

Fred Trotter wrote:
 >  >  I don't
>  > see how the GPL has a monopoly on unobtrusiveness.
> 
> It doesn't. However it is unobtrusive and can be trusted to be
> unobtrusive, which makes it a good default recommendation to medical
> IT decision makers.

The most unobtrusive licenses are the BSD/MIT license, and public domain
"licensing" - because in any situation, one never has to consider the
(often tricky) question "Am I permitted to use this software for this
purpose in this situation?", because the answer is always "Yes". On the
criterion of obtrusiveness, the GPL is the most obtrusive of all FOSS
licenses, because it imposes stricter conditions than any other FOSS
license. However, unobtrusiveness is not the sole criterion on which a
license should be chosen, although I agree with Will that it is an
important one.

>  >  I don't see how
>  > the GPL will guarantee software interoperability.   I don't see the
>  > value of elevating the license to the critical path en route to pure
>  > software interoperability.
> 
> The GPL really does not help with interoperability at all. In fact in
> some cases it can interfere.
> 
>  >  I think it's more important for the
>  > workers to be happy with their tools than for the toolmaker to
>  > enforce some sort of license lock-in strategy.
> 
> But by focusing on having tools we like, rather than focusing on the
> long term viability of the software, is how we got into this mess.

I'd agree with that, but from there you make the unfounded leap that GPL
licensing equates to software viability, or even software re-use, or to
maximisation of sharing of contributions to software development. It
ain't necessarily so.

> What we need are good GPL tools. You are quite right about one thing,
> however, it is impractical to suggest switching to GPL medical
> software that is less capable than a current proprietary solution.

What we need are good FOSS tools which can interoperate at the technical
and licensing levels. I don't care if they are licensed under the GPL,
the MPL, the BSD/MIT license or are public domain, as long as they are
FOSS. Frankly, I doubt many end users of such tools give a toss about
the licensing eiether, except whether the tools are free of proprietary
licensing hassles and costs.

Tim C


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Re: [openhealth] GPLMedicine.org

[Tim.Churches]

Fred Trotter wrote:
> My exclusion of other licenses is quite intentional. The GPL offers
> benifits that others do not. While it can make life difficult in certain
> areas, it does so because it does not compromise on the ethical issue.

It's your Web site, you are free to express whatever opinions and to
promote whatever positions you wish on it.

> The GPL has protection from patents.

Sorry Fred, but in countries which permit sofwtare patents, NO license
provides protection against third party patent claims.

Tim C


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Re: [openhealth] GPLMedicine.org

[Tim.Churches]

Fred Trotter wrote:
> Hey,
>   I know that just about everyone here is a LinuxMedNews regular, and as
> a result have seen my announcement there about GPLmedicine.org. I wanted
> to let everyone know that GrokLaw has picked up the story, so lots of
> people are paying attention.
> 
>   The success of the argument that I am making on the site will be
> largely comparable to the amount of traffic that the site gets. So if
> you all have blogs, link pages or other ways of promoting the new site
> please do so!
> 
>   If you agree with me on this issue, then please take the time to
> comment, on the LMN article, or on gplmedicine itself. Consider linking
> and helping the site to become more popular. If you do not agree with
> me, then all the more reason to do this. Ignoring the moral issues here
> is a mistake in any case.

No argument with the moral issues, just an argument with the apparently
exclusive promotion of GPL licensed projects over projects licensed
under other free, open source licenses.

The GPL is by far the most popular FOSS license, but as has been
explored on this very list and elsewhere, it is also the most legally
ambiguous and difficult to interpret (perhaps intentionally so). It is
also the most restrictive, and in some instances, particularly where
FOSS *needs* to be combined  with or very closely interoperate with
non-FOSS software, the GPL can be a real hindrnance and a more
permissive FOSS license, such as the Mozilla Public Licnse (which is
still copyleft but easier to interface with proprietary software) or the
MIT/BSD license (non-copyleft) or even the public domain (do anything
you like) are more appropriate. A key example of the last is of course
VistA (see http://www.worldvista.org/AboutVistA/ ) - but since it is not
GPL software, it would look strange being featured on your site. A pity.

Also, and I understand that the scope of gplmedicine.org is just medical
practice software, but I nevertheless must point out that there is a lot
more to improving health than medicine. Indeed, it has been cogently
argued that the huge gains in health status seen during the Twentieth
Century in rich and transitional countries were not primarily due to
advances in medicine, but rather due to improvements in sanitation,
water supplies and nutrition - things which still need to be addressed,
urgently, in so many poor countries. Actually, I registered the domain
opensourcehealth.org about a year ago - so I should stop whingeing and
put it to good use...

Tim C


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[openhealth] WHO Bulletin: August special theme: Health Information Systems

[Tim.Churches]

Thanks to Ken Harvey for the following information. A pity that WHO
does not recognise the role of open source software in establishing
suitable and sustainable health information systems in low and middle
income countries.

Tim C

Ken Harvey wrote:
> The latest issue of the Bulletin of the World Health Organization (WHO)
> Volume 83, Number 8, August 2005, 561-640
> Website at http://www.who.int/bulletin/en/
> 
> Summaries of a selection of articles from this month's issue:
> 
> This month's special theme: Health Information Systems
> 
> 
> In the first editorial, Sally Stansfield welcomes growing recognition of
> the need for more  investment in health information systems. Such
> systems may seem expensive for developing countries, but the costs are
> offset by improved efficiencies. In another editorial, Kimberlyn M.
> McGrail & Charlyn Black argue that developing countries starting to set
> up health information systems can learn from the mistakes of  wealthier
> countries. Middle-to-low-income countries should incorporate mechanisms
> to ensure that health data can be easily accessed by those who need
> them. Finally, Tony Williams argues that poor countries should shift to
> policy-making that is based on evidence by developing a health
> information system that adapts the existing data situation.
> 
> Why countries need health information systems
> 
> 
> In the News, Haroon Ashraf writes that developing countries are under
> pressure to build and reinforce their health information systems to
> fulfil donor requirements. In the Bulletin interview, Ties Boerma,
> Director of WHO Department of Measurement and Health Information
> Systems, discusses the development of health information systems over
> the past few decades and why countries need these more than ever today.
> 
> Health data as integral system
> 
> 
> In the leading policy and practice paper, Carla AbouZahr & Ties Boerma
> introduce the theme issue on health information systems and argue that
> health information should be treated as an integral system. This is
> difficult when donors determine data priorities based on their own needs
> and not those of the country as a whole. A further obstacle to a
> well-functioning health information system is cost, but the authors
> conclude that investment in such a system can lead to more efficient
> health-care services and save money in the long term.
> 
> Data for poverty reduction and Equity challenges
> 
> Three papers discuss the role of data in poverty reduction and
> addressing inequities in health. Sarah B. Macfarlane argues
>  ) that efforts to
> strengthen health information systems in low- and middle-income
> countries should forge links with data systems in other sectors. Lexi
> Bambas Nolen et al. 
> review core information requirements for health information systems in
> seeking to address these inequities and they propose short- and
> longer-term strategies for strengthening health information systems as a
> tool to analyse inequities in health. Finally, Vanessa Rommelmann et al.
> (pp. 569-577 
> describe how they examined nine systems that provide a range of health
> and other information in the United Republic of Tanzania.
> 
> Monitoring vaccine safety in Viet Nam
> 
> Health information systems to monitor vaccine safety are used in
> industrialized countries to detect adverse events related to
> vaccinations. Such systems are often absent in developing countries and
> are urgently needed. In his article, Lorenz von Seidlein describes a
> study in which he used a large linked database to monitor
> vaccine-related adverse events in Khanh Hoa province, Viet Nam. The
> study confirmed the safety of a measles vaccination campaign and showed
> that it is feasible to establish health information systems to provide
> reliable data in a developing country at low cost.
> 
> 



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Re: [openhealth] Re: [os-wg] U.S. Will Offer Doctors Free Electronic Records System

[Tim.Churches]

Will Ross wrote:
> Two new Vista's in one week.
>
> http://www.washingtonpost.com/wp-dyn/content/article/2005/07/22/
> AR2005072200589.html
> 
> "Sir, you asked for Vista.  Was that CMS Vista or Microsoft Vista?"

Joseph dal Molin might be able to rent space on
http://www.worldvista.org/ to a firm in Redmond

Tim C


 
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Re: [openhealth] New file uploaded to openhealth

[Tim.Churches]

openhealth@yahoogroups.com wrote:
> Hello,
> 
> This email message is a notification to let you know that
> a file has been uploaded to the Files area of the openhealth
> group.
> 
>   File: /openhealth-list.tar.gz
>   Uploaded by : tw_cook <[EMAIL PROTECTED]>
>   Description : Openhealth List archives 2003-05-27 to 2005-06-23
> 
> You can access this file at the URL:
> http://groups.yahoo.com/group/openhealth/files/openhealth-list.tar.gz
> 
> To learn more about file sharing for your group, please visit:
> http://help.yahoo.com/help/us/groups/files
> 
> Regards,
> 
> tw_cook <[EMAIL PROTECTED]>

Have the attachments in this archive which contain MS-Windows viruses
been removed? When it was sent to me to look at, my Windows machine
reported that it contained several viruses in zip file attachments.

Tim C


 
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Re: [openhealth] Re: openhealth mailing list archive export

[Tim.Churches]

Tim Cook wrote:
> The email I received did not contain the attachment.
> 
> Here's the report form my ISP:
> 
>  >  This email contained an attachment or file which may
>  > be harmful to your computer.
>  >
>  > cdbcccdd.zip was infected with the virus [EMAIL PROTECTED] or appears to
>  > be corrupted.
>  > For your protection, Shaw's anti-virus software
>  > has removed the file from this message.
> 
> 
> Of course the attachment wouldn't have been harmful to my computer 
> but I have no interest in distributing it if it does contain a virus.
> 
> Christian, can you very or deny this virus report?
> Maybe that's why it's failing to post on Yahoo.

Try http://www.uploadr.com/ to transfer the file.

Tim C


 
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Re: [openhealth] REMITT GPL violation

[Tim.Churches]

Fred Trotter wrote:
> Tim,
> 
> 
>  > 5) If SourceCodeA calls SourceCodeB at runtime only, then there is no
>  > requirement for SourceCodeA to be made available under the GPL. Note
>  > that apart from the fact that runtime behaviour is explicitly outside
>  > teh scope of the GPL, this is also a corollary of 4) above. In other
>  > words, even if SourceCodeA and SourceCodeB end up being combined into a
>  > single piece of object code at runtime, because that object code is not
>  > being distributed to others, SourceCodeA does not fall under teh
>  > provisions of ther GPL.
> 
> I do not think this is correct, and I think the FSF also reads the
> license differently.
> 
> http://www.fsf.org/licensing/licenses/gpl-faq.html#IfInterpreterIsGPL
> 
>  >From the link...
> 
> 
> For instance, Perl comes with many Perl modules, and a Java
> implementation comes with many Java classes. These libraries and the
> programs that call them are always dynamically linked together.
> 
> A consequence is that if you choose to use GPL'd Perl modules or Java
> classes in your program, you must release the program in a GPL-
> compatible way, regardless of the license used in the Perl or Java
> interpreter that the combined Perl or Java program will run on.

Nothing is certain under the law, but we have had formal legal advice
that the scenarious descibed above all reflect run-time behaviour, which
is explicitly and unambiguously excluded from teh scope of the GPL by
the following phrases, contained in the body of the GPL itself:
"Activities other than copying, distribution and modification are not
covered by this License; they are outside its scope. The act of running
the Program is not restricted,..."

The bottom line is that the "strong copyleft" provisions of the GPL
certainly exist for copying , modification and combining of source code,
but they are not as pervasive as many people think when it comes to
run-time behaviour. Sad but true.

Tim C


 
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Re: [openhealth] REMITT GPL violation

[Tim.Churches]

Fred Trotter wrote:
> Tim,
> 
>  > Personally I am opposed to software algorithms and business methods
>  > being patentable at all. But in those unfortunate countries in which
>  > such patents are issued (eg US, Australia, Japan, India), what you
>  > propose is probably OK, provided that universal royalty-free patent
>  > licenses are actually granted to all open source implementations (no
>  > just one particular open source implementation). That rarely happens, it
>  > seems.
> 
> Agreed.
> 
> 
>  > Correct me if I am wrong, but they are dynamically linking to your code
>  > at run-time, is that correct?
> 
> They dynamically link with the FreeMED project, but by concern is within
> the REMITT project itself which is statically linked perl.

Sorry, I thought that Perl automatically compiled source code to
intermediate object code at runtime, and that intermediate object code
then runs on a virtual machine? Isn't that correct?

Let's set it out clearly:

SourceCodeA, distributed in a distinct package, is licensed under the
MPL only.

SourceCodeB, distributed in a different, distinct package, is licensed
under the GPL only.

We accept the argument that the GPL and MPL are incompatible.

1) If SourceCodeA is combined with SourceCodeB and the combined source
code is distributed to third parties, then that combination of source
code must be licensed under the GPL.

2) If SourceCodeA is combined with SourceCodeB through statically
compilation, and the resulting object code is distributed to third
parties, then SourceCodeA (as well as SourceCodeB) must be made
available under the GPL.

3) If SourceCodeA is combined with SourceCodeB but the combined source
code is NOT distributed to third parties, then there is no compulsion to
provide access to that combined source code under the GPL.

4) If SourceCodeA is combined with SourceCodeB through statically
compilation, and the resulting object code is NOT distributed to third
parties, then there is no compulsion to make SourceCodeA available under
the GPL.

5) If SourceCodeA calls SourceCodeB at runtime only, then there is no
requirement for SourceCodeA to be made available under the GPL. Note
that apart from the fact that runtime behaviour is explicitly outside
teh scope of the GPL, this is also a corollary of 4) above. In other
words, even if SourceCodeA and SourceCodeB end up being combined into a
single piece of object code at runtime, because that object code is not
being distributed to others, SourceCodeA does not fall under teh
provisions of ther GPL.

Tim C


 
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