Interesting thread.
I just got hot under the collar, and sent out the following, to some big
shots :
===========================
Ladies/Gentlemen:

I hate to do this, but, I thought I would resort to this, to highlight some
inadequacies, meaning, too expensive ways the EHR implementations being
pushed by VITL.

In addition to expensive/vendor-locked-in systems that you would find as
recommendations on VITL site, there are systems based on FOSS . FOSS is
based on a model of Open Source, non-proprietary, meaning the software
source code is open for anyone to read. There are advantages to source code
being open, that I will not go over here. The whole Google infrastructure is
built on FOSS model, a massive grid running on Linux, in case you are afraid
of an alternate model.

Coming to the health field, we have OpenVista EMR from the VA systems. There
are other FOSS EMR systems, not as popular as OpenVista, but very good in
what they do. We are a pediatrics practice using a system - OpenEMR - we are
very happy with.

Some of the immediate advantages are - cost of the software, better support,
very agile to tailor to the practice requirements, inter-operable to any
open-protocol, in addition to being Free as in Freedom, not as in Free Beer.

VITL has done a good job , as far as education for the urgent need of EHR's
is concerned, but they have totally failed in their recommendations, as far
as cost is concerned. I know the State would like to pour some cash for
practices that can't afford the cost, pushing proprietary systems. It's
time, the directors and people in power have a good look at the Open Source
Model, in this day and age of economic times.

The Vermont Health Information Technology Plan put out by VITL does not
mention anything about FOSS, and the only thing I can conclude is how
clueless the authors are, with respect to the FOSS model. Besides, when you
search on the web, you would find other states who have done a  better  job
on their Health Technology Plans with a page or  two  on  FOSS.  I don't
know  how Vermont is any different than other states in Health Technology
Plans. Why would we fund to write our own home-made Vermont Plan, when we
can borrow from what other states have done ?

Yes, I have talked to Mr.Farnham , and others in VITL. My only conclusion is
that they have a different agenda, and there seems to be a high resistance
and lack of motivation for looking at other disruptive models.

Well, you folks don't know me. All I can say is that I am a tax-paying
Vermonter, and this is not how we spend. I also manage a solo Pediatric
Practice using OpenEMR . To know more about openemr, go to openemr.org.
Any more questions, you can reach me at : [EMAIL PROTECTED], mentioning the
subj line - FOSS EHR.
Once again, sorry for spamming you this way :-)

Thanks,
Balu Raman, MSEE.,CCP**
Ryder Brook Pediatrics
P.O.Box 608
Morrisville, VT 05661
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