Balu:

I see over on http://linuxmednews.com/1190745985 that you have been
fighting the good fight opening VITL to FOSS for some time.   Great
work.   (If you had this on VAGUE before, sorry I missed it.   Maybe
Vermont needs a separate list for Open Source EMR issues.   Maybe there
is one and I don't know about it.)

However, I don't quite understand your (or Flint's) negativity about
VITL's stance on FOSS.    They do list FOSS EHR systems that are
available, thanks to you, I am sure.   Okay, they won't fund pilot
projects from off-list vendors (at this time).   This seems reasonable
to me since the pilot projects are funded from private contributions
(which may well be the preferred vendors themselves).  Yes it is vendor
buy-in.   So what?    Caveat emptor.

I have been reading VITL's Vermont Health Information Technology Plan.  
I see no lock-out for off-list vendor's systems, including FOSS-based
systems.  In theory, at least, we should be able to connect a FOSS EHR
into the Vermont HIEN (Health Information Exchange Network).  
http://vitl.net/interior.php/pid/7

Yes, this document is a laundry list of industry standards.   Is is
short on the details of interop.    But most of these standards are open
(at tthis point), so we can press VITL for the details.

Next step I would like to see is for VITL to publish their _technical_
criteria for qualifying Topical Applications (as they call the connected
client hubs) on the "wire" for access to the Vermont HIEN.   They don't
care how you manage the records in your office.   All they can qualify
is the wire format.

Ideally, they should be offering a validating test suite for this.  
Ideally, this test suite would be open.   Ideally, software could be
qualified without having to install copyrighted lexicons, provided it
has the ability to support such lexicons.  Ideally, VITL would not
require an extra fee for qualifying connected hubs.   No fee outside of
their standard subscription rate should apply to FOSS, or any off-list
vendor.    Ideally, the pilot grants (which do favor certain vendors)
would not be used to pay the subscription fee.

Reality is probably not going to match my ideal.    The problem I see is
that VITL does not put details on their site about qualifying off-list
vendors for connection to the network, which is a different matter
entirely from having preferred vendors for the pilot grants.

    * I will be at the upcoming VAGUE meeting, 1/20, in Burlington.  
      Since there is interest on this list, I propose we have a
      chit-chat about getting a test hub qualified for the Vermont
      HIEN.    Just a matter of principle rather than a commercial venture.
    * VITL SUMMIT 2009, Wednesday, Sept. 23 and Thursday, Sept. 24,
      2009, Burlington Hilton.    It's a good target date to shoot for
      to get a FOSS hub qualified.

-- Dan

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