Dear Balu,
I feel like a bit of a "dog in the manger" but fully expect to see you
tonight at the VAGUE meeting at UVM Waterman. That said, some comments
follow:
On Mon, 19 Jan 2009, Balu Raman wrote:
As I understand it, VITL's protocols are open standards
(HITSP/HIE/CDA/ebXML/HL7), except maybe the vocabulary isn't open. Is CPT
required? Is the cost of translation so prohibitive?
In theory, VITL should not care what vendor a practice uses. A FOSS system
should be just as good as one from one of their preferred vendors. A RHIO
regulate only the "wire".
There is a second project within VITL in addition to HIEN, that is , EMRs in
physicians' offices which are needed if the HIEN is to succeed. That seem to
be the motivation for that Technical Document they produced and that's where
I am raising issues for no mention of FOSS.
Where is this document, can it be viewed from the web? What is the URL?
This is the first version I am talking about, they may have updated it
since then. They were funded for producing this document.
If state funded, this document must be available, or we need a legislative
inquiry. Please let us know where it is.
My question was that other states have already done all the study, why
not just adopt instead of claiming Vermont should do their own.
Not to mention the government and commercial interests available....
The second issue is that they hand picked a few commercial vendors for
EMRs and funded a few practices, to implement EMRs and they are now
studying the success of those findings.
Breen systems (http://www.breensys.com/), a local medical information
systems firm, appears to have been cut out of access to the State funded
VITL information and process. I am continuing to investigate this.
I also applied for funding during that time for the OpenEMR in our
office , highlighting Open Source and even if it did not have everything
on their laundry list, they will be implemented. I also conveyed the
advantages of Open Source and how the system will be freely available
for other practices. My intentions were that it could be grown
organically bottom up. I spent quite sometime talking to Farnum, TWO
people from VITL showed up at our office and I demoed our system. They
were much more talking and taking notes but did not show any interest in
the system.
Clearly VITL needs to change orientation on the matter FOSS. On the other
hand, Balu, we need to present FOSS EMR systems in a more formal fashion.
There is a gulf of difference between FAHC and practices. I have mixed
feelings about this HIEN, I have read that some of them have failed out
on the west coast. I see MA talking about the success they are having.
There are other privacy issues, read an item on Slashdot today.
...an item reference URL would be nice...
I am much more focussed on individual practices and EMRs in those offices.
There is a huge cost there which physicians cannot afford. With my tunnel
vision with FOSS, I see this as a huge advantage, especially the cost
involved in too many rules and regulations coming down the line, CCR
etc.etc.
Balu, we need a presentation on this matter.
ePrescription is another big issue.
I almost think that another entity, VIOTL ( Vermont Institute of Open
Technology Institute) should be started, and leave VITL alone.
Speaking with complete selfishness, the Barre Open Systems Institute
(www.bosivt.org), needs the work!
They [VITL] just don't get it. My personality and my current situation
doesn't lend itself to do this. I am looking forward to some you,
younger folks, would do that.
Guru Balu, I am older than you, get some of your medical buddies to slip
you some caffeine, B-12 or something. We really need a poster child, and I
pin my hopes on your genius in this area.
And, they should not require you to use the GE data center assuming your
own data center is accessible to standard queries.
A payoff to GE Taurant and maybe the Republicans!!!!! Are you kidding?
Have a look a the Mirth Project. Its FOSS and I will bet it can
provide an interface acceptable to VITL. (And, if not, I am curious
why.)
I have looked at Mirth and hope to use it soon to get lab data from our
local hospital whenever they are ready.
Presentation boys, we need to understand this architecture at a high
level. Would it help to host a conference at BOSI on Vermont
Bio-informatics? Would VAGUE support such a meeting?
Sorry for the random ramblings from Thompson Flour Shop in downtown
Morrisville, typed on a EeePC running EasyPeasy :-)
You got an EEEPC! You DAWG!!!!
Kindest Regards,
Paul Flint
(802) 479-2360
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Paul Flint
Barre Open Systems Institute
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Work: (202) 537-0480
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Consilium
gratuitum .~.
valet /V\
quanti /( )\
numerantur ^^-^^
