Hail Vaguers! We could have a script party where everyone brings their fav scripts? A "Script-off"!
But I just wanted to get this out, maybe off-topic and not apropos to the meeting or a presentation: [Prelude] Vermont is slated to get about 1Bn in the coming months and a good chunk is going into health-care, lots of it likely earmarked to EMR initiatives that BoB hopes will cut HMR bureaucratic fat. I suspect the 'big wheels keep on turning' and proud mary is beckoning GE et. al. to line up at the trough for their slice of that pie. The opensource debate here is about a loud as that of the 'single-payer' voice relegated to the wilderness, so I strongly doubt it will factor anywhere under a 'big-picture', even if it finds growing resonance with independently minded practitioners. Unless driven by some popular demand. This is due, IMHO, to high professional salaries and the profit incentives of the insurers; that the debate of quality health-care will never show fruit unless insurers are removed from the decision-making process of who is treated and how. Don't hold your breath:) but if you examine the 'assembly-line' theaters in cuba or the ex-soviet union you know that quality surgery can be had for much, much less than what we currently pay and is just, if not more convenient. I honestly have no complaints w/the medical system here in VT. Copley and my 'primary' are as good as anywhere else. But I have insurance, and no real pressing illnesses, and finally know that my little co-pay is just the tip of a cost-shifting ice-berg that keeps people from knowing the true price. I think everyone should pay out of pocket and get re-imbursed, if only for them to fully know how much they are actually being billed. My doc wanted to see me a week after a physical for a follow-up. I went back a week later, sat for 10 in waiting room then got called in. "How ya feeling? OK? No ------? Good let me know if anything changes." That was it - 5 minutes. At reception I get asked for card and make the co-pay. Then I ask how much it really cost. She told me $85. I once asked for an itemized billing when I had to stay at the hospital overnight. The tray table used to serve food was listed at $119. I believe in 'house-calls': in bringing the classroom to the student, the doctor (or dentist) to their patient. I just don't think that every doctor wants to be a millionaire or has mountains of debt to pay off. I suspect that some/many would be happy working for a livable wage if you rid them of the red-tape; that many might even like the concept of being mobile. I'm convinced that this now-quaint system can once again reach more people with preventative and remedial care than appointments in an office; that it can do so for less cost by eliminating the 'profit-motives' of the insurers to a bare minimum and putting the doctor on a (comfortable) salary. I've spent the past couple of months looking at FOSS EMR applications and their potential applicability in the medical community. The debate seems to hinge on both vendor-power and the bureaucratically political fronts; do these apps 'cut it' professionally and, if adopted by a small independently-minded subset of practitioners, the costs of switching and any hurdles they might face on the cusp of Statewide or National integration. [/Prelude] [ Brief Rant] I have no idea where the time goes:) but it seems like most of my day gets swallowed up with immediate 'stuff'. The presentation on blender made me want to get my hands back into 3D modelling. The one on Rosegarden made me wish i could play with synth and sounds. But months later, alas, both lie unused, waiting for the bus. The same could be said for the stages of various other projects: the mythbox, my budding X.10 home net, whatever, the list goes on.... finding balance, between time spend in front of screens vs. getting out and 'living' puts projects and so many good intentions on pause. My point here is that presentations, though extremely interesting, often don't get much traction beyond the door, despite my sincere interest. I guess its a question of practical use. Presentations related to some common denominator that has broad applicability stands a better chance for me to take what i've gleaned and actually put it to use. I wouldn't be inclined to want to sit thru just a demo of openEMR, despite my desire for its continued success. I would be interested in listening to a presentation related to the specifics of how it was implemented, the 'total package' office setup, the costs, the particulars of any devices the server serves, scripts used etc.., how it was pitched and presented, the challenges faced with it's use.... while a demo was running:) [/Brief Rant] So, I guess, for me at least, any presentation of this subject would have to have a wider scope of applicability to hold interest. Otherwise, it will just get pushed into some vague place in the dusty archives of forgetibility. But a notion occurred to me while I was doing this background research that someone here may be able to elaborate on, if not making for good fodder at a meeting: I'm wondering if a bplan could be written for a mobile unit, a converted RV, that is owned and operated by some medical office or company, in conjunction with the State, as a low-cost solution providing basic health-care? I'm still sketchy on the details of the arrangement, but the physician (or dentist) (maybe accompanying EMT or assistant?) would make their 'rounds' and be paid a co-pay regardless of whether the client/patient was insured or not. If insured, the charge would be passed onto the provider, otherwise it is subsumed by a State-sponsored provider who negotiated the policy in conjunction w/other N.E. States similar to bulk prescription drug purchases. Again, note this is just (initially at least) 'basic' care, GP stuff like physicals or cavities. What would make 'house-calls' more efficient than office-visits would be the technology behind the system, the place where we geeks can shine and strut our stuff:) I see a mobile LAN, using openEMS (w/other applications) and an EVDO card for wireless connectivity. Client times would be pre-arranged, heck they could even run like a blood-mobile, parked at a (hot-spotted) location for a specific length of time. Scheduling would be run by a VOIP-based system that robo-calls a neighborhood or community to setup and confirm appointments and then (heuristically?) google-maps out each days schedule. (how would that be done?) Each patitent/client would be issued a thumbdrive/smartcard containing their gpg-encrypted records on an encrypted filesystem. The encrypted key/data would also be on a main server, accessible to the patient from anywhere (incl other offices) via https. (how would that be done?) I'm pulling numbers out of my hat here, but i think the number of patients seen under a system that costs less can cover the salaries and insurances and overhead of the mobile unit. I also think it would take a system/concept like this to get the FOSS camel's nose into the State's medical tent, complete with all the geeky H/w S/W herbs-n-spices that we internetworking folk have come to love to do more with less. Any takers? On Saturday 14 March 2009, Josh Sled wrote: > Paul Flint <[email protected]> writes: > > There had been discussion of featuring FOSS Medical software. > > Yes, and the discussion was that Balu is completely unavailable to talk > about that this month, or in the near future, though he has indicated > that he'd be willing to entertain the idea later in the summer. > > Are you offering to present on that topic? Despite the couple of calls > I've made for contribution, no one has stepped up, so we have no > specific topic, as indicated in the announcement. >
signature.asc
Description: This is a digitally signed message part.
