I'm impressed with the size and activity of the project.
It is big and chaotic and most of the time "evolutionary" (as in a biological system).
Currently some of us are ultimating a EU draft to propose it as an EU health IT pre-standard.
From the presentation at OSHCA in Geneva I have the impression that one of theproblems the project has to solve is exactly that rapid growth.
There are other needs, like solid theoretical support. If we could borrow just 10% of the creativity from all those discussions at the "openhealth list"...
I saw a posting a while ago comparing the SQL --> webserver --> browser interface with that of VistA and it struck me that most of the differences amount merely to Care2x being considerably newer.
As I said, VistA is still the best. I would say that it is an order of magnitude better. But I would not risk to use its informational model to create a Amazon.com, a Google.com, or any other of today's highly successful information "chewers". And until further proof on the contrary it seems to be safer to see hospital IT systems as large information "chewers" with some high reliability needs.
As far as the client goes, the M to HTML "M2Web" work that Jim Self in Los Angeles has done is impressive.
I agree, but it still feels like installing a motor to a horse cart.
I just imagine what it would be (to continue) to express ourselves in latin in order to talk about medicine... or about health IT.
On the SQL side, the EZI-Objects or the MSQL system that is used in the English NHS provide a crossover.
Same thing here. New times need new tools. We must meet the developers needs and try to use the tools that they are comfortable with. The M language; the derived DBMS like services; the proprietary low-level transport protocols, these are all things that, although unquestionably good, are past history. New times need new paradigms.
Unfortunately I do not know the English NHS IT paradigms as well as I would like. What I know of it is more related to the former portuguese effort to use the King's Fund Certification methodologies for hospital quality control. These were good, solid, purveying a sense of quality... but of no practical use because it lets the institutions to continue to mistreat patients, but this time under an "official" seal of quality.
The more interesting parts of these developments are the business code - the routines for handling medical information other than simply storing and retrieving it, becuase each platform will surely be supplanted by another, whereas algorithms go on for ever.
And in order to have good algorithms we need to enlist more creative minds.
I have some code which I shall translate into Perl or Python or something, which is used to handle the NHS numbers - this is a 9 digit number with a check digit a unique one being allocated to each UK resident.
As far as I know that part of the Care2x project is being perfected in UK by UK developers.
I think the German version is less national and more regional, but perhaps there is a similar module in Care2ex?
Yes, that concept of a single universal patient identification code is nuclear to the Care2x environment (I guess that in this area Norway is light years ahead).
But please try to not see Care2x as a German project. It is not.
At most we try our best to keep it free from that old all business/all profit attitude that unfortunately seems to be nuclear to some anglosaxonic countries.
As a bottom line I would say that the easy part is writing the code.
The harder work is:
- to perfect a pragmatic conceptual model for the project,
- to select the real useful functions from the spec. sheets before writing even a single line of code.
And, finally, as this is an open source project (which was not the case of Vista for many years), sometimes it is almost impossible to get the attention of teams from different countries and cultures and with different needs in order to make it all fit together. Sometimes "Babel tower" just gets a new meaning...
J. Antas [EMAIL PROTECTED]
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