Hi

On 25 September 2011 14:18, J. Antas <an...@e-healthexpert.org> wrote:
>
> I was referring to 'command and control' not governance and leadership.
>
> Any software development project needs governance and leadership.
> Healthcare supporting software do need, perhaps, even more than other
> software projects
>
> The problem is that healthcare systems are a special kind of
> systems - complex adaptive systems - and those cannot be governed by
> means of command and control.
> In those systems "the way to go" naturally emerges from the day-to-day
> activities.
> Sometimes, under a few very special conditions, you even influence
> those systems. But you will not be able to dictate "the way to
> go" by decree (either of a single individual or of an illuminated
> oligarchy).

It has been a source of amusement for me over many years that people
involved in a particular kind of system, always think that theirs is
"special kind of system" and that facts common to all other systems do
not apply on theirs. The truth is normally very different...

>
>> amazing job in trying to bring these disparate branches together, but
>> I honestly believe that the best thing to do with care2x_tz is to
>> scrap it, and restart the project from this latest code base.
>
> The real innovators have been Gjergj and Mauri, not Meggle.
> Most of the relevant work that is being raved now I can trace it back
> to Gjergj or to Mauri.
> I find it more difficult to trace back any good code or pragmatical
> ideas to Meggle.
> I have been following, however, that tendency that Meggle has to be
> "the owner of the shop" (looking back, I wonder, is this one of those
> "german things").

Well I know all 3 individuals on a personal and a professional level,
and I am surprised, and I think they will be surprised by this rather
silly and racist statement.

>
>> Well I don't think the care2x developers can be blamed for the demise
>> of the PHP6 project. I too have my doubts about the usefulness of the
>> phone interface, but I'm not sure I would call it a wild goose chase,
>> just an interesting initiative that may or may not come up with
>> something useful.
>
> That's where governance should step in. To call these attempts what
> they are: a waste of already scarce developer resources.

Without any command and control surely people can work on whatever
aspects of the system they want to, not just the ones that you dictate
will be a waste of time. The best ideas will get incorporated, the bad
ones will die. That's how open source works. BTW I think you will find
that the phone interface idea came from Mauri not Robert.

>
>> As for the gui, if you have ever used the current
>> one you will surely agree it could be improved :-)
>
> Well, I have used a lot (for a few years now, I tendo to prefer
> OpenEMR) and I agree that the GUI needs improvement. But that
> improvement is not critical. What is critical, in this fase of the
> project (and, at least in the last 6 years), is the simplification and
> modularization of the code.
>
>> Well after many years in open source, I believe that those projects
>> which have a strong central command are best placed to survive. Look
>> at most of the successful projects they have this strong centre.
>
> A strong leadership and a lean governance mechanism.
> Linux, Ubuntu, Nginx, Postfix are good examples of that.
> MySQL, PHP and Apache are lousy examples.
> Just to cite a few.

Exactly my point I'm pleased to see you have changed your mind are now
in favour of strong leadership.

>
>> Either I don't understand you or this paragraph is nonsense. What
>> emulator platform are we talking about?
>
> Those which try to emulate a LAMP in a non L(inux) machine?

Well just as equally LAMP is an emulator of a WAMP machine then isn't
it. Can you maybe illustrate your point by telling us where the code
works in Linux and not in Windows?

>
>> >  c) use a single widely available platform (price free and open
>> >  source): with single, specific, OS flavor, DBMS, Web server, Web
>> >  interface. Everybody must be using the same platform and living the
>> >  same day-to-day problems, to be able to quickly see what is
>> >  related to the Care2x code and what is due to idiosyncrasies of
>> >  the platform;
>>
>> As above.
>
> To be able to develop and debug Care2x and not be distracted by
> problems not related with the Care2x code, we should reduce
> variability:
> by using a given distro flavor, periodicaly updated following a
> given cicle (problems dealing with the code changes
> in DBMS, PHP and other supporting software are naturally taken care by
> that distro maintainers & update mechanism).

You are missing a crucial point I think. Given that apache, PHP and
mysql are all available under a windows environment, how do you
propose the developers should prevent people from using Care2x in
windows or even on a Mac?

It seems to me that having ranted about command and control earlier
you are not only trying to dictate exactly what the developers can and
cannot work on, but even the computer on which the user can use the
software.

>
> This single change was critical to boost the success of OpenEMR.
> Not so long ago (2 years?) it was quite like Care2x, now it is one of
> the sole Full 'Meaningful Use' Certified Open Source software
> (http://openhealthnews.com/hotnews/openemr-41-achieves-full-meaningful-use-certification).
>
> And, by the way, I continue to think that the best thing that could
> happen to Care2x would be a merge with the OpenEMR project. They need
> those hospital management extensions, and Care2x sure would profit from
> that project leadership and development flexibility and discipline.
>
>> >  d) reduce the number of tables needed to make Care2x run to half of
>> >  what they are now;
>>
>> I agree, but have you checked out the latest code?
>
> Well, yes. And I am sure that if you check with Gjergj he will be
> able to tell you who first suggested the need for that (and a few
> other) changes a few years ago.

Ok, so you are agreeing that your original email was done without
having checked the code, and are now trying to take the credit for the
changes that you hadn't bothered to check for :-)

>
>> This is exactly what Robert and Gjergj have been doing with this 3.0
>> code. Did you not look at it first before sending this email?
>
> Ditto.
>
>> I don't think (though Robert may correct me) that there is any
>> intention to prevent developers from working on the core, its just
>> that as with most projects, having commit access to the core will be
>> restricted to those who have proved their ability first.
>
>  "L'enfer est plein de bonnes volontés et désirs"
>
> I hope that time will show that I was wrong and that you were right.
>

I don't think you really "get" open source ideas. Nobody can actually
stop this from happening.

>
>> > Somewhere in the paper it is written: "Build a standardized process
>> > and business outcomes"
>> > Beware of the fact that standardization and innovation are opposite
>> > variables.
>>
>> Hmmm, I am not sure that this is correct, what is your basis for this?
>
> Try to google for "standardization vs innovation"

I did it brought up many interesting views, some agree with you many
do not. Seems the jury is still out on this one.

>
> If you have a special interest in this subject in this field, I can
> select and sugest a few of the best papers on that subject.
>
>
>> > Since Elpidio's first code releases we have had more and more
>> > standardization and less and less innovation and creativity...
>
> We are in a sore need of another Elpidio in his first days.
>

You are volunteering to contribute positively as well as negatively?

>
> Best regards,
>
> JA
>

Thanks
Tim


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