(from management overview to working programmer) can get at it at the level needed. The community should note that John Glaser at Partners has produced the only book on Strategic Information systems planning for healthcare (and by application how those general principles apply to the use of the M infrastructure). World VistA and the NE MUG need to put there heads together to get active the kinds of forums that used to be present at MTA meetings. Moreover, Nancy Anthracite's recent comments about reactivating the standards (MDC) activities as a vehicle for documneting the common conventions for continued evolution of M as a robust platform for information management in the Enterprise View, Life Cycle Principled perpsective. As both Wolfgang and Terry point out the task is substantial and is no "free lunch" (which is an illusion that many fall for). The M Community and WV can show the world how knowledge and discipline can optimize the the benefits of applying Information and Communication Technology to healthcare and also how to optimize the synergy between the healthcare benficiaries and the industrial Suppliers.
While resurrection of MTA meetings as we knew them once may be history, the MTA community could use a variety of forums to re-create the the rich sociology bewteen Users and Suppliers that once existed and evne enhance and enrich it with the international collaborative experience that will benefit all. I urge WV to seek to stimulate these pathways of effort with some degree of concurrance as individual and organizational participants exist who can make them quickly productive.
On Thu, 9 Sep 2004, Prof. em. Dr. med. Wolfgang Giere wrote:
I agree wholeheartedly with Terry Wiechman's viewpoints. I had exactly the same lessons to learn when we tried to make our BAIK-system available for private practice.
Wolfgang Giere
Terry Wiechmann wrote:
I'm not familiar with all the components of VistA, however, as the project leader of the COSTAR project back in the late 70's (project collaboration between NIH, DEC and the Laboratory of Computer Science, MGH), I learned a few things about private practice software systems that have not changed over the years (they are burned into my memory :-)
Just a couple issues to make the point:
1) MGH thought the greatest asset of the system was the Medical Records component. We told them that was great, but only part of the picture. To be really viable, the system needed an integrated financial package (A/R, etc. as a part of V1). Does VistA meet the requirements of a private practice, does it have a usable financial package and all those components required of these environments? People like Kevin are in a position to make these assessments.
2) DEC wanted to advertise COSTAR as a "turnkey system". It didn't take a genius to figure out that this concept required a superb installation process (not just software) that essentially "dropped in" to make it financially viable for DEC. Is VistA ready to drop into these environments or will it be a long, drawn out process?
These are not criticisms of VistA, I'm just pointing out a couple lessons learned (yes, there were more than a couple).
As a commercial venture, like so many, DEC eventually backed out because it became obvious that it was not going to be profitable for them, MGH shrugged it off and NIH went on to whatever...
To make VistA successful in this sector requires lots of planning and work. If you ignore history, you are bound to repeat its mistakes...
Terry L. Wiechmann www.esitechnology.com 978-779-0257
----- Original Message ----- From: "Kevin Toppenberg" <[EMAIL PROTECTED]> To: "Hardhats Sourceforge" <[EMAIL PROTECTED]> Sent: Friday, August 27, 2004 5:31 PM Subject: [Hardhats-members] Vista <---> Modern Physician Magazine
Hey all,
I just had an interesting discussion with Joseph Conn who is writing an article about VistA for Modern Physician Magazine. Someone gave him my name as a physician trying to implement the system in a private office.
The gist of what I think he was going to write about is that the President has discussed the importance of getting EMR's into offices, and there has been interest in leveraging VistA in this regard... but the VA is in a position of conflict because they are not mandated to help get the technology out, and in fact are not supposed to be in competition to commercial EMR's. So the transfer of software and knowledge there is going to be slow. Certainly the CMS VistA Office initiative may address these issues, but it seems unclear if the purpose of this is to benefit the small primary care physician, or whether it is more for VA benefit. (And I, for one, never count on software in development until its complete.)
I tried to outline the WorldVistA vision of getting VistA into public use, and the support systems that are being gathered. But to answer his questions, the VistA system is clear still not ready for mainstream use in private offices.
We'll see how it turns out...
Kevin T.
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