On Fri, 15 Oct 2004, Joseph Dal Molin wrote:
May I suggest shifting the frame of reference to the global context which is where open source really matters. In this context the numbers of potential adopters for VistA, whether for clinics or hospitals becomes staggering. Not one of any of the current vendors of any system has the capacity or business model to ramp up the way a well designed open source application with an effective community behind it can.
If VistA is documented to show its conformance with common conventions for conceptual content and functions and the process by which it will evolve both conceptually and technically by Life Cycle Principles that VistA vendors can support, it will be attractive to the market. The framework must be general so that the educational system (formal and continuing) can explain the entire framework to the end users. That is not presently the case but it is achievable; figure out how to tell the story and the VistA community will thrive.
> VistA is a classic example of a disruptive technology...stay tuned we are just at the beginning of the ride.
Joseph is correct the opportunity is wide open to those with discipline and hard work. We'll be most interested as to how the upcoming meeting fromaulates the story.
Joseph
On Fri, 2004-10-15 at 17:03, Michael Ginsburg wrote:Bill,
Let's not confuse ourselves. As far as I know, there are no commercial vendors planning to release their products as Open Source or to put them in the public domain. If I'm wrong, please let us know! If I'm right, than the VistA community, regardless of the actual number, is larger than a non-existent (fill in the blank) community. So worrying about something that doesn't exist isn't going to help us.
Having said that, the size of the VistA community will be important as we move forward. It's the law of Small Numbers. 1% market penetration is 4000! That's a lot of potential customers for any business. These are customers that will need help implementing their systems, training their users and fixing problems when they arise. They will also be constantly demanding upgrades and improvements. Figuring out how to provide all that to the same standard set by the best non-VistA vendors is the challenge for the VistA community. And I say community because references and credibility are the keys to product acceptance. If a VistA site crashes and burns it will reflect badly and impede the efforts of everyone. You are right, the community needs to get serious.
As for documentation, I can assure you that VistA-Office EHR will be a high quality product in all respects, including good documentation. As for M, I see that as being a big plus since it's the only technology that I know of that is purpose-built to handle medical information.
But that's just my opinion.
Mike
[EMAIL PROTECTED] 10/15/2004 4:17:15 PM >>>
Hi Michael, ----- Original Message ----- From: Michael Ginsburg To: [EMAIL PROTECTED] Sent: Friday, October 15, 2004 1:18 PM Subject: Re: [Hardhats-members] Fwd: Text of Article from Modern Physician
In my opinion, (and, as always, I speak only for myself) I would agree that in a head to head competition with "Open Logician" that VistA-Office EHR would lose. That is if all you were comparing was functionality. As a system for the physician's office, Logician is a more mature offering, no question. VistA-Office EHR is only in the embryonic stage. However, if you were to compare them in "open source" market and all that implies and entails, VistA-Office EHR would be the clear winner. To the best of my knowledge, Logician does not have a rabid (and I mean that only in the nicest sense!), international community of developers or an organized community of cooperating vendors who can supply professional services, with all working in concert to promote, support and enhance the application.
This community you speak of... how big is it exactly? Compared to the one the exists that could and would sign up to support Open Logician. See my comments re: this topic in my response to Mark.
On the topic of 'rabid' ... I've never seen that included in a recommended list of selection criteria. Reliable, yes. References, yes. Responsive, yes. Cost effective, yes.
Frankly, I'm not sure that VistA has all that yet either and therein lies the challenge and the opportunity! Yes, the serious discussions have to start, but, the VistA community doesn't need a survival strategy, it needs a growth strategy.
We don't disagree on this. It's perspective, I guess. Growth vs. Survival. My background in business has perhaps conditioned me to see that not as a choice, but as an imperative. Grow or die. That's the law of the market.
This will be big. There are roughly 400,000 physicians in the US. If we achieve 1% market penetration...
Your definition of "big" is underwhelming. If 1% is your honest assessment of VistA Office's real market potential, I'd strongly suggest you keep it to yourself when talking to vendors like HP. In fact, I'd strongly suggest you begin working on a statement to "spin" that in case they've already heard you. "What I really meant..."
Even it that's a good number though, the current VistA community couldn't support it unless you think Docs will just line up and wait. They might. I doubt it.
What's needed is a serious discussion to address the two core issues. 1) Documentation - it's got to be there. No option. 2) M - it's got to be a non-issue. Best option here may be to wrap VistA in a SOAP bubble and treat it as a web service. GUI front-ends need to be built for both clinician and sys admin use.
Get these issues resolved and VistA has a real chance.
But if all you're shooting for is 1%...
Back in the early '90's I learned an important lesson. It's easier to get $5 million from a VC than it is $500K. The reason is that they have to invest just as much time and effort into making the business successful either way. The only thing that's different is the size of the potential reward.
Personally, I think the potential here is much larger than 1%. But it all depends on the community getting serious. I am.
Best regards, Bill
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