I agree, the Open Source model is an excellent model to start with. As all things do, it will evolve with experience.
Terry L. Wiechmann www.esitechnology.com 978-779-0257 Skype: twiechmann ----- Original Message ----- From: "Joseph Dal Molin" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, November 25, 2004 3:57 PM Subject: Re: [Hardhats-members] Re: MDC/MUG Revival - Just do it (was) Re: [Hardhats-members] Nov17thinterview [added] Dr. K, MUG, MDC, Goodbye Mumps > I know nothing of the processes etc. of the MDC... but it sounds like > some of the tenents of open source might be helpful....eg. release early > release often, break things down into doable chunks etc. Perhaps there > is an opportunity to adopt some of these methods. > > J. > > Chris Richardson wrote: > > Wolfgang; > > > > I couldn't agree with you more. We need to take a slightly different > > tactic in starting/reviving the MDC. Let us first take a look at why it > > faltered so that we understand the pitfalls we must overcome; > > > > 1) Deliberation was exhaustively slow in that many of us were working on > > this effort only sporadically. Many issues got forgotten and had to be > > recovered. We started to do better in the last couple of years, but more > > streamlined efforts need to be investigated > > 2) Loss of funding/support by MUG contributors and member organizations > > 3) The MDC was looked on as an Ivory Tower. We need to have more eyes on > > the problems and suggestions added to make the solutions smoother. > > > > To these issues, I personally would prefer that we investigate the use of > > something like the IEEE RFC (Request For Comment) as a model for "airing" > > the proposals. This allows lots of eyes to examine the issue and a lot of > > folks thinking about solutions. Each RFC has a champion or a group of > > champions who are identified as the focus point for considering the > > solutions and re-issuing the RFC. Each RFC has a period of review by the > > public which is finite. This gives a bit more timely resolution to the > > problems and keeps a history of the discoveries and ideas. This approach > > can be extended to web structure so that all have access to the ideas and > > progress of these ideas. Progress will be made as individuals get involved > > and make comment. We need to be inclusive and self-enrolling by > > participation. The champions make report to the subcommittees of the MDC. > > The RFC has the deliberation already documented and a specification has been > > presented, and a sample implementation has been modeled. All issues should > > have resolved by the time the RFC gets to the Subcommittee and the job of > > the Subcommittee is to integrate the RFC into the published standard. It > > will be those changes to the standard which are finally passed to the full > > MDC to authorize and then release. > > > > Much of this work can happen from the web and email without much face to > > face effort. As such, much of the deliberation has a paper trail and > > history. The possibilities are numerous and exciting. > > > > Best wishes; Chris Richardson > > > > > > > > ----- Original Message ----- > > From: "Prof. em. Dr. med. Wolfgang Giere" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Thursday, November 25, 2004 8:28 AM > > Subject: [Hardhats-members] Re: MDC/MUG Revival - Just do it (was) Re: > > [Hardhats-members] Nov17thinterview [added] Dr. K, MUG, MDC, Goodbye Mumps > > > > > > > >>This is wonderful. But I would suggest not to raise publicity before it > > > > isn't clear that > > > >>there will be people and support for a new MDC and which route to take. > > > > Better be > > > >>coutious now than frustrated later! > >> > >>I have been member of the MDC and head of the German ISO delegation for > > > > years and could > > > >>afford it thanks to my institute, the center of medical informatics of the > > > > university in > > > >>Frankfurt. I am retired now, my deputy chairman, Wolfgang Kirsten is ill, > > > > not available > > > >>for quite a while and I am afraid, many of other "old hands" are no more > > > > available. .Who > > > >>would volunteer do it? > >> > >>In my opinion there would be three major activity blocks needed (provided > > > > we agree upon > > > >>the need!) > >>: > >>- one development of the standard itself: Tough and tedious work > > > > requiring specialists. > > > >>- one coaching the new standard within the international bodies: Requires > > > > contacts, > > > >>convincing personalities, comittee meetings, much support, time, and > > > > effort > > > >>- one development of the case (probably VistA) in the minds of people, > > > > societies, > > > >>govenment agencies, ... This needs PR at it's best. > >> > >>Probably there should be some few activists coordination the efforts, > > > > structuring the > > > >>cooperation etc. > >> > >>Wolfgang Giere > >> > >> > >> > >>Wolfgang Giere > >> > >>Joseph Dal Molin wrote: > >> > >> > >>>I have just returned from Brasil where I gave a worskshop on open source > >>>in health informatics. I was invited by the Brasilian Health Informatics > >>>Society and as a result have made some good friends and excellent > >>>contacts. I will contact both the current and past president of the > >>>Society as well as colleagues in Sao Paolo to inform them of this > >>>discussion. > >>> > >>>What this will need is a small team of midwives and lots of publicity > >>>and support. With a team in place I will table a motion at our next > >>>WorldVistA board meeting to support to this effort. I should think that > >>>the VSA would want to do the same as well as the Pacific Telehealth Hui. > >>>We can then use press releases etc. to get the word out.... we have good > >>>access to reporters several trade journals etc. We can also use other > >>>medical informatics forums such as the openhealth list....and submit to > >>>Slashdot. Also all the medical informatics schools should also be > > > > contacted. > > > >>>Unfortunately all I can offer is to help launch this group, I have no > >>>expertise in M at all....but I do have a great deal of experience > >>>building communities of this kind in health informatics. > >>> > >>>Cheers, > >>> > >>>Joseph > >>> > >>>Prof. em. Dr. med. Wolfgang Giere wrote: > >>> > >>>>I fully agree with Arden Forrey's remarks. It was a shame that the > > > > "Millenium > > > >>>>Standard" did not happen. It took us a long march through the > > > > institutions to make > > > >>>>Mumps an ISO-Standard. > >>>> > >>>>To revive MDC as official body can be done either using the old > > > > ANSI-affiliation or > > > >>>>through a ISO WG (that would be the "normal" way). Both ways reuire > > > > international > > > >>>>participation. I suppose, MUG Germany would be willing to participate > > > > (I cannot ask > > > >>>>my successor Wolfgang Kirsten, he is hospitalized right now). Also I > > > > guess, Frans > > > >>>>Witte (Netherlands) could be reactivated. Ion Diamond in GB? I do not > > > > know whether > > > >>>>he is still active in the field. But there is a new commercial Mumps > > > > available in > > > >>>>GB. Finland? I do not know the actual state of M-use there. What about > > > > South > > > >>>>America? Could George Timson trigger participation? I once visited > > > > M-using > > > >>>>hospitals in Sao Paulo and might be able to find out. We should get > > > > NEW people. > > > >>>>I did not follow the ISO-story. Is the standard sustained? I have been > > > > asked in > > > >>>>Germany and suggested to vote yes, but I did never ask for the > > > > results. Does > > > >>>>anybody know? > >>>> > >>>>Wolfgang Giere > >>>> > >>>>"A. Forrey" wrote: > >>>> > >>>> > >>>> > >>>>>I definitely support Joseph's statement, as Rick and other hard hats > >>>>>already know. I felt dissolution of both the MTA and the MDC were > > > > wrong > > > >>>>>following the 1999 meeting and the fact that the "Millenium Standard" > > > > was > > > >>>>>ready for ballot at that last meeting but never happened was a > > > > setback. It > > > >>>>>can be reversed. A host organization for the MDC and an organizational > >>>>>framework for an ANSI-accredited SDO must be written. The NE MUG > > > > remains a > > > >>>>>viable organization and encompass all the market, not just healthcare > > > > or > > > >>>>>VistA and this will be important. WV must actively promote getting > > > > this > > > >>>>>done. Bashkar can offer inputs regarding other market segments and an > >>>>>initial listing of Suppliers of of M-based products and services must > > > > be > > > >>>>>compiled quickly to aid in this effort. The HH website can be a > > > > mechanmism > > > >>>>>of dissemination. Another question of great importance has to do with > >>>>>building the education infrastructure to which Dick Walters insights > > > > will > > > >>>>>be important. We must stimulate the creation of programs which feature > > > > M > > > >>>>>and how it is integrated into the Life Cycle Principles for system > > > > design > > > >>>>>and implementation as well as how to utilize its unique features to > >>>>>advantage. This subject was pushed at the Sept 1998 MDC meeting in > > > > Seattle > > > >>>>>but had not taken off by the 1999 San Diego meeting; the resurrecred > > > > MDC > > > >>>>>must be structured to address this education issue in this broad > > > > context > > > >>>>>as it will drive a stake in the heart of the "MUMPS is OLD" saw being > > > > used > > > >>>>>to rid the market of a powerful component. We must draw on the M > > > > vendor > > > >>>>>list to be created. We here at UW will contribute to rebuilding the M > >>>>>Education capabilities. > >>>>> > >>>>>On Wed, 24 Nov 2004, Joseph Dal Molin wrote: > >>>>> > >>>>> > >>>>> > >>>>>>It is definitely time to do it....it is not constructive to see this > > > > kind of > > > >>>>>>press as the VA "hates" MUMPS.... rather it should be seen as "we > > > > need help" > > > >>>>>>to a) address the deficiencies b) we do not be dependent on a single > > > > vendor > > > >>>>>>c) we need company. Ironically, a new MDC that leverages an open > > > > source > > > >>>>>>"business" model, can I believe, without any doubt do what the Red > > > > Sox just > > > >>>>>>did. More importantly the rest of the planet will need an MDC etc. > > > > because > > > >>>>>>the will need the same things the VA needs whether or not the VA > > > > sticks with > > > >>>>>>MUMPS..... > >>>>>> > >>>>>>I am not a MUMPSTer...so I say this from a practical strategic > >>>>>>perspective..... it is indeed a time for revival...a pragmatic > > > > one...that > > > >>>>>>focuses on improving and leveraging what is good about M and > > > > dispelling the > > > >>>>>>mythology and misinformation that has bred in the absence of an > > > > MDC/MUG. With > > > >>>>>>so many vendors still using M, eg. Epic, Meditech, Cerner, McKesson > > > > surely > > > >>>>>>there is both commercial and user interest. Epic for example, has > > > > become one > > > >>>>>>of the best systems in the industry....in part it's its > > > > management...but one > > > >>>>>>cannot ignore its underlying architecture. BTW is there anywhere a > > > > commercial > > > >>>>>>system that uses the full architecture proposed for 5 years from > > > > now?? > > > >>>>>>joseph > >>>>>> > >>>>>>Nancy E. Anthracite wrote: > >>>>>> > >>>>>> > >>>>>>>This is the article I posted days ago that many of you could not > > > > read and > > > >>>>>>>that I said I would try to get for you, so here it is and this was > > > > the > > > >>>>>>>original URL. The original thread was Joseph Conn's interview with > > > > Dr. > > > >>>>>>>Kolodner. > >>>>>>> > >>>>>>>http://www.modernphysician.com/news.cms?newsId=2817 > >>>>>>> > >>>>>>>Notice how the lack of a Mumps Users Group and as a corollary, I'm > > > > sure, > > > >>>>>>>the MDC, is the backbone of his argument that VistA needs to be > > > > moved to a > > > >>>>>>>SQL database. The MDC desperately needs to be revived. > >>>>>>> > >>>>>>>I found this URL interesting last night. This is a company I was > > > > not aware > > > >>>>>>>of. If their product is good, it would seem to satisfy the VA's > > > > burning > > > >>>>>>>desire to extract and analyze their data in an SQL database as they > > > > do not > > > >>>>>>>seem to want to do that straight out of a Mumps database, probably > > > > because > > > >>>>>>>so many people are trained in making SQL queries but not in how to > > > > extract > > > >>>>>>>data from VistA. I actually thought that Cache had this capability > > > > in it > > > >>>>>>>already, but I may be mistaken. > >>>>>>>I suspect that this company owes its viability to already being used > > > > by the > > > >>>>>>>VA, but I don't know about that. In fact, maybe some of the folks in > > > > the > > > >>>>>>>company are on this mailing list or come to WV meetings, I don't > > > > know. One > > > >>>>>>>would think they are as disappointed as we are that the database is > > > > being > > > >>>>>>>moved by the VA. > >>>>>>> > >>>>>>>http://mde.srs-inc.com/aboutmde.html > >>>>>>>It is interesting that he mentioned that it will be inexpensive to > > > > move the > > > >>>>>>>data from one SQL database to another, but the cost of the move from > > > > mumps > > > >>>>>>>to the SQL database will certainly not be. > >>>>>>>I wonder what the cost of performing the needed maintenance to a the > > > > mumps > > > >>>>>>>database would be as compared to the cost of this move. > >>>>>>> > >>>>>>> > >>>>>>>On Wednesday 24 November 2004 01:08 am, Joseph Dal Molin wrote: > >>>>>>> > >>>>>>> > >>>>>>> > >>>>>>>>Could you please provide the URL for this so it is adequately > >>>>>>>>referenced....thanks!!! > >>>>>>>> > >>>>>>>>Joseph > >>>>>>>> > >>>>>>>>[EMAIL PROTECTED] wrote: > >>>>>>>> > >>>>>>>> > >>>>>>>> > >>>>>>>>>Here it is Nancy. > >>>>>>>>> > >>>>>>>>>Tom Henderson > >>>>>>>>> > >>>>>>>>> > >>>>>>>>> > >>>>>>>>>FOIA version of Vista remains available despite recent changes > >>>>>>>>>/*By Joseph Conn <mailto:[EMAIL PROTECTED]> / *November 17, 2004/ > >>>>>>>>>// > >>>>>>>>>Despite plans to overhaul its Vista clinical system, the Veterans > >>>>>>>>>Health Administration will continue to offer copies of its > >>>>>>>>>multimillion-dollar software to private-sector users for a nominal > > > > fee > > > >>>>>>>>>under the Freedom of Information Act, according to the Department > > > > of > > > >>>>>>>>>Veterans Affairs' top physician informaticist. > >>>>>>>>> > >>>>>>>>>"We have the full support of the VHA leadership to continue to > > > > keep this > > > >>>>>>>>>in the public domain," said Robert Kolodner, M.D., acting chief > > > > health > > > >>>>>>>>>informatics officer at the VHA and deputy chief information > > > > officer for > > > >>>>>>>>>health at the VA. > >>>>>>>>> > >>>>>>>>>On Nov. 8, the VA published a request for vendors to submit > > > > statements > > > >>>>>>>>>of their capability to provide the VA with what it called > > > > "rehosting > > > >>>>>>>>>support." It also called for vendors to provide routine service > > > > and > > > >>>>>>>>>support for the VA's Vista healthcare information technology > > > > system. > > > >>>>>>>>>Kolodner said the move also would have no immediate impact on an > > > > effort > > > >>>>>>>>>initiated by the VA and the CMS to develop a version of Vista for > > > > the > > > >>>>>>>>>physician office practice. That software should be ready by summer > > > > 2005, > > > >>>>>>>>>according to the CMS. > >>>>>>>>> > >>>>>>>>>One goal of the proposed five-year contract is to move the VA's > >>>>>>>>>healthcare IT system from the programming language and database on > > > > which > > > >>>>>>>>>it was first written in the late 1970s and where it remains today: > > > > from > > > >>>>>>>>>MUMPS, or the Massachusetts General Hospital Utility > > > > Multi-Programming > > > >>>>>>>>>System (now known as M), to, as much as possible, open-source > > > > versions > > > >>>>>>>>>of the Java programming language and possibly at least two > > > > relational > > > >>>>>>>>>database systems, Kolodner said. > >>>>>>>>> > >>>>>>>>>Kolodner said the VA initially plans to run a national database on > >>>>>>>>>software from Oracle Corp. and regional databases on the > > > > relational > > > >>>>>>>>>database portion of Cache, a program by InterSystems Corp., which > >>>>>>>>>incorporates a proprietary version of M now used by the VA. > >>>>>>>>> > >>>>>>>>>"But it could be on (Microsoft's) Sequel Server or SQL or any > > > > other > > > >>>>>>>>>database," Kolodner said, adding the VA would incur a "relatively > > > > small > > > >>>>>>>>>cost" to convert Vista from one database to another if need be. > >>>>>>>>> > >>>>>>>>>"We've had a history of staying vendor-independent," he said. > >>>>>>>>> > >>>>>>>>>Within the VA, M has developed almost a religious following among > >>>>>>>>>programmers for its speed, dependability, flexibility and > > > > scalability, > > > >>>>>>>>>and several of today's leading commercial healthcare IT systems > > > > have M > > > >>>>>>>>>at their core. But Kolodner said it is time to switch. > >>>>>>>>> > >>>>>>>>>"MUMPS has served us very well over the last 20 years," he said. > > > > "We > > > >>>>>>>>>have done a lot with it, and it has supported our needs." > >>>>>>>>> > >>>>>>>>>However, many M vendors have been bought by InterSystems and a > >>>>>>>>>once-thriving MUMPS user group has gone defunct. Today, there are > > > > fewer > > > >>>>>>>>>programmers skilled in M than in a more modern language, such as > > > > Java. > > > >>>>>>>>>"There are times when it is much too expensive and takes much too > > > > long > > > >>>>>>>>>to make changes and support the needs that we have," he said. > > > > "Java is > > > >>>>>>>>>taught in more schools than MUMPS is." > >>>>>>>>> > >>>>>>>>>In addition, Java and relational databases are better suited > > > > together, > > > >>>>>>>>>he said. > >>>>>>>> > >>>>>>>>------------------------------------------------------- > >>>>>>>>SF email is sponsored by - The IT Product Guide > >>>>>>>>Read honest & candid reviews on hundreds of IT Products from real > > > > users. > > > >>>>>>>>Discover which products truly live up to the hype. Start reading > > > > now. > > > >>>>>>>>http://productguide.itmanagersjournal.com/ > >>>>>>>>_______________________________________________ > >>>>>>>>Hardhats-members mailing list > >>>>>>>>[EMAIL PROTECTED] > >>>>>>>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >>>>>>> > >>>>>>> > >>>>>>------------------------------------------------------- > >>>>>>SF email is sponsored by - The IT Product Guide > >>>>>>Read honest & candid reviews on hundreds of IT Products from real > > > > users. > > > >>>>>>Discover which products truly live up to the hype. Start reading now. > >>>>>>http://productguide.itmanagersjournal.com/ > >>>>>>_______________________________________________ > >>>>>>Hardhats-members mailing list > >>>>>>[EMAIL PROTECTED] > >>>>>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >>>>>> > >>>>> > >>>>>------------------------------------------------------- > >>>>>SF email is sponsored by - The IT Product Guide > >>>>>Read honest & candid reviews on hundreds of IT Products from real > > > > users. > > > >>>>>Discover which products truly live up to the hype. Start reading now. > >>>>>http://productguide.itmanagersjournal.com/ > >>>>>_______________________________________________ > >>>>>Hardhats-members mailing list > >>>>>[EMAIL PROTECTED] > >>>>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >>>> > >>>> > >>>> > >>>> > >>>>------------------------------------------------------- > >>>>SF email is sponsored by - The IT Product Guide > >>>>Read honest & candid reviews on hundreds of IT Products from real > > > > users. > > > >>>>Discover which products truly live up to the hype. Start reading now. > >>>>http://productguide.itmanagersjournal.com/ > >>>>_______________________________________________ > >>>>Hardhats-members mailing list > >>>>[EMAIL PROTECTED] > >>>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >>>> > >>>>. > >>>> > >>> > >>>------------------------------------------------------- > >>>SF email is sponsored by - The IT Product Guide > >>>Read honest & candid reviews on hundreds of IT Products from real users. > >>>Discover which products truly live up to the hype. Start reading now. > >>>http://productguide.itmanagersjournal.com/ > >>>_______________________________________________ > >>>Hardhats-members mailing list > >>>[EMAIL PROTECTED] > >>>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >> > >> > >> > >>------------------------------------------------------- > >>SF email is sponsored by - The IT Product Guide > >>Read honest & candid reviews on hundreds of IT Products from real users. > >>Discover which products truly live up to the hype. Start reading now. > >>http://productguide.itmanagersjournal.com/ > >>_______________________________________________ > >>Hardhats-members mailing list > >>[EMAIL PROTECTED] > >>https://lists.sourceforge.net/lists/listinfo/hardhats-members > >> > >> > > > > > > > > > > > > ------------------------------------------------------- > > SF email is sponsored by - The IT Product Guide > > Read honest & candid reviews on hundreds of IT Products from real users. > > Discover which products truly live up to the hype. Start reading now. > > http://productguide.itmanagersjournal.com/ > > _______________________________________________ > > Hardhats-members mailing list > > [EMAIL PROTECTED] > > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > > > . > > > > > ------------------------------------------------------- > SF email is sponsored by - The IT Product Guide > Read honest & candid reviews on hundreds of IT Products from real users. > Discover which products truly live up to the hype. Start reading now. > http://productguide.itmanagersjournal.com/ > _______________________________________________ > Hardhats-members mailing list > [EMAIL PROTECTED] > https://lists.sourceforge.net/lists/listinfo/hardhats-members > > ------------------------------------------------------- SF email is sponsored by - The IT Product Guide Read honest & candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ _______________________________________________ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
