On Thu, 25 Nov 2004, 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 itisn't clear thatthere will be people and support for a new MDC and which route to take.Better beyears and couldcoutious now than frustrated later!
I have been member of the MDC and head of the German ISO delegation forafford it thanks to my institute, the center of medical informatics of theuniversity inFrankfurt. I am retired now, my deputy chairman, Wolfgang Kirsten is ill,not availablefor quite a while and I am afraid, many of other "old hands" are no moreavailable. .Whowe agree uponwould volunteer do it?
In my opinion there would be three major activity blocks needed (providedrequiring specialists.the need!) : - one development of the standard itself: Tough and tedious workcontacts,
- one coaching the new standard within the international bodies: Requiresconvincing personalities, comittee meetings, much support, time, andeffortsocieties,
- one development of the case (probably VistA) in the minds of people,structuring thegovenment agencies, ... This needs PR at it's best.
Probably there should be some few activists coordination the efforts,contacted.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"Millenium
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 theinstitutions to makeStandard" did not happen. It took us a long march through theANSI-affiliation orMumps an ISO-Standard.
To revive MDC as official body can be done either using the oldinternationalthrough a ISO WG (that would be the "normal" way). Both ways reuire(I cannot askparticipation. I suppose, MUG Germany would be willing to participateguess, Fransmy successor Wolfgang Kirsten, he is hospitalized right now). Also Iknow whetherWitte (Netherlands) could be reactivated. Ion Diamond in GB? I do notavailable inhe is still active in the field. But there is a new commercial MumpsSouthGB. Finland? I do not know the actual state of M-use there. What aboutM-usingAmerica? Could George Timson trigger participation? I once visitedNEW people.hospitals in Sao Paulo and might be able to find out. We should getasked in
I did not follow the ISO-story. Is the standard sustained? I have beenresults. DoesGermany and suggested to vote yes, but I did never ask for thewronganybody 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 werewasfollowing the 1999 meeting and the fact that the "Millenium Standard"setback. Itready for ballot at that last meeting but never happened was aremains acan be reversed. A host organization for the MDC and an organizational framework for an ANSI-accredited SDO must be written. The NE MUGorviable organization and encompass all the market, not just healthcarethisVistA and this will be important. WV must actively promote gettingbedone. Bashkar can offer inputs regarding other market segments and an initial listing of Suppliers of of M-based products and services mustmechanmismcompiled quickly to aid in this effort. The HH website can be awillof dissemination. Another question of great importance has to do with building the education infrastructure to which Dick Walters insightsMbe important. We must stimulate the creation of programs which featuredesignand how it is integrated into the Life Cycle Principles for systemSeattleand implementation as well as how to utilize its unique features to advantage. This subject was pushed at the Sept 1998 MDC meeting inMDCbut had not taken off by the 1999 San Diego meeting; the resurrecredcontextmust be structured to address this education issue in this broadusedas it will drive a stake in the heart of the "MUMPS is OLD" saw beingvendorto rid the market of a powerful component. We must draw on the Mkind oflist 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 thisneed help"press as the VA "hates" MUMPS.... rather it should be seen as "wevendorto a) address the deficiencies b) we do not be dependent on a singlesourcec) we need company. Ironically, a new MDC that leverages an openSox just"business" model, can I believe, without any doubt do what the Redbecausedid. More importantly the rest of the planet will need an MDC etc.sticks withthe will need the same things the VA needs whether or not the VAone...thatMUMPS.....
I am not a MUMPSTer...so I say this from a practical strategic perspective..... it is indeed a time for revival...a pragmaticdispelling thefocuses on improving and leveraging what is good about M andMDC/MUG. Withmythology and misinformation that has bred in the absence of ansurelyso many vendors still using M, eg. Epic, Meditech, Cerner, McKessonbecome onethere is both commercial and user interest. Epic for example, hasmanagement...but oneof the best systems in the industry....in part it's itscommercialcannot ignore its underlying architecture. BTW is there anywhere anow??system that uses the full architecture proposed for 5 years fromread and
joseph
Nancy E. Anthracite wrote:
This is the article I posted days ago that many of you could notthethat I said I would try to get for you, so here it is and this wasDr.original URL. The original thread was Joseph Conn's interview withsure,Kolodner.
http://www.modernphysician.com/news.cms?newsId=2817
Notice how the lack of a Mumps Users Group and as a corollary, I'mmoved to athe MDC, is the backbone of his argument that VistA needs to benot awareSQL database. The MDC desperately needs to be revived.
I found this URL interesting last night. This is a company I wasburningof. If their product is good, it would seem to satisfy the VA'sdo notdesire to extract and analyze their data in an SQL database as theybecauseseem to want to do that straight out of a Mumps database, probablyextractso many people are trained in making SQL queries but not in how toin itdata from VistA. I actually thought that Cache had this capabilityby thealready, but I may be mistaken. I suspect that this company owes its viability to already being usedtheVA, but I don't know about that. In fact, maybe some of the folks inknow. Onecompany are on this mailing list or come to WV meetings, I don'tbeingwould think they are as disappointed as we are that the database ismove themoved by the VA.
http://mde.srs-inc.com/aboutmde.html It is interesting that he mentioned that it will be inexpensive tomumpsdata from one SQL database to another, but the cost of the move frommumpsto the SQL database will certainly not be. I wonder what the cost of performing the needed maintenance to a thefeedatabase 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 nominalofunder the Freedom of Information Act, according to the Departmentkeep thisVeterans Affairs' top physician informaticist.
"We have the full support of the VHA leadership to continue tohealthin the public domain," said Robert Kolodner, M.D., acting chiefofficer forinformatics officer at the VHA and deputy chief informationstatementshealth at the VA.
On Nov. 8, the VA published a request for vendors to submit"rehostingof their capability to provide the VA with what it calledandsupport." It also called for vendors to provide routine servicesystem.support for the VA's Vista healthcare information technologyeffort
Kolodner said the move also would have no immediate impact on antheinitiated by the VA and the CMS to develop a version of Vista for2005,physician office practice. That software should be ready by summerwhichaccording 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 onfromit was first written in the late 1970s and where it remains today:Multi-ProgrammingMUMPS, or the Massachusetts General Hospital UtilityversionsSystem (now known as M), to, as much as possible, open-sourcerelationalof the Java programming language and possibly at least tworelationaldatabase systems, Kolodner said.
Kolodner said the VA initially plans to run a national database on software from Oracle Corp. and regional databases on theotherdatabase 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 anysmalldatabase," Kolodner said, adding the VA would incur a "relativelyscalability,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 andhave Mand several of today's leading commercial healthcare IT systems"Weat their core. But Kolodner said it is time to switch.
"MUMPS has served us very well over the last 20 years," he said.fewerhave 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 areJava.programmers skilled in M than in a more modern language, such aslong
"There are times when it is much too expensive and takes much too"Java isto make changes and support the needs that we have," he said.together,taught in more schools than MUMPS is."
In addition, Java and relational databases are better suitedusers.he said.
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