Richard,
You make some excellent points. Any long-lived system needs to be re-engineered
periodically (continually, if possible) in order to adapt to changing 
technology and the
changing expectations of its users. I would think that much of the 
re-engineering that you
speak of is a necessary part of any manageable comprehensive transition to a 
newer
platform whether it be Java or M2Web or something else.

What are the 30 year old stovepipes? As I understand it, the DHCP kernel was 
formed only
about 20 years ago.

What would your standardized, easily query able format look like? What would 
make it easy?

Richard.Sowinski wrote:
>A rational "plan A" might have been to re-engineer Vista such that the
>clinical packages were lighter, more like front-ends to an underlying
>clinical repository, which stored all the results and data for lab tests,
>procedures, prescriptions, problem lists, diagnoses, etc. in a standardized,
>easily query able format. Instead of in multiple stovepipes, built 30 years
>ago.
>
>The feeding of the CR could have been message-based, making it possible to
>substitute
>best of breed commercial systems for some of the less popular Vista
>packages, if that's
>what individual sites wanted to do.
>
>The new Vista, would also have been much less tightly integrated so that
>you don't need the xxx package installed, in order to run Lab, or the
>yyy package installed in order to run Scheduling.
>
>All of this could have been done in M, by re-engineering what is there.
>
>Don't get me wrong, Vista is a good system, that has been built by many
>talented individuals, over many years, and it has served the VA well.
>
>But, I think it could have been so much better, had sound software
>engineering
>principles been applied, rather than blaming M for any shortcomings that may
>exist.

---------------------------------------
Jim Self
Systems Architect, Lead Developer
VMTH Computer Services, UC Davis
(http://www.vmth.ucdavis.edu/us/jaself)


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