I think easy is a relative thing.  For folks with a background or education
based on procedural languages, a transition to another procedural language
may be much easier than a transition to an OO language.  And a transition to
a procedural language for the modern child of OO may be much tougher than a
move to another OO language.  Then there's Lisp and Prolog, each really in
its own category.  Its more than the language, it's the abstraction the
language represents.  Lisp is functional and recursive, and you must
approach problems accordingly to be proficient.  With MUMPS you have strong
string manipulation and pattern matching, tremendous overloading of
functions and operators, and a different concept of truth.  Perl is the only
thing I've seen come close.  With MUMPS its also the globals, nothing really
like that out there in the mainstream.  You solve problems a different way
when you have sparse arrays.  With VistA, its Fileman.  VistA data structure
is a big step away from your typical MUMPS system, and it takes a while for
even a strong M developer to come up to speed.

Learning a language is one thing, being proficient in a new abstraction is
another and takes time.  I'd say a couple years for most people.  I think I
picked up Java pretty quickly, but I certainly could use a couple years
experience before I'd consider myself solid.


Anyway, I'm not so sure the new architecture for HEV VistA is such a huge
miss.  Certainly there are many advantages to M/Cache and to leveraging the
M expertise VHA employs.  One of the most important being that its how I pay
the bills.  But I don't need to enumerate the pros of M on this list.  

I will say that I think the success of DHCP/VistA has more to do with the
framework that supports it than anything else.  Fileman and Kernel allow so
many possibilities.  Many great applications are developed locally, or by
outside vendors, or IHS, and seamlessly integrate with the national system.
I think the Service Oriented Architecture of HEV may provide a similar
framework once core services are in place.  Anyone can build a service, and
it can live on any platform, including Cache.  The consumer of the service
doesn't know and doesn't care.  It seems to me this will allow the kind of
development that has made VistA what it is today.  It also seems to me that
the platform most likely to support rapid development of new services is the
cache system where the data already lives.  Rehosting VistA applications is
a tough task.  Its going to take a long time, long enough for quite a lot of
other things to be developed.

(now donning flame proof suit)
Maybe the new HEV VistA won't be such a bad thing after all.

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of
[EMAIL PROTECTED]
Sent: Wednesday, April 13, 2005 6:01 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] BIG NEWS re HealtheVet- St. Petersburg Tim
es

I think M is easier to learn than many computer languages.

Certainly easier than ADA, and probably easier than Java, or Delphi/Pascal.

The complex part about becoming a truly proficient Vista programmer
is the shear size of it, under the hood. We're talking 12,000 files,
60,000 fields, and maybe 100,000 routines. Not all well-documented,
and done in many different programming styles. Old style, new style,
structured, unstructured, single-letter variable names, meaningful 
variable names.

The toughest programming job in Vista is not writing new programs, but
modifying existing programs and files in a way that does not cause
unexpected
side-effects, because things can be so intertwined, and not well-documented,
under the hood.

The thing I would have liked to have seen more of, as I've watched and
participated (in a small way)in the evolution of Vista over the past 14
years, is
more encapsulation, more api's, and more programmer's documentation.

But, all in all I think M is an excellent database platform, and I would
prefer
to see the VA evolve the current product, rather than move to something 
completely different, for a main HIS. I think they should look at commercial
ancillary systems, like: cardiology, GI, eye-care, PFT, Dialysis, etc. and
make it easier to integrate them with Vista, but keep and evolve the core
HIS.


-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Gordon
Moreshead
Sent: Wednesday, April 13, 2005 3:59 PM
To: hardhats-members@lists.sourceforge.net
Subject: RE: [Hardhats-members] BIG NEWS re HealtheVet- St. Petersburg
Times


Nancy,

That appears to me to be a highly perceptive take on the situation that
includes considerable truth as well.  I would second your observations and
perceptions.

Gordon

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Nancy
Anthracite
Sent: Wednesday, April 13, 2005 1:53 PM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] BIG NEWS re HealtheVet- St. Petersburg Times

I am afraid that part in the report that said that " VA culture inhibits 
"raising risks, issues, problems or differing opinions" translates into 
people will be risking their jobs to talk to you and be quoted.  However, a 
search through the Hardhats archives will reveal some who have taken the 
chance and have spoken out on the mailing list despite knowing that it is 
risky to stick out your neck where others may be watching.  

My take on it is that the M programmers and others within the VA and on the 
outside are eager to have an opportunity to do what they have wanted to do 
but have been prevented from doing for years, which is to work on 
re-engineering the existing VistA, still in M, to modularize it and clean up

the code to make some of the very things that management complains about 
regarding VistA go away.  No only would that remove some of the complaints 
about about VistA ("it takes $1,000,000 to change a line of code") but it 
would make it easier to port to another language should that ever need to be

done. 

This concept that there are not enough M programmers so it can't be done is 
bogus.  In my experience, programmers know multiple languages and M as easy 
to learn as any other.  If there are so few M programmers, how is it that 
other large M based medical record systems persist and new ones get made but

the VA can't do that?  I also think that many of the changes that are being 
made that tap into VistA to get data are supported by the programmers, maybe

in the form they are in or something different, but allowing Java based 
programs to make use of the data in the M Database is all well and good - a 
multilayered architecture is not opposed by those I have discussed this
with.

However, there is something to the fact that the people who best know VistA 
are getting older and it is time to let them direct the job they are so
eager 
to do and let them fix VistA.  Maybe this will be the kick in the pants for 
everyone that might allow this to happen.

On Wednesday 13 April 2005 02:24 pm, Joseph Conn wrote:
> Any Hardhats/WorldVistA folks want to comment on this Carnegie report
story
> for a story I'm working on??? I've got calls into the VA for comment.
>
> Joseph Conn
> Staff writer
> Modern Physician
> ModernPhysician.com
> Modern Physician STAT
> Heatlh IT Strategist
> 312-649-5395
> [EMAIL PROTECTED]
>
> Check out the NEW ModernPhysician.com, and register now for Modern
> Physician Stat and Modern Physician Alert
>
> >>> [EMAIL PROTECTED] 04/13/05 11:53AM >>>
>
> VA faces another computer problem
> By PAUL DE LA GARZA and STEPHEN NOHLGREN Published April 13, 2005
>
>     A report done for the administration suggests that the VA's
> multibillion-dollar plan to upgrade its system is "not realistic."
>
> A $3.5-billion computer overhaul at veterans hospitals across the country
> is poised to fail unless the Department of Veterans Affairs makes drastic
> changes, according to a closely guarded government study obtained by the
> St. Petersburg Times .
>
http://www.sptimes.com/2005/04/13/Worldandnation/VA_faces_another_comp.shtm
>l

-- 
Nancy Anthracite


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