Hopefully, Cam's comments can help all envision how to revitalize the Community and show all how to discipline the technology to achieve the needed effects. A re-energized MDC will be needed to communicate with the ICT communities about the technical infrastructure while the WV and other associated organizations focus on how to address the the conceptual content issues using the M environment through involvement of the health professional disciplines. Hopefully, Cam can suggest how to concurrently establish dialog with the Va memebers of these health professional disciplines in documneting the "Requirements" for an evolved VistA while the M-oriented ICT professional members address how to educate managers and administrators in the Life Cycle Principles for implementing that conceptual content. Wide appreciation of the ways that this can be best achieved will depend upon the wide-ranging education by the re-0engergized M and VistA communities.
Arden
On Mon, 18 Apr 2005, Cameron Schlehuber wrote:
I've often wondered why things happened the way they did with DHCP and VistA, politics being what it is. Looking at the timeline and the major political players, my naïve take on it is as follows:
Late 1970's -- President Carter -- central management, pre-DHCP goes underground 1980's -- President Reagan and Senator Sonny Montgomery -- note they were from different parties but were champions of local control, DHCP thrives 1990's -- President Clinton -- central management, no retooling, few new versions, waterfall software development lifecycle early 2000's -- President Bush -- central management with local initiatives ... Enterprise Architecture as sound principles could be VERY good ... senior management dictating details of technical implementations frustrating even to central middle management ...
Well centered principles with natural consequences are the foundations of efficiency and good results especially when conducted locally. But even central management without a sound foundation is likely to be worse than local efforts that span the spectrum from good to bad. At least there may be some good things to choose from.
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Bain Henderson Sent: Monday, April 18, 2005 3:07 PM To: hardhats-members@lists.sourceforge.net Subject: Re: [Hardhats-members] VA project funding hits hurdle in House - St. Pete TImes
CONCUR! Health care, like politics, is best delivered locally.
- Bain
At 05:21 PM 4/18/2005, you wrote:The quote in the article from Steve Buyer must be distressing to anyone who remembers anything about the origins and development of VistA:
"Information technology at (the) VA is not centrally managed, and the results are poor service to veterans, inefficiency and wasted tax dollars," Indiana Republican Steve Buyer, the committee chairman, said in a written statement.
My understanding is that overly centralized management of IT in the VA has (almost?) always been the biggest source of "poor service to veterans, inefficiency and wasted tax dollars". Has that changed or is this more of the same?
http://pqasb.pqarchiver.com/sptimes/822736131.html?MAC=995cfe7284bceb318e
9a5098a997569e&did=822736131&FMT=FT&FMTS=FT&date=Apr+15%2C+2005&author=STEPH EN+NOHLGREN&printformat=&desc=VA+project+funding+hits+hurdle+in+Houseinfo,-- Nancy Anthracite
--------------------------------------- Jim Self Systems Architect, Lead Developer VMTH Computer Services, UC Davis (http://www.vmth.ucdavis.edu/us/jaself)
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