Fred,
Isn't it best to concentrate on defining what is common in data dictionaries,
to which all developers can map data in and out?
I think that practitioners and patients are less interested in hub and spoke
models than are the business managers of institutions. Sometimes a choice of
software at a hub (such as hospital) causes some institutions and practices out
there on the so called spokes to believe there is advantage in running the same
software as the hub institution (this shouldn't be the case).
That said,a Vista with proper configuration dialogs should be able to run
on the spokes in addition to the hub (where the massive VA model also has to be
substantially configured or modified at a hospital hub, as Medsphere is doing).
As has been discussed elsewhere, there is a mandate to map data to enable a
running Vista to cooperate with Free B application for billing.
When such mapping is also made available for widely accepted standards of
EMR data, it will not only allow patients to move more easily between providers
and sites (with different software) .... it will allow IT persons to support
their providers in moving (their data) to whatever software they choose.
Of course migrating a whole practice should not be an everyday whim, but it
should not be a fearful process either, and perhaps the day will come when even
a test drive of a new software could truly run substantial parts of accumulated
data, rather than tiny dummy data sets (just a dream).
So I don't see any value in declaring what software should operate on spoke
as opposed to hub. Software which maintains large portions of data mapped to a
common standard will enable the portability of a patient record, but also,
"portability of users" should be a benefit that is not unintended. Then the
users will decide what to use.
I havn't been able to find Nancy Anthracite's earlier posts on the initiative
of the Personal Health Record (is this the correct wording?), but it seems that
such data mapping intitiatives are a start for collaboration between differing
open-source projects. It certainly is a place for a software to show its tools
for moving data in and out.
RustyMaynard
Fred Trotter wrote:
This seems like a good point to discuss the possiblity of a joint
ClearHealth-VistA interaction.
The advantages of ClearHealth in this situation are as follows.
1. Already deployed and tested in a clinical environment
2. Based on more popular technology, a web consultant could handle the
technology with some help from a medical IT person.
3. ClearHealth is on the road to being VistA compatible/component.
As I hope everyone can see, by my more and more pestering emails, I
really want to see a long term partnership between VistA and
ClearHealth. (perhaps something like the quasi-collaborative
relationship between Linux and Free/OpenBSD communities)
The most obvious example of such a system would be a VistA and
ClearHealth hub and spoke system. I envision this as VistA running the
more complex Hospital infrastructure, with satellite clinics running
ClearHealth with a gateway into the VistA EHR system. As a result
ClearHealth would become the clinic window into VistA. Of course I will
refrain from making the VistA and Clear to Window pun, but it is
tempting :)
This situation might be a good opportunity to test this model.
ClearHealth is easy to install, I can get it running from source on a
fresh server in about five minutes, and if I knew all of the information
about a practice I could have a skeleton system up in an about an hour
after that (of course knowing the information about a practice could
take a day to acquire)
What do you think of this Hub and spoke model? generally and in this
situation.
Again I want to be clear that we have not yet decided exactly what do
about this, so do not view this as a statement of our intention, I am
just tossing around ideas?
Anyone?
Regards,
Fred Trotter
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