Then I guess I'm somewhat surprised
that the US government isn't actively solving the health information technology
problem that has been so eloquently described on numerous occasions ("one jumbo
jet crashing every day") with the lowest cost, best piece of software for the
job.
Alas, it is sometimes difficult to live in a democracy
where the Government is not expected to mandate everything to the people, we
still have choice.
After all, if the government pays
for healthcare, it can also actively exert control over its quality.
The Government does not pay for healthcare for most
Americans (44.5%), but they are actively involved in a number of mandated
technology initiatives designed to improve healthcare for all. This
involves mandating standards, not a particular software. (HIPAA
Transaction and Code Sets, NEDSS)
Moreover, it takes standards to build a medical software system that
meets users needs. It does not necessarily start with the full-blown EMR. There
is a more "object oriented" or component approach that can lead to the open
source EMR everyone wants.
There
are several US initiatives that have grown to worldwide acceptance that help to
lay the foundations for an EMR that will meet the needs of US healthcare
providers. To name a few, LOINC form Regenstrief to code the observations,
Prot�g� form Stanford to build the necessary ontology, and HL7 (Tyson Corner, VA
1987) to set the framework for good messaging based on an object oriented RIM,
to name a few.
The
biggest problem we face is not in developing a desktop EMR application that sits
in every docs office, but in developing an application that can seamlessly send
that data from the office to ANY hospital that that doc admits a patient to, or
any other specialists office that the generalist refers a patient to. Will
it be open source, maybe. But I don't really care. I want it to work with the
people I work with and fit into the flow of patient care, be reliable, and
affordable. It comes down to return on investment, and for the busy MD in
practice in the US, that means having a vendor that can provide support. Can
open source do that?
-----Original Message-----
From: John S Gage [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 23, 2003 5:04 AM
To: [EMAIL PROTECTED]
Subject: Re: Greenbelt, MD meeting; VistA rollout plan template
Right now, the VA is really at the forefront of information technology-based patient safety initiatives, yet there does not appear to be the tiniest inclination on the part of anyone at all in the US government to extrapolate these life-saving initiatives outside the VA.
In addition, correct me if I am wrong, but I believe VistA has been attacked again and again in Congress by representatives swayed by lobbying from VistA's opponents.
And incidentally, I know that Octo et al are Americans, I just wish that their initiatives had been adopted nation-wide by the US government.
On Thursday, January 23, 2003, at 01:37 AM, Cecil O. Lynch, MD wrote:
Absolutely true. Not only was VistA developed from US Congressional
funding, it was inspired by USA VA doctors and administrators who are
paid by the US government, in a language developed by a team of USA
doctors at Mass General funded by the USA NIH and maintained by VA
programmers paid from the US Treasury.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, January 22, 2003 9:30 PM
To: [EMAIL PROTECTED]
Subject: Re: Greenbelt, MD meeting; VistA rollout plan template
<<I think all it takes is one major country throwing its resources behind
VistA and the rest is history. Certainly, the good old US of A is not
the right country. Quite the contrary. If VistA had to depend on the
US Gov for its survival, it would be long dead.>>
If it were not for the US government (in the form of the Veterans Administration) paying for the years and years of development, VISTA would not exist today. As a matter of fact, if it weren't for the VAs persistent spending on VISTA it would have died long ago.
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