Dear all,
After spending some philosophical thinking on IS and organizations (Because I have a bad flu and staying at home since 3 days!), I would like to comment on this: Our first course in Information Systems graduate program was a class given by Business Administration Professor named Introduction to IS...And we had used the book Management Information Systems: Managing the Digital Firm Kenneth C. Laudon, New York University Jane P. Laudon, Azimuth Information Systems ISBN: 0-13-153841-1 Publisher: Prentice Hall What I learned from this course was clearly in order to make sustainable success in ICT one has to become a "Learning organization/individual" in the sense that after a certain success by developing an IS not to lay back and get a wrong feeling of continuing success...This is what had happened to most successful projects in the past just because people tend to get caught by the satisfaction of what has been achieved and tend to follow opportunistic ideals most probably brought by politicians/ capitalists /governments. So I now see VistA as a perfect opportunity to deliver a standards based and first true interoperable EHR system...Why? Because you already have passed an incredibly time/energy consuming phase of Problem Definition, Initial Plan and more important elicitation of Requirements phases...So who in the world can write down a better SRS for an EHR system than you? I guess no one...Maybe some small sized/impact EU projects and not more... All needed is a careful redesign and further coding/testing/deployment...And I believe this has to be done before current version gets more popular and deployed in many other sites...Why? Because there exists a "swtiching cost" not only by monetary terms but also psychologically...Every change is blooody! I would also like to remind you that not every takeholder is paid attention yet in Mealth Informatics grounds...There is a huge Genetic community that had solved its standardization/nomenclature problems and had already deployed true interoperable systems worldwide...Please take a look at HUGO affiliated Human Genome Variation Society web pages: http://www.hgvs.org <http://www.hgvs.org/> Also look at: http://hmut-tr.sourceforge.net/ There you will clearly see that all this genomic/proteomic and histologic/micro clinical data awaits to be integrated with our so called "Health Information Systems"...Only then we can start talking about True Interoperability and mass data mining/knowledge extraction projects that will yield in personalized healthcare; i.e. personalized drugs, therapies... So that is my ultimate goal to integrate all genomic/proteomic, clinical and physical environment data...And I am working on this individually! And the very goal of the poor CEREBRUS project...But I see, the EU is now approaching this in a more controlled, careful way and funding projects...This is the very reason why I turned down the grant I got from Harvard Medical School and remained in Turkey (Also the Bush problem of course)...The message from Harvard researcher Kenneth D. Mandl was this: I'm working on establishing regional and national biosurveillance with an emphasis on data integration and algorithmic outbreak detection. --Ken After 9/11 all public funding went into bioterrorism! Funny ha? So even Harvard can not resist populistic drives of politicians... Best regards, Dr. Koray Atalag _____ From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On Behalf Of Gregory Woodhouse Sent: 24 Ocak 2006 Salý 06:24 To: Open Health Subject: Re: [openhealth] Senator Endorses VistA for EHR Standard On Jan 23, 2006, at 4:26 PM, Thomas Beale wrote: > Just to be clear on what I would want to see for VistA to be > considered > "open" in terms of interoperability: information models and service > models. You need both. If I ask VistA for an extract of someone's EHR, > how does my copmputer process it (Information model). How do I ask for > it? (Service model). Even if it isn't conceived in quite those terms, I believe a lot of the discussion on Hardhats right now goes a long way towards laying the foundation for the type of interoperability you describe. This is due to VistA adopters wanting the ability to import data (both patient data and standard files such as formularies and term sets). It is not as easy as it might appear at first blush, and I suspect a major problem here is that VistA adopters have not really felt it a sufficiently compelling problem (squeaky wheel syndrome and all that). > > I agree that it was/is a landmark in open source and a triumph over > bloody-mindedness in the US health system, and everyone involved > should > be proud of that. I have also seen it running, and it is impressive. If nothing else, it shows that it can be done. To a certain extent, I think people feel paralyzed by the magnitude of the task. Building a health information system is not a small thing, but neither is building an operating system kernel or designing an implementing a major new language. Do the people having the skills to build complex software systems have the expertise to know what to build? If I were to decide to build a new compiler, I would have a one significant thing going for me: computing *is* my area of expertise, and I have a reasonably good idea of what is involved in building a compiler. But I'm not a health care professional, which puts me at a decided disadvantage when it comes to designing a system. Conversely, health care professionals may not be experts in computing, and, consequently, do not have the same basic intuitions about what can be built, how difficult a given task is, and what the advantages and disadvantages of a design might be. VistA was initially built by health care professionals who learned how to program, and many of the most active participants in the hardhats community are practitioners. > But > - I think it is still fair to ask questions about interoperability. I do, too. Right now, the demand doesn't seem to be there -- at least to the degree needed to motivate the necessary work. But if VistA is widely adopted, it will become a necessity. Now, yes, VistA does have interfaces with a number of external systems. It does make extensive use of HL7. But at risk of offending others, I might add that many of the existing solutions are of a rather ad hoc nature (in the true sense of the term: they are designed to solve specific, immediate problems), and much less has been done to solve the wider problems of the type I believe you have in mind > My > impression is that it interoperates with itself only (and this is > not a > bad strategy - it works if you are the VHA with 100's of hospitals all > running VistA). I think that's right -- on both counts. === Gregory Woodhouse [EMAIL PROTECTED] "The most profound technologies are those that disappear." --Mark Weiser SPONSORED LINKS Software <http://groups.yahoo.com/gads?t=ms&k=Software+distribution&w1=Software+distr ibution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Sof tware+jewelry&w6=Software+deployment&c=6&s=142&.sig=XcuzZXUhhqAa4nls1QYuCg> distribution Salon <http://groups.yahoo.com/gads?t=ms&k=Salon+software&w1=Software+distribution &w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software+j ewelry&w6=Software+deployment&c=6&s=142&.sig=CW98GQRF3_rWnTxU62jsdA> software Medical <http://groups.yahoo.com/gads?t=ms&k=Medical+software&w1=Software+distributi on&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software +jewelry&w6=Software+deployment&c=6&s=142&.sig=86bMQqtlpuDBvFzrRcQApw> software Software <http://groups.yahoo.com/gads?t=ms&k=Software+association&w1=Software+distri bution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Soft ware+jewelry&w6=Software+deployment&c=6&s=142&.sig=YhKUbszKHqjPXh21AbTSwg> association Software <http://groups.yahoo.com/gads?t=ms&k=Software+jewelry&w1=Software+distributi on&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Software +jewelry&w6=Software+deployment&c=6&s=142&.sig=9EWe0V3gtVyQaCqOgchvlw> jewelry Software <http://groups.yahoo.com/gads?t=ms&k=Software+deployment&w1=Software+distrib ution&w2=Salon+software&w3=Medical+software&w4=Software+association&w5=Softw are+jewelry&w6=Software+deployment&c=6&s=142&.sig=VNvgzp250z70B2EFV3JYqg> deployment _____ YAHOO! 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