Phillipe,
I would like to know your approach to things, more clearly. The list I made is
more in fun than an initiative for OSHCA!! My interest infact is in the use of
IT for the area of Research, audit and CME for clinicians. The BIG jobof making
those for administrators, managers, ministers, governments is far too complex.
I think it has been clearly shown that the ability to communicate between
different type of acpplications and to have an international standard on this
may solve one major issue. Interoperability will stop here, most likely.
How far will SNOMED go, in the worldwide context to standardize nomenclature?
Let us wait and see.
nandalal
Philippe AMELINE <[EMAIL PROTECTED]> wrote: Joseph Dal Molin a écrit :
> > I feel a partnership between a couple of IT savyy clinicians and expert
> > programmers with a wholesome way of looking at things, can create the
> > infrastructure of the future HISs.
>
>Nandalal, you have in one sentence described how VistA was first
>developed and evolved for the better part of its history, all be it the
>number of collaborators was much larger.
>
>So the real issue IMHO is not designing and building the perfect system
>is but how to leverage the vast experience and knowledge that is imbeded
>in VistA's DNA.
>
>Frankly speaking how many lives could be saved and improved by simply
>implementing VistA as far and wide as possible and at the same time
>engaging that community to improve the software? Is chasing perfection
>by starting from a clean slate worth the human opportunity cost?
>
>Joseph
>
>
Joseph,
By "simply implementing VistA as far and wide as possible", do you mean
that you want to provide the patients with Vista ?
Because even if VistA is a very good system, it can't replace all
existing systems (so you will have many discrepancies in the network)
and beside, it is not possible to address the continuity of care issue
through HISs (in the same way motion pictures and still images are
different).
Nandalal's point 5 : "5. Scale to a hospital/region/country/world!" is,
from my point of view, a very dangerous feeling. It gives me the same
feeling as if you would say : our aquarium architecture is made of a
carbon filter and an air pump, and we want to scale it on a lake, a
river, an ocean. A HIS is an "into the box" solution, don't even try to
scale it in order to manage the open world.
This sort of things makes me nervous because in France I am fighting
everyday against HIS vendors selling their solution as "county wide
scalable". Sometimes just because they can manage all Dicom modalities.
I hope I can convince the people in charge of current national health
record that a perfect HIS is a dangerous object in the landscape if it
restricts its scope from in-patient to out-patient and doesn't have as a
primary duty to contribute to a global patient health journey.
As you know, "a single period of time, a single location, a single
problem" is the usual architecture of... the classical tragedy.
Philippe
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