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Hi Dan,
Please note that this reply must be assumed to NOT be sarcastic.
Just my (hopefully) reasoned, if pointed, opinion.
Daniel L. Johnson wrote:
>
> But... this is our best hope for non-proprietary EHR software in the
> USA, and is worth pursuing.
I believe there is a lot of room for disagreement here. First of all are
you distinguishing between VistA and VistA-Office? Because at this
point I would judge VistA-Office as proprietary if the code cannot be
downloaded or even obtained through a FOIA request.
The idea of this being a "best hope" is certainly misleading and I would
like to know what facts you base that assertion on. There are other EMR
applications that from all appearances are being supported rather
successfully by dependable vendors. The best part is that they already
are open source, sustainable and experiencing incremental improvements
through customer funded desires. No "softening" needed.
> There's been considerable softening of the
> government position on use and sharing of VistA code, and so we all need
> to continue to encourage CMS (the agency formerly known as HCFA) to
> permit open, collaborative development on the VistA-Office code, and to
> support its use and propagation on open-source platforms.
So for those that know....who is the PERSON that we should "encourage
(within) CMS"? Pointing to a shapeless, soulless bureaucracy is not
very helpful.
> A year ago, I had forged an initiative by the Wisconsin QIO ("Quality
> Improvement Organization") to fund development of VistA-Office on Linux,
> and distribution, but we were prohibited by CMS from proceeding.
>
That doesn't bode well for community supported, sustainable software now
does it?
> Joseph Dal Molin was then awarded a contract by CMS to develop "vendor
> training" for VistA Office, and anyone who wants to form a company to
> support this "open" VistA Office is welcome to work with Joseph to help
> make this truly OS and collaborative. Anyone who could do so, should.
> Otherwise, don't complain.
The same can be said for end-users that constantly complain that they
don't have an open source EMR when in fact there are several available
if they were to make a decision to implement one and get on with it. In
fact, this is even an easier solution than forming a company based on
supporting a proprietary MUMPS based EMR. Implementing an EMR is a
painful process for the end-user, but essentially the same process no
matter which one is chosen. Building a business supporting a proprietary
EMR (defined as one where you do not have access to inspect the source
code and participate in the ongoing design and development) would be a
much greater financial risk. IMHO of course.
> In any case, VistA Office is committed to remaining code-compatible with
> the official VA system VistA,
So then there will only be one VistA? IF not ... What are the
differences? Why the different name?
and the VA is not currently willing to
> subject its code to free and open collaborative development
Ok.
- -- so
> collaboration on VistA Office will have to occur in the presentation
> layer.
So are you saying that someone (outside the VA) has or will start and
run an open source VistA-Office presentation project? I would be
interested in hearing your sustainability model for that. Certainly
would be difficult to build a support business on it since any end-user
willing to use a proprietary EMR would just as likely chose the
proprietary presentation.
> This is not an entirely bad thing;
...and what part of that is not a "bad thing" for people that want to
use and support open source software?
and if that develops, my
> guess is that useful pressure could be put on the VA to crack open a
> bit.
If what develops? I didn't understand the context of that phrase.
> Dan Johnson, md
> (open-source EHR fan,
Hmmmmm, I would question the veracity of that characterization based on
this email.
QIO trustee,
Very nice.
simple backwoods internist)
>
self-deprecation is seldom flattering.
Cheers,
Tim
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