Thanks Joseph, for the clarification. It is good to know that the value of the open source model is becoming more accepted and that in the future, GUI based versions of VistA too, will be open source. What type of open source licence is likely to be used for these implementations? "Public Domain" is a bit tricky on the legal front, as legally it is owned by the US Public, and therefore, the US government. They could refuse certain countries the free use of VistA for political reasons for example? Please clarify. Nandalal
Joseph Dal Molin <[EMAIL PROTECTED]> wrote: Hopefully the following facts about VistA and VistA-Office (VOE) will set the record straight about their claim to "openness": First a couple of points of clarification: WorldVistA, not I, was awarded the tender by the Iowa Foundation for Medical Care in May of last year to establish the VistA-Office Vendor Support Organization (VVSO). IFMC is the prime contractor to CMS for VistA-Office. My role was writing the RFP response for WorldVistA and I am WorldVistA's program manager for the VVSO. Regarding the Wisconsin QIO initiative that Dan mentioned: one of the QIO's roles is to provide impartial advice to physicians to help them select an EHR. The QIO's are funded to do this work by CMS. Unfortunately the QIO's direct funding of a VOE port to Linux fell into a gray area which would have created a potential for conflict of interest. It was for this reason the parties involved decided it was best not to proceed. Ironically, this disappointment was a blessing in disguise as we have applied a large number of enhancements to VOE since last summer, bringing it up to date with FOIA VistA. Our plans are to port VOE to a full open source stack in the next couple of weeks. ...now to the discussion at hand ~ FOIA VistA (the version released under the Freedom of Information Act by the VA) is public domain software and as such the source code is free to be downloaded and used in any way you want. It can be downloaded from the VA's FTP site....this version requires a proprietary database to run. Alternatively you can download a full open source stack of VistA based on GT.M and Linux from the WorldVistA Sourceforge site (www.worldvista.org). FOIA VistA has been available as public domain for over 15 years through the VA. The open source stack has been available from WorldVistA for about 3 years. It is an open source stack which is currently being implemented by the Mexican government's IMSS healthcare agency, which is implementing VistA in 200 public hospitals. ~ VistA Office EHR, whose development is funded by CMS (Centers for Medicaid and Medicare) is currently in beta testing and will also be made available primarily as public domain software when this process is complete late this year. Although as I will explain shortly, some parts of it will have an open source license. An evaluation version has been available for download since last August by registering at the WorldVistA VVSO web page (http://www.worldvista.org/vvso/add). The software comes bundled with a vendor qualification test which we are using to determine whether vendors are qualified to support VOE. So far 6 vendors have passed the test. Initial VOE development was indeed a closed process....it was the "traditional" contracting and development model you find in gov't and private industry. This is not surprising given that the open source model was very unfamiliar territory to CMS nearly 3 years ago when the project was conceived. Over the past year the development process has been gradually, all be it quietly, opening up. This in part was a result of WorldVistA's role in the project expanding and because IFMC and CMS became more familiar with the strategic value of the open source model and how open, collaborative development can be managed. We have in the past few months begun accepting external contributions to VOE and are currently in the process of integrating code developed by VOE Solutions (which is LGPL) and the Pacific Telehealth Hui. Suffice it to say that the open source approach has become a key strategic building block for VOE's future. The bottom line is that VistA, while public domain, is definitely open source and has a large, growing and very active community of users and developers....just visit the Hardhats mailing list archive on Sourceforge. As for VOE, while its development was initially closed, the plan has always been to make it available as public domain. The development process for VOE is now open and as the full infrastructure needed to support collaborative development is better established community participation will be more proactively encouraged. Regards, Joseph VP Business Development, WorldVistA Tim Cook wrote: > > > -----BEGIN PGP SIGNED MESSAGE----- > Hash: SHA1 > > 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 > > -----BEGIN PGP SIGNATURE----- > Version: GnuPG v1.4.3rc2 (MingW32) > Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org > <http://enigmail.mozdev.org> > > iD8DBQFEl+T9MOzvb7luwR0RAgYPAKCbiFRsFTzRVSbu0ADOtKF8qKudIQCgsdNR > 6mi+pIyzORVD+mx+5mOoC4A= > =68dj > -----END PGP SIGNATURE----- > > [Non-text portions of this message have been removed] > > --------------------------------- Yahoo! Sports Fantasy Football 06 - Go with the leader. Start your league today! --------------------------------- Ring'em or ping'em. Make PC-to-phone calls as low as 1¢/min with Yahoo! Messenger with Voice. 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