Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
I unreservedly agree with this excellent summary of the situation. I would add that this phenomenon is not limited to the specific case at hand. Instead, Tom has characterized a very general model for understanding the 'resistantance' to innovation we have seen everywhere in the IT industry. This model is not specific to the Government, but rather flourishes in the commercial world equally well. My years of efforts in 'cultural diffusion' on behalf of MUMPS while in the leadership group of the M Users Group were continuously frustrated by this process. Today, on this list I see repeated evidence that the process persists. ...sigh Regards, Richard. From: Tom Munnecke [EMAIL PROTECTED] Reply-To: [EMAIL PROTECTED] Date: Wed, 15 Dec 2004 13:32:09 -0800 To: [EMAIL PROTECTED] Subject: Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million Arden, I think more than a forum for dialog is necessary... for VA and DoD to share anything would involve someone losing some bureaucratic turf. Unfortunately, this protection-of-turf instinct is more important than cost savings, patient safety, effectiveness of systems, or even the mission of the agencies. I had a working model of a VA/DoD shared system operating between VA Loma Linda and March AFB in 1984. Rather than use this as a seed system for further evolution, this system was just left in the dust. I had a full network design in MailMan ready to go for CHCS, but this was removed at the government's request, only to be reinvented years later. So, we are dealing with organizational problems, not technologies. The reality of the situation is that civil service employees are rewarded for their inefficiencies. If they solve a problem with fewer resources, they could find their job security threatened. If they solve it with additional staff and resources, they could find themselves promoted. (For example, I was demoted for my efforts in designing DHCP-seems I was working laterally with lots of other hardhats instead of building up my own supervised team). As long at these perverse incentives drive things, we are not going to see more efficient systems emerge. Quite the opposite. On Wed, 15 Dec 2004 11:21:47 -0800 (PST), A. Forrey --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
Arden, I think more than a forum for dialog is necessary... for VA and DoD to share anything would involve someone losing some bureaucratic turf. Unfortunately, this protection-of-turf instinct is more important than cost savings, patient safety, effectiveness of systems, or even the mission of the agencies. I had a working model of a VA/DoD shared system operating between VA Loma Linda and March AFB in 1984. Rather than use this as a seed system for further evolution, this system was just left in the dust. I had a full network design in MailMan ready to go for CHCS, but this was removed at the government's request, only to be reinvented years later. So, we are dealing with organizational problems, not technologies. The reality of the situation is that civil service employees are rewarded for their inefficiencies. If they solve a problem with fewer resources, they could find their job security threatened. If they solve it with additional staff and resources, they could find themselves promoted. (For example, I was demoted for my efforts in designing DHCP-seems I was working laterally with lots of other hardhats instead of building up my own supervised team). As long at these perverse incentives drive things, we are not going to see more efficient systems emerge. Quite the opposite. On Wed, 15 Dec 2004 11:21:47 -0800 (PST), A. Forrey [EMAIL PROTECTED] wrote: Nancy and hardhats: As many hardhats know DoD developed CHCS from VistA in the late 1980s; SAIC was the contractor. There is much commonality in the architectures of the two systems but there has been relatively little cross dialog about the common conceptual content of the two architectures. In view of the federal efforts, a forum for such dialog is sorely needed in order to relate to the recent VA Procurement notices recently posted. From the notice posted it is unclear how the digitization is proceeding in terms of the underlying business processes. Heretofore, many healthcare enterprises were just creating digital images of paper records but with CHCS at WRAMC it would seem that they are doing something else. The WV and hardhats efforts would be most interested in further detail. On Wed, 15 Dec 2004, Nancy E. Anthracite wrote: I just made two mistakes. This is the first one. Walter Reed does use CHCS I. A big bird just told me. On Wednesday 15 December 2004 12:54 pm, Nancy E. Anthracite wrote: http://www.modernphysician.com/news.cms?newsId=2931 To bad the DOD just didn't put in VistA years ago. Looks like now they will be scanning in their records. It's saddening. -- Nancy Anthracite --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
[Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
http://www.modernphysician.com/news.cms?newsId=2931 To bad the DOD just didn't put in VistA years ago. Looks like now they will be scanning in their records. It's saddening. -- Nancy Anthracite --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
Nancy and hardhats: As many hardhats know DoD developed CHCS from VistA in the late 1980s; SAIC was the contractor. There is much commonality in the architectures of the two systems but there has been relatively little cross dialog about the common conceptual content of the two architectures. In view of the federal efforts, a forum for such dialog is sorely needed in order to relate to the recent VA Procurement notices recently posted. From the notice posted it is unclear how the digitization is proceeding in terms of the underlying business processes. Heretofore, many healthcare enterprises were just creating digital images of paper records but with CHCS at WRAMC it would seem that they are doing something else. The WV and hardhats efforts would be most interested in further detail. On Wed, 15 Dec 2004, Nancy E. Anthracite wrote: I just made two mistakes. This is the first one. Walter Reed does use CHCS I. A big bird just told me. On Wednesday 15 December 2004 12:54 pm, Nancy E. Anthracite wrote: http://www.modernphysician.com/news.cms?newsId=2931 To bad the DOD just didn't put in VistA years ago. Looks like now they will be scanning in their records. It's saddening. -- Nancy Anthracite --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
I just made two mistakes. This is the first one. Walter Reed does use CHCS I. A big bird just told me. On Wednesday 15 December 2004 12:54 pm, Nancy E. Anthracite wrote: http://www.modernphysician.com/news.cms?newsId=2931 To bad the DOD just didn't put in VistA years ago. Looks like now they will be scanning in their records. It's saddening. -- Nancy Anthracite --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
RE: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million
The article isn't very clear on what digitize means. It could be capturing images of such things as ECG's and text documents. It could also mean OCR scanning of text documents generated outside the system. It appears the article was more about contract $ than about EHR. I seem to recall an article, early 90's, regarding something like $2.5M logistic program the DOD commissioned prior to the Gulf War, and later scrapped in favor of FileMan because the contractor wasn't ready when deployment had to begin. .../t -Original Message- From: [EMAIL PROTECTED] [mailto:hardhats- [EMAIL PROTECTED] On Behalf Of A. Forrey Sent: Wednesday, December 15, 2004 1:22 PM To: [EMAIL PROTECTED] Subject: Re: [Hardhats-members] Walter Reeds Records to be Digitalized for $3.7 million Nancy and hardhats: As many hardhats know DoD developed CHCS from VistA in the late 1980s; SAIC was the contractor. There is much commonality in the architectures of the two systems but there has been relatively little cross dialog about the common conceptual content of the two architectures. In view of the federal efforts, a forum for such dialog is sorely needed in order to relate to the recent VA Procurement notices recently posted. From the notice posted it is unclear how the digitization is proceeding in terms of the underlying business processes. Heretofore, many healthcare enterprises were just creating digital images of paper records but with CHCS at WRAMC it would seem that they are doing something else. The WV and hardhats efforts would be most interested in further detail. On Wed, 15 Dec 2004, Nancy E. Anthracite wrote: I just made two mistakes. This is the first one. Walter Reed does use CHCS I. A big bird just told me. On Wednesday 15 December 2004 12:54 pm, Nancy E. Anthracite wrote: http://www.modernphysician.com/news.cms?newsId=2931 To bad the DOD just didn't put in VistA years ago. Looks like now they will be scanning in their records. It's saddening. -- Nancy Anthracite --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members --- SF email is sponsored by - The IT Product Guide Read honest candid reviews on hundreds of IT Products from real users. Discover which products truly live up to the hype. Start reading now. http://productguide.itmanagersjournal.com/ ___ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members
