Re: [openhealth] VistA Office as 'open' EHR software
On Jun 21, 2006, at 6:54 PM, Tim Cook wrote: > > Hi Greg, I'd really rather let someone from WorldVistA address your specific points, but I think you're confusing VistA (which is in the public domain), with VistA Office EHR (VOE), which is not the same thing. I'll grant that it's a bit confusing how many different things there are out there that are effectively different flavors or derivatives of standard VistA. Gregory Woodhouse [EMAIL PROTECTED] "Judge a man by his questions not his answers." --Voltaire [Non-text portions of this message have been removed] Yahoo! Groups Sponsor ~--> Great things are happening at Yahoo! Groups. See the new email design. http://us.click.yahoo.com/TISQkA/hOaOAA/yQLSAA/W4wwlB/TM ~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
Re: [openhealth] VistA Office as 'open' EHR software
-BEGIN PGP SIGNED MESSAGE- Hash: SHA1 Hi Greg, Your analysis of the raw materials is of course correct. However, that is not the issue with VistA. From all accounts it is an outstanding EMR. Also, I like the fact that VistA uses a hierarchical data storage model (I am assuming this is correct based on my limited knowledge of MUMPS based healthcare applications on other platforms). The problem with VistA is the disconnect between the discussions here about it being "open" and the FACT that it is not licensed and maintained under an open source license. In fact according to Dan Johnson there has been at least one incidence where a group was "prohibited from proceeding" with development of Office-VistA on Linux. Now it's not clear if the prohibition was based on purely economics or not but tone of the statement led me to believe it was a policy decision. The past 3-4 years have seen some big improvements in existing open source EMR projects products. There are legitimate companies supporting those products, doing training, customizations, etc. All the things you would expect from any EMR company. The applications are already licensed under open source licenses and hold all the potential for the technical and long term economic advantages that open source applications have displayed in other industries. Unless there is a solid commitment to change in policy by the funding & development bodies controlling VistA then it will continue to be another proprietary application. I will readily admit to not knowing what the status of Open VistA is and whether or not it is a going project with an attitude to open development. My impression is thought that anyone trying to build an open source licensed VistA is going to quickly find themselves being out of sync with the government funded versions. As Nandalal pointed out this situation is simply going to lead to more confusion. Cheers, Tim Greg Woodhouse wrote: > > --- Nandalal Gunaratne <[EMAIL PROTECTED]> wrote: > >> I agree with Tim. VistA has a lot going for it, but there are some >> good fully FOSS projects that can be developed further. They are >> build on modern languages and well established FOSS - like LAMP. The >> end users are more IT literate now than at the time VistA started, >> and would like to be able to modify things easily themselves. >> >> I fail to see VistA developing in a true FOSS way, and the various >> implementations will cause legal confusion with time as to where the >> open source bits of software end and proprietary begins. >> >> Nandalal >> > > I've often tried to make the argument to VistA developers and adopters > that MUMPS is really peripheral to VistA. It's very much like the > building where I work. The building is constructed from steel, concrete > and glass, but that has nothing to do with whether it is a well > designed building or one that is poorly designed. But, of course, there > is nothing special about MUMPS in this context. In the case of LAMP > based products, Linux, MySQL, Perl/Python/PHP and so forth are just raw > materials, just as the steel and concrete from which this building is > made are raw materials. The Sears Tower or Chrysler Building may > beautiful building (I'm in the U.S.), but there are many other > buildings that no one talks about, some very poorly designed, some not. > LAMP may be a good platform, but it is no more true that LAMP can make > an EMR into a good product than MUMPS can do the same for VistA. It can > perhaps be argued that LAMP provides a better foundation than MUMPS, > but whether it is or is not is really irrelevant. The raw materials, > whatever they may be, are only a small part of what goes into a well > designed system. > > === > Gregory Woodhouse <[EMAIL PROTECTED]> > > "Judge a man by his questions not his answers." > --Voltaire > > > > > Yahoo! Groups Links > > > > > > > > > -BEGIN PGP SIGNATURE- Version: GnuPG v1.4.3rc2 (MingW32) Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org iD8DBQFEmfhNMOzvb7luwR0RAme5AJwP8EshsI7vgt/1odHO+o9orUD6PACgrwCW d+rvI01pTxKePhFDm0b57bg= =MWWD -END PGP SIGNATURE- [Non-text portions of this message have been removed] Yahoo! Groups Sponsor ~--> Check out the new improvements in Yahoo! Groups email. http://us.click.yahoo.com/6pRQfA/fOaOAA/yQLSAA/W4wwlB/TM ~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
Re: [openhealth] VistA Office as 'open' EHR software
--- Nandalal Gunaratne <[EMAIL PROTECTED]> wrote: > I agree with Tim. VistA has a lot going for it, but there are some > good fully FOSS projects that can be developed further. They are > build on modern languages and well established FOSS - like LAMP. The > end users are more IT literate now than at the time VistA started, > and would like to be able to modify things easily themselves. > > I fail to see VistA developing in a true FOSS way, and the various > implementations will cause legal confusion with time as to where the > open source bits of software end and proprietary begins. > > Nandalal > I've often tried to make the argument to VistA developers and adopters that MUMPS is really peripheral to VistA. It's very much like the building where I work. The building is constructed from steel, concrete and glass, but that has nothing to do with whether it is a well designed building or one that is poorly designed. But, of course, there is nothing special about MUMPS in this context. In the case of LAMP based products, Linux, MySQL, Perl/Python/PHP and so forth are just raw materials, just as the steel and concrete from which this building is made are raw materials. The Sears Tower or Chrysler Building may beautiful building (I'm in the U.S.), but there are many other buildings that no one talks about, some very poorly designed, some not. LAMP may be a good platform, but it is no more true that LAMP can make an EMR into a good product than MUMPS can do the same for VistA. It can perhaps be argued that LAMP provides a better foundation than MUMPS, but whether it is or is not is really irrelevant. The raw materials, whatever they may be, are only a small part of what goes into a well designed system. === Gregory Woodhouse <[EMAIL PROTECTED]> "Judge a man by his questions not his answers." --Voltaire Yahoo! Groups Sponsor ~--> Great things are happening at Yahoo! Groups. See the new email design. http://us.click.yahoo.com/TISQkA/hOaOAA/yQLSAA/W4wwlB/TM ~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
[openhealth] VistA Community Meeting - final major revision (hopefully)
In response to the last round of suggested improvements, there is now an updated VistA Community Meeting program (http://www.worldvista.org/Event_Calendar/vista_community_meeting_RMU). Although we will continue to refine it, the intention is for this to be the final major revision, and what we will do henceforth is just tweaking as needed. As always, VistA Community Meetings are *your* meetings, so please do not hesitate to send in any suggestion that you think will make it more worthwhile for you. Also, if you haven't registered, please do so ASAP. [Your suggestions will carry more weight if you have registered.] Regards -- Bhaskar Yahoo! Groups Sponsor ~--> See what's inside the new Yahoo! Groups email. http://us.click.yahoo.com/2pRQfA/bOaOAA/yQLSAA/W4wwlB/TM ~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
[openhealth] On the proper way to ask questions and report bugs
A lunchtime random walk through the web yielded two pages of food for thought: How To Ask Questions The Smart Way - http://www.catb.org/~esr/faqs/smart-questions.html How to Report Bugs Effectively - http://www.chiark.greenend.org.uk/~sgtatham/bugs.html -- Bhaskar VistA - a journey, not a destination Yahoo! Groups Sponsor ~--> Check out the new improvements in Yahoo! Groups email. http://us.click.yahoo.com/6pRQfA/fOaOAA/yQLSAA/W4wwlB/TM ~-> Yahoo! Groups Links <*> To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ <*> To unsubscribe from this group, send an email to: [EMAIL PROTECTED] <*> Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/
Re: [openhealth] VistA Office as 'open' EHR software
I agree with Tim. VistA has a lot going for it, but there are some good fully
FOSS projects that can be developed further. They are build on modern languages
and well established FOSS - like LAMP. The end users are more IT literate now
than at the time VistA started, and would like to be able to modify things
easily themselves.
I fail to see VistA developing in a true FOSS way, and the various
implementations will cause legal confusion with time as to where the open
source bits of software end and proprietary begins.
Nandalal
Tim Cook <[EMAIL PROTECTED]> wrote: -BEGIN
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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 knowwho 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,
Hm, 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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