RE: [openhealth] Open Source HIT and data.gov

[Stephen Beller]

Agreed. What we could really use is a comprehensive "biopsychosocial" (i.e.,
biomedical, psychological and social) data set of signs, symptoms,
treatments, history, etc. to help guide the development of health
information tools that would be of meaningful use to clinicians, researchers
and consumers. See, for example, an outline of such an extensive data set
that we compiled 10 years ago at http://nhds.com/clinical_dataset.html.

 

Steve Beller

 

From: openhealth@yahoogroups.com [mailto:openhea...@yahoogroups.com] On
Behalf Of Mark Spohr
Sent: Friday, September 04, 2009 4:03 AM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Open Source HIT and data.gov

 

  

Data.gov looks like a good start but there really isn't very much
health data there. I searched the "Health and Nutrition" category and
it only came up with 61 records. Most of these were Medicare spending
reports for various time periods.
I know the government collects a lot more data than this and it should
be on this site.

.Mark

On Thu, Sep 3, 2009 at 10:42 PM, fred trottermailto:fred.trotter%40gmail.com> > wrote:
> Hi,
>  More and more, I get interview requests asking for me to give the
> open source perspective to healthcare issues. Sometimes, the questions are
> excellent, showing pretty deep insights into the problems (other times the
> reporter has no clue what our movement is about)
>
>  When a reporter asks me good questions, I like to reward them by
> giving them not only me own insights and opinions but also a sampling of
> what the community at large thinks. The better the question, the less
likely
> I am to be certain of the answer.
>
> Recently, a reporter wanted my take on the information available
> from data.gov from the perspective of the FOSS health IT community. She
> asked the following specific questions that I wanted to pass on to the
> community at large. Feel free to reply to me privately if you have
opinions
> you would prefer not to be recorded publicly.
>
>
>
> 1. What is your view of the healthcare related data sets available on the
> www.data.gov Web site? How useful are they? Who are the likely users?  Are
> there enough? Which ones do you find most promising?
>
>
>
> 2. What additional healthcare related data sets would you like to see
> available on www.data.gov?
>
>
>
> 3. How significant do you think www.data.gov is as an open source of
health
> information? How would you like to see it evolve?
>
>
>
> 4. Do you foresee any barriers to more healthcare data being shared via
> www.data.gov?
>
>
>
> --
> Fred Trotter
> http://www.fredtrotter.com
>
>
> [Non-text portions of this message have been removed]
>
>
>
> 
>
> Yahoo! Groups Links
>
>
>
>

-- 
Mark Spohr, MD





[Non-text portions of this message have been removed]

[openhealth] Re: Liberty HSF Certification and Meaningful Use

[Stephen Beller]

I've just posted an original definition of meaningful use, which opposes
the HIMSS defintion. The definition is tied to the clinical decision
support and patient-centered cognitive support, and stresses the need to
increase care value (effectiveness and efficiency). Feel free to use an
portions you deem supportive of FOSS. It's at
http://curinghealthcare.blogspot.com/2009/06/meaningful-use-clinical-dec\
ision.html


Steve Beller




--- In openhealth@yahoogroups.com, fred trotter 
wrote:
>
> The most pressing order of business for LibertyHSF is the status of
FOSS EHR
> systems in the coming stimulus package.
>
> There are two issues that I believe LibertyHSF must weigh in on.
>
> The first is the definition of meaningful use from the FOSS
perspective.
>
> The second, and more pressing, is the issue of certification,
currently only
> WorldVistA is a CCHIT certified FOSS project and that certification
will run
> out soon. If CCHIT cerfitication is used as a criteria for stimulus
funding
> in the current form of the certification it will be detrimental to
FOSS
> projects.
>
> CCHIT has been listening and working with us, but we need to decide if
and
> at what point we need to setup a competing certification method and
body. On
> the 16th CCHIT is hosting a town hall meeting specifically to discuss
the
> FOSS certification isssues. By that time I want to have a semi formal
> process in place for deciding what the communities (to the degree that
> LibertyHSF can represent it) response will be.
>
> To that end, I am sending an inviation email to individual community
members
> to participate on the important sounding 'meaningful use and
certification
> commitee'.
>
> If you get an second email from me within the hour, you were invited,
if you
> did not you were not. But my criteria for inclusion in this group is
merely
> that you have A. Contributed to the discussion so far in a meaningful
way or
> B. You are supporting a FOSS EHR in more than one live deployment. If
you
> have talked to me about this issue either in person or over email over
the
> last few months then I have tried to include you. If you meet these
criteria
> and you want to be formally involved then please email me today or
tomorrow
> requesting that I include you.
>
> I am inviting several people who I want to specifically point out in
advance
> of their acceptance of the invitation because I know that they might
be
> controversial.
>
> The first is Greg Caulton. I have been very critical of PatientOS in
the
> past and I see no reason why I will not be -personally- critical of
them in
> the future. But LibertyHSF is not 'freds party' but intended to be
> representative of the entire FOSS community. Whatever else I have to
say
> about PatientOS it does appear to be in the process of becoming a
ligit FOSS
> project. The reason that I feel Caultons/PatientOS inclusion may be
> controversial is that the project has the CCHIT feature set as an
implict
> design document. In short PatientOS has implicitly endorsed the CCHIT
> definition of what an EHR is, as far as I know, they are the only FOSS
EHR
> project to have taken this stand. While I disagree with this and other
basic
> design decisions that PatientOS has made I can see no reason why
PatientOS
> should not get a vote at this table.
>
> The second is Dr. Kibbe. I am inviting Dr. Kibbe specifically because
he is
> an effective critic of the CCHIT model generally, and because he has
> participated in our community in the past. Recall that he attempted to
> promote a FOSS EHR for AAFP. If he accepts the bridge I hope that he
will
> serve as a bridge to other groups who are frustrated with CCHIT and
are
> wondering what to do.
>
> Last but certainly not least, I plan on including Dennis Wilson from
CCHIT.
> Dennis is the project leader for Laika and is therefore a full member
of the
> FOSS healthcare community. Better than anyone else at CCHIT he
personally
> understands the implications of what a FOSS license implies, and what
> running a FOSS project is like. Most importantly we need a person from
CCHIT
> to give balance to our discussion.
>
> I am inviting Dr. Kibbe and Dennis to specifically be outside advisors
to
> our group, although they will have full access to any meetings or
> mailinglists, they will not be included in a final vote, unless the
> committee itself decides to overrule me on this stance. I have not
idea if
> either Dennis, Dr. Kibbe or Greg will accept my invitation, but I
wanted to
> let everyone know that they would be invited.
>
> Besides them, I am inviting the usual suspects.
>
> I have been advised to err on the side of being too inclusive with
> LibertyHSF, and the list of people that I am inviting to this is
intended to
> be an initial stab at doing just that. All those in favor remain
silent, all
> those opposed bitch loudly.
>
> -FT
>
>
>
>
> --
> Fred Trotter
> http://www.fredtr

[openhealth] Re: Liberty HSF formation process

[Stephen Beller]

My comments over the past few days are in response to Fred's new initiative in 
which I thought they may have come up with a novel way bridge the 
FOSS-proprietary divide. I was mistaken. Nevertheless, since I still believe in 
FOSS and in promoting low cost/resource conserving solutions for better world 
health, I intend to remain engaged and contributing additional non-proprietary 
programs; no strings attached. 

I don't know who's calling who names, Mark, and I certainly didn't want to make 
this a contentious discussion. The reason I hadn't evolved my blog in the last 
year is because I had given up on any possibility of resolution; so, yes, we're 
going commercial. Although I don't recall any testiness on my part, there were 
times I felt attacked simply because I have a patent--and was, by default, 
automatically lumped in with software patent-holders who behaved 
unethically--which I felt was unfair and I said so. Anyway, that was almost a 
year ago.

What frustrates me now, however, is the inability to find a win-win way to 
offer our cyberinfrastructure and computational healthcare models (which use 
our patented methodology) through some sort of hybrid FOSS license. What about 
making it available as FOSS only for products deployed in third world nations? 
I don't know how practical that would be … Just brain-storming here. If there's 
no solution, so be it!

Steve

--- In openhealth@yahoogroups.com, Mark Spohr  wrote:
>
> Steve,
> I went back and re-read your blog to see if your thinking had evolved
> with something new but it does not seem to have changed.
> 
> You want to 'open source' your software but keep part of it patented.
> It's nice that you are interested in FOSS but it doesn't work that
> way.  If you want it to be open source, you need to give it all away
> and not put restrictions on it.  Don't expect FOSS to make a special
> 'Steve' license.  Your blog is a bit testy and accusatory but I don't
> think you should take it personally.   You don't have a FOSS product.
> Just release it as a commercial product and rake it the big bucks from
> your 'tens of thousands of dollars of investment over the past 15
> years'.  We all wish you the best.  Just stop calling us names and
> getting your shorts all knotted up.
> 
> .Mark
> 
> 
> On Sun, Jun 7, 2009 at 4:50 PM, Stephen Beller wrote:
> > I didn't think you were pointing to me, Fred, but I do thank you anyway for 
> > clarifying.
> >
> > To follow up on Alvin's comment, I have several other programs I'm 
> > considering licensing as FOSS, but the functions that I believe would be 
> > most useful to the FOSS community consist of a radical/disruptive (novel 
> > and non-obvious) underlying patented methodology. The problem is that the 
> > BOD and shareholders in our small company simply refuse adopt a FOSS 
> > license since it would mean relinquishing the tens of thousands of dollars 
> > and man-hours we've invested over past 15 years, even though I personally 
> > believe in the FOSS model. This is why I've not been able to participate as 
> > much as I would like. I've discussed this issue on my blog at 
> > http://opensourceandpatents.blogspot.com/.
> >
> > While a free *noncommercial* use license would be acceptable, the idea that 
> > other companies could profit from the methodology for which we've invested 
> > so much, but without even minimal return on our investment, is simply not 
> > acceptable to those in my company. I was hoping for some mutually 
> > acceptable solutions, but at this time I still do not know how to resolve 
> > this dilemma.
> >
> > Steve
> >
> > --- In openhealth@yahoogroups.com, Alvin Marcelo  wrote:
>

[openhealth] Re: Liberty HSF formation process

[Stephen Beller]

I didn't think you were pointing to me, Fred, but I do thank you anyway for 
clarifying. 

To follow up on Alvin's comment, I have several other programs I'm considering 
licensing as FOSS, but the functions that I believe would be most useful to the 
FOSS community consist of a radical/disruptive (novel and non-obvious) 
underlying patented methodology. The problem is that the BOD and shareholders 
in our small company simply refuse adopt a FOSS license since it would mean 
relinquishing the tens of thousands of dollars and man-hours we've invested 
over past 15 years, even though I personally believe in the FOSS model. This is 
why I've not been able to participate as much as I would like. I've discussed 
this issue on my blog at http://opensourceandpatents.blogspot.com/. 

While a free *noncommercial* use license would be acceptable, the idea that 
other companies could profit from the methodology for which we've invested so 
much, but without even minimal return on our investment, is simply not 
acceptable to those in my company. I was hoping for some mutually acceptable 
solutions, but at this time I still do not know how to resolve this dilemma.

Steve

--- In openhealth@yahoogroups.com, Alvin Marcelo  wrote:
>
> Hi all,
> 
> We're a small university-based research group with a FOSS EHR (for govt
> health facilities).
> 
> Are there sites/resources for business models on how such FOSS apps can
> prosper (economically), where the principles of FOSS are respected but where
> the 'investments' of the original team are also taken into consideration?
> 
> alvin (manila)
> 
> 
> 
> On Sun, Jun 7, 2009 at 5:28 AM, fred trotter  wrote:
> 
> >
> >
> > I was speaking to patent-holders generally, and not you personally. The
> > negotiations we have had together are the template for how a patent-holder
> > and a community might potentially work together. Should not have used 'you'
> > in this context. Sorry.
> >
> > -FT
> >
> >
> > On Sat, Jun 6, 2009 at 6:19 AM, Stephen Beller 
> > >
> > wrote:
> >
> > > Although it's easy to resent your implication of duplicity (trickery), I
> > do
> > > understand your practical, though rigid, position.
> > > Thanks,
> > > Steve
> > >
> > > --- In openhealth@yahoogroups.com , fred
> > trotter  wrote:
> > > >
> > > > On Thu, Jun 4, 2009 at 3:29 PM, Stephen Beller  wrote:
> > > >
> > > > > Fred,
> > > > >
> > > > > This is encouraging and I wish you great success!
> > > > >
> > > > > Two questions:
> > > > >
> > > > > 1. How do you define "hybrid vendors" and distinguish them from FOSS
> > > > > vendors?
> > > >
> > > >
> > > > Anyone who makes money by supporting FOSS AND by selling proprietary
> > > health
> > > > software.
> > > >
> > > >
> > > > >
> > > > > 2. What roll, if any, do you see for companies having patented
> > > > > methodologies?
> > > >
> > > >
> > > > That is largely uncharted territory, but in general I would like to
> > treat
> > > > that in a similar fashion to hybrid vendors. They will be included and
> > > > welcomed, while their slight bias against our core values will be
> > > explicitly
> > > > labelled.
> > > >
> > > > In my experience the FOSS community does not like to treated
> > > condescendingly
> > > > or tricked. If a vendor disagrees with some of our values, but still
> > > wants
> > > > to work with us in those areas that they agree with us, we should make
> > > that
> > > > fall over easy for them to do. I would think the same would hold true
> > to
> > > > patents. Do not try to trick us into implementing something that you
> > are
> > > > going to later try and charge us for, use standard FOSS patent
> > licensing
> > > > techniques and we should be just fine.
> > > >
> > > >
> > > >
> > > > >
> > > > >
> > > > > Thanks,
> > > > > Steve Beller
> > > > >
> > > > >
> > > > >
> > > > >
> > > >
> > > >
> > > > --
> > > > Fred Trotter
> > > > http://www.fredtrotter.com
> > > >
> > > >
> > > > [Non-text portions of this message have been removed]
> > > >
> > >
> > >
> > >
> > >
> > > 
> > >
> > > Yahoo! Groups Links
> > >
> > >
> > >
> > >
> >
> > --
> > Fred Trotter
> > http://www.fredtrotter.com
> >
> > [Non-text portions of this message have been removed]
> >
> >  
> >
> 
> 
> 
> -- 
> Alvin B. Marcelo, MD (www.alvinmarcelo.com)
> 
> Director, UP Manila - National Telehealth Center
> Director for Southeast Asia, International Open Source Network
> Associate Professor of Surgery (Trauma), University of the Philippines
> Manila GPG: 0x77B200CA
> 
> Check out PANACeA: http://www.panacea-ehealth.net
> 
> Join IOSN ASEAN+3 discussion:
> http://lists.iosnasean.net/listinfo.cgi/iosn-asean3-discuss-iosnasean.net
> 
> Join IMIA WG on Health Informatics for Development:
> http://lists.iosnasean.net/listinfo.cgi/imia-wg-hi4dev-iosnasean.net
> 
> 
> [Non-text portions of this message have been removed]
>

[openhealth] Re: Liberty HSF formation process

[Stephen Beller]

Although it's easy to resent your implication of duplicity (trickery), I do 
understand your practical, though rigid, position. 
Thanks,
Steve

--- In openhealth@yahoogroups.com, fred trotter  wrote:
>
> On Thu, Jun 4, 2009 at 3:29 PM, Stephen Beller  wrote:
> 
> > Fred,
> >
> > This is encouraging and I wish you great success!
> >
> > Two questions:
> >
> > 1. How do you define "hybrid vendors" and distinguish them from FOSS
> > vendors?
> 
> 
> Anyone who makes money by supporting FOSS AND by selling proprietary health
> software.
> 
> 
> >
> > 2. What roll, if any, do you see for companies having patented
> > methodologies?
> 
> 
> That is largely uncharted territory, but in general I would like to treat
> that in a similar fashion to hybrid vendors. They will be included and
> welcomed, while their slight bias against our core values will be explicitly
> labelled.
> 
> In my experience the FOSS community does not like to treated condescendingly
> or tricked. If a vendor disagrees with some of our values, but still wants
> to work with us in those areas that they agree with us, we should make that
> fall over easy for them to do. I would think the same would hold true to
> patents. Do not try to trick us into implementing something that you are
> going to later try and charge us for, use standard FOSS patent licensing
> techniques and we should be just fine.
> 
> 
> 
> >
> >
> > Thanks,
> > Steve Beller
> >
> >
> >
> >
> 
> 
> -- 
> Fred Trotter
> http://www.fredtrotter.com
> 
> 
> [Non-text portions of this message have been removed]
>

[openhealth] Re: Liberty HSF formation process

[Stephen Beller]

Fred,

This is encouraging and I wish you great success! 

Two questions: 

1. How do you define "hybrid vendors" and distinguish them from FOSS vendors? 

2. What roll, if any, do you see for companies having patented methodologies?

Thanks,
Steve Beller



--- In openhealth@yahoogroups.com, fred trotter  wrote:
>
> Thanks for replying... I sent you a private email about coordinating our
> efforts.
> 
> -FT
> 
> On Thu, Jun 4, 2009 at 1:10 PM,  wrote:
> 
> > Hi Fred!
> >
> > Congratulations! As co-chair of the EFMI LIFOSS WG and member of the IMIA
> > OS WG I am looking forward to work together with LibertyHSF. I am confident
> > that we share the same long term goals and that we can collaborate to
> > achieve these comon goals.
> >
> > Our current focus is on fostering the collaboration between different FLOSS
> > in health care projects and to organize conferences and workshops to
> > disseminate knowledge about the benefits and prospects of FLOSS. We recently
> > organized a workshop at BIOSTEC (OSEHC) and will organize a second edition
> > of OSEHC in 2010. We also organized a workshop at Med-e-Tel 2009 and will
> > have another one in 2010. At MIE2009 there will be a workshop about FLOSS
> > -HC and in 2010 we participate in the organization of the International
> > workshop on ehealth in emerging economies (IWEEE).
> >
> > Thanks for taking the initiative of founding LibertyHSF and looking forward
> > to work together with you.
> >
> > Best wishes,
> > Thomas Karopka
> >
> >
> >
> >
> >
> >
> >
> > FOSS Community,
> >
> > I am writing to let you know that Liberty Health Software
> > Foundation has received 501c3 status.
> > Dr. Valdes and I have been working on this for over two years and we are
> > ready to present this to the community-at-large.
> >
> > The purpose of Liberty Health Software Foundation (LibertyHSF) is to
> > improve
> > the delivery and science of healthcare by supporting the development and
> > use
> > of Free/Libre Healthcare Software.
> >
> > We are in a unique position with the organization because we want to both
> > be
> > careful with how we set things up for long term sustainability, as well as
> > getting some critical tasks done now. I wish this email were somewhat more
> > organized, but as it stands it is just several lists of directions that we
> > want to take as well as open questions about a slew of issues. Feel free to
> > email me privately or call me to discuss anything that you would prefer to
> > remain outside the public forum. I am and will remain baised towards those
> > who have contributed towards our community, I will listen to everyone, but
> > I
> > will act based on the opinions of those who have sacrificed for our
> > movement.
> >
> > OPEN QUESTION?
> > How do we choose a BOD?
> >
> > OPEN QUESTION?
> > We want a mix of FOSS corporate and FOSS community interests. Sometimes
> > what
> > our successful FOSS companies do is in the interests of the FOSS developer
> > and user interests and sometimes it is not? Our community has several
> > non-vendor roles: deployers, which include IT specialist who deploy FOSS,
> > clinical users, developers and finally the consumers who have their health
> > data stored in FOSS systems. How do we balance community and vendor
> > interests?
> >
> > OPEN QUESTION?
> > We want to include and embrace hybrid FOSS/proprietary companies like
> > Mysis,
> > ECW and DSS but still acknowledge that at least part of their interests are
> > to support proprietary software. How do we strike a balance of encouraging
> > the risks that these hybrid companies are taking, but still remaining true
> > to the FOSS values?
> >
> > Liberty HSF goal: Certification: Create a certification system compatible
> > with FOSS
> >   -> Current plan: work with CCHIT to become the scholarship
> > organization for CCHIT certification, and to make CCHIT have a reasonable
> > cert option for FOSS
> >   -> Backup plan: become an FOSS oriented CCHIT alternative
> >
> > OPEN QUESTION?
> > How do we deal with CCHIT as an organization AND as a community of
> > independent thinkers?
> >
> > OPEN QUESTION?
> > When do we decide that we need to 'fork' CCHIT and setup an alternative
> > certification system?
> >
> > Liberty HSF goal: Vendor organization: be a FOSS EHRVA (this is what we are
> > talking about here)
> >   -> Represent FOSS Vendors the way that EHRVA claims to and
> > HIMSS pretends it does not.
> >   -> Lobby (in compliance with the rules for 501c3) for FOSS
> > vendor interests
> >   -> Create our own definition of 'meaningful use' to through
> > into the mix
> >
> > OPEN QUESTION?
> > We need to give a vehicle the FOSS vendors to express their views, as
> > distinct from the community. Vendor profitability is critical to our
> > community, we need FOSS vendors to form the backbone of our community. How
> > do we carve out a space for vendors specifically, while ensuring that the
> > ov

RE: [openhealth] Re: I have been invited to testify on 'Meaningful Use'

[Stephen Beller]

When it comes to using computational models for cognitive support  - which
can be argued to be one of the biggest gaps in today's HIT (see
http://www.nlm.nih.gov/pubs/reports/comptech_prepub.pdf) -- innovative use
of spreadsheets as reporting tools has enormous benefits. 

 

If we really want to improve healthcare quality and efficiency, then we
should expand our data models to include information on clinical processes
outcomes that go way beyond transactional (i.e., administrative claims data)
data; the mind-body connection; compliance to and variance from
evidence-based guidelines; the efficacy and cost of complementary and
alternative treatment approaches; observations of daily living (see
http://rwjfblogs.typepad.com/pioneer/2009/04/2nd-round-project-healthdesign-
cfp-targets-observations-of-daily-living.html); etc. And these data should
be made available to researchers who crunch the numbers and collaborate with
clinicians to generate and evolve clinical the guidelines. Furthermore, we
need more innovative software programs that deliver cognitive support to
clinicians and consumers through use of computational models. In other
words, today's data and technology standards, and the conventional crop of
HIT tools, are sorely inadequate. Radical innovation is needed for radical
healthcare reform/transformation; and I contend that the innovative use of
spreadsheets is a key component to realizing this goal.

 

Steve

 

---

Stephen E. Beller, PhD

CEO/President

National Health Data Systems, Inc.

Wiki: http://wellness.wikispaces.com  

Blog: http://curinghealthcare.blogspot.com
 

Web: http://www.nhds.com  

 

 

 

From: openhealth@yahoogroups.com [mailto:openhea...@yahoogroups.com] On
Behalf Of Mark Spohr
Sent: Sunday, April 19, 2009 12:17 PM
To: openhealth@yahoogroups.com
Cc: open-ehealth-collaborat...@googlegroups.com; hardh...@googlegroups.com
Subject: Re: [openhealth] Re: I have been invited to testify on 'Meaningful
Use'

 






The article seemed to be more about how the EMR/PHR was NOT used,
rather thank MIS-used. He kept pointing out that there was
information in the EMR which would have improved his care. However,
people were not even looking at the EMR.

The data model is really irrelevant to the use of data. The user
interface and work flow determine how useful the record is. You could
store all of your data in a spreadsheet and if it had a good user
interface and good work flow access, it would be golden.

(Please don't take this as an endorsement of spreadsheets... I am a
founding member of a society dedicated to stamping out spreadsheets
and people who think they are databases.)

.Mark

On Sun, Apr 19, 2009 at 5:08 PM, Rod Roark mailto:rod%40sunsetsystems.com> > wrote:
> Interesting article, but I'm not sure its conclusions are on-target.
> The data model is more a symptom than an underlying cause of the problem.
>
> In my view the key point is that we cannot trust the existing
> "custodians" of medical IT to get it right.  They haven't come close
> yet.  The only way we'll get there is to require complete transparency
> at all levels.  And fortunately the new administration does seem to
> value transparency.
>
> And yes, transparency is of course what FOSS is all about.  However that
> point should not be raised prematurely... but perhaps when responding to
> the question of "how do we achieve transparency"
>
> Rod
>
> Scot Silverstein wrote:
>> If you get a chance, please touch on "meaningful misuse"  as in this
story by a software engineer who became a patient:
>>
>> The Data Model That Nearly Killed Me
>> http://www.syleum.com/2009/03/17/healthcare-data-model/
>>
>> Scot
>>
>> 
>> Scot M. Silverstein, MD
>> Consultant in Medical Informatics
>> Teaching faculty in Healthcare Informatics and IT (Sept. 2007-)
>> Director, Institute for Healthcare Informatics (2005-7)
>> College of Information Science and Technology
>> Drexel University
>> 3141 Chestnut St.
>> Philadelphia, PA 19104-2875
>>
>> Email:  scot.silverst...@ischool.drexel.edu
 
>> Bio:  www.ischool.drexel.edu/faculty/ssilverstein/biography.htm
>> Common Examples of HIT difficulty:
>> www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm
>> ARS KU3E, member www.arrl.org
>>
>> -openhea...@yahoogroups.com
  wrote: -
>>
>> To: open-ehealth-collaborat...@googlegroups.com
 
>> From: fred trotter mailto:fred.trotter%40gmail.com> >
>> Sent by: openhealth@yahoogroups.com 

>> Date: 04/18/2009 06:05PM
>> cc: "hardh...@googlegroups.com  "
mailto:hardhats%40googlegroups.com> >,
"openhealth@yahoogroups.com  "
mailto:openhealth%4

RE: [openhealth] Patient Portals and PHR's

[Stephen Beller]

In a series of blog posts, starting at
http://curinghealthcare.blogspot.com/2007/05/knowledge-standards-and-healthc
are.html , I discuss in detail the issue of standards. My conclusion is that
any sustainable program must be able to adapt to any and all standards, now
and in the future, without great cost or difficulty. I agree that the
information models and technology standards are much less important than the
terminology and measurement standards, which should be able to convey rich
semantic detail and which are likely to continue changing over time.  I
don't think the professional healthcare community will ever agree on a
single term for a concept like blood pressure, nor should they. So, mapping
to  the dozens of terms referring to the same concept  is crucial, while
retaining the nuanced meanings between those terms is critical, imo.

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of Koray Atalag
Sent: Wednesday, December 10, 2008 5:32 PM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Patient Portals and PHR's

 

Hi Wayne and others,

I agree with you that openEHR offers the most elegant and yet 
implementable methodology to build EHR that makes "sense".

As both a clinician and an informatician (my mom still doesn't 
understand what my profession is!) I think we (meaning most of the 
health informatics community) are too much focused on solutions rather 
that the requirements or factors which may result in satisfactory 
implementations. Interoperability is a great buzzword nowadays - but do 
we all agree on what this is all about? What are the requirements, what 
are the essential elements? Achieving systems that can interoperate 
(systems interoperability) needs first to achieve information 
interoperability.

I strongly believe that interoperability at large in healthcare is not 
all about information models, XML, CCR, HL7, Webservices or whatever. 
But this is all bout people - and perhaps the medical profession itself. 
A good strategy would probably be to introduce formal information 
management courses in the medical curriculum. Once a consensus is 
reached on common terminology and processes then we can talk about 
systems interoperability and all those fancy technologies and standards.

Coming to my first argument, openEHR is the only formalism that is 
offering methods and tools for establishing a common language and 
reusable clinical models couple with a best of breed reference model and 
many many open source tools and artifacts for creating those models and 
systems. I may be biased here because my Ph.D. research was based on 
openEHR methodology - but I am interested with others' views on this.

As Wayne has pointed out, global standardisation efforts in this area 
(EHR/PHR/EMR etc) have finally boiled down to HL7 and its allies vs. 
CEN/openEHR. I think if EHR projects, no matter how big and strong, are 
not designed by using these are doomed to death - wasting lots of money, 
effort, lives and hopes. And complying with these standards is not a 
matter of writing interfaces or plugins - it means seriously investing 
and redesign.

Cheers,

Koray Atalag, MD, Ph.D

Clinton Bedogni Research Fellow
The University of Auckland,
Department of Computer Science,
Private Bag 92019, Auckland 1142, New Zealand

Tel: +64 (9) 373 7599 ext. 87199
Fax: +64 (9) 308 2377
Email: [EMAIL PROTECTED] <mailto:koray%40cs.auckland.ac.nz> 

Stephen Beller wrote:
>
> Please explain what you mean by CCR or HL7 CDA *concepts* . Do you 
> mean the
> actual strings/terms used within the XML markup tags that define the data
> elements?
>
> Steve
>
> From: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com>
<mailto:openhealth%40yahoogroups.com> 
> [mailto:openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com>  
> <mailto:openhealth%40yahoogroups.com>] On
> Behalf Of Mark Spohr
> Sent: Tuesday, December 09, 2008 9:25 PM
> To: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com>
<mailto:openhealth%40yahoogroups.com>
> Subject: Re: [openhealth] Patient Portals and PHR's
>
> The issue isn't really about converting the format of the data since this
> can easily be done with any number of tools (the Mirth Project offers 
> a very
> capable HL7 interface engine which can do lots of useful format
> conversions mirthproject.org open source).
> The issue is that the Indivio PHR does not seem to support the CCR or HL7
> CDA concepts in it's default configuration. It seems that everyone is
> encouraged to add their own concepts to it which is an invitation to data
> chaos. It doesn't do any good to be able to send the data from one system
> to another if the receiving system doesn't understand the concepts 
> that are
> being sent. Google Health and Health Vault each

RE: [openhealth] Patient Portals and PHR's

[Stephen Beller]

Please explain what you mean by CCR or HL7 CDA *concepts* . Do you mean the
actual strings/terms used within the XML markup tags that define the data
elements?

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of Mark Spohr
Sent: Tuesday, December 09, 2008 9:25 PM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Patient Portals and PHR's

 

The issue isn't really about converting the format of the data since this
can easily be done with any number of tools (the Mirth Project offers a very
capable HL7 interface engine which can do lots of useful format
conversions mirthproject.org open source).
The issue is that the Indivio PHR does not seem to support the CCR or HL7
CDA concepts in it's default configuration. It seems that everyone is
encouraged to add their own concepts to it which is an invitation to data
chaos. It doesn't do any good to be able to send the data from one system
to another if the receiving system doesn't understand the concepts that are
being sent. Google Health and Health Vault each collect data using these
concepts so that they have the same definitions to the sender and the
receiver and can be understood.

Again, I must apologize if I have gotten this wrong. My understanding is
just from reading their web site where there is no mention of CCR and CDA
but there is a piece about how easy it is to define your own concepts... we
definitely don't want this if we want to exchange information.

.Mark

On Tue, Dec 9, 2008 at 10:12 PM, Stephen Beller <[EMAIL PROTECTED]
<mailto:sbeller%40nhds.com> > wrote:

> I offered an Excel-based macro that converts an XML-based CCD to a clean
> CSV, which I assume the FOSS PHRs can consume thereby solving this
> limitation. We've successfully incorporated that macro to import the CCD
> medication data into our in our Excel-based Personal Health Profiler
> report.
> There has been no offers from the community to convert the Excel macro to
> an
> open source script, however. It's available at
> https://sourceforge.net/projects/convertxmltocsv/
>
> Steve
>
>
>
> From: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com>
[mailto:openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com> ]
On
> Behalf Of Mark Spohr
> Sent: Tuesday, December 09, 2008 2:57 PM
> To: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com> 
> Subject: Re: [openhealth] Patient Portals and PHR's
>
>
>
> XML is only a representation standard and is relatively unimportant. What
> is of concern is that the software doesn't seem to support the CCR or CDA
> concepts, thus severely limiting the interoperability (and usability) of
> the
> information. It doesn't do much good to collect information that is
> incompatible with the existing standards.
>
> .Mark
>
> On Tue, Dec 9, 2008 at 7:20 PM, balu raman <[EMAIL PROTECTED]
<mailto:braman20012001%40yahoo.com> 
> <mailto:braman20012001%40yahoo.com > >
> wrote:
>
> > I thought CCR and CDA are also XML based.
> > I am sure Indivo can be configured to handle CCR. FOSS may not support
> > everything under the sun, out of the box, but one can value-add any
> > scratch for an itch. That's the beauty of FOSS.
> >
> > balu raman, msee.,ccp
> >
> > ===
> >
> > "In fact, when I die, if I don't hear 'A Love Supreme,' I'll turn
> >
> > back; I'll know I'm in the wrong place."
> >
> > - Carlos Santana
> >
> >
> >
> > Disclaimer: Any resemblance between the above views and
> >
> > those of my creator, my terminal, or the view out my window
> >
> > are purely coincidental.
> >
> >
> >
> > Any resemblance between the above and my own views is
> >
> > non-deterministic. The question of the existence of views
> >
> > in the absence of anyone to hold them is left as an exercise
> >
> > for the reader. The question of the existence of the reader
> >
> > is left as an exercise for the second god coefficient.
> >
> > (A discussion of non-orthogonal, non-integral polytheism is
> >
> > beyond the scope of this article.)
> >
> > --- On Mon, 12/8/08, David Chan <[EMAIL PROTECTED]
<mailto:davidhcchan%40yahoo.com> 
> <mailto:davidhcchan%40yahoo.com > > wrote:
> > From: David Chan <[EMAIL PROTECTED] <mailto:davidhcchan%40yahoo.com>
<mailto:davidhcchan%40yahoo.com>
> >
> > Subject: Re: [openhealth] Patient Portals and PHR's
> > To: openhealth@yahoogroups.com <mailto:openhealth%40yahoogroups.com>
<mai

RE: [openhealth] Patient Portals and PHR's

[Stephen Beller]

I offered an Excel-based macro that converts an XML-based CCD to a clean
CSV, which I assume the FOSS PHRs can consume thereby solving this
limitation. We've successfully incorporated that macro to import the CCD
medication data into our in our Excel-based Personal Health Profiler report.
There has been no offers from the community to convert the Excel macro to an
open source script, however. It's available at
https://sourceforge.net/projects/convertxmltocsv/ 

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of Mark Spohr
Sent: Tuesday, December 09, 2008 2:57 PM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Patient Portals and PHR's

 

XML is only a representation standard and is relatively unimportant. What
is of concern is that the software doesn't seem to support the CCR or CDA
concepts, thus severely limiting the interoperability (and usability) of the
information. It doesn't do much good to collect information that is
incompatible with the existing standards.

.Mark

On Tue, Dec 9, 2008 at 7:20 PM, balu raman <[EMAIL PROTECTED]
 > wrote:

> I thought CCR and CDA are also XML based.
> I am sure Indivo can be configured to handle CCR. FOSS may not support
> everything under the sun, out of the box, but one can value-add any
> scratch for an itch. That's the beauty of FOSS.
>
> balu raman, msee.,ccp
>
> ===
>
> "In fact, when I die, if I don't hear 'A Love Supreme,' I'll turn
>
> back; I'll know I'm in the wrong place."
>
> - Carlos Santana
>
>
>
> Disclaimer: Any resemblance between the above views and
>
> those of my creator, my terminal, or the view out my window
>
> are purely coincidental.
>
>
>
> Any resemblance between the above and my own views is
>
> non-deterministic. The question of the existence of views
>
> in the absence of anyone to hold them is left as an exercise
>
> for the reader. The question of the existence of the reader
>
> is left as an exercise for the second god coefficient.
>
> (A discussion of non-orthogonal, non-integral polytheism is
>
> beyond the scope of this article.)
>
> --- On Mon, 12/8/08, David Chan <[EMAIL PROTECTED]
 > wrote:
> From: David Chan <[EMAIL PROTECTED]  >
> Subject: Re: [openhealth] Patient Portals and PHR's
> To: openhealth@yahoogroups.com  
> Date: Monday, December 8, 2008, 9:39 PM
>
>
>
>
>
>
>
>
>
>
>
> I am pretty sure Indivohealth supports CDA.
>
> David
>
>
>
> David H Chan, MD, CCFP, MSc, FCFP
>
> Associate Professor
>
> Department of Family Medicine
>
> McMaster University
>
>
>
>  _ _ __
>
> From: Mark Spohr <[EMAIL PROTECTED]  >
>
> To: [EMAIL PROTECTED] ups.com
>
> Sent: Monday, December 8, 2008 2:12:24 PM
>
> Subject: Re: [openhealth] Patient Portals and PHR's
>
>
>
> One concern I have about Indivo is that it does not seem to support either
>
> the CCR or CDA interoperability standard that are used by Google Health
and
>
> HealthVault. They seem to have an XML model and invite people to develop
>
> concepts using archetypes. I don't think this is a wise course... unless,
>
> of course, I misunderstand.
>
>
>
> .Mark
>
>
>
> On Mon, Dec 8, 2008 at 4:49 PM, fred trotter 
> wrote:
>
>
>
> > Hi,
>
> > We already have a very strong FOSS PHR project in Indivo
>
> > http://www.indivohe alth.org/
>
> > Indivo is FOSS, it is being massively deployed as part of Dossia
>
> > http://www.dossia. org/
>
> >
>
> > It is already basically the number 3 PHR available after Google
>
> > Health and HealthVault.
>
> >
>
> > Also, Tolvens project has a PHR component.
>
> >
>
> > If we as a community are looking for something to "get behind"
>
> > as far as PHRs go, this seems pretty obvious... Am I missing
>
> > something?
>
> >
>
> > -FT
>
> >
>
> > --
>
> > Fred Trotter
>
> > http://www.fredtrot ter.com
>
> >
>
> >  - - --
>
> >
>
> > Yahoo! Groups Links
>
> >
>
> >
>
> >
>
> >
>
>
>
> --
>
> Mark Spohr, MD
>
>
>
> [Non-text portions of this message have been removed]
>
>
>
> [Non-text portions of this message have been removed]
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
> [Non-text portions of this message have been removed]
>
>
> 
>
> Yahoo! Groups Links
>
>
>
>

-- 
Mark Spohr, MD

[Non-text portions of this message have been removed]

 



[Non-text portions of this message have been removed]

[openhealth] Re: Announcing release of a spreadsheet-based XML-CCD to CSV data conversion tool

[Stephen Beller]

Stuart:

I don't use a Mac, so I can't answer that question for you. If you send
me your email, I will send you a copy of the CSV.

The macro strips out every XML tag. All you end up with are the data
labels and values.

Since I didn't create the XML, and since the XML-XSL parsing & rendering
is done via a native Excel procedure evoked by a single line of
code--Workbooks.OpenXML Filename:=pFlPthSel, Stylesheets:=Array(1)--I
cannot respond intelligently to your XSD question. All I know is that
the procedure requires that both the XML and XSL files exist.

Steve


--- In openhealth@yahoogroups.com, Stuart Turner <[EMAIL PROTECTED]>
wrote:
>
> Steve:
>
> Thanks also for releasing your work to the community.
>
> I downloaded the binary xsl file, but unfortunately could not run it
> under MS Excel for the Mac (2004) due to a compatibility error and
> Microsoft has stripped VBA functions from their version of Excel for
> Mac 2008 altogether. I believe there is VBA supported reported to
> exist in some versions of OpenOffice, but not my version of NeoOffice.
> Therefore I was unable to see the resulting CSV output.
>
> So my question is - does the script in your macro strip away all XML
> and not just the Table of Contents section of the CCD document?
>
> I didn't see a pointer to a CCD schema in the XML (just the normative
> CDA.xsd pointer in the XSL document). Therefore I didn't understand if
> the macro persists the XML somehow to allow a way to roundtrip the CCD
> XML document if the file was edited or annotated and therefore
> maintain the intrinsic semantics and constraints offered by the
> schema, or if the CSV was simply providing raw data for a specific
> local use case? If so, it would be ideal to at least validate the CCD
> document against the normative schema prior to conversion to CSV.
>
> Thanks,
>
> ~ Stuart
>
> On Nov 16, 2008, at 1:13 PM, Stephen Beller wrote:
>
> >
> > I've had lengthy, and sometimes heated, debates with leaders of the
> > open
> > source community about the value of having both FOSS and proprietary
> > software systems. I made the case that inventors who hold patents
for
> > truly original and useful breakthrough software programs—and who
are
> > compassionate, empathetic, socially-minded individuals—should
not be
> > lumped together with people who receive software dubious patents for
> > insignificant inventions. These latter inventors sole purpose is to
> > enrich themselves by "holding other developers hostage" and
> > constraining
> > them from creating health information technology programs that could
> > have great benefit for the greater good. And I fully support FOSS
for
> > taking a hard-line stand against such practices!
> >
> > I made the case, therefore, that FOSS programs, and proprietary
> > programs
> > offered by decent inventors, can live together peacefully for
> > everyone's
> > benefit.
> >
> > I now want to announce that I've just offered a CCD (continuity of
> > care
> > document) data conversion program under a FOSS license. For anyone
> > interested, it's located at this link:
> >
http://opensourceandpatents.blogspot.com/2008/11/first-open-source-offer
> > \
> > ing-xml-to-csv.html
> >
<http://opensourceandpatents.blogspot.com/2008/11/first-open-source-offe
> > \
> > ring-xml-to-csv.html>
> >
> > Steve
> >
> > [Non-text portions of this message have been removed]
> >
> >
> >
>

[openhealth] A practical way to ise the XML-CCD to CSV data conversion tool

[Stephen Beller]

I'd like to thank everyone for their words of encouragement.

I've been asked for some practical examples of how my program can be
used. One obvious use is for data transmission in the  most efficient
way since all that's in the CSV are the data labels and values; all the
XML tags are stripped out and no XSL is need. That means a 3KB data file
vs. an 67KB XML and  19KB XSL, a size reduction of about 97% before
compression.

What else can you do once you have the CSV? Well, one thing is to write
another script (macro) that consumes the CSV and exports any selected
data values to a database table. There are a number of ways to do this,
but one is to locate each data element via a search routine, defining
the found data value as a variable, then used that variable in an SQL
query that exports the value to a table.

Note that I'm responding to Stuart questions in a separate post.

Steve

--- In openhealth@yahoogroups.com, "Stephen Beller" <[EMAIL PROTECTED]> wrote:
>
>
> I've had lengthy, and sometimes heated, debates with leaders of the
open
> source community about the value of having both FOSS and proprietary
> software systems. I made the case that inventors who hold patents for
> truly original and useful breakthrough software programs—and who
are
> compassionate, empathetic, socially-minded individuals—should not
be
> lumped together with people who receive software dubious patents for
> insignificant inventions. These latter inventors sole purpose is to
> enrich themselves by "holding other developers hostage" and
constraining
> them from creating health information technology programs that could
> have great benefit for the greater good. And I fully support FOSS for
> taking a hard-line stand against such practices!
>
> I made the case, therefore, that FOSS programs, and proprietary
programs
> offered by decent inventors, can live together peacefully for
everyone's
> benefit.
>
> I now want to announce that I've just offered a CCD (continuity of
care
> document) data conversion program under a FOSS license. For anyone
> interested, it's located at this link:
>
http://opensourceandpatents.blogspot.com/2008/11/first-open-source-offer\
\
> ing-xml-to-csv.html
>
<http://opensourceandpatents.blogspot.com/2008/11/first-open-source-offe\
\
> ring-xml-to-csv.html>
>
> Steve
>
>
>
> [Non-text portions of this message have been removed]
>




[Non-text portions of this message have been removed]

[openhealth] Announcing release of a spreadsheet-based XML-CCD to CSV data conversion tool

[Stephen Beller]

I've had lengthy, and sometimes heated, debates with leaders of the open
source community about the value of having both FOSS and proprietary
software systems. I made the case that inventors who hold patents for
truly original and useful breakthrough software programs—and who are
compassionate, empathetic, socially-minded individuals—should not be
lumped together with people who receive software dubious patents for
insignificant inventions. These latter inventors sole purpose is to
enrich themselves by "holding other developers hostage" and constraining
them from creating health information technology programs that could
have great benefit for the greater good. And I fully support FOSS for
taking a hard-line stand against such practices!

I made the case, therefore, that FOSS programs, and proprietary programs
offered by decent inventors, can live together peacefully for everyone's
benefit.

I now want to announce that I've just offered a CCD (continuity of care
document) data conversion program under a  FOSS license. For anyone
interested, it's located at this link:
http://opensourceandpatents.blogspot.com/2008/11/first-open-source-offer\
ing-xml-to-csv.html


Steve



[Non-text portions of this message have been removed]

[openhealth] Re: FreeOpenSourceSoftware.org -- New Wiki

[Stephen Beller]

You're right. I looked for a "discussion" or "comment" tab on wiki 
page, but couldn't find one; and I thought about editing the wiki, 
but didn't want to assume I was welcomed to inject my questions and 
views into Bill's fine work. Nevertheless, I have no problem with 
anything from my blog being appended to the wiki if Bill wants to. 

--- In openhealth@yahoogroups.com, Adrian Midgley <[EMAIL PROTECTED]> 
wrote:
>
> -BEGIN PGP SIGNED MESSAGE-
> Hash: SHA1
> 
> 
> 
> >  > > I did, however, have some concern regarding your FOSS 
philosophy
> >  > > discussion at http://freeopensourcesoftware.org/index.php?
> >  > 
> >  > > title=FOSS_Philosophy. There appears to be a double-standard 
by
> >  > FOSS
> >  > > purists about what is worthy of financial compensation and 
what
> >  > > isn't.
> >  > >
> >  > > I just posted a response to my blog at
> >  > > http://curinghealthcare.blogspot.com/2008/06/free-vs-
commercial-
> >  > 
> >  > open-
> >  > > source-software.html
> 
> 
> It would be a wiki-like response to edit the wiki to reflect the 
range
> of opinion, or add to the discussion page associated with that page
> those comments.
> 
> Commenting elsewhere doesn't improve the common resource, the wiki.
> 
> 
> -BEGIN PGP SIGNATURE-
> Version: GnuPG v1.4.6 (GNU/Linux)
> Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org
> 
> iD8DBQFIa8tIb80am9d/StcRAkG9AKDaER7ZActB5mLwPsEovC0n/a1P5wCgrxX3
> /BrnPmw5wv/2d3RVOzAuNB4=
> =YBKT
> -END PGP SIGNATURE-
>

[openhealth] Re: FreeOpenSourceSoftware.org -- New Wiki

[Stephen Beller]

It's a pleasure corresponding with the OS community, Bill. I'm 
learning a great deal and getting good guidance. I'm now working with 
others in this community to offer an acceptable FOSS license and for 
our continuity of care record application later this month.

--- In openhealth@yahoogroups.com, "Wm. Stewart" <[EMAIL PROTECTED]> 
wrote:
>
> 
> Hi Stephen, thanks to you and the thoughtful responses of your 
> correspondents.  I essentially agree with the responses!
> Cheers,
> Bill
> 
> Stephen Beller wrote:
>  >
>  > FYI - I just responded to two excellent comments on my post about
>  > Bill's FOSS-COSS philosophy distinction, which is at:
>  > https://www.blogger.com/comment.g? 
<https://www.blogger.com/comment.g?>
>  > blogID=25132358&postID=5801635888685043227&page=1
>  >
>  > --- In openhealth@yahoogroups.com <mailto:openhealth%
40yahoogroups.com>,
>  > "Stephen Beller" 
>  > wrote:
>  > >
>  > > You've done a great job on the wiki, Bill!
>  > >
>  > > I did, however, have some concern regarding your FOSS 
philosophy
>  > > discussion at http://freeopensourcesoftware.org/index.php?
>  > <http://freeopensourcesoftware.org/index.php?>
>  > > title=FOSS_Philosophy. There appears to be a double-standard by
>  > FOSS
>  > > purists about what is worthy of financial compensation and what
>  > > isn't.
>  > >
>  > > I just posted a response to my blog at
>  > > http://curinghealthcare.blogspot.com/2008/06/free-vs-
commercial-
>  > <http://curinghealthcare.blogspot.com/2008/06/free-vs-commercial-
>
>  > open-
>  > > source-software.html
>  > >
>  > > I hope you (or anyone) can address the issues I raised.
>  > >
>  > > Regards,
>  > > Steve
>  > >
>  > > --- In openhealth@yahoogroups.com <mailto:openhealth%
40yahoogroups.com>,
>  > "Wm. Stewart" 
>  > > wrote:
>  > > >
>  > > >
>  > > > Hi Folks,
>  > > >
>  > > > I'm the author of the Internet reference site
>  > > > http://www.livinginternet.com/ 
<http://www.livinginternet.com/> , 
> and was
>  > lucky enough to get the
>  > > > FreeOpenSourceSoftware.* domains. As you probably know, much 
of
>  > the
>  > > > Internet was originally built on varieties of free software. 
I
>  > have
>  > > > donated this domain to the community and set up a wiki. The
>  > > purpose is to
>  > > > provide a home for documentation of pure FOSS, free in all
>  > > versions, as
>  > > > separate from Commercial Open Source with proprietary 
versions.
>  > > I've
>  > > > seeded it with starting information. Hope it becomes useful 
to
>  > > you. Feel
>  > > > free to add information, and please spread the word to let 
others
>  > > know of
>  > > > the launch!
>  > > >
>  > > > http://freeopensourcesoftware.org/ 
<http://freeopensourcesoftware.org/>
>  > > >
>  > > > Cheers,
>  > > > Bill
>  > > >
>  > > > --
>  > > >
>  > >
>  >
>  >
>

[openhealth] Re: FreeOpenSourceSoftware.org -- New Wiki

[Stephen Beller]

FYI - I just responded to two excellent comments on my post about
Bill's FOSS-COSS philosophy distinction, which is at:
https://www.blogger.com/comment.g?
blogID=25132358&postID=5801635888685043227&page=1

--- In openhealth@yahoogroups.com, "Stephen Beller" <[EMAIL PROTECTED]> 
wrote:
>
> You've done a great job on the wiki, Bill!
> 
> I did, however, have some concern regarding your FOSS philosophy 
> discussion at http://freeopensourcesoftware.org/index.php?
> title=FOSS_Philosophy. There appears to be a double-standard by 
FOSS 
> purists about what is worthy of financial compensation and what 
> isn't. 
> 
> I just posted a response to my blog at 
> http://curinghealthcare.blogspot.com/2008/06/free-vs-commercial-
open-
> source-software.html
> 
> I hope you (or anyone) can address the issues I raised.
> 
> Regards,
> Steve
> 
> --- In openhealth@yahoogroups.com, "Wm. Stewart"  
> wrote:
> >
> > 
> > Hi Folks,
> > 
> > I'm the author of the Internet reference site
> > http://www.livinginternet.com/ , and was lucky enough to get the
> > FreeOpenSourceSoftware.* domains.  As you probably know, much of 
the
> > Internet was originally built on varieties of free software.  I 
have
> > donated this domain to the community and set up a wiki.  The 
> purpose is to
> > provide a home for documentation of pure FOSS, free in all 
> versions, as
> > separate from Commercial Open Source with proprietary versions.  
> I've
> > seeded it with starting information.  Hope it becomes useful to 
> you.  Feel
> > free to add information, and please spread the word to let others 
> know of
> > the launch!
> > 
> > http://freeopensourcesoftware.org/
> > 
> > Cheers,
> > Bill
> > 
> > --
> >
>

[openhealth] Re: FreeOpenSourceSoftware.org -- New Wiki

[Stephen Beller]

FYI - I just responded to two excellent comments on my post about 
Bill's FOSS-COSS philosophy distinction, which is at: 
https://www.blogger.com/comment.g?
blogID=25132358&postID=5801635888685043227&page=1">this link.

--- In openhealth@yahoogroups.com, "Stephen Beller" <[EMAIL PROTECTED]> 
wrote:
>
> You've done a great job on the wiki, Bill!
> 
> I did, however, have some concern regarding your FOSS philosophy 
> discussion at http://freeopensourcesoftware.org/index.php?
> title=FOSS_Philosophy. There appears to be a double-standard by 
FOSS 
> purists about what is worthy of financial compensation and what 
> isn't. 
> 
> I just posted a response to my blog at 
> http://curinghealthcare.blogspot.com/2008/06/free-vs-commercial-
open-
> source-software.html
> 
> I hope you (or anyone) can address the issues I raised.
> 
> Regards,
> Steve
> 
> --- In openhealth@yahoogroups.com, "Wm. Stewart"  
> wrote:
> >
> > 
> > Hi Folks,
> > 
> > I'm the author of the Internet reference site
> > http://www.livinginternet.com/ , and was lucky enough to get the
> > FreeOpenSourceSoftware.* domains.  As you probably know, much of 
the
> > Internet was originally built on varieties of free software.  I 
have
> > donated this domain to the community and set up a wiki.  The 
> purpose is to
> > provide a home for documentation of pure FOSS, free in all 
> versions, as
> > separate from Commercial Open Source with proprietary versions.  
> I've
> > seeded it with starting information.  Hope it becomes useful to 
> you.  Feel
> > free to add information, and please spread the word to let others 
> know of
> > the launch!
> > 
> > http://freeopensourcesoftware.org/
> > 
> > Cheers,
> > Bill
> > 
> > --
> >
>

[openhealth] Re: FreeOpenSourceSoftware.org -- New Wiki

[Stephen Beller]

You've done a great job on the wiki, Bill!

I did, however, have some concern regarding your FOSS philosophy 
discussion at http://freeopensourcesoftware.org/index.php?
title=FOSS_Philosophy. There appears to be a double-standard by FOSS 
purists about what is worthy of financial compensation and what 
isn't. 

I just posted a response to my blog at 
http://curinghealthcare.blogspot.com/2008/06/free-vs-commercial-open-
source-software.html

I hope you (or anyone) can address the issues I raised.

Regards,
Steve

--- In openhealth@yahoogroups.com, "Wm. Stewart" <[EMAIL PROTECTED]> 
wrote:
>
> 
> Hi Folks,
> 
> I'm the author of the Internet reference site
> http://www.livinginternet.com/ , and was lucky enough to get the
> FreeOpenSourceSoftware.* domains.  As you probably know, much of the
> Internet was originally built on varieties of free software.  I have
> donated this domain to the community and set up a wiki.  The 
purpose is to
> provide a home for documentation of pure FOSS, free in all 
versions, as
> separate from Commercial Open Source with proprietary versions.  
I've
> seeded it with starting information.  Hope it becomes useful to 
you.  Feel
> free to add information, and please spread the word to let others 
know of
> the launch!
> 
> http://freeopensourcesoftware.org/
> 
> Cheers,
> Bill
> 
> --
>

[openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Hi Tony,

Interestingly, the most recent eWeek publication has a brief article 
titled "Crypto Manners," in which the Electronic Frontier Foundation 
is calling the current limits to crypto exports unconstitutional.

I'm not a cryptologist, but, from what I've read, there's a risk of 
having an encryption key stolen and used to unencrypt data, and if 
the encryption algorithm is based on a password, it is possible to 
hack the key by breaking the password. A multi-key encryption 
solution, in which each key is different and all the keys are 
required to unencrypt a file, may be more secure (which is what we 
have with our Multicryption prototype). 

FWIW,
Steve

--- In openhealth@yahoogroups.com, Tony McCormick <[EMAIL PROTECTED]> wrote:
>
> Hi all,
>   This is a fascinating conversation.  more useful than most I've 
seen 
> on this and other venues.   I am a bit confused by the 
email/encryption 
> discussion.  Is it still "illegal" to use greater than 48bit 
inscription 
> across international borders?  Because higher levels of encryption, 
even 
> without Steve's extra indirection, are, for all practical purposes, 
> unbreakable and meet HIPAA regs just fine.   I have a similar 
> application for in home health care data collection that uses 1024 
bit 
> PGP encryption with email as the primary (but not sole) delivery 
system 
> into the OpenEMR system.   I can't see how that's a problem.
> 
> I think that much of Lopo's suggestions are great alternatives as 
well, 
> be email is tried and true and dirt simple to implement.   It may 
have 
> higher band width, compared to socket-to-socket or similar 
protocols, 
> but no so much as it would be an issue, in my opinion.
> 
> Tony McCormick
> Medical Information Integration, LLC
> www.mi-squared.com
> 
> 
> 
> 
> [Non-text portions of this message have been removed]
>

[openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Good points, Lopo. 

Although I'm not claiming that email is a better solution than what 
you suggest, here's how the email process I'm describing could 
avoid "sniffers."

1. Whether the data file attachment is decomposed (split up) or not, 
the file(s) would be encrypted.

2. Upon receiving the data file (which we actually call a "Content 
File"), the subscriber's node checks its authenticity. There are 
several ways to do this. For example, before any data are 
transmitted, a Subscriber Node sends a message to a Publisher Node 
that requests the Publisher to send the subscriber a Content File 
with a certain data set, along with a Report Template for viewing the 
data. Each of these nodes maintains a list of the e-mail addresses to 
which Content Files and Report Templates files are authorized to be 
sent (from the Publisher node) and received (by the Subscriber node). 

Also, note that (a) the data in the Content File are organized in a 
way that corresponds to its Report Template file and (b) the Template 
files are sent independently of the Content Files. That means someone 
intercepting a Content File would need access to its corresponding 
Template file in order to make sense of the data. Furthermore, 
Template files will not process any Content File unless it has the 
proper version number.

3. Our MultiCryption application scrambles and pads the Content File, 
and can decompose it as well, which adds another level of security. 
See http://www.nhds.com/mc/product.html

Anyway, I'd love to have multiple methods of transport used. I'll 
review the links you sent. Thanks again.

Steve

--- In openhealth@yahoogroups.com, "Lopo Lencastre de Almeida" 
<[EMAIL PROTECTED]> wrote:
>
> Hi Steve,
> 
> Splitting info over several emails won't do. Or the data in those
> emails is encrypted and signed or it will be easier to catch.
> 
> Read this links:
> 
> 
http://searchsecurity.techtarget.com/news/article/0,289142,sid14_gci11
87590,00.html
> 
http://searchnetworking.techtarget.com/sDefinition/0,,sid7_gci213016,0
0.html
> 
> MailSniff: http://secureinf.com/ms_about.php
> 
> It won't be compeltely impossible to make a traffic sniffer worm-
like
> that would allow to reconstruct your splited data a post it 
somewhere
> else.
> 
> Neverthless, there are no bullet proof solutions ;)
> 
> 1,
> Lopo
> 
> --- In openhealth@yahoogroups.com, "Stephen Beller"  
wrote:
> >
> > Hello Lopo,
> > 
> > Thanks for sharing your ideas! I sincerely appreciate your input.
> > You are more knowledgeable than me concerning all these alternate 
> > means to e-mail. Just to clarify the e-mail solution I mentioned, 
> > note that it (a) uses encrypted file attachments, not plain text 
> > email messages; (b) uses aliases, not patient names; (c) would 
> > operate on a VPN; and (d) can decomposite the attached data file, 
so 
> > that other patient identifiers (e.g., all demographic data) are 
sent 
> > separately from the other data (e.g., they can be sent to 
subscribers 
> > along with the reporting templates when the publisher-subscriber  
> > connection is first made and prior to any clinical data being 
> > shipped). These would comply with HIPAA regs. 
> > 
> > Nevertheless, a great thing about OS is the opportunity to 
explore 
> > alternatives. As such, I am eager to learn about different 
methods 
> > for data transmission, as well as alternatives to Excel 
spreadsheets. 
> > So, I fully support all innovative ideas (including yours), even 
> > though they may be beyond my personal technological skill set. 
All 
> > that matters to me is that we continually evolve a collaborative 
> > solution that provides the least costly, most secure way to 
create, 
> > deliver and use better knowledge supporting ever-more effective 
and 
> > efficient delivery of quality care.
> > 
> > FYI - We are closing in on a dual licensing OS approach and the 
> > subsequent release of our source code, but it will take several 
more 
> > weeks.
> > 
> > Thanks again,
> > Steve
> > 
> > --- In openhealth@yahoogroups.com, "Lopo Lencastre de Almeida" 
> >  wrote:
> > >
> > > Hi Steve,
> > > 
> > > On your blog, at [1], you said this:
> > >  
> > > «(...) occasional e-mail over low bandwidth connections and a
> > > spreadsheet. For many regions of the world, our low cost, low 
> > resource
> > > consumption, peer-to-peer solution makes very good sense.»
> > > 
> > > IMHO, I disagree with this approach of using an email system for
> > > solving this bandwidth problem of the poor countrie

[openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Hello Lopo,

Thanks for sharing your ideas! I sincerely appreciate your input.
You are more knowledgeable than me concerning all these alternate 
means to e-mail. Just to clarify the e-mail solution I mentioned, 
note that it (a) uses encrypted file attachments, not plain text 
email messages; (b) uses aliases, not patient names; (c) would 
operate on a VPN; and (d) can decomposite the attached data file, so 
that other patient identifiers (e.g., all demographic data) are sent 
separately from the other data (e.g., they can be sent to subscribers 
along with the reporting templates when the publisher-subscriber  
connection is first made and prior to any clinical data being 
shipped). These would comply with HIPAA regs. 

Nevertheless, a great thing about OS is the opportunity to explore 
alternatives. As such, I am eager to learn about different methods 
for data transmission, as well as alternatives to Excel spreadsheets. 
So, I fully support all innovative ideas (including yours), even 
though they may be beyond my personal technological skill set. All 
that matters to me is that we continually evolve a collaborative 
solution that provides the least costly, most secure way to create, 
deliver and use better knowledge supporting ever-more effective and 
efficient delivery of quality care.

FYI - We are closing in on a dual licensing OS approach and the 
subsequent release of our source code, but it will take several more 
weeks.

Thanks again,
Steve

--- In openhealth@yahoogroups.com, "Lopo Lencastre de Almeida" 
<[EMAIL PROTECTED]> wrote:
>
> Hi Steve,
> 
> On your blog, at [1], you said this:
>  
> «(...) occasional e-mail over low bandwidth connections and a
> spreadsheet. For many regions of the world, our low cost, low 
resource
> consumption, peer-to-peer solution makes very good sense.»
> 
> IMHO, I disagree with this approach of using an email system for
> solving this bandwidth problem of the poor countries.
> 
> Sending an email wouldn't be a great solution since you will have to
> comply with HIPAA and other national regulation in what concerns 
data
> retention, transmission and its security[2], and not only in the
> richer countries as you surely know. I do believe you tought about 
it
> and got a solution but...
>  
> Using plain text email messages is not the best way to do it hence 
you
> will have to have either a POP3 server with SSL/TLS or will have to
> encrypt and sign the message to guarantee that it is secure to use 
and
> that patient's private data is safe all the way.
> 
> Besides that, and even if you don't need the message encryption, 
email
> messages have a few lines in the header that are useless to anything
> else than email programs. And those extra lines mean extra bytes
> transmited in the same connection. And on fail all the email must be
> re-fetched.
> 
> A much better solution would be to use, on the client side, 
GNU/Linux
> (Xubuntu[3] or Puppy[4] with LightHttpd[5] running on localhost,
> PHP[6] and sqlLite[7]) plus a light browser or Swiftfox[8] for low 
end
> PCs or PHP-GTK[9] or even Python[10], Ruby[11] or Perl; which are
> easier to work with than any C variant and much more portable 
between
> Operating Systems.
> 
> In the case of PHP, the client app could use JQuery[12] or Dojo[13]
> and a modified version of PHP's Simple Spreadsheet[14] (or JQuery
> Spreadsheet[15] or Dojo Spreadsheet[16]) and communication between
> client/server could use encrypted data over HXP[17], HL7[18], REST
[19]
> or SOAP[20] (using a similar concept to OpenID[21] with HMAC[22] and
> data encryption[23] for instance) to initiate the authentication and
> further light peer-to-peer communication.
> 
> Best,
> Lopo
> 
> 
> 
> Links mentioned above:
> 
> [1] 
> http://curinghealthcare.blogspot.com/2008/05/interesting-article-
about-open-source.html
> [2]  http://en.wikipedia.org/wiki/HIPAA
> [3]  http://www.xubuntu.org/
> [4]  http://www.puppylinux.org/
> [5]  http://www.lighttpd.net/
> [6]  http://www.php.net/
> [7]  http://www.sqlite.org/
> [8]  http://getswiftfox.com/download.htm
> [9]  http://gtk.php.net/
> [10] http://www.python.org/
> [11] http://www.ruby-lang.org/en/
> [12] http://www.jquery.com/
> [13] http://www.dojotoolkit.org/
> [14] http://www.simple-groupware.de/cms/Spreadsheet/Home
> [15] http://os.arandomurl.com/jqueryspreadsheet/
> [16]
> http://blog.tremend.ro/wp-
content/uploads/2006/09/spreadsheet_custom_build/test_spreadsheet.htm
> [17] http://hxp.sourceforge.net/
> [18] http://en.wikipedia.org/wiki/HL7
> [19] http://en.wikipedia.org/wiki/REST
> [20] http://en.wikipedia.org/wiki/SOAP
> [21] http://openid.net/
> [22] http://en.wikipedia.org/wiki/HMAC
> [23] http://lopo.users.phpclasses.org/browse/package/1297.html
>

RE: [openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Thanks, Mark . I certainly do want the opinions and advice from this
community!

 

I'm not saying that patents aren't problematic. I, too, have a problem with
healthcare patents that prevent people from getting the care they need (or
even better care) because the patent-holder puts unreasonable demands on its
use. I'd even extend this issue beyond software: What about patented
medications whose price, prior to becoming generic, makes them too expensive
for some people? The same can be said for medical devices. In all these
cases, people are  prevented from getting the best possible care because the
economic system driving healthcare is like other businesses: It is built on
profit. Actually, some people even make the case that all doctors should be
salaried, and there should be universal healthcare with no string attached,
otherwise the profit motive will continue to drive up costs and reduces
access to care, without improving quality. 

 

If I had my way, our entire economic system would be reformed so that people
whose products and services offer the greatest benefit to the common good
receive the most economic gain, with healthcare products and services likely
being at the top of the list. Instead, our current system rewards companies
for destroying competitors who have better and less costly solutions, so
they can raise prices and deliver lower value to the consumer for greater
profit. I agree that patents can play a role in this.

 

However, prior to open source becoming a viable business model, small
independent inventors like me risked being victims of the 800 pound gorillas
in their industries, unless they had legal protection via copyrights or
patents, or unless they kept their intellectual property trade secrets.
Taking away these protections frighten small businesses innovators and
encourage the vultures to start circling. Think about it. It's just the way
our nutty system is set up!

 

Some OS models are now offering reasonable alternatives to patents for
inventors fearful of financial ruin if they were to disclose their IP
without legal protection. 

 

Bottom line: I agree that patents can be very problematic when it comes to
healthcare. The problem as I see it, however, is not with patents, per se,
but with the pathologically mutated form of capitalism that has been driving
our country, which has made patents almost a necessity to inventors. If our
economic system were different, there may have never been the need for
software patents to allay the fears of small inventors. Thankfully, OS may
very well be an innovative "work-around" in our nutty economic system.

 

Furthermore, while he took it from a different perspective, I see the logic
in Fred's point that inventors should have the right to use an OS software
license to exert control over a vendor using their IP, in the same way
propriety vendors presume control of a clinician through their traditional
software license.

 

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of Mark Spohr
Sent: Thursday, May 08, 2008 1:30 PM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Re: An inventor of disruptive technology looking
for advice about open source

 

I've read your blog posting and I think that you have correctly identified
the problem. We have capitalism run amok with no controls, legal or
ethical.

What I don't understand it why you think that software patents aren't part
of the problem. To me, it is morally repugnant to 'own' an idea in the way
that patent's permit. When you have patents on health care applications
where health is on the line, you are in the same category as the people you
cite in your article who purchased nursing homes and ruthlessly cut
services. They put personal profit ahead of people's health.

If you really believe what your wrote in your blog, you should put your
patent in the public domain so that everyone can benefit from it without
payment.

You did ask for our advice...

.Mark

On Thu, May 8, 2008 at 5:22 PM, Stephen Beller <[EMAIL PROTECTED]
<mailto:sbeller%40nhds.com> > wrote:

> Our entire economic system can be characterized as "pathological mutation
> of
> Capitalism," as I discuss at this link --
>
>
http://curinghealthcare.blogspot.com/2007/10/path-to-profound-healthcare.htm
> l
>
>
>
> As such, legal, yet morally corrupt practices--in which a few gain
> financially as others are harmed--have become an "acceptable" way of doing
> business. When patents of any kind fall into this category, I accept the
> argument that they are bad for society. I wouldn't, however, not place
> every
> patent holder in that category. Instead, I would argue that there are
> situations in which inventors with patented software are truly committed
to
> helping humanity with their innovation. They are not driven by greed or

RE: [openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Accepted, Bhaskar . and I thank you for sharing your thoughts. I'd be happy
to engage in deeper conversation at a later time.

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of K.S. Bhaskar
Sent: Thursday, May 08, 2008 11:48 AM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Re: An inventor of disruptive technology looking
for advice about open source

 

Steve --

I don't have the bandwidth right now to engage in a discussion on 
whether Government granted legal monopolies like patents are societally 
beneficial from a macro-economic perspective, and whether or not greed 
is good or is morally corrupt. These are fascinating and deep topics 
that I enjoy discussing - but not at this time. For now, I only wanted 
to express my personal and very subjective preferences, to the extent 
that knowing the personal preferences of a group of people may help you 
to choose your course of action.

Regards
-- Bhaskar

On 05/08/2008 11:22 AM, Stephen Beller wrote:
>
> Our entire economic system can be characterized as "pathological 
> mutation of
> Capitalism," as I discuss at this link --
>
http://curinghealthcare.blogspot.com/2007/10/path-to-profound-healthcare.htm
> l
>
[KSB] <...snip...>

__

The information contained in this message is proprietary and/or
confidential. If you are not the 
intended recipient, please: (i) delete the message and all copies; (ii) do
not disclose, 
distribute or use the message in any manner; and (iii) notify the sender
immediately. In addition, 
please be aware that any message addressed to our domain is subject to
archiving and review by 
persons other than the intended recipient. Thank you.
_

 



[Non-text portions of this message have been removed]

RE: [openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Our entire economic system can be characterized as "pathological mutation of
Capitalism," as I discuss at this link --
http://curinghealthcare.blogspot.com/2007/10/path-to-profound-healthcare.htm
l

 

As such, legal, yet morally corrupt practices--in which a few gain
financially as others are harmed--have become an "acceptable" way of doing
business. When patents of any kind fall into this category, I accept the
argument that they are bad for society. I wouldn't, however, not place every
patent holder in that category. Instead, I would argue that there are
situations in which inventors with patented software are truly committed to
helping humanity with their innovation. They are not driven by greed or ego,
and they do not want their patent to adversely affect society. They
sacrifice much for the common good and have no intention of being part of
any pathologically mutated form of Capitalism.

 

I see myself as being such an individual, which is why we're looking into
open source. We have not yet decided about the particular OS license because
there is a great deal to understand and consider.

 

Steve

 

From: openhealth@yahoogroups.com [mailto:[EMAIL PROTECTED] On
Behalf Of K.S. Bhaskar
Sent: Thursday, May 08, 2008 10:33 AM
To: openhealth@yahoogroups.com
Subject: Re: [openhealth] Re: An inventor of disruptive technology looking
for advice about open source

 

If you have FOSS that is protected by a patent, the license is 
important. If I were a user, I wouldn't touch the software unless it 
was released under either GPL v3 or Affero GPL v3.

In general, I am turned off by software patents. I say this as someone 
who was awarded one of the early patents in the US where software was 
even permitted to be a component of the patent (filed circa 1981) and 
another which was one of the early pure software patents (filed circa 
1986), but who has now come to view software patents as a social evil 
that must be lived with, along the lines of breathing second hand smoke 
when entering or exiting buildings, or finding banana peels or 
pre-chewed gum in airplane seat pockets.

-- Bhaskar

On 05/06/2008 04:46 PM, Stephen Beller wrote:
>
> Yes, I do realize patents are a problem for open source. We received
> our software method patent in 1998 and have it in the US and two
> other countries. Anyone interested can read about it at
> http://cpsplit.typepad.com/
>
> Anyway, there's nothing to prevent us,however, from licensing our
> patented software method royalty free for use with our Personal
> Health Profiler. So, I don't see this as a deal-breaker, but it does
> complicate matters.
>
> I'm willing to discuss the details openly in this forum if people
> here can offer sound advice.
>
> Thanks,
>
> Steve
>

__

The information contained in this message is proprietary and/or
confidential. If you are not the 
intended recipient, please: (i) delete the message and all copies; (ii) do
not disclose, 
distribute or use the message in any manner; and (iii) notify the sender
immediately. In addition, 
please be aware that any message addressed to our domain is subject to
archiving and review by 
persons other than the intended recipient. Thank you.
_

 



[Non-text portions of this message have been removed]

[openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

I look forward to reluctant offer of offlist communication, Fred.

Regarding the health software patent paradox, I actually do understand
the point you're making about the ethical questions of patented
healthcare tools, especially if greed or pride prevent the use of such
tools for improving health.

In my situation, I had no thought of patents (or even commercialization)
when I began this journey in 1981. As a newly licensed clinical
psychologist, all I wanted to do was create a computerized tool that
would help be help my patients by developing a symptom checklist to
track their progress and outcomes. Since I had no formal I.T. training,
and since I was fascinated by Visicalc, I naturally turned to
spreadsheets for developing the checklist (going from Appleworks to
Lotus 123 to MS Excel). A couple of years into it, I asked myself this
question: What if, instead of just tracking psychological symptoms, I
expanded the data set to track and analyze every piece of potentailly
useful information by adding biomedical and mind-body interaction data
to the psychological symptom data. Later, I wanted to include assessment
of patients' thoughts processes and the causes & consequences of
their stressful life situations. Most recently, I started adding
wellness assessment data. All this focused on helping with treatment
planning, delivery of treatment, use of self-help tools (e.g., using
problem solving tools), and assessing patient progress and outcomes.

It wasn't until around 1993 that I began having thoughts of starting
a software company centered on selling the application I've
developed to my mental health colleagues. NHDS was incorporated in May
1994. Despite encouragement and support from some wonderful people, a
few sales to early adopters, the bottom line was that I came to market
about 15 years too early into a hostile business environment.

Several years later, I realized that the application I developed had
many unique technological functions and capabilities, which had nothing
to do with healthcare per se. We then reasoned that patenting these
underlying components might be a way into other markets. So, I wrote the
CP Split technology patent in 1997, which was granted in 1998. A few
years later, we used the patented process for a knowledge management
application developed for the oil & gas industry and for an application
in education. In addition, we used in prototypes applicable to financial
services, retail/wholesale, space science, and research. Our involvement
in healthcare was minimal during this period since we didn't see
real opportunities to market our technology.

Anyway, it wasn't until the summer of 2005—with the Office of
the National Coordinator for Health Information Technology (ONCHIT)
RFP—that we saw an opportunity and a good reason to refocus on
healthcare.

Looking back now, I can say that if we had greater success in healthcare
during our initial efforts in the early 1990's, it's unlikely we
would have decided to spend big bucks to patent our software processes
and we wouldn't have shifted our focus away from healthcare and onto
developing applications for non-health-related industries. But
that's the nature of business and disruptive innovation.

Nevertheless, since (a) our patented (and non-patented) processes have
the potential to transform healthcare worldwide in a radically positive
way (as I will describe in little while), and since (b) open source is
emerging as a viable business model, then (c) I see, for the first time
in my life, a real opportunity for making our world a better place
through international cooperation among compassionate people focused on
improving the health and wellbeing of all … something that excites
me since I've only dreamt of it in the past!!!

You were the first to point out that my generalized blog statement—
"Note that there are dozens of other open source licenses, including
those that prohibit derived work and free sharing"—is inaccurate. I
changed "prohibit " to "restrict", btw, which I hope
correct the error. Thank you. FYI, my reason for having stated it
incorrectly are things I've read such as "Musicians, for
example, may prohibit derivative works." [Reference
  ]. I figured,
why can't software decide to do the same? And this: "Open source
licenses may be broadly categorized into the following types: (1) those
that apply no restrictions on the distribution of derivative works (we
will call these Non-Protective Licenses because they do not protect the
code from being used in non-Open Source applications); and (2) those
that do apply such restrictions (we will call these Protective Licenses
because they ensure that the code will always remain open/free)."
[Reference   ]
Anyway, I'm no lawyer and do find it all a bit confusing, so I do
appreciate the feedback I've been getting.

You wrote: <>

While I don't think it's appropriate for 

[openhealth] Re: An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Yes, I do realize patents are a problem for open source. We received 
our software method patent in 1998 and have it in the US and two 
other countries. Anyone interested can read about it at 
http://cpsplit.typepad.com/

Anyway, there's nothing to prevent us,however, from licensing our 
patented software method royalty free for use with our Personal 
Health Profiler. So, I don't see this as a deal-breaker, but it does 
complicate matters.

I'm willing to discuss the details openly in this forum if people 
here can offer sound advice.

Thanks,

Steve

--- In openhealth@yahoogroups.com, Adrian Midgley <[EMAIL PROTECTED]> 
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> > I've only recently heard about Open Health. As the inventor of a
> > disruptive/discontinuous health information technology, which 
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> > patented components, I'm looking for advice about open source 
licensing.
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> Patents are a problem.
> If they are on devices, less so.
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[openhealth] An inventor of disruptive technology looking for advice about open source

[Stephen Beller]

Hello,

I'm new to this group and hope you can help me.

I've only recently heard about Open Health. As the inventor of a
disruptive/discontinuous health information technology, which includes
patented components, I'm looking for advice about open source licensing.
My primary motivation is my company's core mission to promote better
health and wellbeing worldwide--including addressing the needs of the
poor in all nations--thorough better use of better knowledge. We believe
our technologies enable us to achieve this mission because it offers a
cost-effective way to bring together loosely connected networks of
people who share information, models and knowledge via a peer-to-peer
(node-to-node) communication architecture. Toward this end, we've been
exploring the pros and cons of open source licensing, and how joining
the fine Open Health organization, could be a win-win.

I written a post about this issue at this link to my Curing Healthcare
blog
  and welcome you to read it.

Should anyone here have advice for me, I'd certainly appreciate your
feedback.

Thank you in advance,

Steve Beller



Stephen E. Beller, PhD
CEO/President
National Health Data Systems, Inc.
Croton-On-Hudson, NY 10520
Email: [EMAIL PROTECTED] 
Wiki: http://wellness.wikispaces.com 
Blog: http://curinghealthcare.blogspot.com

Web: http://www.nhds.com 



[Non-text portions of this message have been removed]