Re: [openhealth] Re: What do you keep explaining about Health IT
of lifelong records. I have argued for the seven generation test. Now some peope call it the Trotter Test contributing to my already big fat head. Finally, local to you the USA has a huge problem with fragmentation due to the private health care system, and I'm willing to bet not even the President of the US will be able to shout down all the private interests making money out of your ill- health. The billing problems you mention are only the start; given that healthcare is about 18% of GDP, don't bet on being able to inject any common sense. There are too many vested interests making money on it staying just the way it is, and unless greed starts to be seen as a negative attribute, the status quo is bound to continue. Ian From: fred trotter fred.trot...@gmail.com To: hardhats hardh...@googlegroups.com; openhealth openhealth@yahoogroups.com Sent: Fri, 3 September, 2010 2:13:03 PM Subject: [openhealth] Re: [Hardhats] Re: What do you keep explaining about Health IT I really appreciate the wonderful questions and answers that I have gotten on this question so far. However, many of them have been focused on Doctors not understanding fundamental IT notions. This makes sense. Our community is often trying to convince various groups of doctors to make good leadership decisions, and focusing on the problems with that process makes it easier to answer what do doctors not get. But I had two parts to my question. The other part was What do (non-health) IT people not get about Health IT. To get us started I will start with the most shocking Health IT reality that I learned about when I first started in this community: The degree to which medical billing impacts the health IT process. I was shocked by the need for clearinghouses, that X12 was the new standard (dates me, I know) rather than a sensible choice like XML. I was shocked to see the arms race between insurance companies reasons for not paying and doctors justifying expenses... Then the degree to which that process locked us into billing ontologies that prevent more reasonable ontologies from flourishing. For those of us on the IT/Programming side, what was a painful/dramatic/profound lesson that you needed to learn about the way health IT operates? -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] [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]
[openhealth] What do you keep explaining about Health IT
Hi, One of the experiences that I have had, time and time again is that when I talk to doctors about Health IT, they have some basic Information Technology gaps in their education. They simply do not understand some of the fundamentals of Information Technology and have trouble even understanding what I am talking about when I talk about things like structured data. Alternatively, normal IT people do not get some of the fundamental complexities of the healthcare delivery process that prevents them from understanding certain Health IT concepts. The kind of thing I find myself repeatedly explaining to doctors include Why you need to include prescription data in a normalized way in the patient chart, rather than just writing in plaintext in a note The kind of thing I find myself repeatedly explaining to IT people include Why billing data cannot be relied upon for clinically accurate data mining In your experience, what other things do you as Health IT people have to consistently explain to doctors and/or IT people about Health IT. I am looking for the kinds of things that you have explained at least three or four times. Perhaps you have explained them enough times that you have an impatient lecture that you have to give on the topic? Another way to ask the question is If there were a FAQ for Health IT, what should go on it? Thanks, -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] What do you keep explaining about Health IT
Jel, I probably should not have suggested a FAQ what I am looking for is much more like what Philippe put forward. High level concepts that are very difficult to grasp but are vitally important. The problem with a FAQ or wiki model is that really, these topics are far too deep for that. To fully explain the issue that Philippe has put forward would require hundreds of questions and answers. Rather than thinking of this as a FAQ (my fault for starting down that path) perhaps we should think about it as the High Level Concept Barriers to understanding Health IT. -FT On Mon, Aug 30, 2010 at 12:04 PM, Jel Coward j...@wildmedic.org wrote: I think the examples you cite are typical. It would be great to have such an FAQ...perhaps in wiki style/functionality that we could all contribute to. Anyone care to set that up? Cheers Jel Coward Sent from a super-snazzy open-source Android phone. Making the iPhone look so '20th century' :-) On Aug 30, 2010 9:31 AM, fred trotter fred.trot...@gmail.com wrote: Hi, One of the experiences that I have had, time and time again is that when I talk to doctors about Health IT, they have some basic Information Technology gaps in their education. They simply do not understand some of the fundamentals of Information Technology and have trouble even understanding what I am talking about when I talk about things like structured data. Alternatively, normal IT people do not get some of the fundamental complexities of the healthcare delivery process that prevents them from understanding certain Health IT concepts. The kind of thing I find myself repeatedly explaining to doctors include Why you need to include prescription data in a normalized way in the patient chart, rather than just writing in plaintext in a note The kind of thing I find myself repeatedly explaining to IT people include Why billing data cannot be relied upon for clinically accurate data mining In your experience, what other things do you as Health IT people have to consistently explain to doctors and/or IT people about Health IT. I am looking for the kinds of things that you have explained at least three or four times. Perhaps you have explained them enough times that you have an impatient lecture that you have to give on the topic? Another way to ask the question is If there were a FAQ for Health IT, what should go on it? Thanks, -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] Yahoo! Groups Links [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]
Re: [openhealth] What do you keep explaining about Health IT
Philippe, Excellent exposition. Precisely the kind of high-level issue that I am looking for! Others? -FT On Mon, Aug 30, 2010 at 2:36 PM, Philippe Ameline philippe.amel...@free.frwrote: Hi Fred, This is a topic I have been trying to address for years. In France, practitioners are mainly using the kind of software whose main selling argument is to imitate paper. Since I have always been developing information systems based on highly structured information, I have always been looking for evidence in favor of advanced health IT against office dedicated systems. And I reached a dead end! The first reason for this is that when I tried to convince medical doctors that it is a nonsense for them to only use Electronic Document Management systems when they should use group-ware and project management systems (I mean, some way to work as a team around patients), they clearly don't get the point. The usual answer is that MD have always communicated through reports and cannot even imagine working another way. The second reason is that highly structured information mainly allows for knowledge management (KM). When I graduated, it was called Artificial Intelligence, but KM is a better term. And, as a guy that managed to have practitioners use a system that hosts a bunch of knowledge sources (the kind of smart agents that are controlled by a blackboard), I can tell you something highly disturbing : any medical doctor will restrain the information she stores to the data that her brain can easily process (optimizing the signal/noise ratio). It means that this complex information that smart agents could process for her benefit is simply not there! (with the exception of Risk Management, because it is considered complex enough for the MD to be willing to feeding agents with the data they need). The solution to this is rather straightforward: just switch to continuity of care, as the place where practitioners work as a team and share a lot of information they are not used to processing with their brain (say, they cannot restrain the information that get stored and will suffer from a low signal/noise ratio). But when you just reach this point, there is high chance that you realize that your customer will probably never be a practitioner ;-) This is the dead end... the moment when you realize that this box is too small and that, unless you are able to provide the proper tools for a paradigm shift, there is no use trying to sell advanced systems in a context where they will never really work. Philippe Ameline Le 30/08/2010 18:31, fred trotter a écrit : Hi, One of the experiences that I have had, time and time again is that when I talk to doctors about Health IT, they have some basic Information Technology gaps in their education. They simply do not understand some of the fundamentals of Information Technology and have trouble even understanding what I am talking about when I talk about things like structured data. Alternatively, normal IT people do not get some of the fundamental complexities of the healthcare delivery process that prevents them from understanding certain Health IT concepts. The kind of thing I find myself repeatedly explaining to doctors include Why you need to include prescription data in a normalized way in the patient chart, rather than just writing in plaintext in a note The kind of thing I find myself repeatedly explaining to IT people include Why billing data cannot be relied upon for clinically accurate data mining In your experience, what other things do you as Health IT people have to consistently explain to doctors and/or IT people about Health IT. I am looking for the kinds of things that you have explained at least three or four times. Perhaps you have explained them enough times that you have an impatient lecture that you have to give on the topic? Another way to ask the question is If there were a FAQ for Health IT, what should go on it? Thanks, -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] [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]
[openhealth] anyone using Twitter/Status for ODLs
http://stackoverflow.com/questions/3482315/tweet-meta-syntax-for-odls -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Status of Open Source in healthcare
If your project is doing something amazing, please get in contact with me so that I can promote it in my talk at OSCON! http://www.fredtrotter.com/2010/05/22/speaking-at-oscon/ I also want to note that I will be pushing my own Open Source Healthcare conference pretty hard: http://www.oshealthcon.com You can still get cheap tickets... signup now -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] Fwd: Oho Linux Fest is also planning an Open Source Medical Track
I am very happy to announce that there is a yet-another-fine open source healthcare track at another major conference this year!! Ohio Linux Fest 2010 will have a healthcare track. Please see the email from Philip Reiche below. You can send your conference proposals to him. This talk is very close to OSHealthCOn (http://oshealthcon.com) time-wise but if you live near Ohio it will probably be easier to make and I will try not to be too bitter. This seems to be a growing trend and we should all be very happy about this. Hopefully Ignacio will post something about on the venerable LinuxMedNews.com -FT -- Forwarded message -- From: Philip Reiche philip.rei...@gmail.com Date: Wed, Apr 14, 2010 at 7:46 PM Subject: Oho Linux Fest is also planning an Open Source Medical Track To: fred.trot...@gmail.com Fred, I'm Phil Reiche, speaker co-chair for the 2010 Ohio Linux Fest. I just stumbled across your website researching OpenVistA and Astronaut , and was wondering if you would be interested in giving a talk at our con, or could suggest someone who might be interested. We are meeting in Columbus Ohio, Sept 10 and 11, and are just putting together our program. Thanks, Phil Reiche -- Fred Trotter http://www.fredtrotter.com
[openhealth] Healthcare track at OSCON
http://www.oscon.com/oscon2010/public/cfp/108 This -might- be even more important than the conference that I am putting on... which not enough of you have signed up for... http://www.oshealthcon.com -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] only two more $50 tickets
would prefer these to go to FOSS community members. http://www.oshealthcon.com/ -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Biosurveillance software
http://www.trisano.org/ and just released at HIMSS http://www.cdc.gov/BioSense/ I think Trisano has legs... HTH, -FT On Wed, Mar 10, 2010 at 1:34 AM, Tim C tim.churc...@gmail.com wrote: Have a look at NetEpi Collection at http://code.google.com/p/netepi/ - production-ready, with large scale deployments, and under active, funded development. And runs on Linux. If you need help getting it installed, just email us on the mailing list. Tim C On 10 March 2010 08:54, David Chan davidhcc...@yahoo.com wrote: Sorry for cross posting: Hi there, my name is Hector, im from Argentina, I want know if anyone can send me a little list of apps of Public Health and Biosurveillance e.g. epi-info, I need an alternative to this, to use in gnu/linux mandriva or another SO likes *nix. Let me know, thanks in advance. -- Hector R Lopez mail: beat006[at]gmail[dot]com Corrientes-Argentina CP:3400 Movil: 03783 15534876 David H Chan, MD, CCFP, MSc, FCFP Associate Professor Department of Family Medicine McMaster University __ Get the name you've always wanted @ymail.com or @rocketmail.com! Go to http://ca.promos.yahoo.com/jacko/ [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]
[openhealth] If you are at HIMSS
And you would like for me to promote that fact on my blog or twitter account, please drop me a link. If you are speaking, or have a booth or anything like that and you are an open source organization or person.. I want to get you more attention... I am not able to make it this year, but that does not mean that I cannot help promote the light at the annual darkness convention. -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] How are we doing on security?
http://www.fredtrotter.com/2010/02/16/security-reviews-in-open-source-health-software/ -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] regarding open source healthcare project governance
Hi, Recently i2b2 asked me to write about project governance as it applies to healthcare projects. How should an open source healthcare project be run? I would love comments from the Hardhats and OpenHealth communities on my ideas, please find them here: http://www.fredtrotter.com/2009/11/17/on-project-governance/ -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Open Source HIT and data.gov
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]
[openhealth] mostly final FOSSHealth schedule
In yet another fine demonstration of the amateurism of me your conference host, I am putting the final schedule up for FOSSHealth only 5 days before the conference. You can take a look here: http://fosshealth.eventbrite.com While I must admit that I could have been much better organized for this conference, I am very proud of the quality of the speakers who are coming. These speakers represent the whos-who of the FOSS healthcare community. Heck even the attendees are rock stars! It is not to late to register and you can still use the code 'open' for $100 off the price of your ticket. If you are out-of-work, contact me for scholarship information and there is already a student rate. Regards, -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Open World Forum 2009, Paris, 1-2 October 2009
Let me know when this is certain to happen and I will add it to the events page on LibertyHSF.org -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: FOSS Health logistics
We also have tony mccormick and xavier talking about OpenEMR. Is Hoyt a OpenEMR user? It looks like we will probably have slots for him to speak no matter what but I want to keep it to FOSS in healthcare, not IT in healthcare. HIMSS/AMIA is for that Generally, I am planning on having 50 minute sessions. 30 minutes of talking and 20 minutes of discussion. So your sessions would be Tony McCormick Xavier You Not sure what Hoyt will talk about. Dr Brody will be talking about CCHIT and FOSS specifically. Your timeslots will not be sequential either , Dr. Brody specifically requested that he speak on Friday I will try to bunch everyone else on Saturday though, if that is what you want? Is that what you want? -FT On Tue, Jul 21, 2009 at 9:32 PM, sickleofzeus drbo...@charter.net wrote: --- In openhealth@yahoogroups.com, fred trotter fred.trot...@... wrote: Hi everyone, So we have just gotten 95% confirmation that the facilities for FOSSHealth 09 (which happens at the end of the month) will be provided by HAL-PC. http://www.hal-pc.org/ HAL-PC is the largest PC users group in the world. We will have space for two tracks as well as a break room and (usually) a computer lab. The HAL-PC office is right by the galleria mall. If you are a confirmed speaker this year, please reply to this email. I am finalizing the speaking order and I do not want to forget anyone. If you have constraints like you have to speak on a particular day, then please include it here. Give us a one paragraph summary of your talks (great advertising!!) Generally, you should expect to talk for 50 minutes. However, your talk length should be no more than 30 minutes. You should leave 20 minutes for discussion and questions. If this is not enough time, then let me know, I will see about getting you an extra session. This is the first time when FOSS has been the focus of the entire conference and that gives us some flexibility. Please expect lots of chaos this year. It is our first year and we are just learning the conference ropes. If you are a sponsor, I am assuming that you will have at least two tracks on your projects, one overview and one highly technical. I do not think I have gotten checks from all of the sponsors, so if you could fix that, it would be great. If you are an attendee, consider preparing a lighting talk. This is a five minute talk on your choice, and we will try and have several lightning sessions If you have not already signed up http://fosshealth.eventbrite.com/ Thanks!! -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] Your Agenda has the OpenEMR scheduled for Saturday 10:00 - 12:00 Room 1 I wanted to update you and make sure I am on track with my thinking. The OpenEMR group is to have a break out session from 10-12 on Saturday, August 1st. I think you wanted me to speak on the practical application of implementing an Electronic Health record in a physician's office? I have asked Robert Hoyt, Captain, USN, and professor of Health Care Informatics at University of West Florida, Pensacola to speak about what is known to be true about EHR what really does work and what we think works but doesn't. Dr. Michael Brody is also coming and is an experienced speaker. Dr. Brody is a working physician, has experience with PHP and LAMP programming, and is a big open source proponent. He holds seminars on HIPPA compliance. Dr. Brody is a member of HITSP has recently been named a physician member of CCHIT. He is fresh off of the CCHIT meeting in Chicago and will have the freshest information on what is coming down the pipeline in terms of certification. We though we would break our time into 40 minute time slots, from 10:00 - 12:00 Sincerely, Sam Bowen, MD -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Re: [Hardhats] Re: VistA Open Community Proposal v.2
Any user of VistA or VistA derivatives. I want the process by which the VA might open up to private institutions to be of benifit to other goverment agencies like IHS and even other governments. In fact if someone could put me in touch with the powers that be at IHS, that would be very helpful. -FT. On Sat, Jul 18, 2009 at 11:07 AM, Mike Ginsburg mginsb...@dssinc.comwrote: Who comprises the VistA community for whom you are speaking? -Original Message- From: hardh...@googlegroups.com on behalf of fred trotter Sent: Fri 7/17/2009 8:08 PM To: Hardhats; openhealth@yahoogroups.com; open-ehealth-collaborat...@googlegroups.com Subject: [Hardhats] VistA Open Community Proposal v.2 Here is the next version. The biggest changes are to move from having a VistA-community person to a VistA-community process Thoughts? add them here please. http://libertyhsf.org/index.php/ovcp This is the version .2 of the VistA Open Community Proposal that the LibertyHSF will present on behalf of the VistA community to the VA regarding a new era of openness and collaboration around the VA VistA-based software. - Create a process for creating with the VistA community outside the VA. This process should recognize the following operating principles - Formally acknowledge that the VistA community outside the VA can benefit Veterans by contributing improvements to VistA back to the VA. - Formally acknowledge that the VistA community outside the VA can provide better care to Veterans in private hospitals and clinics that are VistA enabled. Many Veterans do not qualify for treatment at VA hospitals but can still benefit from VistA. - The VA should prefer Open Source Software in its software acquisition process. This enables VistA users outside the VA to follow the VA in software decisions and allows the community to further enhance VA software by making their improvements available to the VA. - Create a default open stance to FOIA requests. Create a process that not only completes FOIA requests for software source code resources, but provides a feedback mechanism to ensure that the FOIA releases are complete. - Some FOIA requests for VistA are very complex because they include requests for complex sourcecode or data files that have mixed copyright permission (CPT codes) find ways to ensure that complicated requests can be met. - By default, when FOIA available source code and applications is made evailable insider the government, make it available to the public too. (i.e. ensure that the contents of the VA Intranet software server, as much as possible, is also published externally) - Create a bridge-team: Ensure that the bridge process has enough people invested that no single person can become a single point of failure with VA communication with the outside VistA community. - Overturn the moratorium of local VA hospital VistA development. - Reinvest in local VA hospital VistA instances. Centrally managed instances of VistA, with locally deployment. Flawed VistA modules from one hospital should not take down the VistA instance of another hospital. - Empower the bridge process with a VistA Community Portal. That portal should provide the following services: - Allow for the submission of improved VistA components back into the VA, to be evaluated as Class III code for possible adoption by local VA hospitals. - Those submissions should always be public unless they are security issues, and then they should be made public immediately after being confirmed-patched/denied-ignored - Publish a list of approved licenses for contributing VistA components back (probably from proprietary friendly licenses like Apache, Mozilla, BSD, MIT, X11, EPL etc etc, or just chose one if that is easier). - Organizations that submit patches, or improvements should expect that someone from the bridge team will publicly comment on reasons for rejection for a particular patch or software, if the VA will not adopt the software. - Have a feature request system, that is accessible only to groups who are or represent live VistA instances outside the VA. This should include local VA hospital programmers and CACS, people from IHS, representatives from foreign organizations like Mexico and Jordan, and private hospitals running VistA. This should provide a means for the community to give feedback to the VA about the consequences of central VA development decisions. However, this would not put the VA in the position of accepting feature requests from people who merely 'might' use and improve VistA. - The features and contributions should be analysed against the current VA 'modernization' plan to create a new modernization plan
[openhealth] VistA Open Community Proposal v.2
Here is the next version. The biggest changes are to move from having a VistA-community person to a VistA-community process Thoughts? add them here please. http://libertyhsf.org/index.php/ovcp This is the version .2 of the VistA Open Community Proposal that the LibertyHSF will present on behalf of the VistA community to the VA regarding a new era of openness and collaboration around the VA VistA-based software. - Create a process for creating with the VistA community outside the VA. This process should recognize the following operating principles - Formally acknowledge that the VistA community outside the VA can benefit Veterans by contributing improvements to VistA back to the VA. - Formally acknowledge that the VistA community outside the VA can provide better care to Veterans in private hospitals and clinics that are VistA enabled. Many Veterans do not qualify for treatment at VA hospitals but can still benefit from VistA. - The VA should prefer Open Source Software in its software acquisition process. This enables VistA users outside the VA to follow the VA in software decisions and allows the community to further enhance VA software by making their improvements available to the VA. - Create a default open stance to FOIA requests. Create a process that not only completes FOIA requests for software source code resources, but provides a feedback mechanism to ensure that the FOIA releases are complete. - Some FOIA requests for VistA are very complex because they include requests for complex sourcecode or data files that have mixed copyright permission (CPT codes) find ways to ensure that complicated requests can be met. - By default, when FOIA available source code and applications is made evailable insider the government, make it available to the public too. (i.e. ensure that the contents of the VA Intranet software server, as much as possible, is also published externally) - Create a bridge-team: Ensure that the bridge process has enough people invested that no single person can become a single point of failure with VA communication with the outside VistA community. - Overturn the moratorium of local VA hospital VistA development. - Reinvest in local VA hospital VistA instances. Centrally managed instances of VistA, with locally deployment. Flawed VistA modules from one hospital should not take down the VistA instance of another hospital. - Empower the bridge process with a VistA Community Portal. That portal should provide the following services: - Allow for the submission of improved VistA components back into the VA, to be evaluated as Class III code for possible adoption by local VA hospitals. - Those submissions should always be public unless they are security issues, and then they should be made public immediately after being confirmed-patched/denied-ignored - Publish a list of approved licenses for contributing VistA components back (probably from proprietary friendly licenses like Apache, Mozilla, BSD, MIT, X11, EPL etc etc, or just chose one if that is easier). - Organizations that submit patches, or improvements should expect that someone from the bridge team will publicly comment on reasons for rejection for a particular patch or software, if the VA will not adopt the software. - Have a feature request system, that is accessible only to groups who are or represent live VistA instances outside the VA. This should include local VA hospital programmers and CACS, people from IHS, representatives from foreign organizations like Mexico and Jordan, and private hospitals running VistA. This should provide a means for the community to give feedback to the VA about the consequences of central VA development decisions. However, this would not put the VA in the position of accepting feature requests from people who merely 'might' use and improve VistA. - The features and contributions should be analysed against the current VA 'modernization' plan to create a new modernization plan that considers the needs and contributions of outside-VA VistA users. Original text by Fred Trotter http://www.fredtrotter.com Changes: v.1 to .2 spelling corrections Changed to focus on a bridge process rather than a bridge person Propose that the VA instead create a process which acknoledges the basic value of outside commitments etc etc Meta level policies that are intended to address Nancies outstanding issues. Changed the name from Open VistA Community Proposal to VistA Open Community Proposal b/c OpenVistA is trademarked, and not what I am referencing. Addressed comments from Hardhats and co-ment instance -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message
[openhealth] Fwd: physician privileges
Does any one know of a FOSS application that managed physician privileges? -FT On Wed, Jul 15, 2009 at 3:04 PM, Brian Sherman briancsher...@gmail.comwrote: Fred, I was looking around for an open source project that handles physician privileges for large hospitals, something along the lines of http://www.hcpro.com/coreprivilegeplus/ It seems like this would be an important part of healthcare IT interoperability with CMS and, by extension, any integrated government healthcare solution. I figured if anyone had that kind of information at their fingertips, it would be you. -brian -- Fred Trotter http://www.fredtrotter.com -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] FOSS Health logistics
Hi everyone, So we have just gotten 95% confirmation that the facilities for FOSSHealth 09 (which happens at the end of the month) will be provided by HAL-PC. http://www.hal-pc.org/ HAL-PC is the largest PC users group in the world. We will have space for two tracks as well as a break room and (usually) a computer lab. The HAL-PC office is right by the galleria mall. If you are a confirmed speaker this year, please reply to this email. I am finalizing the speaking order and I do not want to forget anyone. If you have constraints like you have to speak on a particular day, then please include it here. Give us a one paragraph summary of your talks (great advertising!!) Generally, you should expect to talk for 50 minutes. However, your talk length should be no more than 30 minutes. You should leave 20 minutes for discussion and questions. If this is not enough time, then let me know, I will see about getting you an extra session. This is the first time when FOSS has been the focus of the entire conference and that gives us some flexibility. Please expect lots of chaos this year. It is our first year and we are just learning the conference ropes. If you are a sponsor, I am assuming that you will have at least two tracks on your projects, one overview and one highly technical. I do not think I have gotten checks from all of the sponsors, so if you could fix that, it would be great. If you are an attendee, consider preparing a lighting talk. This is a five minute talk on your choice, and we will try and have several lightning sessions If you have not already signed up http://fosshealth.eventbrite.com/ Thanks!! -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Open VistA Community Proposal
this debate on just Hardhats, I want to open it up to everyone. You can now comment on proposal using a co-ment instance (co-ment is the successor to stet which was used to take comments on the GPlv3) that is available through http://LibertyHSF.org Regards, -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Mirth meetup at the CONNECT conference
Hey, I just got a final ok from the mirth guys on having an 'old-school' interoperability meetup at Harry's (closest goggle maps result from hotel is correct) after the end of the conference Monday. I would love to expand that to a Mirth/MOSS meetup! Alesha/Tim are you guys here? Any one else from the old school community able to make it? We would love to see some VistA people there? No one is not invited Figure we can kick things off around 7 pm! -ft -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Do we have a problem with CCHIT 2.0?
It appears that we have nothing but either positive comments or questions about what happened. Rather than try and accurately summarize, I would prefer to link in the pdf that CCHIT created to cover the new certification model. http://tinyurl.com/kteyoq My inaccurate summary: They will no longer require updated certification based on version changes. They will allow for site level certification. (which is open source friendly) They will allow for modular certification (different products doing different parts) -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Do we have a problem with CCHIT 2.0?
I have not heard much about CCHIT since the townhall. I was very pleased, they addressed all of the issues I was concerned with. Everyone I have spoken with seems satisfied. I am inclined to embrace the new verification models whole hog. Can anyone think of a reason not to? Any lingering or new concerns? It seems like a complete ( and mutual) victory but I just want to be sure that we are not missing something. -ft -- Fred Trotter http://www.fredtrotter.com
[openhealth] Fwd: Updated invitation letter
Dear FOSS vendors, I have been generally concerned that organizations that do analysis/evaluations of EHR systems tend to be biases towards proprietary systems, or more generally clients. No one I have talked to believes that KLAS for instance, is credible. Recently I met Arthur Gasch and he made a good pitch that his EHR evaluation tool was free from the kinds of financial bias that seem to be the norm in our industry. He takes a fee from vendors to be in his system and he takes a fee to let clients search the system. But he does not take 'consulting fees' that seem to be norm in the industry. After hearing, this I have been working with him to create a 'Open Source License' button in his EHR selection tool. I think if people were aware of the basic implications of a FOSS license, and were aware that there was an option here, they would often choose the right path. Arthur and I are still working on how to include this selector in his EHR evaluation tool, but I want to let you know about his service and so I am forwarding you his pitch. I will be endorsing tools like this that inform users about the option of FOSS and have some kind of commitment to not take extra money from a particular vendor. -FT -- Forwarded message -- From: Arthur Gasch art.ga...@medsp.com Date: Thu, Jun 11, 2009 at 5:32 AM Subject: Updated invitation letter To: fred trotter fred.trot...@gmail.com Dear Vendor From time to time we hear of open source EMRs. Fred Trotter does an excellent job promoting them, as alternatives to proprietary, CCHIT-certified EMRs, but the question remains - functionally, how competitive are they. MSP would like to offer you the opportunity to answer that question definitively. You can register your current product on the MSP EHR Selector (www.ehrselector.com), where its capabilities can be matched against our database of other EMR product features. The normal fee is $795, but MSP will waiver that for six months, if you will complete the product profile and put the system up live. If, after 6 months, you want to continue, pay just $495 for the next year - the price we charged for an EMR developer subscription 3-years ago. Open source EMRs could get a fair number of orders if they can show that they are truly competitive, as physicians visit us from collaborating organizations that include HIMSS, MGMA, ACC, AGA, AHQA and ACP, they search our site for more than a few general requirements, so they are sure what they are getting. There are plenty of deals to go around, what is missing is any open source vendors. We invite open source vendors to check out the EHR Selector by visiting the site http://www.ehrselector.com, and by watching a brief video http://www.ehrselector.com/ehr_video.wmv. Here are some recent enhancements we have made to the EHR Selector which you may not be aware of. - 23 new practice specialties added, 45 total practice specialties now supported. - Simple, Search-and-Assert user interface. - New EMR Profile Search feature - Pick ASP Profile and assert all ASP criteria in 2 mouse clicks - Regained assertion by individual criteria for our experienced users and EMR consultants based on 600 individual criteria available - 2006, 2007, 2008, 2009 CCHIT certifications, expanded from CCHIT certification. - All 2009 PQRI measures added - New EMR sites - SNF, Home Health, Hospital in addition to Group Practice - Drill down of hospital EMR into ED, OR-PACU, OB, Adult ICU, Neonatal and General Ward - Expanded the Search feature into a Search Select user interface - Reorganized all Sections into logical sequence - Added Consultants, Legal Services, Accounting, Post Install IT Service, more - Support for all major User Interfaces (Scanning, dictation, Speech, Handwriting, Pick list, etc.) - A new ARRA Meaningful Use feature Flag - features will be flagged when announced. - HIPAA compliance flags by features - New Literature Request button - Expanded DEMO button that now emails and also runs live demo (if you provide one) - Instant Vendor GO LIVE for all non-Vetted Items - New Vendor Sales Activity reports - MORE... If open source EMR want the widest possible exposure, being on the MSP EHR Selector is a way to achieve it. If you would like to take advantage of this offer, please contact Betty at 732-219-5090 X20 and she can provide a login and password instantly. It usually takes 1 to 1.5 hours to complete the feature summary, and most features go live then. Forty remain until vetting occurs, something we do within a couple of days at a mutually convenient time with your company. You participation for the first six months will cost you nothing but your time to complete the EMR profile. I hope you will join the other vendor systems here. Kind regards, Arthur Gasch Founder, Medical
[openhealth] Liberty HSF Certification and Meaningful Use
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.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: Liberty HSF formation process
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 sbel...@nhds.com 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 fred.trot...@... wrote: On Thu, Jun 4, 2009 at 3:29 PM, Stephen Beller sbel...@... 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]
Re: [openhealth] Liberty HSF formation process
manuals? - Like toolkits? - Like services that the community needs, like CA services etc etc OPEN QUESTION? How do we tell the difference between projects that need extra development dollars and coders, and those that are largely self-sufficient? How do we choose what projects to support? To a great extent, this will have to be determined by those who donate either time or money? OPEN QUESTION? How do we interact with other organizations like Open Health Tools and WorldVistA? My plan so far: The following seems obviously true and represents 'already made' decisions. - We need to move away from me as benevolent dictator of this organization quickly, to establish credibility. But a full BOD should be something that the community has input on, we should have general nominations etc etc. So Dr. Valdes, David Whitten and I will appoint an arbitrary interim BOD (announced soon) which will allow us to move quickly and take our time thinking about the BOD issue long term. - No one is going to have tons of time for this, and there need to be sub-groupings of LibertyHSF for different purposes, sub-groups should have latitude to take positions for LibertyHSF on particular issues. These should take the form of small committees. - Obvious initial groups include: - A vendor association committee, made up of representatives of FOSS and Hybrid vendors in order to establish strictly vendor positions. A critical first question for this group will be how does the FOSS community define 'meaningful use'? - A certification committee who will take over my role as chief negotiator with CCHIT and determine when and if LibertyHSF needs to become a certifying body. - Conferences and Development committees are equally important, but as we have no general funds for development yet that is a non-issue, and the conferences are already happening without LibertyHSF so these can wait. My short-term priorities are to create grass roots lobbying during this politically critical time and to sort out the certification issue ASAP. Should I have other very-short term priorities? Long term my priorities for LibertyHSF are: to create an formal meeting place for the vendors in the industry that represents them towards governments, to sponsor important development that is not particularly 'profitable' (assuming vendors will sponsor profitable development), like documentation, or helpful libraries. to create a conference or series of conferences that become the central meeting point(s) for our community to increase between project collaboration to educate clinicians about software freedom to lobby in support of FOSS in healthcare to encourage the use of FOSS in health academia to collaboratively develop standards/position documents when no other existing organization can/will address the issue to apply for grants for development funds to provide education for the implications of FOSS licensing in healthcare to provide a trusted third party for devisive community issues to make health databases and health data services available in a FOSS compatible fashion, (like a FOSS drug database) to encourage proprietary health software vendors to become hybrid or purse FOSS software vendors to remain neutral to particular projects but still recognizing the relevance of a user base (i.e. no preference between Canonical and Redhat but still recognize that GNU/Linux is more relevant than FreeDOS) to make LibertyHSF -our- organization and not just -my- organization... to that end: What long term and short term priorities am I missing? What does the community want and need from this organization? -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] [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]
Re: [openhealth] Liberty HSF formation process
1. Training Programs - Both Paid and Sponsored That makes sense, but it is unclear what we should train on. WorldVistA is, as at first blush, a better organization for handeling VistA training, and there are typically corporate backers that offer training for other projects. Still I would like to consider that door open. 2. Healthcare Information Systems Certification programs and in this case can be Basic, Intermediate and Advanced User Certs We are considering setting up an alternative to CCHIT. User certification will be difficult if we are to remain project neutral. 3. A professional network that runs Liberty Health Software Conferences and Seminars for the masses around the 50 states as well as in Canada and other countries where you would like to expand out to. I am learning alot about running Health conferences with my experience with FOSSHealth. It is an open question how many conferences can be supported by us and if we should move to support local users groups. We are a very small community and i can (and have) called in favors to ensure good talks at a single conference, but how to ensure that there are good talks across the world? Not sure. 4. The training manual is a good idea but I see the need for a book or a number of books on Free Open Source Software in Health Care and FOSS Health Care Information Systems. You can produce these books and distribute them under Creative Commons free for online download where as print and sell them through www.lulu.com. Again, how do choose which projects get books like this published? This is a really good idea and a big part of what we would like to do... 5. There is no harm in maintaining a community of FOSS developers at the foundation virtually or physically. Software Bundles with Support options. You can provide software free but charge for the following: a. Software Bundles with personal support US$250, group support US$500, clinical support US$1000, large clinic support US$5000, Small Scale Hospital Support US$10,000, Medium Scale Hospital Support US$50,000 and Enterprise Scale Hospital Support US$1-500,000 plans. b. Consulting Plans c. Training Plans d. Maintenance Plans e. Remote Support Plans f. Customized Development Plans I do not want to get into software support which I consider to be the domain of for-profit companies. We do not want to be seen as competing with the vendors that we hope to represent. Still if the vendors themselves clalled for some kind of support program, we might be willing to consider it. 6. I would also recommend you to apply for a grant to the Rockefeller Foundation as they are still supporting numerous FOSS programs and organizations. That is exactly the plan. 7. I would recommend you to float CCHIT development on Google Summer of Code and other FOSS Initiatives. This is a good idea, but I would not want to do this in competition with different projects. 8. Partnership with universities, especially medical healthcare capacity development or academic centres to offer certificate trainings. Not sure how this would work.. but perhaps a textbook? 9. In the end, you need a strong marketing plan, every social enterprise needs it and so do you so that the world knows you exist and you add value to the social and economic systems either in the US or abroad. Agreed. 10. Get working on public relations, use means such as google adwords, facebook and linked in. Get the show rolling! Agreed! I hope these ideas will be useful and I am always available for joining the foundation in strategy support etc. Btw, this me just in case: http://satc.pk/?q=node/14 -- Regards. -- Fouad Bajwa FOSS Advocate (South Asia) @skBajwa Answering all your technology questions http://www.askbajwa.com http://twitter.com/fouadbajwa -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] Re: Liberty HSF formation process
Everyone I have talked to in the FOSS community has indicated that the feature-bucket testing model that CCHIT currently puts forward does not work for us. I would like to work with CCHIT, but not under the constraints of accepting aspects of the current model that are broken. If anyone in our community has expressed concern with CCHIT to me, I can assure you that those complaints are at the forefront of my mind as I deal with CCHIT. So far CCHIT has been responding well, they have really listened and publicly acknowledged that there -is- a problem with thier current certification model. However, to actually address our needs, CCHIT may be forced to alienate their current, paying, consituency. So while I have respect for CCHIT, I have doubts that an organization formed under one certification model can adopt a substancially new one. So when do we as a community stop working with CCHIT and start our own certification body? I do not know. Dr. Kibbe has put forward a notion of certification that has resonated with many of the other groups who have felt disenfranchised with CCHIT. If they start an alternative to CCHIT and it is compatible with FOSS, that might be a third option that we should contribute our resources to rather than setting up our own certification body. However, certification of FOSS systems -should- be dramatically easier than certifying anything proprietary no matter what your certification model. Source code reviews are powerful and simple. We can do them easily and CCHIT et al cannot. So if we were not going to work with CCHIT, I would not want to get into a situation where we were doing a bunch of work, so that others could remain code-closed. I would like to propose that LibertyHSF Certification committee intentionally include a non-voting status so that we an invited people like Dr. Kibbe to partipate formally in our process without explicitly endorsing his perspective on certification generally. All those in favor remain silent and all those opposed bitch loudly. -FT On Thu, Jun 4, 2009 at 8:42 AM, David Kibbe kibbeda...@mac.com wrote: Fred and Colleagues: Congratulations on the foundational steps for Liberty Health Software Foundation! A red letter day, to be certain. Let me also suggest that too narrow a focus on just one approach to software development for health care might simply duplicate the problems of the past and of the legacy products. In other words, isn't the real issue innovation? Aren't we trying to level the playing field so that generative, creative, affordable, and easier-to-obtain-and-use products and services can (finally) reach the market? Becoming the FOSS arm of CCHIT is to buy into the old paradigm of control and exclusion, not to open up the aperture of innovation and offer welcoming arms to what is new and different. Becoming the FOSS arm of CCHIT is to accept a definition of EHR-as-feature-set-from-1995 that most people in these forums probably don't accept as useful, and see as restrictive. Why not reject certification all together as a principle of this new organization, Liberty HSF, and propose an alternative quality assurance and qualification approach to products/services, based around their use-ability, conformance to open standards, safety of use, and security of information? Kind regards, and I look forward to an interesting discussion. DCK David C. Kibbe, MD MBA Senior Advisor, American Academy of Family Physicians Chair, ASTM International E31Technical Committee on Healthcare Informatics Principal, The Kibbe Group LLC ___ 919-647-9651 office 913-205-7968 mobile ___ dki...@aafp.org kibbeda...@mac.com CONFIDENTIALITY: This e-mail message (including attachments, if any) is confidential and is intended only for the addressee. Any unauthorized use or disclosure is strictly prohibited. Disclosure of this e-mail to anyone other than the intended addressee does not constitute waiver of privilege. If you have received this communication in error, please notify me immediately and delete this. Thank you for your cooperation. This message has not been encrypted. Special arrangements can be made for encryption upon request. On Jun 3, 2009, at 6:33 PM, fred trotter wrote: 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
Re: [openhealth] Re: Liberty HSF formation process
On Thu, Jun 4, 2009 at 3:29 PM, Stephen Beller sbel...@nhds.com 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] Liberty HSF formation process
-groups should have latitude to take positions for LibertyHSF on particular issues. These should take the form of small committees. - Obvious initial groups include: - A vendor association committee, made up of representatives of FOSS and Hybrid vendors in order to establish strictly vendor positions. A critical first question for this group will be how does the FOSS community define 'meaningful use'? - A certification committee who will take over my role as chief negotiator with CCHIT and determine when and if LibertyHSF needs to become a certifying body. - Conferences and Development committees are equally important, but as we have no general funds for development yet that is a non-issue, and the conferences are already happening without LibertyHSF so these can wait. My short-term priorities are to create grass roots lobbying during this politically critical time and to sort out the certification issue ASAP. Should I have other very-short term priorities? Long term my priorities for LibertyHSF are: to create an formal meeting place for the vendors in the industry that represents them towards governments, to sponsor important development that is not particularly 'profitable' (assuming vendors will sponsor profitable development), like documentation, or helpful libraries. to create a conference or series of conferences that become the central meeting point(s) for our community to increase between project collaboration to educate clinicians about software freedom to lobby in support of FOSS in healthcare to encourage the use of FOSS in health academia to collaboratively develop standards/position documents when no other existing organization can/will address the issue to apply for grants for development funds to provide education for the implications of FOSS licensing in healthcare to provide a trusted third party for devisive community issues to make health databases and health data services available in a FOSS compatible fashion, (like a FOSS drug database) to encourage proprietary health software vendors to become hybrid or purse FOSS software vendors to remain neutral to particular projects but still recognizing the relevance of a user base (i.e. no preference between Canonical and Redhat but still recognize that GNU/Linux is more relevant than FreeDOS) to make LibertyHSF -our- organization and not just -my- organization... to that end: What long term and short term priorities am I missing? What does the community want and need from this organization? -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [Hardhats] Re: [openhealth] Announcing Liberty Medical Software Foundation and a petition in support of the current VistA as Utility act
Ok... I will call that a consensus and we will change the name!! -FT On Mon, May 11, 2009 at 8:23 AM, Elwell, Tim tim.elw...@misys.com wrote: I believe 'health' is more appropriate as well. Tim Elwell -Original Message- From: open-ehealth-collaborat...@googlegroups.com [mailto: open-ehealth-collaborat...@googlegroups.com] On Behalf Of fred trotter Sent: Sunday, May 10, 2009 9:30 PM To: open-ehealth-collaborat...@googlegroups.com Cc: hardh...@googlegroups.com; openhealth@yahoogroups.com Subject: Re: [Hardhats] Re: [openhealth] Announcing Liberty Medical Software Foundation and a petition in support of the current VistA as Utility act If there is a broad consensus that 'Health' is a more appropriate name, then I will change the name. I have registered LibertyHSF.org for that purpose. Anyone care to add an opinion? -FT On Sun, May 10, 2009 at 7:05 PM, Edmund Billings edmund.billi...@medsphere.com wrote: Health is broader and may be more appropriate than Medical... Medical connotes physician centered care which is just part of the solutions. Edmund ___ Edmund Billings MD Chief Medical Officer Medsphere 1917 Palomar Oaks Way Suite 200 Carlsbad, CA 92008 760.692.3700 office 415.505.8953 cell www.medsphere.com Transforming Healthcare through Open Source From: hardh...@googlegroups.com [hardh...@googlegroups.com] On Behalf Of fred trotter [fred.trot...@gmail.com] Sent: Sunday, May 10, 2009 12:59 PM To: openhealth@yahoogroups.com Cc: open-ehealth-collaborat...@googlegroups.com; hardh...@googlegroups.com Subject: [Hardhats] Re: [openhealth] Announcing Liberty Medical Software Foundation and a petition in support of the current VistA as Utility act This is unlikely to be a problem if we simply consistently refer to the organization as either 'LibertyMSF' and/or 'Liberty Medical Software Foundation' please help me be referring to it that way. Once we have do that for a while, the distinction should become clear. -FT On Sat, May 9, 2009 at 9:42 AM, David Forslund forsl...@mail.com wrote: My only concern about this proposal is that there is a company with the name Liberty Medical out there (http://www.libertymedical.com). That might create some confusion as well as some legal issues, but then I'm no lawyer. (in fact, when I saw the title of the email, I initially thought it was something connected with that company, which does a lot of advertising on TV). Dave Forslund fred trotter wrote: Hi, At the behest of many of the vendors and individuals within the community, we are now announcing the creation of the Liberty Medical Software Foundation. http://libertymsf.org http://libertymsf.org This organization will exist to be our HIMSS, our EHR vendor association and, if needed, our CCHIT. It is intended to serve both the needs of the FOSS vendor community, and the community of individual developers and clinical users of FOSS EHR software. It is intended to be a place where FOSS companies like Medsphere or ClearHealth can sit at the same table with FOSS friendly proprietary companies like Misys and DSS! This is intended to be a place where a single developer from OpenEMR will be shown the same deference and respect as the CEO of IBM. We cannot afford an Open Source vs. Free Software divide in our community. That is the reason we chose the term 'Liberty' for our name. Openness is good, but it is not enough, we need freedom. But we cannot go around having the conversation: When I say Free, I do not mean what you hope it means. You hope it means costless. In fact I plan to charge quite allot of money for this free stuff, but you will have freedom when I am done. Of course it is -often- true that when I say free I mean that you can just download it off sourceforge for no cost. So I mean 'Free-as-in-freedom' and 'free-as-in-beer' at different points in this conversation and you are expected to keep up based on context clues. The vendors are going to have trouble trying to sell 'free' stuff no matter how you cut it. Also, even if we wanted to use Open, everyone and their dog has an organization that begins with 'Open' I can rattle off seven without thinking hard. When we previously discussed starting something like this using the term 'Free' people got pretty huffy. Liberty is the compromise. You might be paying millions for the deployment of software that you can download from sourceforge for no cost, and that is OK but what you need to have is 'Liberty'. I hope everyone is as please with this compromise as I am. We will be announcing membership and leadership shortly, but you can be assured the usual suspects will be involved or at least invited. Our first project, and the reason that we are unveiling this now
[openhealth] Foss Health 09
Dr. Brody has been helping me to setup a hotel discount for FOSShealth 09. If you have not registered yet go to http://fosshealth.eventbrite.com If you have registered but do not have a hotel, please read below for good group rates, close to the conference. -FT -- Forwarded message -- From: Michael Brody mbr...@tldsystems.com Date: Fri, May 8, 2009 at 2:23 PM Subject: Hotel Stuff To: fred trotter fred.trot...@gmail.com We have a block of rooms available at $89 / night at the Marriott Houston West Loop by the Galleria There are a limited number of Rooms for Thursday, Friday and Saturday Night The Group Name is FOSS The hotel # is (713) 960 0111 The rooms are being held for us for a limited time. Please post so people can make reservations it would be great if many of the meeting participants were at the same hotel. That would make after conference networking much easier. Michael -- Fred Trotter http://www.fredtrotter.com
[openhealth] Re: Foss Health 09
Be sure to use 'open' as a registration code for a significant discount! -FT On Sun, May 10, 2009 at 3:06 PM, fred trotter fred.trot...@gmail.com wrote: Dr. Brody has been helping me to setup a hotel discount for FOSShealth 09. If you have not registered yet go to http://fosshealth.eventbrite.com If you have registered but do not have a hotel, please read below for good group rates, close to the conference. -FT -- Forwarded message -- From: Michael Brody mbr...@tldsystems.com Date: Fri, May 8, 2009 at 2:23 PM Subject: Hotel Stuff To: fred trotter fred.trot...@gmail.com We have a block of rooms available at $89 / night at the Marriott Houston West Loop by the Galleria There are a limited number of Rooms for Thursday, Friday and Saturday Night The Group Name is FOSS The hotel # is (713) 960 0111 The rooms are being held for us for a limited time. Please post so people can make reservations it would be great if many of the meeting participants were at the same hotel. That would make after conference networking much easier. Michael -- Fred Trotter http://www.fredtrotter.com -- Fred Trotter http://www.fredtrotter.com
Re: [Hardhats] Re: [openhealth] Announcing Liberty Medical Software Foundation and a petition in support of the current VistA as Utility act
If there is a broad consensus that 'Health' is a more appropriate name, then I will change the name. I have registered LibertyHSF.org for that purpose. Anyone care to add an opinion? -FT On Sun, May 10, 2009 at 7:05 PM, Edmund Billings edmund.billi...@medsphere.com wrote: Health is broader and may be more appropriate than Medical... Medical connotes physician centered care which is just part of the solutions. Edmund ___ Edmund Billings MD Chief Medical Officer Medsphere 1917 Palomar Oaks Way Suite 200 Carlsbad, CA 92008 760.692.3700 office 415.505.8953 cell www.medsphere.com Transforming Healthcare through Open Source From: hardh...@googlegroups.com [hardh...@googlegroups.com] On Behalf Of fred trotter [fred.trot...@gmail.com] Sent: Sunday, May 10, 2009 12:59 PM To: openhealth@yahoogroups.com Cc: open-ehealth-collaborat...@googlegroups.com; hardh...@googlegroups.com Subject: [Hardhats] Re: [openhealth] Announcing Liberty Medical Software Foundation and a petition in support of the current VistA as Utility act This is unlikely to be a problem if we simply consistently refer to the organization as either 'LibertyMSF' and/or 'Liberty Medical Software Foundation' please help me be referring to it that way. Once we have do that for a while, the distinction should become clear. -FT On Sat, May 9, 2009 at 9:42 AM, David Forslund forsl...@mail.com wrote: My only concern about this proposal is that there is a company with the name Liberty Medical out there (http://www.libertymedical.com). That might create some confusion as well as some legal issues, but then I'm no lawyer. (in fact, when I saw the title of the email, I initially thought it was something connected with that company, which does a lot of advertising on TV). Dave Forslund fred trotter wrote: Hi, At the behest of many of the vendors and individuals within the community, we are now announcing the creation of the Liberty Medical Software Foundation. http://libertymsf.org http://libertymsf.org This organization will exist to be our HIMSS, our EHR vendor association and, if needed, our CCHIT. It is intended to serve both the needs of the FOSS vendor community, and the community of individual developers and clinical users of FOSS EHR software. It is intended to be a place where FOSS companies like Medsphere or ClearHealth can sit at the same table with FOSS friendly proprietary companies like Misys and DSS! This is intended to be a place where a single developer from OpenEMR will be shown the same deference and respect as the CEO of IBM. We cannot afford an Open Source vs. Free Software divide in our community. That is the reason we chose the term 'Liberty' for our name. Openness is good, but it is not enough, we need freedom. But we cannot go around having the conversation: When I say Free, I do not mean what you hope it means. You hope it means costless. In fact I plan to charge quite allot of money for this free stuff, but you will have freedom when I am done. Of course it is -often- true that when I say free I mean that you can just download it off sourceforge for no cost. So I mean 'Free-as-in-freedom' and 'free-as-in-beer' at different points in this conversation and you are expected to keep up based on context clues. The vendors are going to have trouble trying to sell 'free' stuff no matter how you cut it. Also, even if we wanted to use Open, everyone and their dog has an organization that begins with 'Open' I can rattle off seven without thinking hard. When we previously discussed starting something like this using the term 'Free' people got pretty huffy. Liberty is the compromise. You might be paying millions for the deployment of software that you can download from sourceforge for no cost, and that is OK but what you need to have is 'Liberty'. I hope everyone is as please with this compromise as I am. We will be announcing membership and leadership shortly, but you can be assured the usual suspects will be involved or at least invited. Our first project, and the reason that we are unveiling this now, is to activate the community in support of the Health IT Public Utility Act of 2009. We have created a petition that we will be submitting to generously to congressional representatives. (Just go to our homepage) Note that we specifically choose a petition engine that allows you to sign with comments, and those comments will be passed along as slightly modified petitions. Essentially this is a way for you to both sign a letter to Congress, and also send an individual note, with LibertyMSF doing most of the grunt work. (Note: Dr. Billings did much of the content of the petition in his letter published here earlier) Most importantly, you can forward the petition to your email contacts, or your favorite social network. If you are reading this, and you agree
[openhealth] Questions for the 'Meaningful Use' panel
Hi, As I mentioned before I have been asked to testify at the NCVHS Hearing on Meaningful Use. As far as I know I am the only FOSS representative there (although I know that Dr. Billings from Medsphere is planning on attending, can anyone else make it?) I have just received more specific questions from the NCVHS. Please use this thread to discuss these points inline. Also please recognize that I am specifically representing FOSS as opposed to Health IT generally, so making general points does not help me as much as making specific points about what implications FOSS community/licenses/process has for a question. Regards, -- Fred Trotter http://www.fredtrotter.com NCVHS Hearing on Meaningful Use April 28-29, 2009 Question for Panel Input Panel 1: Vision of Health and Health Care Transformed 1. What are the critical characteristics and enablers of a safe, patient-centric, high-quality health care system that optimizes patient outcomes? 2. What have been the major barriers to system-level improvement in the health care system? 3. How can incentives programs best be structured to support health reform? Panel 2: Meaningful Use Capacity/Functionality in EHRs 1. What EHR capacities/functionalities are absolutely required to enable a safe, patient-centric, high-quality health care system that optimizes patient outcomes? 2. What are the critical EHR functionalities (e.g., e-prescribing, decision support, problem list management) of which providers should be required to demonstrate use in order to be earn an incentive as a “meaningful user” of certified EHR technology in 2011? Should the functionalities or other specific requirements to meet the statutory “meaningful use” criteria be different or specific to provider type (i.e., eligible professionals, hospitals)? 3. Are these functionalities supported in current certified EHR products? If not, what are the gaps? 4. What additional functionalities would be most important to require providers use by 2014 or 2015? Panel 3: Meaningful Use Capacity/Functionality in Health Information Exchanges 1. What are the ways in which health information exchange enables a safe, patient-centric, high-quality health care system that optimizes patient outcomes? 2. What will the health information exchange landscape look like in 2011 (e.g., penetration of operational HIOs, e-prescribing networks), and how would that enable or constrain meaningful information exchange requirements? 3. What would be the trajectory over time of increasingly robust requirements for information exchange as more opportunities for exchange become available? 4. How might the incentives criteria be constructed so as not to penalize providers in areas not serviced by HIOs, and how would this change over time? Panel 4: Meaningful Use Capacity/Functionality in Quality Reporting 1. What are realistic goals for certified inpatient and ambulatory EHRs to achieve with respect to capture, retrieval, and reporting of data needed for quality measurement and informed clinical decision making in 2011? 2. What is the trajectory over time toward a “quality data set” to enable broader standardization of electronic data capture and reporting with EHRs needed to support clinical care and quality measurement? Describe the end goal and any interim milestones, barriers and enablers? 3. What other infrastructure or policy requirements need to be considered for HHS to enable and prepare for the sharing of electronic data for quality measurement? 4. Insofar as quality measures reporting using EHRs would be to State or Federal agency designated repository, what if any potentially practical mechanisms or other implications for assuring accuracy, validity, and privacy of submitted data should be considered? Panel 5: Path to Meaningful Use Capacity for Vendors 1. What is the “time to market” cycle from adoption of standards to installation across the client base? How does that enable or constrain criteria for 2011 for eligible professionals? Hospitals? Later years? 2. What are vendors’ expectations with respect to increased product demand in 2011 and after, and how do they expect to meet it? What are potential risks (for example, need for additional technical support to assure successful implementations) and how can they be mitigated? 3. How will vendors need to adapt their product development and upgrade cycles to synchronize with progress toward increasingly robust requirements for meaningful use, information exchange, and quality reporting? 4. What changes are anticipated in the vendor marketplace between now and 2016 as a result of the incentives? Panel 6: Path to Meaningful Use Capacity for Providers 1. What do providers see as the critical EHR functionalities to enable a safe, patient-centric, high-quality health care system that optimizes patient outcomes? 2. What
Re: [openhealth] [Fwd: [openEHR-announce] Microsoft Connected Health Framework (CHF) uses archetypes]
Certainly a victory for the standard. Can you safely build FOSS with the Microsoft Connect Health Framework? -FT On Wed, Apr 22, 2009 at 2:54 PM, Tim Cook timothywayne.c...@gmail.com wrote: Forwarded Message From: Thomas Beale thomas.be...@oceaninformatics.com To: openehr-announce openehr-annou...@openehr.org Subject: [openEHR-announce] Microsoft Connected Health Framework (CHF) uses archetypes Date: Mon, 20 Apr 2009 17:08:55 +0100 The latest edition of Microsoft's Connected Health Framework - a strategy based on the idea of 'knowledge-driven health' (see http://www.microsoft.com/industry/healthcare/technology/HealthFramework.mspx) - includes openEHR (ISO 13606-2) archetypes as part of its domain knowledge architecture. There is much worth reading in this set of documents, including a good analysis of the problem space, deployment scenarios and issues, semantic and services architecture and much else besides. opinion The quality of this work may surprise some used to working mostly in the open source world. To those sceptics, I would recommend a read. It can only be a good thing if domain-enabling from the openEHR knowledge-oriented health computing platform appear in both open source and commercial platforms such as Microsoft Windows. - thomas beale ___ openEHR-announce mailing list openehr-annou...@openehr.org http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-announce -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
[openhealth] I have been invited to testify on 'Meaningful Use'
Hi, It looks like I have been invited to testify in Washington on what it means to have 'Meaningful Use' of EHR systems. http://www.ncvhs.hhs.gov/090428ag2.pdf As before, I want to ensure that my testimony reflects the attitudes and values of our culture. Using Google moderator for the CCHIT meeting seemed to work. It is even more important this time, because I may be the only voice of reason (the FOSS angle) at this meeting. For this reason: http://moderator.appspot.com/#15/e=4a793t=4a795 -- Fred Trotter http://www.fredtrotter.com
[openhealth] Re: I have been invited to testify on 'Meaningful Use'
Sounds good... its got to be short. I do not have much time! -FT On Sat, Apr 18, 2009 at 4:52 PM, Edmund Billings edmund.billi...@medsphere.com wrote: We should collaborate on a position paper I will work some points. Edmund __ Edmund Billings MD 415.505.8953 On Apr 18, 2009, at 2:46 PM, fred trotter fred.trot...@gmail.com wrote: Hi, It looks like I have been invited to testify in Washington on what it means to have 'Meaningful Use' of EHR systems. http://www.ncvhs.hhs.gov/090428ag2.pdf As before, I want to ensure that my testimony reflects the attitudes and values of our culture. Using Google moderator for the CCHIT meeting seemed to work. It is even more important this time, because I may be the only voice of reason (the FOSS angle) at this meeting. For this reason: http://moderator.appspot.com/#15/e=4a793t=4a795 -- Fred Trotter http://www.fredtrotter.com --~--~-~--~~~---~--~~ You received this message because you are subscribed to the Google Groups Open eHealth Collaborative group. To post to this group, send email to open-ehealth-collaborat...@googlegroups.com To unsubscribe from this group, send email to open-ehealth-collaborative+unsubscr...@googlegroups.com For more options, visit this group at http://groups.google.com/group/open-ehealth-collaborative?hl=en -~--~~~~--~~--~--~--- -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] foss / cchit meeting details
Mostly it was just the fact that they seemed willing to listen and recognize that FOSS really was different, and to see how their current structure did not really work for us. -FT On Mon, Apr 13, 2009 at 2:19 AM, Mark Spohr msp...@nnk.com wrote: Thanks for posting this, Fred. It is a good overvirw of the situation and description of the problems. I was wondering what CCHIT said that gave you hope that the FOSS certification problems could be solved under their framework? Regards, Mark On 4/12/09, fred trotter fred.trot...@gmail.com wrote: I have been writing a summary of the meeting.. I just posted it. http://www.fredtrotter.com/2009/04/11/towards-fair-ehr-certification/ It includes the link to the audio for the sessions. -FT On Sun, Apr 12, 2009 at 8:00 AM, Tim Cook timothywayne.c...@gmail.com wrote: So. anyone care to report any results for those of us that could not be there? Thanks, Tim On Mon, 2009-04-06 at 09:46 -0500, fred trotter wrote: Hey, Just a reminder. The foss/cchit meeting is today at 2:00 p.m. It is in room 10d at the McCormick Hyatt in downtown Chicago. I have been assured that himss registration -is not- required to attend this meeting. It is open to the public! If I find a room change or have other relevant information I will update this message. -ft -- Fred Trotter http://www.fredtrotter.com -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com Yahoo! Groups Links -- Sent from my mobile device Mark Spohr, MD Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] foss / cchit meeting details
I have been writing a summary of the meeting.. I just posted it. http://www.fredtrotter.com/2009/04/11/towards-fair-ehr-certification/ It includes the link to the audio for the sessions. -FT On Sun, Apr 12, 2009 at 8:00 AM, Tim Cook timothywayne.c...@gmail.com wrote: So. anyone care to report any results for those of us that could not be there? Thanks, Tim On Mon, 2009-04-06 at 09:46 -0500, fred trotter wrote: Hey, Just a reminder. The foss/cchit meeting is today at 2:00 p.m. It is in room 10d at the McCormick Hyatt in downtown Chicago. I have been assured that himss registration -is not- required to attend this meeting. It is open to the public! If I find a room change or have other relevant information I will update this message. -ft -- Fred Trotter http://www.fredtrotter.com -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
[openhealth] fosshealth 09 tickets still cheap for 10 hours
Hey, Just a reminder, FOSS health tickets are still cheap for 10 hours. http://fosshealth.eventbrite.com/ -- Fred Trotter http://www.fredtrotter.com
[openhealth] foss / cchit meeting details
Hey, Just a reminder. The foss/cchit meeting is today at 2:00 p.m. It is in room 10d at the McCormick Hyatt in downtown Chicago. I have been assured that himss registration -is not- required to attend this meeting. It is open to the public! If I find a room change or have other relevant information I will update this message. -ft -- Fred Trotter http://www.fredtrotter.com
[openhealth] FOSSHealth in Houston
Hi, The almost early bird rating has expired. I have gotten some complaints about the newly very expensiveness of the conference, and I have also gotten some requests to have a cheap option for those who might meet our community for the first time at the CCHIT meeting in Chicago next week. As before I have to be fair to those who signed up for the early and almost early bird rates. So I am raising the price again and creating another short term tickets. These will no longer be available after the HIMSS week. Please buy now. Do not be the guy who emails me saying... we just missed it (you know who you are...) http://fosshealth.eventbrite.com -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] Early registration for the Houston FOSS in health conference ends today
http://fosshealth.eventibrite.com -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] What are we asking CCHIT for?
HI, Please help me determine what I will present as the FOSS community perspective at the upcoming CCHIT/FOSS meeting. I have setup a Google Moderator page for determining what suggestions, exactly, are considered as favorable to the larger community. The Google Moderator system allows you to propose issues, and allows others to vote on those issues. I will do my best to cover the top rated suggestions. I have created several initial suggestions based on my original contact with CCHIT. Please find the page to contribute/vote on questions here: http://moderator.appspot.com/#15/e=35c32t=36f61 Regards, -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] Re: CCHIT meeting FOSS at HIMSS
Tim, That is great news! On Sat, Mar 14, 2009 at 2:50 PM, Elwell, Tim tim.elw...@misys.com wrote: Fred -- Thanks for posting this. I have been asked to participate in the CCHIT Meeting at HIMSS during the 2-3pm timeslot. Who else will be participating? I know that Medsphere will show up in force, and I think that the other 'usual suspects' (ClearHealth, WebReach, DSS) will be there as well. I would like to see more of the community come out. I am concerned that projects like WorldVistA-Community and OpenEMR, who have large communities but not very much corporate presence will be under-represented. This invitation is to try and get more of them in the room. I am also not sure what the call-in capability will look like and I am concerned that people who call-in will have a substantially less good experience... Perhaps we could use this forum to collect, aggregate and consolidate concerns representing various OS community stakeholders and reduce to a White Paper for submission. Anytime I hear the word 'stakeholder' I cringe. What that often means is 'listening to the most well-funded'. This is the mistake that makes CCHIT assume that they have already been working with us as a community. The Medspheres and ClearHealths of the world can take care of themselves. Significant community members like Webreach, Misys Open Source Software, OpenMRS, Open Health Tools and OpenClinica might be sympathetic but do not have a direct interest in FOSS EHR systems in the U.S. I really hope that the WorldVistA-Community shows up in force, since they are a large community and they have the only certified FOSS system I know of. (Are there others? That's a question I have not been able to get answered, and is very relevant now) So I think we will have to not only have to be inclusive with regards to stakeholders but find a way to fairly differentiate between interests. Still I think a white-paper is at least in part the way to go. I think it is something that we should consider sending not only to CCHIT but to the government. I also think we need to find a way to extend the opportunity to weigh in to people who are not there. I am glad that CCHIT is reaching out to people like you that are listening in the right places (and in the right way!!) that is a very good sign that this could work out. I'd be happy to include the summary in my remarks to CCHIT. Regards, Tim Elwell Misys Open Source Solutions tim.elw...@misys.com -Original Message- From: open-ehealth-collaborat...@googlegroups.com [mailto: open-ehealth-collaborat...@googlegroups.com] On Behalf Of fred trotter Sent: Saturday, March 14, 2009 2:45 PM To: openhealth@yahoogroups.com; open-ehealth-collaborat...@googlegroups.com; Hardhats; Mark Leavitt; Dennis Wilson Subject: CCHIT meeting FOSS at HIMSS Hello, Recently, I was asked by several community members to begin 'activating' the community at large against certain threats to FOSS in healthcare. Dr. Valdes and I have been planning on doing this for years, and, in our own ways, have both begun to attempt to make the public aware of the issues that our community (FOSS Health IT) faces. Dr. Valdes has been publishing several articles on the subject at http://linuxmednews.com, which have meet with considerable success. Including slashdotting: http://science.slashdot.org/article.pl?sid=09/03/10/2055229 While Ignacio has been taking a hard-line Free Software approach, I have been (in a twist for me) taking an 'Open Source' approach. The people who approached me at DOHCS were unanimous in their belief that what FOSS needed from the government was merely a level playing field, so that we could compete, and win, on our own merits. The largest single threat to the future of FOSS in healthcare in the US is the certification process mandated by the stimulus act. The language provides funding for -certified- EHR systems and eventually penalties for not using -certified- EHR systems. The best established certification body is CCHIT. They have not been named as the certification body, but they are likely lobbying for that role. However, CCHIT has had an anti-open source stance for years. For years, I and other activists in the community have chosen to largely ignore this bias. Simply because CCHIT was an optional certification. Now, things have changed. It is possible that the government will mandating a certification program that is either CCHIT or similarly unfriendly to FOSS. Recently I submitted my complaints to Dennis Wilson (associated with both FOSS Laika and employed by CCHIT) who put me in touch with Mark Leavitt. As a main result of that discussion, Mark has agreed to have a meeting with the community-at-large about this issue at HIMSS (please see the forwarded message from the CCHIT e-newsletter below). Granted, this is like offering to meet with the Rebel Alliance
[openhealth] Should we make FOSS Health conference exclusive?
Hi, So Early bird sales for the conference have gone really well. Much better than I expected, and potentially problematically well. If DOHCS attendance is any indicator, there will be a spike of late registrations. I may be running out of space, which is not a problem if I know months in advance but is a problem if I know days or hours. I have had several people email me saying I just missed early bird registration, can I still get tickets at that price? The answer is no, that would not be fair to the people who have registered on time. However, in sympathy to your pleas I have created a new almost early bird ticket sale that costs only a little more than early bird. You can purchase the tickets here: http://fosshealth.eventbrite.com I am telling you know, if you want to go, or you think you might want to go, buy your tickets now. Otherwise, you will forget and then you will be emailing me asking for special treatment again. The people who register earliest will get the best deal, I will only raise prices as the deadline approaches. Do not let this happen to you!! Now for the main point of my message. Is it appropriate for me to make this an invitation-only event, like FOO camp? I could call it Friends of Fred or FOF (ok thats a terrible idea). The point is, it would help me keep the conference size down and ensure that everyone there was really important and/or doing really interesting work. Frankly I do not like the idea, it feels bad to make anything FOSS closed like that, but otherwise, conference planning might be impossible. Let me know what you think!! -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Using Cell Phones to interface with OpenMRS
I am a little confused about what you are trying to do. What information. Exactly are you hoping to use SMS text to send -to- the clinician? What information, exactly are you hoping to use SMS text to get information -from- the provider? SMS is not at all a consistent platform, it is difficult to be sure texts have been received for certain, so I cannot imagine how you could build something reliable on top of it... Could you clarify your aims somewhat? -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] misys connect
misys-connect was open sourced. You can find it if you look hard on sourceforge. Most importantly, the valuable and unique components from misys connect were contributed to the Mirth project, where they are currently maintained. Myself and several other community members specifically requested this from Misys, rather then creating a separate competing project. If you have any questions you should direct them to Alesha with Misys, who can give you the official story (I have no formal ties to Misys). -FT On Tue, Jan 27, 2009 at 10:06 AM, balu raman braman20012...@yahoo.com wrote: Folks, Is misys-connect open source ? I see an announcement sometime in March 2008 where they claimed it to be open sourced. I don't see any sites I can d/load from. - balu raman === [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Community EMR project in the Mid West (US)
The two top solutions for patient portals that I know of are Tolven and Indivo. -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] A National Health IT dialogue
I wanted everyone to be aware of the National Dialogue website that is opening for a few days to discuss Health IT. http://www.thenationaldialogue.org/info/about/ The site is a Digg-like collaboration to gather, comment on, and rate ideas. It is hosted by the National Academy of Public Administration. If you have an idea you would like to put forward regarding Health IT, now is the time, as the site will only be open for a few days. I have put forward my basic credo, we should only be using FOSS in Health IT here: http://www.thenationaldialogue.org/ideas/insist-on-open-source/ Please rate it and comment on it. I know many of you really agree with me, and some really do not. Either way, this will be a very public debate and it is a good chance for your voice to be heard. Of course this applies especially to those of you who agree with me!! ;) -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Re: [oshca_members] FOSS for health in Malaysia
, not sold. The name PCDOM and PrimaCare must not be used to endorse or promote products derived from this software without prior written permission. For written permission, please contact [EMAIL PROTECTED] This EULA does not grant you any rights to trademarks or service marks of PCDOM. 4. NO RENTAL/COMMERCIAL HOSTING. You may not rent, lease, lend or provide commercial hosting services with the Software. 5. CONSENT TO USE OF DATA. You agree that PCDOM may collect and use non-medical (technical) information gathered as part of the product support services provided to you, if any, related to the Software. PCDOM may use this information solely to improve our products or to provide customized services or technologies. Unless expressly approved by you via written consent, PCDOM will not disclose this information in a form that personally identifies you to third parties. 6. ADDITIONAL SOFTWARE/SERVICES. This EULA applies to updates, supplements, add-on components, or Internet-based services components, of the Software that PCDOM may provide to you or make available to you after the date you obtain your initial copy of the Software, unless they are accompanied by separate terms. PCDOM reserves the right to discontinue Internet-based services provided to you or made available to you through the use of the Software. 7. TERMINATION. Without prejudice to any other rights, PCDOM may terminate this EULA if you fail to comply with the terms and conditions of this EULA. In such event, you must destroy all copies of the Software and all of its component parts. 8. DISCLAIMER OF WARRANTIES. THIS SOFTWARE IS PROVIDED UNDER THE PCDOM PRIMACARE PROJECT AS IS.ANY DATA DISCREPENCIES DUE OR ANY EXPRESSED OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE DISCLAIMED. IN NO EVENT SHALL THE PCDOM DEVELOPMENT TEAM OR ITS CONTRIBUTORS BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THIS SOFTWARE, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. WE STRONGLY DISCOURAGE AGAINST UNAUTHORISED MODIFICATIONS OF THE SOURCE CODE. 9. ENTIRE AGREEMENT; SEVERABILITY. This EULA (including any addendum or amendment to this EULA which may be included with the Software) is the entire agreement between you and PCDOM relating to the Software and the support services (if any) and they supersede all prior or contemporaneous oral or written communications, proposals and representations with respect to the Software or any other subject matter covered by this EULA. To the extent the terms of any PCDOM policies or programs for support services conflict with the terms of this EULA, the terms of this EULA shall control. If any provision of this EULA is held to be void, invalid, unenforceable or illegal, the other provisions shall continue in full force and effect. -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Google Health
Google does not typically take help from outsiders that it does not seek out. They are a tad ivory tower that way. Indivo and Tolven are our top two PHR efforts. They will and do listen to us and we should focus our efforts there. -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] FOSS PACS
Hi, Where are we on an open source PACS system? Do we have something that is reliable and has actually been deployed and integrated? Opinions and Bias welcome here -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Re: An inventor of disruptive technology looking for advice about open source
In Steves defense I see no reason why proprietary companies should not have to pay to use his patent. It makes sense to me that in the world of openess and freedom, everything should be open and free. While if a proprietary software vendor presumes to exert control of a clinician using a software license, then I see no reason at all that Steve should not exert control over said vendor. -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] An inventor of disruptive technology looking for advice about open source
Stephen, You are the second person who has approached our community about using a hybrid patent/open source business approach. I had already decided to work with the first group, and your comment has urged me to move this higher on my priority list. I will try to communicate with you offlist regarding exactly how to move forward. You should know that I, and others within this community, will work with you only with great hesitation. Many in our community, including me think that generally, patents are immoral. We are unique in the FOSS community in that it really is a high-stakes moral game that we are playing. If Microsoft has patents on the Xbox. Who cares really? If they have a patent on HealthVault, then some life-saving idea that they have in there could be trapped for 20 years. This creates what I lovingly refer to as the health software patent paradox The degree to which a medical software is innovative and useful, and is therefore patentable, is directly proportionate to degree to which it is immoral to pursue patenting What if a car company created a new safety device that reduced car accident deaths as easily and cheaply as seatbelts do currently. Innovative? yes. Patentable? probably. A technology unethical to trap in the hand of one car company? Clearly. I cannot see any substantive HealthIT patent that does not fall into this moral quandry. However, I recognize that I am unlikely to convince you regarding this matter, and I also see that you are reaching out to us in a friendly manner. So if you will take my reluctant help, I would be glad to give it. First please read what I have already written on the subject of licensing medical software. Much of it may not apply to you. But it is useful context for you to have. http://www.freesoftwaremagazine.com/columns/sharing_medical_software_foss_licensing_in_medicine Second, from what I have seen on your blog you have some confusion about what open source means. You wrote there Note that there are dozens of other open source licenses, including those that prohibit derived work and free sharing. Very complex indeed! This is not true. If a license does these things then it does not meet the Open Source definition. The issue is confusing, but not particularly complex. The OSI makes the definition. The OSI approves the licenses. If it does not meet the definition AND make the list, then it is not an open source license. A glance at your technology stack indicates that your patent involves using a thick-client spreadsheet as a front end to some sort of data network. Frankly, I seriously doubt that a patent that you got as recently as 1998 with a technology description that is as general as the one that your blog describes will not have substantial prior art available. Ergo, I doubt your patent is valid. Further, in the current FOSS community, we are aggressively pursing multiple AJAX interfaces, as well as really smart, XML based plumbing to move data around. Thankfully, these standards-based technologies are largely unpatentable. They work so well, that I doubt anyone here will bother to implement your technology. Feel free to convince me and others otherwise, but market speak like: interact at the presentation level, which creates an interoperable platform for the simple, secure, fluid exchange of reports between disparate system architectures through the transmission of content stored in delimited files. This kind of broad, glowing descriptions sound marvelous, but mean so much (whatever you want them too) that they might as well mean nothing. If you could give me an example of something your technology does right now that is not found in the combined technology pool of VA Vista, OpenMRS, ClearHealth and Mirth, I would be very very surprised. I say that because I will try and help you, but I need to be sure that you understand that I am helping you because I think it is important that we, as the FOSS community, work with patent holders to arrange for a peaceful resolution to patent problems. I am not working with you because I am impressed by your technology. Perhaps I will be impressed later on, but I am certainly not impressed now. Given that, you should take a look at this page www.rosenlaw.com/IC-Business-Model.pdf Which outline an effort to create a Patents, Free for Open Source everyone else pays strategy. I am working with Larry Rosen now to see how best to apply this to a medical environment. Regards, -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] Problems with NPI
If you are having issues with NPI you might take this survey which CMS will be given to CMS in a few days... http://surveys.hittransition.com/npi -- Fred Trotter http://www.fredtrotter.com
[openhealth] IF you are at HIMSS 08
Drop me a line and we will try to get a FOSS meetup going... -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] HIMSS in Orlando
I will be going to HIMSS and I would like to arrange another FOSS meetup!! -FT On Thu, Feb 21, 2008 at 4:08 AM, Tim Cook [EMAIL PROTECTED] wrote: Hi All, Is anyone on this list attending this conference? http://www.himssconference.org/ It would be great to hear thoughts about Eric Schmidt's (Google CEO) keynote and if any open source advocates have a press pass for the press conference afterwards that would be very cool. Maybe they are about to release news about their PHR? http://www.himssconference.org/education/keynoteSpeakers.aspx Cheers, Tim -- Timothy Cook, MSc Health Informatics Research Development Services LinkedIn Profile:http://www.linkedin.com/in/timothywaynecook Skype ID == timothy.cook ** *You may get my Public GPG key from popular keyservers or * *from this link http://timothywayne.cook.googlepages.com/home* ** [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Re: Creating the Free Medical Software Foundation
Sam, Obviously, I disagree with you on several points. OSMS is exactly what you are proposing with this new organization. The main difference is that Fred Trotter trusts Fred Trotter to do the right thing but not the rest of us. That is an assumption. Perhaps I have other motivations, see below. Obviously, using your own non-conflict-of-interest policy, you do not qualify for your own Board of Directors. I should hope that I am ideal for the Board of Directors. My current idea is not to include project owners as BoD members. I am no longer the project manager for ClearHealth, David Uhlman is. MirrorMed is 90% code-identical with ClearHealth and 100% compatible. As far as I am aware, I am the single largest contributer to the ClearHealth project besides ClearHealth Inc employees (who obviously contribute vastly more than I do). MirrorMed is my trademark for selling ClearHealth. It would also be my trademark for selling OpenEMR, FreeMED or UltimateEMR. The whole point of MirrorMed is to allow me to develop on my own when I need to, but to not create yet-another-php-EHR-project. In fact that is where the name comes from... it is a mirror get it ;) The same is true of FreeB. I view the openemr community as the maintainers of FreeB v1.x ( the perl version). Again FreeB v2 the php version is completely based on the ClearHealth billing module. In all three cases, MirrorMed, FreeB v1 and FreeB v2, someone else is leading the projects. I am just a developer. In the past I have developed code for FreeMED and through FreeB I have contributed to several different projects. I have done VistA development (that should someday real soon now be made public) and I am currently working with Mirth. My participant as a developer on several projects and the fact that I continue to have business interests in Open Source medical software, should qualify me for a role like this, instead of disqualify me. Further, I have consistently demonstrated that I am interested in the movement rather than a particular project. Mirth will soon eclipse my work in this regard, but FreeB was the first substantial piece of medical software that was useful to several different projects. As for Open Source Medical Software (OSMS), the organization was chartered to serve all free open source medical software projects. I have offered previously in this forum to support any and all of the existing FOSS medical software. I was mostly met with suspicion and criticism, but the offer still stands. Honestly, I missed the public offer, but I am sure you made it just as you mention. However, please do not pretend that this has always been the position of your foundation. I specifically proposed to you, and your board that you take on the MirrorMed codebase as a second codebase to hold under your group besides OpenEMR. If you recall I was even willing to assign the trademark to your non-profit to make that happen. Here was the reply you sent me: We had out board of directors meeting on Friday. The consensus is ( 3:1 against a merger) that they still prefer working with the current OpenEMR code base. The more experienced developers feel that fixing the older code base is not going to be that hard. They prefer the functionality that already exists with OpenEMR. I think the issue boils down to the fact that that they prefer a different design philosophy than what you are using with MirrorMed. So if the Open Source Medical Software was designed to serve all open source medical software projects rather than just OpenEMR, this decision is a little confusing. I certainly respect your decision to not work with MirrorMed, you should be able to do whatever you want. But you cannot not reject my proposal to work with a different codebase and then also claim to be project-neutral. I know for a fact that the charter of FreeMED Foundation also says that it also can support any Open Source medical software, but practically speaking the FreeMED Foundation is focused supporting the FreeMED project. You can tell because all of the people on the FreeMED Foundation BoD are FreeMED people. Just as your foundations board are entirely composed of OpenEMR people. Hopefully, by having many different associations among the BoD members we can achieve a neutral board, if not the perception of neutral board members. I would be willing to discuss the possibility of re-purposing the Open Source Medical Software foundation to do what we had hoped to with the FMSF. However, just as the FMSF will have no ties with the MirrorMed project, the Open Source Medical Software foundation would have to sever its strong ties with OpenEMR. That would mean removing most of the OpenEMR people on your current board and replacing it from exactly the same kind of people that we are seeking for our board. My concern is that then you would need to create another foundation to directly work with OpenEMR development (which I think is a very good thing
Re: [openhealth] Creating the Free Medical Software Foundation
Rod wrote: I'd have a very hard time being interested without (at least tentative) answers to those questions up front. How can you not care if another perfectly good organization is already dedicated to the same things? fair enough. Answers below: Tim wrote: There is nothing wrong with this, it just appears to me that Fred is proposing a project neutral organization. I could not have said it better. But remember that project neutral does not mean the same thing as merit neutral. Just because a project has a FOSS license does not mean that the FMSF should blindly support it. Still I would hope to do things that will benefit projects like OpenEMR. There are also things that the project focused foundations might be able to accomplish that the FMSF might have trouble with, things like narrowing in on one license in order to indemnify and protect contributing developers. This is the reason that the Apache Foundation uses only the Apache License, doing that sort of thing with several licenses becomes intractable. (Thanks for that insight Ryan) We might refer to foundations that exist to push a particular solution or license as 'Apache-foundation-style' groups; the community obviously needs such organizations and the FMSF would hope to work with these kinds of organizations. Tim wrote: In this case the only organization I can think of that it would be in any way in competition with is OSHCA. I believe that FMFS and OSHCA can be complimentary. That is our hope too. One important distinction is that FMSF will be US-Based and a 501c3. Obviously, having different vehicles for different projects could be advantageous. There are several projects that *I* hope to undertake that are impossible without 501c3 status, which is why we decided to start a new group, rather than work through the committees of an existing group, which would slow us down. It is already taking way too long to get this up and going. The other thing that we will be handling differently than OSCHA is the conflict of interest issue regarding the outside projects of board members. Instead of making a judgment about whether an individuals secondary interest is compatible with the foundation, we can include members who have potential conflicts by creating the non-voting group of Board of Advisors. The idea is to create a space for hybrid players; like Misys or eMds, where the fact that they are not pure FOSS is not a problem. Also we want to able to include people like Rod Roark, David Uhlman or VistA people or OpenMRS people who have very strong ties to particular projects, in a way that competing projects will have less of a problem with. Obviously, we can also move people back and forth between the voting BoD and the non-voting BoA, so if I ever take up the role of project manager again, I would just give up my vote, and continue participating. Again, this is how *I* think this should work, but *I* will not be making the decisions about exactly what we are trying to accomplish. Once the FMSF is formed it will take its own direction, and you can count on it being different than what I am envisioning. I just want to clarify what my personal intentions were and explain my own reasons for being involved. What I want to know from the community is what do *you* think the FMSF should do? I have seen no nominations or volunteers for BOD members yet? Do not be shy -FT -- Fred Trotter http://www.fredtrotter.com
[openhealth] Creating the Free Medical Software Foundation
Hello, We are starting a 501c3 non-profit foundation to advance FOSS in healthcare. Here is our mission statement: To improve the quality of healthcare through the advancement of Free and Open Source Medical Software. The Free Medical Software Foundation will encourage the use of Free and Open Source software by sponsoring development, education and Health IT initiatives. So far this is a project that both I and Ignacio Valdes have committed to. In order to make the FMSF as transparent as possible, Ignacio and I will be taking public nominations for Board of Directors and Board of Advisers positions. We have already invited people we know we want to be involved in the BOD, and we will potentially pass on nominations without giving any reasons for doing so. However, we want the communities input even at this initial stage. For all BOD and BOA members, we have a preference for either technical expertise, or clinical expertise. We also strongly prefer 'do'ers to 'talk'ers. We like short meetings. BOD members: Must be committed to the FOSS health software movement as a whole, as opposed to being associated strongly with a particular project or company. We hope that the BOD members will be well-known community members who instantly command respect. BOD members will get a formal vote on the actions of FMSF. BOA members: Are committed to the advancement of a particular project or effort within the community. We will be inviting people who are associated with either proprietary and FOSS companies, but who are making a significant contribution to health FOSS in some fashion. BOA will not get a vote on the actions of FMSF. Now, I am sure many of you will wonder What exactly should this organization do? or Is this organization in competition with organization X? I have specific answers to none of those types of questions. Ignacio and I have several initiatives that are critically important to the community that do not work well without a non-profit behind them. We will be supporting and/or hosting conferences. We will pursing funding for the purposes of sponsoring development on important projects. Besides that, we want to have an organization that can be used to scratch our collective FOSS in healthcare itch. What else that will mean will depend in large part on who you suggest as BOD members. So, this is not an opportunity to discuss what the FMSF will be doing, as much as who gets to make that decision. In short, who does the community at large trust. Who represents our communities ideals and values? Who would therefore make a good BOD member? What projects are important enough that we should invite their community members specifically to the BOA? Feel free to nominate or volunteer now. Please give some detail on why you would make a good candidate. -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Regarding FOSS Clinical Messaging
On Feb 5, 2008 3:56 AM, Mark Spohr [EMAIL PROTECTED] wrote: Just a couple of points to put into the basket when you are considering how to approach this problem... - Mirth is an interface engine. As such it handles messages. It can receive these in a number of formats. It stores, transforms, filters, and re-send messages in various formats. It does not have a 'user interface' that any user would ever use. Your application would provide the user interface to create and receive the messages. good thought! - eMail is any easy analogy for people to understand and is probably a good way for users to think of your system. However, email on the back end is a mess from an informatics standpoint (lack of structure on input and output will drive you crazy parsing messages and trying to retrieve useful data) so you should probably avoid it as a foundation piece. Something more structured is definitely in order. Agreed. I have mostly structured data, along with a plain text message. It is intended to look and feel to the user like email. But the plumbing should be much more normalized. All the best, Mark On Feb 4, 2008 6:28 PM, Fred Trotter [EMAIL PROTECTED] wrote: All, Thanks for your responses. As always I have more information than I can easily digest. It looks like I have some reading to do. Mark suggested that I look into Mirth, and I definitely have an eye towards integration with that project. However, I am very concerned with human side interfaces, which I do not think Mirth does yet. (I understand that might be changing!!) The other is the email analogy. I do want people to think of email with my system, because that is relatively easy to understand. Heck, e-mail itself is a technology that references the prior model (snail mail). So I am going with the KISS principle for now. Does anyone know what kind of messaging is available in VistA? -FT -- Fred Trotter http://www.fredtrotter.com Yahoo! Groups Links -- Mark Spohr, MD [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
[openhealth] DOHCS a good conference coming up... we need more.
Hello, I just wanted to remind everyone of the DOHCS portion of the SCALE conference running this weekend. This will be the second year I have gone and presented my talk on Whats going on in open source healthcare. DOHCS is becoming a better and better conference. It continues to feature the whos-who of the FOSS healthcare movement. I want to pay particular attention in my talk to projects that will not be featured elsewhere at the conference. So let me know if you are doing something neat that you would like me to mention! I also wanted to get some feedback on the idea of a Houston-based FOSS healthcare conference. I know everyone needs to know about these things about a year in advance, so I doubt that it will be happening this year. DOHCS is successful in no small part because it piggy backs on SCALE, which is a great conference by itself. As far as I know there is nothing as impressive to piggy back here in Houston. I had thought of corrdinating a WorldVistA community meeting in Houston with a more general FOSS healthcare conference. I have recieved pretty good feedback from the VistA community members I have mentioned this too, and I wanted to see what everyone else thought. More generally, I want to know what would make a good FOSS healthcare conference. If you have been to DOHCS in the past, tell me what you liked about it? If you are not going this year what keeps you from going? At this point I can say that DOHCS has become the central US-based conference for FOSS healthcare (in large part due to David Uhlmans tireless efforts... thanks for that!), given that the attendance (which continues to grow) is pretty dissappointing to me. It seems to me that we should see hundreds of out-of-towners coming to a conference like DOHCS. I know this community is based all over the world and all across the US. My question is: what makes it worthwhile to get on a plane, spend a bunch of money on conference tickets and lodging to go to a FOSS healthcare conference? Regards, -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Re: DOHCS a good conference coming up... we need more.
I wan thinking of making the Houston conference a community meeting rather than just a conference. There are several projects in the US that are two small to have a community meeting on their own, but with a larger conference we might be able to have several community meetings one after another. Also, with projects like Mirth, there are more and more opportunities for code sharing. I can see at least two tracks being useful. A developer/community track, essentially a managed hackathon. and then an end user track more focused on training and demonstrations. -FT On Feb 5, 2008 8:41 PM, Paul [EMAIL PROTECTED] wrote: Honestly, I believe that paradigms will change significantly once actual collaborative development efforts begin in earnest. There will be reasons to meet and work together. Speaking from a personal perspective, if I knew there was something that I'd accomplish or not be able to get through an email or phone conversation, then I'd consider making the hike across the country for a one day meet. Seems like a lot of the DOHCS content is more informational and content I could get by browsing the web. Not sure how many folks come to the DOHCS meeting, but our 2nd OpenMRS meeting in Cape Town had close to 200 attendees. In large part, there were fairly specific reasons each attendee was there. Most were contributing more than they were gaining. Maybe if the third annual meeting was a rallying cry with a specific focus of fostering a collaborative effort? -Paul For example, --- In openhealth@yahoogroups.com, Fred Trotter [EMAIL PROTECTED] wrote: Hello, I just wanted to remind everyone of the DOHCS portion of the SCALE conference running this weekend. This will be the second year I have gone and presented my talk on Whats going on in open source healthcare. DOHCS is becoming a better and better conference. It continues to feature the whos-who of the FOSS healthcare movement. I want to pay particular attention in my talk to projects that will not be featured elsewhere at the conference. So let me know if you are doing something neat that you would like me to mention! I also wanted to get some feedback on the idea of a Houston-based FOSS healthcare conference. I know everyone needs to know about these things about a year in advance, so I doubt that it will be happening this year. DOHCS is successful in no small part because it piggy backs on SCALE, which is a great conference by itself. As far as I know there is nothing as impressive to piggy back here in Houston. I had thought of corrdinating a WorldVistA community meeting in Houston with a more general FOSS healthcare conference. I have recieved pretty good feedback from the VistA community members I have mentioned this too, and I wanted to see what everyone else thought. More generally, I want to know what would make a good FOSS healthcare conference. If you have been to DOHCS in the past, tell me what you liked about it? If you are not going this year what keeps you from going? At this point I can say that DOHCS has become the central US-based conference for FOSS healthcare (in large part due to David Uhlmans tireless efforts... thanks for that!), given that the attendance (which continues to grow) is pretty dissappointing to me. It seems to me that we should see hundreds of out-of-towners coming to a conference like DOHCS. I know this community is based all over the world and all across the US. My question is: what makes it worthwhile to get on a plane, spend a bunch of money on conference tickets and lodging to go to a FOSS healthcare conference? Regards, -- Fred Trotter http://www.fredtrotter.com Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
[openhealth] Regarding FOSS Clinical Messaging
Hi, I would like to discuss my current thoughts on clinical messaging systems, and encourage others do so here as well. What follows is a brief documentation of the design of a clinical messaging system that I have working in MirrorMed now. The MirrorMed parent project, ClearHealth, is planning on doing clinical messaging in a different way, and my not accept my patches. But when it is stable I will be submitting it back, as a module. My purpose in emailing this list is to both learn better ideas, but also to formally publish what I am doing in a way that can be referenced as prior art, for software patents. I would encourage others to use this list for the same purpose. My clinical information system is designed to work with an interface similar to email. Messages can be about a patient, if they are, that patient is notified with a message that his providers are discussing his case. To choose to send someone a message, you first find the patient you want to discuss, then you move to the send message interface. Here you either choose that person from a drop-down, auto-suggest or simple typing an email. Then the user chooses a priority for the message, and decides if the message is a todo item. Depending on the priority of the message, user can receive a standard email notification of a message. To read the message, the user must either be logged in via a PHR or the EHR. Patients can be messaged through the system. Patients can also initiate messages through the PHR, but only to those providers who are part of that patients provider list. In email, when you forward a message, that can be done with, or without the original senders knowledge. However, in a clinical messaging system, it is vital that all participants in a virtual consultation know the entire context of the message. Thus, when a new clinical user is introduced to a thread, the system ensures that that user can see all of the previous messages in that thread. Generally, the system tracks which users have read which messages. When the user logs in to view messages, already-read messages are rolled up and only display the subject line. If a Message has not been read, the system displays the entire message. The priority of a message determines whether or not an email is sent informing a user that a message exists, and when a todo item is sent, users can mark items as done or not done. So that the messaging system can hand out simple tasks that might not be encompassed in an orders system. Features that I have not implemented yet that are pretty obvious: 1. Allowing intermediate users to approve and forward messages, so that staff members can protect clinicians from frivolous messages from patients. 2. Allowing group email targets, like all nurses or all doctors or all users at the main st location. 3. Allowing attachments. 4. Allowing links to different elements in the patients record. I want to know what I am missing? What else makes a good clinical messaging system? What else is available in open source that I should be emulating. Remember publishing your ideas here is a big step to prevent bad patents from being made! -FT -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Re: Open Sourcing of Proteus Tools
Regarding multiple licensing: The problem with this is that you have to be more careful with user contributions. Suppose that you want to use both the GPL and MPL (which is a fine choice btw). Suppose that I make a signifigant improvement and you want to accept those improvements back into your project. What license am I using to license my work back to you? I have the right, under typical multiple licencing schemes, to decide which license I am accepting. You need to careful that either I am licensing my work back you under the same set of multiple license or that I am assigning copyright back to your project. If I only give you my improvements under the GPL, you cannot then redistribute my improvements, together with your original code, under one of the other licences you originally choose. Generally you will make you life much much easier if you decide to use a single license AND get copyright assignments from contributors. I have no problem assigning copyright to a project that I know will provide my copyright back to me under one of the Google 7. This will give you the option of using the MySQL proprietary/free dual licensing revenue model in the far future. Unless you are careful to aquire the copyright from contributors from early on, this option will likely be unavailable to you in the far future. HTH, -FT On Dec 18, 2007 3:02 PM, Hemant Shah [EMAIL PROTECTED] wrote: I was counting on you and you guys you came through. Your many inputs have managed to push me to that higher level of confusion from which only enlightenment can emerge. All licenses I am considering are in the Google 7 suite as Fred Trotter describes in his article. Bhaskar, Adrian and Fred make a strong case for GPL but Gunther's arguments have more or less convinced me to go with MPL. I feel that MPL or LGPL will allow more people to consider working with the code than would GPL. I do not mind if they take much more and give only a miniscule back. That miniscule could be precious. However, issues I did not consider earlier have now clambered on to my frame of cognition and I need to resolve those. I list the issues here: - *Multiple licensing ab initio* which combinations are compatible? MPL + GPL? MPL + LGPL? - *Using single license initially, later considering issuing it under other licenses* which licenses give us such flexibility? LGPL? GPL? MPL? - I clearly hear roll-your-own is not a good idea. What I don't clearly hear is why so? There is the suspicion for the strange with which the FOSS developers will approach such projects and several other reasons that Fred's article covers. Besides this, do the FOSS organizations offer additional protection/support if we use a standard license? I need to convince the legal team here about this stance. Learning from the stalwarts is fun. Considering the ease with which you can create your own decision support process with Proteus, I might author a process that guides novices like me through the steps to help select the right license for them. Thanks guys, Hemant -- Hemant Shah, M.D., M.Surg. Sr. Research Informatician Henry Ford Health System Detroit, MI 48202 http://www.proteme.org %20http://www.proteme.org%20 On Dec 18, 2007 2:19 PM, ksbhaskar [EMAIL PROTECTED] wrote: --- In openhealth@yahoogroups.com openhealth%40yahoogroups.com, K.S . Bhaskar [EMAIL PROTECTED] wrote: [KSB] ...snip... 2. It is the license that IMHO best protects the software developer from seeing his work incorporated into a non-FOSS proprietary piece of work. [KSB] This ( http://www.softwarefreedom.org/news/2007/dec/17/busybox-xterasys-settlement/ ) is just one of several recent out-of-court settlements that those who have released software under GPL have been able to reach. [To me, an out-of-court settlement much the better alternative to going to trial.] If you want to protect yourself against someone downstream taking your work and making it a part of their non-FOSS work, there is nothing like the GPL. Regards -- Bhaskar [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] Yahoo! Groups Links * To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ * Your email settings: Individual Email | Traditional * To change settings online go to: http://groups.yahoo.com/group/openhealth/join (Yahoo! ID required) * To change settings via email: mailto:[EMAIL PROTECTED] mailto:[EMAIL PROTECTED] * 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] Re: [FOSS_health] MyGOSSCON 2007 on 6-7 December KL
Dr. Cheah, There is something very disturbing about this thread. Unless I missed a post, you are being silent on the core issue. The issue of how certifications will work with FOSS licenses is interesting and critical to our success. However, Tim Cooks core question has gone unanswered. Where is the code? To be clear, you have a responsibility to answer that question. Publicly distributing code is a critical part of the ideals of the healthcare FOSS community, separately from the open source and free software communities at large. An EHR is the backbone of the any healthcare IT infrastructure. Part of your moral responsibility as a FOSS vendor of EHR software is to allow other organizations or companies to support the software. I fully support your right to not publicly distribute all of your GPL software, I do the same thing. However it is unethical to do this with EHR software. Withholding toolkits, rollout systems or software that gives you a competitive advantage BUT does not subject clinicians to vendor lock-in is fine. But what you appear to be doing is finding a way to get vendor-lock-in with FOSS code. Of course you might not be doing that. You might be doing something else entirely. But given your leadership role in OSCHA you pretty much have to answer this question. Otherwise, we will all have to assume the worst which will negatively impact your credibility and by proxy the credibility of OSCHA. If you would like I can rephrase Tim's question in another way. How do you ensure that other organizations are able to support the code that you are using? The license might permit a non-public release, but this is not compatible with our values as a community. You may have some reasons that we do not yet understand, but you need to tell us about that. You may not actually be doing what we think you are doing, but you need to tell us about that. You can have silence or credibility. Pick one. -FT On Nov 13, 2007 6:54 AM, Tim Cook [EMAIL PROTECTED] wrote: On Sat, 2007-11-10 at 18:36 +1100, Tim C wrote: On 10/11/2007, Jason Tan Boon Teck [EMAIL PROTECTED] wrote: Dear Molly, We are interested to participate in the exhibition, to promote PCDOM PrimaCare. Is PCDOM PrimaCare open-source software? If so, where or from whom can I obtain a copy of its source code? Dr. Cheah, I am wondering, especially in your capacity of leadership in OSHCA, why these seemingly simple questions, but important questions (a link would do) go unanswered; while you do apparently have the time to answer other questions about a conference that you do not control (MAMPU/OSSC)? -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] free as in beer: lines of criticism
I have thought that for this reason, I should recommending the new Affero GPL for FOSS ehr software. There is also the issue of ensuring access to current data, and I am not sure that this can be addressed via a licensing agreement. -FT On Nov 15, 2007 9:33 AM, Joseph Dal Molin [EMAIL PROTECTED] wrote: I totally agree with Tim... the pure ASP model is an accident waiting to happen...I would not want to put a patient's life in the hands of a network provider. Hurricane Katrina is a good exampleand the recent network failure in California in the VA system is another example (which BTW they would have avoided had they not started down the path to consolidating data centers). Joseph Tim Cook wrote: If; 1) the **patients** have a choice in what information is used about them 2) and there is a guaranteed standard way to retrieve all of their data if desired Then I have no issue with this model. I do have serious concerns about the sanity of the doctors trusting their patient records to a single point. There are far too many communications interruptions (even in the US) for that to make any sense. The hosted EMR is a really bad idea; except for maybe if you are Google and have tons of connecting points. Still, the clinic link to the Internet is a critical point of failure. Tim On Thu, 2007-11-15 at 14:10 +, Adrian Midgley wrote: http://www.ama-assn.org/amednews/2007/05/07/bisb0507.htm Expensive - by UK standards - if they don't take the adverts. I suspect that the licencing model is such that when the company folds, the software goes away, or alternative and likely more expensive ways of supporting what by then will be a practice asset will be imposable upon users. Whereas with an open source model, none of this applies. Who is an AMA member who could write to the journal? -- Midgley Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] Open Source Personal Health Record
The other mature PHR project besides Indivo is Tolven... -FT On 11/2/07, David Chan [EMAIL PROTECTED] wrote: We have been using this project for a few years with much success: http://indivohealth.org David David H Chan, MD, CCFP, MSc, FCFP Associate Professor Department of Family Medicine McMaster University -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] FOSS Medical Office/EHR
OSCAR is the dominant platform in Canada, I believe GnuMED has a strong german contingent. OpenMRS is doing a lot of work in Africa. Remember the AMIA EHR evaluations... ehr.gplmedicine.org We would love to have some help expanding/updating this. -FT On 10/18/07, balu raman [EMAIL PROTECTED] wrote: Hi, Is there a list , somewhere, that lists all FOSS medical applications ? My memory fetches - openEMR, FreeMed, MirrorMed, ClearHealth, OSCAR, Indivo ( ?) , WorldVista, something from Canada, something from Europe, something from South Africa - you see my memory is fading :-) I am writing a report for our State (VT) where there's some fundings going on for EHR's and people involved are not aware that FOSS is a viable option. Balu Raman openEMR user in Pediatrics __ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com [Non-text portions of this message have been removed] Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] patientos?
I mean Misys On 7/30/07, Fred Trotter [EMAIL PROTECTED] wrote: I have never heard of them and the release is .1... so I think not. I have already requested an email interview to see whats going on... Mysis is the big news though... -FT On 7/30/07, Adrian Midgley [EMAIL PROTECTED] wrote: Do we know http://www.patientos.org/ ... already? Adrian Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com -- Fred Trotter http://www.fredtrotter.com
Re: [openhealth] patientos?
I have never heard of them and the release is .1... so I think not. I have already requested an email interview to see whats going on... Mysis is the big news though... -FT On 7/30/07, Adrian Midgley [EMAIL PROTECTED] wrote: Do we know http://www.patientos.org/ ... already? Adrian Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com
[openhealth] Medsphere Poll
As many of you know Medsphere continues to sue the Shreeves. Interestingly Medsphere has also released some of the code that the Shreeves originally put on sourceforge. This puts the community in an interesting position. Should we collaborate with Medsphere as they continue to attack community members? (Besides the Shreeves, the lawsuit names anonymous sourceforge downloaders as defendants) How can we encourage Medsphere in this release, (which is a good thing) while discouraging them from suing their own developers? I have asked the Hardhats community to participate in a poll regarding this issue. Now I would like to expand on this poll to the larger FOSS medical community. If you go to GPLmedicine.org you will find several polls at the bottom right of the page. The questions are meant to determine exactly what the community thinks about this issue. Again here is the link: http://www.gplmedicine.org I will not keep the polls up forever, so make your voice heard now!! Regards, -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Medsphere really is an open source company after all?
The software in question was not VistA at all. It was developed internally at Medsphere. We are simply talking about a company that placed an open source offering on sourceforge and then, dramatically, had the software removed. They have since released one of the items they yanked under an open sourcy badgeware license (OSI is debating internally regarding the validity of badgeware), they have also released some changes to VistA as GPL. They have also released public statements that they will always keep 5% proprietary. As a result Medsphere is a hybrid company, both open source and proprietary. I would suggest that they should be listed on the OSCHA website, but along side IBM which also releases both FOSS and proprietary medical software. There is a difference between companies that commit to releasing everything under a FSF and OSI approved licenses, like mine, and those that do not. I would hope that OSCHA would make the distinction. -FT On 3/5/07, Gregory Woodhouse [EMAIL PROTECTED] wrote: On Mar 5, 2007, at 9:17 PM, Fred Trotter wrote: Tim, I suggest you wade through the mess under the blog post entitled Medsphere betrays community on GPLmedicine.org. This is a very complicated situation and there is little short of understanding everything that will give clarity. I don't see how it clarifies your reference to the original license. VistA is in the public domain in the sense that it may be obtained though FOIA. That's not the same as being licensed under an open source license. Indeed, speaking as a non-lawyer, I don't see how anyone can release VistA itself under GPL or any other license. At best, I'd think modifications to VistA could be released under an open source license. Medsphere's client is, of course, unrelated to VistA (unlike OpenVista, which I understand to be a modified form of VistA). Gregory Woodhouse [EMAIL PROTECTED] Life can only be understood going backwards, but it must be lived going forwards. --Søren Kierkegaard [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]
Re: [openhealth] Medsphere really is an open source company after all?
They have taken a step in the right direction, but they are not done. OK, thanks, that makes it much clearer. But is it fair to say that Medsphere has now satisfactorily answered the previous fairly vehement criticisms on this list that it was not really an open source company? Tim C -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Medsphere really is an open source company after all?
Tim, I suggest you wade through the mess under the blog post entitled Medsphere betrays community on GPLmedicine.org. This is a very complicated situation and there is little short of understanding everything that will give clarity. On 3/5/07, Tim Churches [EMAIL PROTECTED] wrote: Fred Trotter wrote: In short they need to 1. Release everything that the originally released under the original licenses What do you mean by original licenses? I thought that the VistA code on which Medsphere's OpenVista products are based was in the public domain, and thus not under any license. Is that not correct? This refers to the release for which the Shreeves were sued, which was the GPL. But they do seem to have released code for a complete working system, including new code for a GUI front end. That is a lot better than 99% of health software vendors, who release no code under open source licenses at all. The current client license is badgeware, and not technically open source. But yes it is better than nothing. 2. Stop suing the Shreeves. I am not defending such litigiousness, but that seems orthogonal to whether or not Medsphere can be considered a provider of open source health software. Being a health software vendor of any kind depends on trust. Medsphere has violated that trust. Tim C On 3/5/07, Tim Churches [EMAIL PROTECTED] wrote: Fred Trotter wrote: They have taken a step in the right direction, but they are not done. Fred, What else do they need to do, in your opinion? Tim C OK, thanks, that makes it much clearer. But is it fair to say that Medsphere has now satisfactorily answered the previous fairly vehement criticisms on this list that it was not really an open source company? Tim C Yahoo! Groups Links Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Suppressing Sensitive Info From Free Text
Will, I am confused too. Wouldnt such a technology have to be turning test capable? Are you looking for something that can search Free Text make a determination if it is related to HIV, and then catagorize the whole text as related to HIV? Or are you looking for something that is capable of allowing the rest of the note to pass through, and only eliminate the portions relating to HIV. (which seems much harder). Could you give an example of how your application might work? -FT On 3/2/07, Will Ross [EMAIL PROTECTED] wrote: I'm looking for a tool to suppress sensitive information (e.g., HIV status, etc.) from free text clinical notes prior to allowing the notes to be published from a protected, physician-only area into general circulation patient records for the clinic. What existing FOSS solutions are available? With best regards, [wr] - - - - - - - - will ross chief information officer mendocino health records exchange 216 west perkins street, suite 206 ukiah, california 95482 usa 707.462.6369 [office] 707.462.5015 [fax] www.mendocinohre.org - - - - - - - - Getting people to adopt common standards is impeded by patents. Sir Tim Berners-Lee, BCS, 2006 - - - - - - - - Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
[openhealth] HIMSS FOSS ad hoc meeting
There are several of us going to HIMSS that are planning on meeting for informal handshake and hangout. We are planning to meet at. This may change if we cannot get to the booth at that hour! Tuesday 9:00 p.m. Redhat Booth -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: list of diagnoses and procedures
A derivative work includes some portion of the original verbatim and that should be avoided. In order to work for billing the codes themselves would have to be carried over from the CPT system. Thus making any attempt to re-describe CPT codes a derivative work and largely useless. -FT -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: list of diagnoses and procedures
I dont think so. From what I understood the codes themselves are copyright. Further, thier use is mandated by the government for use in medical billing. This issue has already been the subject of litigation. http://www.usdoj.gov/atr/cases/f2000/2076.htm -FT On 12/11/06, mspohr [EMAIL PROTECTED] wrote: The codes would be the same as those that they currently accept (i.e. the AMA CPT codes) so there is no issue with the codes. The problem with the AMA is that they copyright the descriptions and prevent distribution of their copyrighted descriptions. The project would be to create new descriptions that were functionally the same and could be freely distributed under an open license such as the Creative Commons license (http://creativecommons.org/). /Mark --- In openhealth@yahoogroups.com, David Forslund [EMAIL PROTECTED] wrote: This effort would require commitment from the payor that they would accept those codes for reimbursement. Otherwise this effort will be relatively useless. Dave mspohr wrote: The goal of the CPT code project would be to create a version of procedure codes for use in billing in the US that could be freely distributed. While it would be nice to fit this into an overarching ontology, this would introduce overhead which is not warranted. The CPT codes themselves are a dead end (except for billing in the US) from both intellectual property and information design standpoints and the task of an ontology of procedures is better left to something more suitable such as Snomed or ICD or even the HCPCS. I think KISS applies here. /Mark --- In openhealth@yahoogroups.com mailto:openhealth%40yahoogroups.com, Adrian Midgley amidgley2@ wrote: Rod Roark wrote: Perhaps I don't understand what you mean, but CPT codes are just for procedures. The project I was suggesting was limited to restating the descriptions for them, with about the same standards for preciseness currently found in CPT. A broader scope would be very daunting. But if we are going to do (an) ontology, let us not handicap ourselves by building it for just one lot of data. It could be written one chapter at a time, certainly. Yahoo! Groups Links -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: Open Source?
For what it is worth, I would rather always give the source code away as part of any deal, and we will certainly work toward that goal. But a higher priority is to make sure the company survives obviously. So...watch this space. - thomas Thomas, Thank you this is exactly what I was looking for! I am sorry that I must be so difficult about this. But the VistA community has been recently burned by Medsphere regarding this kind of thing. I respect your right to take your time to sort this out. Please hurry since there are many of us might be hesitant to invest in OpenEHR until this is settled. Once we know whats in the open source pile and whats out of it, we can more comfortably move forward. As I have made clear before I would hope that you would end up making all of the medical software that you have available under the GPL and I applaud your releases thus far. You may feel that you are taking too much heat over this and you are absolutley right, but with the Medsphere drama we need to be more and more careful about what commitments are made to the community from corporations. I am very enthusiastic about both OpenEHR and Ocean Informatics. Regards, -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: Open Source?
I have been staying on the sidelines for this one but I think this is an important point that does need clarifiication. You can answer hybrid. You can say that your product is both an open source and a proprieatary product. What is important it that your company be very clear about what it is commiting to and what it is not. This has been the problem with Medsphere, they want to take advantage of the open source buzz but they have not been willing to make a commitment. Everyone has seen me tear into them publically, well the only response to my criticisms from Medsphere is this press release. http://www.medsphere.com/press/20061121 This essentially says We are a proprietary/FOSS hybrid company the problem is that this a slight of hand. When the Shreeves released the code to sourceforge, Medsphere had made no public statements regarding what exactly it was commiting to the community. Now they want to pretend that this hybrid strategy is what the Shreeves SHOULD have respected. Medsphere is changing its position and hoping the community will not notice! What we, as the community need from Ocean Informatics is a very clear commitment about - What you are releasing open source - When you will be releasing it - What license it will be under - Where it can be downloaded - What you are not releasing open source - What your reasoning is for releasing some things as FOSS and some things not - We need a public commitment. We need this to be on a page on your website written in very clear terms so that when your company is sold, the new owners cannot pursue a new strategy for your company without breaking clearly articulated promises to the community. In short answering questions on this thread is not enough. Now, granted, you may already have a public statement like this that is web accessible. If so, great! then all you need to do to repy to Mark is to post a link. Regards, Fred Trotter If yes, then there should be a place where we can download the source with a GPL type license. If no, then this is a proprietary system and you shouldn't make statements that it is open source. No arguments. We just want to know. Is this open source or not? /Mark -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: [openhealth] Re: Datamodels was Open Source?
Tim, Thanks for the clarification. This is obviously a complex issue, and my comments may not completely apply given the disctinction between a standard and software. Still what I would really like out of this discussion is for the relationship between the community and the openEHR project/ocean informatics company to be clearly documented and published somewhere for everyone to read. I realized that I needed to do this too, so here is the result of that effort. http://www.synseer.com/index.php?module=htmlpagesfunc=displaypid=6 This is a commitment from SynSeer to release all of the code that we have the right to under the GPL. We do not always allow costless downloads of our GPL software. Often we do not own the copyright to software that we write and cannot release it at all. Still other times prior licensing means that we must release under a different license (i.e. Mozilla) but when we own the code and we have the choice we use the GPL. I am sure the OpenEHR policy is substancially more complex. What I want is that this thread be the end of the issue. Whatever the case is... publish it. Make it public. I do not begrudge Ocean Informatics the ability to make money. I just want what they do to be very very clear. So far I have had two bad experiences (Medsphere being one) with companies seeming to be open source. I want to be able to read exactly what you just described on some official webpage. Is that possible? -FT On 11/30/06, Tim Cook [EMAIL PROTECTED] wrote: Hi Fred (and all), While I do not in any way officially speak for openEHR.org, Ocean Informatics, or other openEHR developers; I must say that I think there is some confusion over the differences between the specification and the software and maybe even what openEHR is and is not. openEHR is a completely open specification and data model for health care information. We ask for public participation via the various mailing lists and websites. Decisions are made by a core group based on public input and resulting through discussions within that group. Though I am not the 'deciding person' if you would like to commit to a long-term commitment to the project and you have ability/knowledge in the domain then please volunteer. From a software standpoint I think there is some confusion as well. REMEMBER! that the specification and the software are very different. Maybe; somewhat like the W3C specs and all the Internet software available (InternetExplorer or Firefox, etc.) An openEHR repository is much like a database engine. It has certain specifications and behaviors that are guaranteed to act and react in a specified way. Much like when you develop an application that talks to MySQL or Postgres. So what is being offered (by Thomas) is an opportunity to develop applications (templates and archetypes) that interact via web services with/and can be tested against an actual openEHR compliant backend. Is there anywhere you can build an application that can be tested against an Eclipsys or an IDX or an (name your vendor) backend? So if the vendors of an openEHR server decide to sell their back end for a price there still needs to be written the user interaction with that back end. That user interaction is dependent upon the implementation. This is whether it is an ER or a GP or a specialists system. I have no idea what their business model is going to be but I can say that this makes PERFECT sense to me. *** IMHO *** If I may back up a bit. There is a VAST confusion in the field as to what is a 'data model' and an 'implementation' in the database IT world. This has been promulgated via academic courses being influenced by commercial database companies over the past two - three decades. Please see websites like www.dbdebunk.com and books like Databases, Types and the Relational Model (search Amazon) in order to separate the issues. So, whether the software offered by Ocean Informatics is open or not is irrelevant. What they are offering is a backend that YOU can test YOUR open source software against. Of course if I am wrong here I am sure thaTHamos will correct me. ;-) Cheers, Tim Fred Trotter wrote: I have been staying on the sidelines for this one but I think this is an important point that does need clarifiication. You can answer hybrid. You can say that your product is both an open source and a proprieatary product. What is important it that your company be very clear about what it is commiting to and what it is not. This has been the problem with Medsphere, they want to take advantage of the open source buzz but they have not been willing to make a commitment. Everyone has seen me tear into them publically, well the only response to my criticisms from Medsphere is this press release. http://www.medsphere.com/press/20061121 http://www.medsphere.com/press/20061121 This essentially says We are a proprietary/FOSS hybrid
[openhealth] SCALE call for papers.
Hopefully everyone here saw the SCALE announcement on LMN... http://www.linuxmednews.com/1163665301/index_html We (the healthcare day coordinators) are trying to get some good talks from the FOSS healthcare community. If you missed LinuxWorld, this is your chance! You can read about what kind of papers we are looking for, but generally, we are looking for the type of papers that you would assume that we would be! You can read more and find out how to submit here... http://www.socallinuxexpo.com/healthcare07/oss-healthcare2007-cfp.pdf -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed]
Re: Re: [openhealth] PeaceHealth open source web-based personal health-record system
Aquiring software like this is dangerous without having a lawyer take a look at the license. Without the code under a common FOSS license, the implications for your own work could be hugley impacted. So downloading this is definately a bad idea for anyone who is a serious FOSS developer. Much better would be for someone to contact them to see if they will use a better license... which I will be working. -FT Indeed. This illustrates teh dangers of drawing up one's own open source license, or even hiring lawyers who are inexpert in software licensing to draw one up for you - much better to use one of the existing licenses or if you must, make only very minor chnages to an existing, well-regarded license. However, it is clear that the intent, and probably the effect of the license is one of open sourcing. Perhaps someone with time and a particular interest in shared EHRs could obtain a copy and tell us about it, or even share it with us? Tim C -- Fred Trotter http://www.fredtrotter.com [Non-text portions of this message have been removed] Yahoo! Groups Links * To visit your group on the web, go to: http://groups.yahoo.com/group/openhealth/ * Your email settings: Individual Email | Traditional * To change settings online go to: http://groups.yahoo.com/group/openhealth/join (Yahoo! ID required) * To change settings via email: mailto:[EMAIL PROTECTED] mailto:[EMAIL PROTECTED] * 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] Re: request for advice re electronic medical record
If you feel like performing a careful review, feel free to add it to ehr.gplmedicine.org. OSCAR was exculded from my review only in the interests of time. -FT On 5/11/06, James Busser [EMAIL PROTECTED] wrote: On May 9, 2006, at 3:24 PM, sickleofzeus wrote: It is difficult for the average open source user to set up working systems especially with the more difficult configurations like OSCAR. Would any of the developers from MirrorMed, GnuMed, TORCH, and OSCAR be willing to set up demo programs of their software on www.openmedsoftware.org ? Or, if not an installation of the program, then a link to an available, running demo (with instructions available at one end if not both ends of the link). Yahoo! Groups Links -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] SPONSORED LINKS Software distribution Salon software Medical software Software association Software jewelry Software deployment YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] request for advice re electronic medical record
I take it as tenant of faith that proprietary systems had their shot at the throne and have missed it so badly that the throne will be held someday by a FOSS system... making my comment about OSCAR more reasonable... -FT On 5/7/06, Will Ross [EMAIL PROTECTED] wrote: Fred, First of all, a question (showing my ignorance) -- OSCAR is written in Java? Second, FWIW I think it is important to keep in mind that the title the throne of US EHR systems is a rather sweeping statement. I hope the competition for this throne is open to any system, whether open source or not. I expect the the marketplace will confer its own rewards on title contenders, regardless of any testbench ranking system. With best regards, [wr] - - - - - - - - On May -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] request for advice re electronic medical record
Yep... either someone needs to hire me (always a good idea! go to SynSeer.com)... or someone with motivation and skill needs to start hacking on it, getting questions answered by visiting my FreeB support forum (subsection of the MirrorMed.org forums). -FT On 5/8/06, Jel Coward [EMAIL PROTECTED] wrote: Andrew Schamess wrote: Thank you! It sounds like a very good EMR, though the fact that it's configured for a Canadian billing system may rule it out for me... In any case the info is very helpful. Thanks again. Fred, any more thoughts on FreeB integration with OSCAR? -- Jel Yahoo! Groups Links -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] SPONSORED LINKS Software distribution Salon software Medical software Software association Software jewelry Software deployment YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] request for advice re electronic medical record
I think we agree that really is all about helping patients.. still no matter
what your goals are... its good to be the king.
Thanks for the development update. I am to disconnected from the OSCAR
market.
-FT
On 5/8/06, David Chan [EMAIL PROTECTED] wrote:
P.S. OSCAR's main aim is NOT to sit on any throne but
to help patients. Our programmers are reminded
regularly to that very fine point;-)
David
--- Will Ross [EMAIL PROTECTED] wrote:
Fred,
First of all, a question (showing my ignorance) --
OSCAR is written
in Java?
Second, FWIW I think it is important to keep in mind
that the title
the throne of US EHR systems is a rather sweeping
statement. I
hope the competition for this throne is open to any
system, whether
open source or not. I expect the the marketplace
will confer its
own rewards on title contenders, regardless of any
testbench ranking
system.
With best regards,
[wr]
- - - - - - - -
On May 6, 2006, at 11:50 AM, Fred Trotter wrote:
This is a good time to point out that the only
thing that keeps
OSCAR from
being a major player in the US, is its billing
engine. We have
tossed around
an effort to intergrate FreeB with OSCAR for some
time. If that
happened
FreeB would provide the US billing that OSCAR
lacks, and we would
have a
solid Java-based contender for the throne of US
EHR systems.
-FT
Great scheduler - but billing is Canadian (Ontario
and BC modules)
--
Fred Trotter
SynSeer, Consultant
http://www.fredtrotter.com
http://www.synseer.com
[Non-text portions of this message have been
removed]
Yahoo! Groups Sponsor
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[wr]
- - - - - - - -
will ross
project manager
mendocino informatics
216 west perkins street, suite 206
ukiah, california 95482 usa
707.462.6369 [office]
707.462.5015 [fax]
www.minformatics.com
- - - - - - - -
Getting people to adopt common standards is impeded
by patents.
Sir Tim Berners-Lee, BCS, 2006
- - - - - - - -
David H Chan, MD, CCFP, MSc, FCFP
Associate Professor
Department of Family Medicine
McMaster University
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Fred Trotter
SynSeer, Consultant
http://www.fredtrotter.com
http://www.synseer.com
[Non-text portions of this message have been removed]
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Re: [openhealth] request for advice re electronic medical record
This is a good time to point out that the only thing that keeps OSCAR from being a major player in the US, is its billing engine. We have tossed around an effort to intergrate FreeB with OSCAR for some time. If that happened FreeB would provide the US billing that OSCAR lacks, and we would have a solid Java-based contender for the throne of US EHR systems. -FT Great scheduler - but billing is Canadian (Ontario and BC modules) -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] SPONSORED LINKS Software distribution Salon software Medical software Software association Software jewelry Software deployment YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] Re: oshca inaugural meeting - constitution
OSCHA committee, It is a little troublesome that Will's membership is being discarded along with his comments. Essentially the arguments of the committee is lets get it working and then worry about getting it right. This is fine but I, at least, will have to wait to see it working right before I can toss my hat in the ring. This is not so much a criticism, perhaps the committee has the right idea! But until there is an entity that merits trust (which means having a forum for dissenting supporters) then I will have to stay on the sidelines with (apparently) Will. -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] Re: oshca inaugural meeting - constitution
I think it will take along time before the value of OSCHA approaches the value of the openhealth list. As long as the lurkers are the right people, they can be very valuable. OpenHealth has been key to the formation of relationships that are actually producing code. My relationship with Will Ross is a good example of this. Will has already done more for FOSS medicine, than just about anyone I know (Of course he competes with other members of the list in that regard). He manages several successful projects in real world environs. Will is a doer, and like many other doers on the list, only rarely enters debates. In any case, be sure NOT to simply discount what he says as irrelevant interferance. As a doer Will is an example of exactly the sort of people who can make your organization valuable. If you feel that it would be wiser to move fast than to further debate, fine, do so. But I would take care to make certain that Ross was included as a dissenting founding member. (If he still wants that) I for one, simply cannot afford to invest much in an organization that is not tangibly moving FOSS forward. Its not that I do not believe in the OSCHA vision, rather that I just spend a little too much time on the bleeding edge as it is. Once you have a meeting that I can attend, with people who are worth meeting attending.. I will be there!!! -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] OSHCA inaugural meeting - important announcement
On the OSCHA website issue. I am sure there are about 10 people that would be willing to host the website. For those of us with server resources the cost approaches zero. It is so easy to transfer a website that the host need not be a permenant. It would be worthwhile to have a temporary website for even three months. I have a web server that lives at 64.39.27.128 If someone will point the domain at that server, then I will setup a simple blog to track the progress of the formation, as well as a simple file repository, which I will give Molly ftp upload access to. I will also post several initial blog posts which link to these openhealth discussions, so that someone new to the organization can quickly catchup on all of the important discussions we have had so far. At the bottom of the page I will add a link that says OSCHA.org is currently sponsored by the MirrorMed project At the option of Molly and the newly forming board I will contriute the resourses needed for permenant hosting. (i.e. forums, wiki, or other standard communit enablers). But please if you do not get hosting help from me get help somewhere. -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] YAHOO! GROUPS LINKS Visit your group "openhealth" on the web. To unsubscribe from this group, send an email to:[EMAIL PROTECTED] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
Re: [openhealth] EHR Review makes progress, needs help!
Generally just add what project you think are missing with full descriptions about what they are. Also feel free to change the names of things to be trademark accurate/neutral. -FT On 4/6/06, Joseph Dal Molin [EMAIL PROTECTED] wrote: Nandalal Gunaratne wrote: It seems to me that Fred is going to review just these, and others are supposed to chiop in with some reviews or part of reviews of any other EMRs worth talking about. Open VistA remains to be reviewed and OSCAR. May I suggest that we use the label VistA as the name OpenVistA has been trade marked by one of the companies involved with VistA and does not represent the open source version which WorldVistA is making available to the global community. Zope based SPIRIT? SPIRIT isn't an EHR its a repository of open source projects in the health sector. Yahoo! Groups Links -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] 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] EHR Review makes progress, needs help!
I hope that everyone has seen the new announcement of the latest work on the EHR review on LinuxMedNews. I hope that by using stats drawn directly from the projects version control systems, I can make the reviews more objective. Here is the link to the LMN announcement. http://www.linuxmednews.com/1144128464/index_html At this point, I have finished about 80% of the reviews. Now is the time for your input on the portions that are finished! I would like to have discussion on the appropriateness of my methods, adjustments to my prose, even substantial modifications of my conclusions. The review needs editorial guidance from the other members of the OSWG and openhealth mailing lists! Please take a look at the new and improved reviews. If you have something to say about the review, please do not reply to this letter! Instead use the discussion feature of the wiki to enter your comments! If you have comments on the review as a whole then please enter them on the discussion for the main page. Remember that it is almost as easy to improve the review as criticize it. Do you think that your favorite EHR should have been reviewed? Dont just complain, put it on the list of un-reviewed EHRs with a comment as to why you like it. Regards, -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] 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] sumultaneous registrations and registration form
I think what Will, Molly, Tim and others are suggesting is that we allow Molly to register the organization were it is most convient for her, (since she has been the one pushing for this) and then allowing the organization itself to consider registering or not registering OSHCA in other places on an as needed basis. I see no reason why OSHCA cannot change its registration or duplicate it registration much later in the process. Frankly as an organization OSCHA will have lots to do before duplicating the structure of the organization becomes important. Ultimatley it is important to support those people who are working to get OSCHA off the ground. Let them decide when and if to register in the US, France, Canada or anywhere else. If you want to have influense on that decision, then consider running for a position in OSCHA when the time comes for that. That is really the appropriate way to get what you want. In the mean time, the best way to hedge your bets for winning such an election is to be as helpful to the process as possible. Please note that one helpful thing to do in processes like this is simply to listen silently until they ask for specific help... -FT -- Fred Trotter SynSeer, Consultant http://www.fredtrotter.com http://www.synseer.com [Non-text portions of this message have been removed] 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/
