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-----Original Message-----
From: fred trotter <fred.trot...@gmail.com>

Date: Thu, 4 Jun 2009 15:45:18 
To: <open-ehealth-collaborat...@googlegroups.com>
Cc: <openhealth@yahoogroups.com>; Hardhats<hardh...@googlegroups.com>
Subject: [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
>
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>
>
>
> 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 it is just several lists of directions that
> we want to take as well as open questions about a slew of issues. Feel free
> to email me privately or call me to discuss anything that you would prefer
> to remain outside the public forum. I am and will remain baised towards
> those who have contributed towards our community, I will listen to everyone,
> but I will act based on the opinions of those who have sacrificed for our
> movement.
>
> OPEN QUESTION?
> How do we choose a BOD?
>
> OPEN QUESTION?
> We want a mix of FOSS corporate and FOSS community interests. Sometimes
> what our successful FOSS companies do is in the interests of the FOSS
> developer and user interests and sometimes it is not? Our community has
> several non-vendor roles: deployers, which include IT specialist who deploy
> FOSS, clinical users, developers and finally the consumers who have their
> health data stored in FOSS systems. How do we balance community and vendor
> interests?
>
> OPEN QUESTION?
> We want to include and embrace hybrid FOSS/proprietary companies like
> Mysis, ECW and DSS but still acknowledge that at least part of their
> interests are to support proprietary software. How do we strike a balance of
> encouraging the risks that these hybrid companies are taking, but still
> remaining true to the FOSS values?
>
>
> Liberty HSF goal: Certification: Create a certification system compatible
> with FOSS
>                -> Current plan: work with CCHIT to become the scholarship
> organization for CCHIT certification, and to make CCHIT have a reasonable
> cert option for FOSS
>                -> Backup plan: become an FOSS oriented CCHIT alternative
>
> OPEN QUESTION?
> How do we deal with CCHIT as an organization AND as a community of
> independent thinkers?
>
> OPEN QUESTION?
> When do we decide that we need to 'fork' CCHIT and setup an alternative
> certification system?
>
>
> Liberty HSF goal: Vendor organization: be a FOSS EHRVA (this is what we are
> talking about here)
>                -> Represent FOSS Vendors the way that EHRVA claims to and
> HIMSS pretends it does not.
>                -> Lobby (in compliance with the rules for 501c3) for FOSS
> vendor interests
>                -> Create our own definition of 'meaningful use' to through
> into the mix
>
> OPEN QUESTION?
> We need to give a vehicle the FOSS vendors to express their views, as
> distinct from the community. Vendor profitability is critical to our
> community, we need FOSS vendors to form the backbone of our community. How
> do we carve out a space for vendors specifically, while ensuring that the
> overall purpose of Liberty HSF to represent every member of our community is
> not damaged?
>
>
>       -> Community Organization: be a FOSS HIMSS
>                -> Create and back FOSS conferences (like DOCHS and
> FOSSHEALTH)
>
>
> OPEN QUESTION?
> How do we run better conferences and meetings so that eventually we can
> compete with HIMSS?
>
>       -> Development organization: be a FOSS RWJ
>                -> Fund and/or internally develop FOSS solutions that are
> 'orphan', the kind of projects that are not clearly profitable, but are
> still useful.
>                            -> Like documentation?
>                            -> Like user 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
>
>
>
>
>
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-- 
Fred Trotter
http://www.fredtrotter.com


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