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  A Tale of Modern Electronic Medical Record Software
LinuxMedNews Posted by Ignacio H. Valdes, MD, MS on Monday August 06, 2007 @ 04:21 AM
from the Linux Medical News dept.
Once upon a time there was a prosperous and entrepreneurial port city named EMR. EMR had many ships and many ship owners who ferried lots of people to the healing spas that existed in nearby mountains. Unfortunately for the ships and passengers, the harbor was quite rocky and treacherous. Shipwrecks were common with large and grievous losses of life. Many of the entrepreneurs in the city thought that EMR could benefit from a modern marvel called a lighthouse.

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Many of them set about building lighthouses. Soon, dozens of lighthouses sprang up on a rocky outcropping and all of the lighthouse companies sought contracts with the ship owners to provide a 'custom' lighthouse for 'their needs'. Each lighthouse had its own type of light that could only be seen through special glasses that the company supplied. Ship owners acknowledged the need for a lighthouse but were confused by the myriad of choices of lighthouses on the rocky shore.

"With my lighthouse contract a custom fog horn sound that only you can access will be configured." intoned a salesman wearing a bow tie. "Mine is certified by the Center for Certification of Lighthouse Technology (CCLT)" said another.

All of the passengers and ships owners agreed that the lighthouse idea was a good one that saved lives. Some owners bought contracts, others did not out of confusion over which to get. The ones that did paid a high price and weren't sure if what they were getting was worth it.

Some of the lighthouse companies made money; others did not and closed down leaving the ship owners stranded and scrambling for another, expensive contract. Sometimes ships with lighthouse contracts collided with ships without lighthouse contracts. No one was really happy.

One day a Mr. FOSS came to town. Mr. FOSS said: "Why don't we have all these companies use the same lighthouse design? Why don't we have all the ship owners and the community own the design instead of all these companies re-inventing the same thing over and over?" So Mr. FOSS went to the town council and to all the ship owners and to consortia of passengers and showed them how to draw up a special license which later came to be called a FOSS license. This license said to only use the design for the lighthouse that was owned by everybody and not the lighthouse companies. The owners began to only choose lighthouse companies that would use lighthouses that were of that kind. If one lighthouse went out, anyone could use the others without changing their glasses because they worked the same.

The lighthouse companies at first were very cross with Mr. FOSS. "Why that's un-EMRican!" they said. Mr. FOSS replied "For lighthouses it is as EMRican as apple pie!" Then the lighthouse companies realized that they did not have to engineer custom lights anymore. Then they had many more customers because nearly every ship owner, the city government and some passenger groups gladly paid for service contracts because everyone was using the same lighthouse and knew how it worked. What's more, the price dropped while the light improved dramatically from lots of lighthouses shining together using the same design. Now everyone could see the light.

The shipwrecks ended and everyone was happy.

The End.

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  • The Fine Print: The following comments are owned by whoever posted them.
    ( Reply )

    Re: A Tale of Modern Electronic Medical Record Sof
    by bats on Monday August 06, 2007 @ 06:21 AM
    Nice analogy, I applaud the sentiment but worry about how the reality of hardware fits into the picture. The biggest EMR company has standardised the glass and the fog horns and forced them to fit one design (tm) which no-one else can afford to build, so the rest of the world just supplies those parts while one or two small lighthouse companies try to build alternatives.

    Mr FOSS is ignored by captains because they are in a rut (or too scared, or too over extended) and cannot get away from the MurkyInsightClandestineRockyOutcropSeashoreOutlineFlameTemples company.

    But perhaps things work differently in EMRville.
    [ Reply to this ]
    • Re: A Tale of Modern Electronic Medical Record Sof
      by Ignacio H. Valdes, MD, MS on Monday August 06, 2007 @ 01:15 PM
      Mr. FOSS and his followers begin to be on EMR's lighthouse 'task forces' and 'committees' where they influenced the decision process through 'advocacy'. Communities sprang up such as WorldVistA that have the lighthouse already built and multiple vendors to service the lighthouse. It was a bit stormy at first but then everyone realized how much better it was. The scar of previous poor acquisitions no longer give him pain. All was well.

      -- IV

      [ Reply to this ]
      • Re: A Tale of Modern Electronic Medical Record Sof
        by John Norris on Monday August 06, 2007 @ 03:10 PM
        Other communities tried to build their own lighthouses, and as Mr FOSS instructed, they allowed others to help them out. These villages did not have the resources that the pre-built light house communities had. These villages had their own particular needs for their light houses and simply couldn't share too much with their neighbors. Their's was a slow way to build light houses.
        [ Reply to this ]
        • Re: A Tale of Modern Electronic Medical Record Sof
          by Cecil E Collins Jr D.C. on Friday August 10, 2007 @ 02:01 PM
          Great analogy, I can only give my personal thoughts as a response. A great corporation was created giving the backbone for a lighthous scheme but to use this you had buy their scheme first.Then buy the lighthouse($1,000-$10,000) and pay monthly support fees. Amazingly another entity (LINUX)was born that also gave backbone to the lighthouse scheme and it was completely free.A lighthouse could be created from it for free also but the installation instructions were very hard to find and often difficult to configure properly.So a few companies created a lighthouse and although technically free most could not get it to work.But the companies had a solution, just pay us to set your lighthouse up ($thousands$) and pay us a support fee to keep it working. Free, well maybe so, but not like Linux was intended. My analogy follows: Free Mercedes available brand new beautifull automobile with all options, amazing deal!! To drive, operate, or use in any way you must pay a one time setup fee of $10,000 and purchase the support package for $2,000 per month forever.
          [ Reply to this ]
          • Re: A Tale of Modern Electronic Medical Record Sof
            by Ignacio H. Valdes, MD, MS on Friday August 10, 2007 @ 02:17 PM
            Then Dell decided to install it at the factory and all was once again well! Until the proprietary lighthouse companies in an under the table deal used their collective muscle to quash the deal. -- IV
            [ Reply to this ]
    Re: A Tale of Modern Electronic Medical Record Sof
    by Ignacio H. Valdes, MD, MS on Tuesday August 07, 2007 @ 09:08 PM
    FYI, click on the links in the story for more entertainment. -- IV
    [ Reply to this ]
    The Fine Print: The following comments are owned by whoever posted them.
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