Re: Massively Expensive IT Failures in the 90's

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Re: Massively Expensive IT Failures in the 90's
by Hemant Shah on Monday August 21, @03:03PM

That the closed-source medical software does not work is no secret. Indeed, that is stating the obvious and no dispute about that. However, the surmise that it does not work because it is closed source is at best tenuous. The fallacy in the argument, which open-source zealots make, is due to the fact that only software that did exist till now was closed source. The open source medical software is just a speck on the horizon now and as yet untested. To my mind, the key reasons for failure of medical software are: · Trying to naively apply the principles of other domains in medicine – when medicine is radically different from all others · Not adequate effort in identifying what constitutes the clinical requirements and clinical information – which is central to healthcare · Research organizations’ obsessive focus on esoteric areas rather than the needs at the point of care · Lack of approaches where the healthcare professionals become participants in the information modeling and management · Too many disparate tools or technologies – no significant effort in creating an integrating framework to accommodate these or encourage development of compatible tools Amongst other things, these have led to alienation of the physician from the entire effort. The physician has become, for no fault of hers, the weak link in the chain of information. The problems stem from flaws at analysis and design level not at the developmental level. Much of the value of open source is from what it brings to the coding. Whereas the problems of healthcare software are due to lack of understanding (as even the referenced article mentions repeatedly). Much of this “understanding” is open source, anyway. So, I am not sure we will make any significant progress, even if the code is open. It’s back to the drawing board situation, really. I do believe that open source movement in medicine has a promise, but if we attribute everything that was wrong to source being closed, we will be repeating the same mistakes – may be at far greater costs. Regards, Hemant Hemant Shah MD, M. Surg. Research Fellow, Medical Informatics National Library of Medicine 38A/Floor 10 8600 Rockville Pike Bethesda MD 20894 Ph (301) 435 3262 h.shah@computer.org shahh@nlm.nih.gov

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