Drugref.org Launched

Medical software depends on reliable pharmaceutical reference information. Up to now, such information was either incomplete or restricted by non-free licenses. Non-free licenses are often too expensive for free software projects. This is about to change. Yesterday, the drugref.org new website was launched in order to develop a free, independent, and peer reviewed drug database designed for use in expert system engines.

A web interface to the database is partially functional already, information can be contributed now.

We invite all people related to free medical software projects to contribute their bit of information (“adopt a drug”) in order to make this happen as soon as possible for all of us.

Kaiser to Publish Treatment Guidelines

Kaiser Permanente will make available on its’ web site a set of highly regarded treatment guidelines. According to this New York Times article, the move was part of a setttlement of a lawsuit by consumer organizations. It is viewed as empowering for patients as well as setting a high quality standard for comparing doctor performance. Could this be a trend towards open source treatment guidelines? Excerpt: ‘…doctors will still be free to deviate from them without penalty. But Kaiser patients � and the public � will now have access to information they can use to assess the treatment they receive and discuss it with their doctors. Patients will have to look up the information themselves on Kaiser’s Web site. Consumer advocates said the moves by Kaiser would push other managed care companies and medical groups to make similar disclosures regarding both treatments and doctors’ compensation…’ Thanks to Gary Kantor for this link and his thoughts.

LATimes: Cedar-Sinai Suspends CPOE

The Los Angeles Times (free registration required) is reporting that: ‘Cedars-Sinai Medical Center, the largest private hospital in the West, is suspending use of a multimillion-dollar computerized system for doctors’ orders after hundreds of physicians complained that it was endangering patient safety and required too much work…’ According to this they were using Patient Care Expert (PCX) which was likely built by Perot Data Systems using their Digital Health System. Hmm, guess they didn’t read this research article. Thanks to David Derauf, Tim Cook, Molly Cheah and Wayne Wilson and the Openhealth list for the above info and links.

BolinOS – open source medical information / web operating system

BolinOS http://med-ia.ch/med-ia/bolinos/ is also a health-oriented medical information system. The BolinOS project dates of 1995. The final goal is to offer a multimedia web-operating system for health professionals. Open-source has been chosen as a philosophy as it seems to be one of the most pragmatic and efficient peer-reviewing systems for software development (no proof, just good vibes).

In order to reach it, a few strategic steps have been chosen by us, health professionals: development of a clear and solid data-architecture, creation of a generalist online multimedia authoring environment and web operating system, creation of health-related applications working on the system and consolidation of the tool under professional conditions

Health-professionals are not supposed to be computer professionals , but human-information professionals that may need computer tools to help them, not burden them. We believe that our energy should not be put into the development of obscure computer works that dictate us how we shall heal, but that we shall unite and help each other build a computer-based aid that can readily be used and understood and that will adapt to our know-how, not the opposite.

Let’s face it, BolinOS is not a top-down approach on computer integration in complex information environments, it is more the result of random thinking on the work of health-professionals and there translation to online computer systems. Have fun, the list expands day after day (check and yours on the BolinOS website, under the “health-oriented” section):
Computer shall help us heal better (this seems logical). The computer shall not force us to adapt our know-how, it must help us refine it (we are not computer scientists, we are health-professionals!!!).
Computers shall help us enhance our work quality since we are happier when we heal (the sky is not so blue for most of us, I should have done insurer or rockstar).
The cost of computers shall not overwhelm other needs (is the new pet-scan or cafeteria more important than this fantastic-looking ultra-mega-maxi-terahertz computer server?).
One hour healing is better than one our knowing how to click on weird buttons that triggers random cryptic alerts (remember that “error x1222a-cff23.344 type c please contact the system administrator, the one that’s on vacation, sorry your holidays have been cancelled until restoration of system hard-disk reboot backup thank you”).
Computers must not be black boxes (I shall be able, as a health-professional, to easily share my knowledge on the network).
Health-related computer work shall be complementary to personal use (I know how to get my personal email, I don’t need to do it differently for my professional one).
The information must follow the health-professional not the opposite (wow, I need to go to building C because this is how things have been decided, why?).
I can’t do this because my computer specialist says I can’t (but why can I do it at home then?).
I want to express myself!! (nobody never listens to me)
My patients are enthusiastic when it comes to pay the price of this fantastic web-managment system (or are they really?).
Developping countries must be able to share our Internet based medical tools and participate with us to develop them further (why should our economical power make us better professionals?).

Today the platform is only used by a few groups. They are developing and refining what has been done in order to have an even more stable and efficient open-source platform. We shall be happy if you too, health professional or not, take part in this adventure. 🙂

Here are a few historical milestones until this first installer version of BolinOS 3:
creation of a solid and open data-architecture (1995 – Sqeleton 1.0 – http://wild.ch)
design of group-oriented tools based on the architecture (1999 – Sqeleton 2.0 – http://poinch.ch)
design of a complete platform for multimedia authoring and web-operation software (january 2000 – BolinOS 1.0)
stabilisation and fine-tuning of the system on open-source standards Apache/PHP/mySQL (april march 2000 – BolinOS 1.5)
complete rewriting of the source code (january 2001 – BolinOS 2.0)
completion of basic set of administration and user-tools and complete code rewriting (september 2002 – BolinOS 3.0)
completion of a simple installer to facilitate open distribution (january 2003 – BolinOS 3.0), yahooooooo!!!!! 😉

We are having lots of fun developing and using the BolinOS, hope you will too!


Reader Question: Missing Medication Documentation?

From: “Deb”
To: “Ignacio Valdes”
Subject: Re: cyberren software
Date: Thursday, January 16, 2003 3:37 AM

Dear IV,

First of all I’m a nurse, and pretty much computer illiterate. What I’m trying to do is find some answers to why some of my documentation is missing especially medications. We have a real problem at work with sharing passwords, screens left open etc… I am also wondering if some of my documentation might have been deleted intentionally, or unintentionally. Tell me a little bit about why close source, vendor lock in, non-standard interface, and Windows 95 is bad. Cybernius said that they could find no record on the Cyberren program of the specific deletions, however I didn’t expect them to come right out and tell me any problems they have had with their software. Another concern I have is potential loss of information, this program crashes weekly, and becomes very slow to respond freezing screens for 10-20 mins a time


Conference: Open Source in Healthcare and Public Health

‘…As part of the upcoming conference on “Open Source for National and Local eGovernment Programs in the U.S. and EU” organized by The Cyber Security Policy and Research Institute (CSPRI) of The George Washington University, The Center for Open Source in Healthcare and Public Health Preparedness is proud to present a one-day session dedicated to exploring and discussing the role of Open Source in Healthcare and Public Health Informatics and Emergency Preparedness. We are pleased to invite you to submit speaking and demonstration proposals for this conference…’ Full text of the announcement and contact information is within.

Open Source in Healthcare and Public Health

Call for Speakers and Participation

(please forward to other interested parties)

Conference: Open Source for National and Local eGovernment Programs in the U.S. and EU.

Date: March 17-19, 2003 (Full day Healthcare track scheduled for March 18)

Venue: The Marvin Center Grand Ballroom
The George Washington University
800 21st Street, NW
Washington, DC 20052

Organizers: The Cyber Security Policy and Research Institute (CSPRI) of The George Washington University, United Nations Development Program, World Bank InfoDev, GSA, DISA, NAVY Office of the CIO, NIST, The Danish National IT and Telecom Agency

Website: http://www.eGovOS.org


As part of the upcoming conference on “Open Source for National and Local eGovernment Programs in the U.S. and EU” organized by The Cyber Security Policy and Research Institute (CSPRI) of The George Washington University, The Center for Open Source in Healthcare and Public Health Preparedness is proud to present a one-day session dedicated to exploring and discussing the role of Open Source in Healthcare and Public Health Informatics and Emergency Preparedness.

We are pleased to invite you to submit speaking and demonstration proposals for this conference.

These sessions are designed to discuss best practices, raise awareness and share experiences among policy makers, government officials, users/consumers, universities, and industry specialists in Open Source and Healthcare, Public Health and Emergency Preparedness. The conference will draw participants from local, national and international organizations from the public, private and academic sectors.

Submission of Proposals

Please submit your proposal no later than January 10, 2003.

To submit a proposal go to:


Please check Health Care and any other relevant fields in the submission form.

Submission and editorial questions should be directed to Dr. Nick Guzman (mailto:guzmann@gwu.edu).

Suggested Topics
Suggested topics include, but are not limited to, the following:

* Policy and Regulatory Issues
* Open Source, the FDA and Software Validation Requirements of 21CFR11
* Electronic (Computerized) Health/Medical Records
* Open Source and HIPAA Compliance
* Open Source and Open Standards
* Open Source and the National Health Information Infrastructure
* State/Local Government Uses of OS for Healthcare and Public Health
* The Role of Open Source in Homeland Security
* Open Source in BioSurveillance and Disease Tracking
* Open Source in Public Health and Emergency Preparedness
* Open Source and Distributed Intelligence for Rapid Emergency Responses
* XML Web Services in Healthcare, Public Health and Emergency Preparedness
* Open Source XML Solutions
* Open Source and Enterprise Architecture
* Demonstrations of Open Source Projects in Healthcare and Public Health
* Open Source in TeleHealth and TeleMedicine
* Open Source Applications for Medical Imaging and Pathology
* Open Source for Medical Simulations and Training
* Open Source for Distance Learning
* Open Source in Medical and Health Sciences Education and Training
* Open Source in Training First Responders and Healthcare Providers
* Potential of Open Source in IT Training of Healthcare Providers
* Open Source in Biomedical Research
* Open Source in Bioinformatics
* Business Cases: OSS and Total Cost of Ownership in Healthcare
* Open Source Empowering People with Disabilities
* Open Source and Section 508
* Open Source Licenses and other Legal Issues in Healthcare

Dates to Remember

Deadline for speaking proposals: January 10, 2003
Notification of acceptance: January 20, 2003
Final submissions due: January 31, 2003
Conference: March 17-19, 2003
Healthcare sessions scheduled for March 18, 2003

We look forward to your participation.

Nicolas J. Guzman, M.D.
The George Washington University School of Medicine
2150 Pennsylvania Ave., NW, ACC 4-425
Washington, DC 20037

Phone: (202) 741-2283
Direct: (202) 741-2291
Fax: (202) 741-2285
E-mail: guzmann@gwu.edu

OpenEMed Featured on Newsforge

Pretty good writeup on Newsforge about the OpenEMed project with comments by project leader David Forslund: ‘…”[OpenEmed’s] main goal is to detect bioterrorism,” Forslund says, “but we also want to make it able to react to natural disease outbreaks…By making it open source and free, we hope we can get it deployed to many sites, because the broader the base, the more sensitivity we have to a problem…’

Open Source Order Entry Preferred Over Closed

JAMIA reported in this research article that Physician’s preferred the Free/Open Source based order entry system in the Veterans Administration VistA software versus a commercial one: ‘…Overall, house staff were dissatisfied with the commercial system, giving it an overall mean score of 3.67 (95 percent confidence interval [95%CI], 3.37-3.97). In contrast, the CPRS had a mean score of 7.21 (95% CI, 7.00-7.43), indicating that house staff were satisfied with the system…’ While this data is compelling, it is worth pointing out that Free/Open Source Software does not pre-clude or exclude commercial companies from selling installation, support, training and documentation for it. They just don’t ask you to give up your rights in doing so.