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Re: Live from the AMIA Conference in Los Angeles
by Saint on Monday November 06, 2000 @ 01:55 AM
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I just met with Alex Caldwell of tk_familypractice fame and we sat down for a demo of the software. Pretty good program I thought, well along the way in its features and probably ready to use in everyday practice. Some of the screens where busy, but it also looked like it had everything you would need to do scheduling, and progress notes as well as some basic accounting features.
I'm still looking for ex-marine Tim Cook of the FreePM project. He promised to bring a rocket launcher. Many open source medical software participants are going to Yosemite later in the week, however I will be unable to attend. If anyone goes, feel free to report here.
Meanwhile, I've been schmoozing with lots of people such as the National Library of Medicine who have a booth as well as Medscape, SNOMED and many others that I've never heard of. Most seem receptive and some seem genuinely excited by Linux and open source in medicine. Except for one lady who seemed like she wanted to be talking to someone, anyone but me. Can't win them all. My stack of flyers is getting smaller.
I'll report in again tomorrow.
-- Saint
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'90 days.'
by Saint on Tuesday November 07, 2000 @ 05:02 PM
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I'm back in Houston from the conference so I'll give a recap of the events of Monday Nov 6th. If anyone could write in about the Monday 7:00pm meeting, I would appreciate it. I met with Alex Caldwell, Dan Johnson, Tim Cook and Robert Hausan for breakfast, then with Tim Cook, Russ Baldwin and Michelle Head the last of Linuxnews.com fame for lunch.
The breakfast get together which became something of a group of five summit meeting was remarkable for the amount of consensus at the table. Especially remarkable considering the number of MD's in attendance. Dan Johnson was particularly lucid in his explanations of open source software and how it applies to medicine. Robert Hausan of Theradoc.com was interested in knowing just what this was all about and we where happy to fill him in.
The talk ranged from 'what's in it for vendors?' answer: lower development cost, lower maintenance cost and a bigger market. 'What's in it for doctors?' Answer: intraoperability, low cost and better quality. There was strong agreement that closed-source was not working well in medicine and frequently leads to expensive disasters. The consensus was that open source in medicine was here to stay and the future belonged to open source. Very upbeat.
I was impressed with all of the attendees, particularly Tim Cook and Alex Caldwell who seemed very committed to making this work. Tim Cook had a booth at the exhibitor conference and was showing off FreePM. Many closed-source exhibitors where in the exhibit hall and one of them came over to inquire what FreePM was. When told, he became somewhat derisive saying how could free software be any good? Tim Cook's thoughts where: 'we'll see who is still around two years from now.'
Of all those I've met, Cook seemed to be putting his money where his mouth is. He has financial backing and continues to look for more, formed a corporation for developing FreePM and finally has some ties with VA Linux who donated the machines for his booth.
I was also impressed with the cooperation Tim, Andrew P. Ho and Alex Caldwell have between FreePM, OIO and Tk_familypractice respectively. I think they will succeed, but I wonder if Tim will need more coders than he currently has.
Tim reports that he thinks FreePM will be viable in a real-world setting in '90 days.' Good luck if he can make it, but I have some doubts given the engineering resources he currently has and the amount of functionality in FreePM. I do not doubt its eventual success, but perhaps 90 days is premature. Tim let me poke around at the code he has and it was interesting to see how little of it there was compared to how much function it produces on screen. Zope is clearly a formidable development environment for electronic medical records.
I compared notes with Michelle Head about running news sites such as Linuxnews.com and of course my site. Michelle has about 8 years in the medical industry including ICU experience. I was pleasantly surprised to find out that her site gets 1,000,000 hits a month. We also talked about collaborating in the future which I have no reservations about.
The most lasting impression I had of the conference was in the midst of papering a conference room with LinuxMedNews.com flyers. I stayed for the first 10 minutes of a panel discussion on the experience of implementing several electronic medical records systems. I was heartened and at the same time saddened to listen to virtually the same issues: physician resistance, inability to wean from paper, legacy record conversion that I had read in a journal article: 10 years ago.
The good news is that open source may have the answer.
-- Saint
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Re: Live from the AMIA Conference in Los Angeles
by NLMFellow on Wednesday November 08, 2000 @ 02:00 AM
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As an NLM post-doc fellow, I am amazed at how little my instructors know about open source software and its potential in the medical software arena. I was therefore very happy to see the flyers on the seats that Saint left in the conference rooms. To try and help in my own (small) way, I’m writing a paper on OSS in medicine, and hope to develop a thesis on this topic as well.
I had a nice talk with Tim Cook and it was great to see him in there with the other vendors. I guess you need a Marine to be in that viper pit!
I attended the workshop on Saturday morning hosted by Dan Johnson, MD on “How Open Source Development Really Works.” There was an interesting presentation by Tim Smith, from MIT, on how open source has worked in the physics community. This was followed by a very informative lecture by Dr. Johnson’s son, who works at Red Hat. There were eight people in attendance, all with different interests and levels of experience.
The workshop reflected the newness of this campaign to win medicine. Little was done to make the connection from the physics or operating system worlds to the medical world. I still left with some lingering questions for my paper: what is the roadmap for medical OSS’s success? Who will do the programming and spec-ing (our user base has slightly less programming experience than the physicist and Linux communities)? I think well-worked out answers to these questions will be necessary to convince the many skeptics of this effort. (IMHO, the NLM should start financing open-source solutions with the IAIMS grants… just my 0.02).
However, I think that once physicians understand this movement, they will be drawn to it. Overall, we are an individualistic group, not impressed by glitz, more impressed by results. The challenge will be to deliver on this in an efficient and self-sustaining manner. Presenting and demonstrating work at AMIA is an important step in promoting the open source movement.
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Thesis on OSS
by Allan on Wednesday July 10, 2002 @ 09:33 PM
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Hi,
I am a newcomer to this site. I am thinging to do the same thing as you mentioned in your message: to develop a thesis on OSS for my Master degree. Have you finished your paper/thesis? Could you explain it in more details?
I am from the background of Computer Science / Business Administration. So my topic will be more inclined towards these perspectives. But now I haven't got a clue about the specific topic, nor what kind of research to do (survey, case study, etc).
So any hint or suggestion from the community will be highly appreciated. Thanks in advance.
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Thesis on OSS
by Allan on Wednesday July 10, 2002 @ 09:35 PM
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Hi,
I am a newcomer to this site. I am thinging to do the same thing as you mentioned in your message: to develop a thesis on OSS for my Master degree. Have you finished your paper/thesis? Could you explain it in more details?
I am from the background of Computer Science / Business Administration. So my topic will be more inclined towards these perspectives. But now I haven't got a clue about the specific topic, nor what kind of research to do (survey, case study, etc).
So any hint or suggestion from the community will be highly appreciated. Thanks in advance.
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Monday 7pm CPRI-HOST GEHR session and drinks after
by Andrew P. Ho on Wednesday November 08, 2000 @ 02:35 AM
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Mary Kratz, Pat Wise, Sam Heard, Peter Schloeffel, Joe Dal Molin, David Forslund, Dan Johnson, Alex Caldwell, Jack Corley, David Pepper, Robert Hausan, Tim Cook, Ed Hammond, Steve Shreeve, and others were present.
It was great to finally meet the authors of the lively email discussions.
Since open source development approach is a forgone conclusion in my mind, I am not going to repeat what the Saint has so elegantly expressed.
However, a better product needs more than a better approach - better vision and design are also necessary. That is where GEHR really makes its contribution.
I very excited by the convergence of 3 ideas expressed by 3 individuals from the evening:
1) Joe Dal Molin's 4 ingredients for "virtuous spirals" of open source development, one of which is an accessible software base.
Joe said that this means code and development tools that are within the capabilities of the intended "developers". An example is the Mozilla project that did not have significant developer participation until the code became modular. I can add that I would not be able to access the technology needed to implement OIO without Zope's ease of programming.
2) Sam Heard described GEHR's major breakthrough when they divided the GEHR design into two levels - Concrete (GEHR object model) and Meta models (Archetypes for clinical content). The idea, according to Sam, is to allow clinicians to build new applications by creating new Archetypes. Sam and I have previously traded email and we both agree that GEHR-Archetype and OIO-Forms metadata are very similar. Both systems have the same 2-levels. Perhaps OIO can even be seen as a Zope-Postgres implementation of GEHR (which is now implemented in Eiffel).
3) Ed Hammond during drinks after, expressed his strong view that mandating too many data elements is a major reason that EHR have failed to blossom over the past 30 years. He says he should know since he has been trying since 30 years ago and the same problems have not been solved. He thinks that EHR should contain only the data elements relevant to the clinical task at hand - and allow flexible configuration at patient/ physician/ encounter levels. This seems to validate the GEHR/OIO's approach that favors extensibility/flexibility over built-in data element comprehensiveness.
Taken together, it seems that if we can successfully implement an accessible software base using the GEHR/OIO's 2-level model, then we can have a physician-extensible, usable, and hopefully physician-acceptable EHR that can be customized as necessary.
Am I just seeing what I want to see?
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