Internet Technology Aids the Practice of Emergency Medicine

Near and dear to my heart is the practice of emergency medicine. The Health section of USA Today online sports an article Get me that web site, stat! which explores how the Internet is helping those providers that practice emergency medicine. My favorite web site to have set as the web browser default home page for the ER is the web page. Check out those calculators for ER providers – Wow!

Corel Linux Second Edition

A friend of mine who now inhabits the bowels of NIH sent along this link to an article reviewing Corel’s 2nd Edition release of Linux. Excerpt: …Corel Linux is the easiest Linux distribution we’ve seen by far. Installation is a breeze. Simply boot your PC, and the Corel logo screen (replete with a Stonehenge image) fades in, with a display that tells you Corel has everything under control…

QuickView Offers Open Source Experience

The Alliance of Medical Internet Professionals has an article about QuickView (login: pcaware, password: pcaware) a project out of UC-Davis Clinical Resource Center. The article discusses difficulties with implementation on a tight budget, as well as a number of issues such as security and the question: to web or not to web. It is now the 43rd open source medical software project on the list.

RFC: Journal of Open Source Medical Software

Updated: 5/8/01 The journal is a reality at: This is a Request For Comment (RFC) article on beginning a Journal for open source medical stuff. This will be a scholarly journal about open source medical software development and similar topics. I’m tentatively calling it as above in the title, but if anyone has a suggestion, I’m willing to entertain it. Please let your views be known below. If you’d like to be on the editorial board, please e-mail with subject line: Editorial board, then in the body: Name, Occupation, relevant Editing/Writing experience and CV.

Review: Helixcode, Eazel Go the Last Mile for Linux

Recent industry buzz has been about the Nautilus, Helix GNOME and Evolution projects. These three juggernauts address important areas to Linux adoptees in group medical practice: the need for an intuitive Graphical User Interface (GUI), easy automated software upgrades, and enterprise groupware.

The Nautilus desktop environment is based on GNU GNOME and is being developed by Eazel, Inc., whose founders include Andy Hertzfeld and Michael Boich, architects of the Apple Macintosh user interface. Nautilus provides file managing software of the highest caliber, with sophisticated features such as integrated web browsing and esoteric file classification such as by MP3 audio data rate.

Helix Code, Inc. GNOME is a GPL’ed, polished distribution of the popular GNOME desktop. The difference is that it adds needed ‘voltage’ to the interface, says Miguel de Icaza, Helix Code and GNOME desktop environment founder.

Helix GNOME features ‘The Updater’ which provides the ability for Helix Gnome to upgrade its’ software to the lastest release via the ‘Net. This removes the chore of searching for GNOME RPM packages, wondering which is the latest stable release and dealing with RPM upgrade dependency problems. It also includes powerful set up tools which make configuring a snap. To top it all off, a groupware personal information manager called Evolution is also in the works that will allow enterprise calendaring and collaboration.

I switched to Helix GNOME on my Dell PC running Red Hat V6.2 a few months back when it was an alpha release. Unusual for an Alpha release, I had no problems and still don’t. The updater and The Helix Gnome solution brings Linux one step closer to being a widely-accepted desktop alternative to Microsoft Windows in health care organizations.

Open and ‘Free’ Equivalent of SNOMED Needed

‘A Flurry of Terms, But Not Many Users’, in the current issue of Health Data Management, describes the Systematized Nomenclature of Medicine – SNOMED. SNOMED is a standard medical vocabulary that offers consistent identification of a patients medical condition, something that cannot be done effectively through the use of free form text entries in a medical record. Medical record databases that make use of ICD-9 and CPT-4 code sets, which are used primarily for billing and reimbursement purposes, cannot match a SNOMED encoded database, with respect to aggregating clinical information for the purpose of performing clinical outcomes analysis and research. So what’s the problem? It isn’t free.

As pointed out in the article, extracting a dataset from a clinical information system that consists of “all female patients between the ages of 30 and 45 with chronic hepatitis C who had undergone liver biopsies during the preceding 30 months” is a snap with a SNOMED-encoded database. With ICD-9 and CPT-4 encoded data, the resulting dataset would be of questionable integrity (missing and/or cases included that do not fit the criteria). Medical records that consist of free-form text entries would require extensive data analysis, validation and scrubbing prior to being certified for use in a clinical research project.

Despite the benefits of SNOMED, it is not as widely used in medical information systems as one would suppose. As pointed out in the article, licensing of SNOMED can be costly with respect to annual fees and the process of negotiating reasonable terms. Additionally, the learning curve associated with SNOMED may be akin to the learning curve associated with Linux – not rocket science, but time will need to be set aside for training and experimentation, before results are seen in everyday use.

As Open Source and Free Software Foundation enthusiasts have shown, proprietary systems and software that present steep ownership costs, distribution/licensing challenges, and extreme manpower requirements can be met effectively through the creation of Open and ‘Free’ solutions. So when can we expect an Open Source and/or ‘Free’ medical vocabulary project that would offer the benefits of SNOMED as well as integrate with Open Source medical information systems currently under development? Inquiring minds want to know.

If one spends any amount of time looking at software in healthcare, you cannot escape two lettters and one number HL7 the mysterious acronmy stands for an organization called Health Level 7 that does nothing but write standard specifications for health care. Robert Dolin, MD of Kaiser Permanente has an
overview on of HL7 and how it relates to all the other alphabet-soup standards such as LOINC and SNOMED. This still won’t end the age-old debate: what comes first standards or applications?
Tastes great, less filling.