WSJ: Businesses Seek Higher Hospital Standards

The November 15th Wall Street Journal’s print edition section A-3 (maybe the online edition did too, I don’t subscribe to it) reported this week that a heavy weight line up of businesses called ‘The Leapfrog Group’ which includes GE, GM, Delta Air Lines, AT&T, IBM, Boeing and Xerox are using their more than $40 billion health care dollar muscle to force hospitals to install computerized prescription systems. The consortium would direct its employees only to hospitals that have the requisite systems installed. ‘…The group was formed earlier this year to respond to a disturbing government report last year that found that medical mistakes at hospitals result in between 44,000 and 98,000 deaths a year and produce more than $20 billion in added costs.’ Wouldn’t 1/1000th of this money funnelled into open source projects for prescriptions be the right approach?

.NET Roundup

Perhaps you have heard of Microsoft’s recent announcement of its .NET strategy. Or not. In the formative stages, .NET encompasses many ideas about computer languages, objects, interoperability and the Internet. Some believe it is the great unifier, others believe it is an ‘updated set of handcuffs’ and a ploy by Microsoft to lure and then trap developers into Windows. Here is a roundup on the subject both pro and con: Jim Farley has a cogent article with a good executive summary at the end, particularly with regard to competitor J2EE and how the playing field will change for open source advocates. Madhu Siddalingaiah points out the proprietary differences between .NET and the more open Java technologies. There is of course, Microsoft’s view and a detailed, perhaps one-sided, article by Bertrand Meyer on how great .NET is. Finally, one company’s experience of working with Microsoft to integrate the Eiffel programming language into .NET Thanks to Wayne Wilson for these links.

Health IT’s ‘Thematic Wilderness’

Thomas Beale of the Good Electronic Health Record (GEHR) has an article that identifies problems of Health IT: ‘…

Those working in health IT do so in somewhat of a thematic `wilderness’, usually led by pioneers using an ad hoc
collection of available tools. Great progress can be made in this manner but it rarely leads to sustainable or
cooperative ventures. The software created, which is often inextricably linked to both particular technologies and data
models, does not generally communicate with other systems. Further, newer technologies make progressing the
previous work unattractive, resulting in systems which are maintained for a period and then discarded…
He goes on to say that a movement should occur from ‘isolated development to open development’ and details the basis for GEHR based on his reasoning.

FreeMed 0.2.0 (Phoenix) Released

The FreeMed project has released the latest version of its GPL’d Electronic Medical Record and Practice Management system onto This release is described as: ‘…A near-complete UI rewrite, database changes, and a new requirement of phpwebtools and PHP 4.’ They have more coders now and project leader Jeff Buchbinder sends his assurance that they are alive and well despite not releasing in several months.

Netscape 6.0: Finally

Updated 11/15/00: The comments of most people on other sites and articles has not been positive for this release. Most indicate waiting for 6.1 CNet has a story about todays long awaited release of Netscape 6.0. The article reviews the reasons Netscape originally went for an open source version of its browser and how the gamble has finally paid off. “If you look at how long it takes to write a software product from start to finish, it wasn’t such a long time,”
said Sol Goldfarb, director of the browser product marketing team at Netscape. “We’re proud of how quickly
the product came out the doors.”
This is an important development for Linux in general and open source medical software in particular as a robust, stable browser is key to the success of both. We outlined why in an April, 2000 LinuxMedNews article. You can find some early reviews: ZDnet’s here and’s review here.

Possible VistA Licensing Controversy?

Free and open source medical sofware advocates on the openhealth-list discussed a possible licensing difficulty between the VistA project and the recently announced Gnu Public Licensing (GPL’ing) of Sanchez Computer Associates GT.M database. The debate centers on the fact that VistA, a large collection of Veterans Administration medical software programs, is public domain. The source code for the programs are available by the Freedom of Information Act and has no license at all. However, VistA requires a database like GT.M to run.

Under the terms of the GPL: ‘…A related issue concerns combining a free program with non-free code. Such a combination would inevitably be non-free;
whichever freedoms are lacking for the non-free part would be lacking for the whole as well. To permit such combinations would
open a hole big enough to sink a ship. Therefore, a crucial requirement for copyleft is to plug this hole: anything added to or combined
with a copylefted program must be such that the larger combined version is also free and copylefted…’

The question appears to come down to whether code obtainable under the Freedom of Information Act is already considered ‘Free’ by the GPL and/or if VistA is modified to run with a GPL’ed program whether it automatically becomes GPL’ed.

The GPL, or ‘copyleft’ was developed by the Free Software Foundation in order to keep software that is released under the license and its derivative works ‘free’. Free software according to the GPL and the Free Software Foundation is frequently defined as ‘Free as in speech, not as in beer.’ to denote that the software is not free of charge, just freely available for end users to view, modify and improve.

It has at times been compared to and critized for its virus like nature in that all derivative works and any software combined with GPL’ed software, must become GPL’ed.

There are other licenses that have different restrictions, particularly with regard to commercial use of software such as the FreeBSD License. The Free Software Foundation does not consider these licenses to be ‘Free’ licenses.