Fresno III: Commercial Model Has Failed

Fresno III was recently held to discuss free and open source medical software. The full press release follows. Some of the highlights of the meeting where as follows:

  • Agreement reached that commercial model of software development in family medicine/general practice has failed.
  • Continued collaboration and partnership is advantageous.
  • A model for patient involvement with the EHR was agreed.
  • A framework for further international collaboration has been achieved, although funding sources remain to be secured.
  • Specific aspects of primary care computerization needs are better met in the UK than the USA and vice versa, though neither fully reflects the concepts identified in GEHR (Good Electronic Health Record)

Summary Statement and Press Release

Fresno III OS-IHI Working Group

Feb 2-4th 2001

In summary; its Open Source, Output vs. Input and Object oriented programming that were the “kernels” of this meeting. Here are the summary points as framed by Dr. Ellis and Dr. Pepper. All addendums and comments appreciated.

In Attendance:

Dr Alex Caldwell Family Practitioner. Tulare CA. USA (alcald@psnw.com)

Tim Cook President FreePM. Miami, Florida. USA (tim@freepm.com)

Dr Nikki Ellis Research Fellow. University of Manchester. UK (nikki.ellis@dial.pipex.com)

Dr Chason Hayes Orthopaedic Surgeon. Charlotte N Carolina. USA (chasonh@freepm.com)

Peter Hudson Nurse Practitioner. Fresno USA (pjhudson@thesocket.com)

Dr Adrian Midgley General Practitioner. Homefield Surgery. Exeter (midgley@mednetics.org)

MJ Midgley Nurse Practitioner. Homefield Surgery. Exeter UK (mj@92tr.freeserve.co.uk)

Dr David Pepper Assoc.Prof UCSF@Fresno. CEO-MAP Masters (drpepper@medmapper.com)

Dr Robert Shepard Medical Director. Helena Healthcare. Montana USA (bob@rmshep.mt.net)

In addition to this core group, an additional 20 people attended an evening session that further explored the issues being raised and discussed by the core.

Format

The third in a series of Open Source International Health Informatics (OS-IHI) retreats was held in Fresno, California during the 2nd to the 4th February 2001 to explore ways to improve electronic health care record keeping for outpatient primary care practitioners.

  • A review of six primary care systems, and associated decision support software, was undertaken.
  • Progress to date on the Open Source (OS) projects represented by those present was discussed.
  • A demonstration of the TkFP GUI Front end was held.

Key Points

  • Agreement reached that commercial model of software development in family medicine/general practice has failed.
  • Specific aspects of primary care computerization needs are better met in the UK than the USA and vice versa, though neither fully reflects the concepts identified in
    GEHR (Good Electronic Health Record)

  • Continued collaboration and partnership is advantageous.
  • Agreement that an Object Orientated approach to systems development will be explored within an Open Source environment as a likely emerging and powerful technology.
  • A framework for further international collaboration has been achieved, although funding sources remain to be secured.
  • A model for patient involvement with the EHR was agreed.
  • Agreement that the unique needs of health informatics dictate specific requirements for Output versus Input modes for viewing data.

Outcomes

Submission for Theatre Style demonstration to AMIA 2001 (Fall Congress)

Submission for Knowledge Sharing House Panel to Medinfo2001: Commercial research aspects of OS-IHI

Two Papers in the OS&IHI series have been drafted and will be completed and submitted for publication (First paper in series: Open Source & International Health Informatics: Placebo or Panacea? Ellis et al submitted to medinfo2001)

  • Open Source & International Health Informatics: Consideration Of Object Orientated Design
  • Open Source & International Health Informatics: The Business Case
  • Application of MAP-Masters to the NIST (www.atp.nist.gov) for funding

Areas Requiring Further Work

In keeping with the OS Development model, anybody who can offer assistance in these areas would be welcomed to either participate in this work virtually or to attend future retreats.

  • An Open Access/Target international drug preparation database
  • An Open Access/Target clinical coding system or thesaurus

Further Information

Please contact anybody listed as in attendance at the head of this statement for further information on any aspect outlined above.

Support from B-M-Squibb is graciously appreciated for the speakers expenses.

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