Monthly Archives: August 2002

Slashdot: Is Win2K + SP3 HIPPAA compliant?

Slashdot has a discussion up on the conundrum of software updating and HIPAA compliance: “…After reading the discussion on here about the new EULA for Win2k SP3, I had a disturbing thought. As far as I can tell, if you use Windows 2000 then you’re going to be out of compliance whatever you do. If you install the patch, then theoretically Microsoft could access those medical records (possibly by accident) without ‘due cause or need’ in the process of updating your machine. If you don’t patch your system then you’ll fail the security requirements of the law…”

PICNIC Conference in Paris – Web Services for Regional Healthcare

The EC Fifth Framework PICNIC project is pleased to announce the “Web Services for Regional Health Care Networks” conference to be held in Paris on
September 26-27 at the Novotel Atria Hotel (Porte de Bagnolet).

PICNIC was initiated by regional health care providers, who are developing the next
generation of regional health care networks supporting new ways of providing health and social care.

PICNIC will deliver open source components, develop a model for future regional health care networks, and make the European market for telematic care services more cohesive.

For more information, visit us at http://picnic.euspirit.org

SQL Clinic 1.1.0 Released

SQL clinic version 1.1.0 is available with the numerous improvements. Version 1.2.0 should be released sometime this month which will ‘support Oracle out of the box’. The complete list of enhancements follows.

*** SQL Clinic 1.2.0 is being tested now and will be released this month:

This is the first version of SQL Clinic to support Oracle out
of the box. Expected release date: 19 August 2002
(No other enhancements will be offered in this release.)

*** NEW SQL Clinic Version 1.1.0 is available for download NOW at:
www.sqlclinic.net

New features include:

* New Library File Added With User Defined Options:

clinic.lib created, an updated version of pg_utils.lib
that has user defined options and complies with
-w and the use strict pragma. (Oracle support to be
added for non-beta release of 1.2.0)

* Auditing Subsystem Added (Turned On/Off in Library):

audit trails created (in both database schema, i.e. tables
prefixed with audit_ , and in src tree routines.) Any
patient record modified by user is first copied to the
corresponding audit_ table and then the record to be
modified is tagged as modified (with user’s name and
modification date being appended to the audit_trail field.)

* Additional Functionality for IT personnel Added:
webhosting applications track all related data

* All principal patient data tables now contain Chart ID
data (JCAHO compliance)

* Patient Pain Assessments and Nutrition Screenings
added (JCAHO Compliance).

* Staff Time Clock feature added.

* New Menuing system added. Site Map created.
Previous menuing preserved as button at top of screen.
Site Search feature added.

* Broadcast E-Mail (all employees) feature added.

* External Mailing Lists (sendmail aliases) replaced
with internal lists managed via Setup Menu.

* Patient Medical History and Status added (JCAHO compliance).

* Pain Assessment and Nutrition Screenings (JCAHO compliance).

* Patient photo (on Face Sheet) capability added.

* Prototype programs (/prototypes) and varous test routines
(/test) added for developers.

* Progress Note Editor reduced to Billable/Non-Billable Toggle
(OMH Compliance)

* Initial (72 Hour) Treatment Plan added.

* Patient Intake Program improved for ease of use (one form
admits patient to dept and unit.)

* Inter-Departmental Patient Status Change (census) Report added.

* Monthly Discharge Report added.

* Mission Statement added.

* Removed developer html, moved it to web site (reduce download size)

* Removed perl modules, moved to website (reduce download size)

* documentation: updated for version 1.1

* shell scripts: updated for version 1.1

* schema update sql script in /upgrade

Enjoy SQL Clinic!

———————————————————————–

Thomas Good e-mail: tomg@sqlclinic.net

Programmer/Analyst phone: (+1) 718.818.5528

Residential Services fax: (+1) 718.818.5056

Behavioral Health Services, SVCMC-NY mobile: (+1) 917.282.7359

—
—

SQL Clinic – An Open Source Clinical Record www.sqlclinic.net

————————————————————————

IBM, HP Strategies at OSHCA

Joseph Dal Molin is announcing the draft agenda for 2002 OSHCA which can be found here. ‘…This year, for the first time we will hear what two major vendors’, IBM and HP, strategies are for the open source market. We will also for the first time be co-hosting the regular Developer’s meeting of the remarkable team that has been porting VistA to the Linux/G.TM/x86 platform…’ The full text of the announcement is enclosed within.

OSHCA 2002 Update

Planning for OSHCA 2002 is progressing very well and this years meeting
is shaping up to be as lively and interesting as last years.

This year, for the first time we will hear what two major vendors’, IBM
and HP, strategies are for the open source market.

We will also for the first time be co-hosting the regular Developer’s
meeting of the remarkable team that has been porting VistA to the
Linux/G.TM/x86 platform. If you ever know anything about VistA this is
your chance to meet many of the experts

David Chan’s presented his plans for OSCAR in London last year…OSCAR is up and running at the McMaster Dept. of Family Medicine clinics…come and hear how it was done, see it running and find out where OSCAR is heading next…isn’t Hollywood near LA?

There is much more…and I will highlight a couple of the other events in my next update. The working draft of the agenda can be found at:

http://www.openparadigms.com/oshca2002

Select “All Items” This draft agenda will be updated as we add and
confirm speakers and details. You should soon also be able to find a
copy or link to the agenda at the www.oshca.org site.

We are making arrangements to implement the registration system and plan to have that up soon. In the mean time if you are interested in presenting at OSCHA please send me an email with a brief one to two
paragraph abstract.

—

Cheers,

Joseph Joseph Dal Molin

e-cology corporation www.e-cology.ca

Practical Use of PDA’s in Medicine

An article in the NY Times (registration required) describes how PDA’s are proving practical at Miami Children’s Hospital. The telling quote from Dr. Redmond Burke chief of cardiac surgery at Miami Children’s Hospital;
“I was frustrated that Federal Express could keep better track of a package than we could track patients,” he recalled. “We were walking around with 5-by-7-inch index cards as the hospital database. They got lost. You couldn’t access them. I wanted to have one hand on a sick baby and in the other hand, I wanted to hold that baby’s information. That’s where the hand-helds came in.”

Read the rest of the story here.

Open Paradigms Announces TORCH

Open Paradigms has forked FreePM into a new project called Trusted Open source Records for Care & Health (TORCH). Looks better. Works better. Will Live Longer.

TORCH – New open source EHR released for public scrutiny.
Following the separation of the founder, Tim Cook, from Free Practice Management Inc. Open Paradigms is delighted to announce the release of TORCH � Trusted Open source Records for Care & Health.

TORCH is a forked development based on the GPL licensed FreePM code and as such maintains backwards compatibility to version 1.0b6 of FreePM. However, TORCH has been developed extensively beyond the capabilities of FreePM.

TORCH is partially integrated with an open source intranet application and is undergoing other renovations in the template and scheduling modules.
For further information, or to see the online demonstration of TORCH, please refer to http://www.openparadigms.com

Open Paradigms
Open Paradigms specialises in the development and use of open source applications in health care. In particular, Open Paradigms provides all support services, including installation, training & education for its own EHR application � TORCH. Open Paradigms also provides specialist training and education regarding the use of an EHR in health care with a particular interest in family practice. Additional consultancy options are available to assist you in progressing towards a paperless practice.

Open Paradigms believes strongly in the open source paradigm and therefore all software developed entirely by the company is released under GPL licence. However, there are components of health applications, such as certain coding systems, that can not be made available in this way. Therefore, Open Paradigms collaborates extensively with other organisations to ensure that full integration and flexibility is inherent in all Open Paradigms products. By collaborating in this way, Open Paradigms believes that the essential infrastructure needed for health applications will be both stronger and more durable in the long term.

For further information please visit our website or
contact Tim Cook by E-Mail or Tel.: 731 884 4126

interesting-developments

In the second of a major pair of announcements (see previous article), Steve Shreeve writes about Medsphere on the openhealth list: ‘…The recent “million dollar question” posed by David Derauf, the public announcement of “WorldVistA” by Joseph Dal Molin, and this weekend’s completion of the successful four-day “Medsphere 1 Conference” in Aliso Viejo, California have prompted me to formally introduce Medsphere Systems Corporation and explain where we fit in the overall picture of open-source healthcare systems…We provide VistA configuration, deployment, support, and maintenance for domestic and international healthcare organizations. The full text of the announcement is within.

Openhealth,

During the past year, this list has tracked several open-source healthcare projects. However, there has been one major project that has quietly been gaining momentum and that may have monumental importance for the global healthcare industry. The recent “million dollar question” posed by David Derauf, the public announcement of “WorldVistA” by Joseph Dal Molin, and this weekend’s completion of the successful four-day “Medsphere 1 Conference” in Aliso Viejo, California have prompted me to formally introduce Medsphere Systems Corporation and explain where we fit in the overall picture of open-source healthcare systems.

First off, for those who are unaware, VistA is a fully-integrated healthcare information system that was developed by the United States Department of Veterans Affairs (often called the “VA”). VistA manages all the clinical, financial, and administrative data for healthcare organizations of all sizes. As the largest healthcare provider in the United States (with 26 million patients) the VA has deployed VistA at its nearly 1,300 sites across the country. The system includes more than 125 modules, including computerized physician order entry, scheduling, radiology, bar code medication administration, lab and pharmacy systems, and dozens of others. An easy-to-use, yet powerful, graphical user interface allows healthcare providers to quickly and efficiently provide better care for their patients. In short, VistA is a fully-integrated, proven, and robust healthcare information system that has achieved an incredible degree of success within the VA. However, this system has never has never been deployed to the private sector on a large scale basis.

That’s where Medsphere fits in… We provide VistA configuration, deployment, support, and maintenance for domestic and international healthcare organizations. Our model is essentially the same as “VistaVoice” that was referred to by Todd Smith. We offer the system in either a hosted or in-house model and charge a monthly subscription for support and maintenance. Customers receive an affordable, integrated, enterprise-wide platform that drives their entire organization. Medsphere is also the first healthcare information technology company to commit to open-source at the enterprise level – the code is freely available for enhancement, improvement, and modification (thereby negating one of the biggest problems in healthcare today – proprietary “vendor lock”). In addition, we leverage a number of other open-source solutions, which have no associated license fees. The overall benefit for healthcare providers is a platform that is affordable, flexible, standards-based, technically robust, secure, and that directly impacts their ability to deliver quality healthcare.

As indicated in Joseph’s recent email, the WorldVistA non-profit organization was created to “[further] the cause of affordable health care information technology worldwide”, but specifically states that WorldVistA “will not sell services or engage in other revenue generating project activities.” Again, this is where Medsphere fits in. We are currently engaged with WorldVistA and other developers on the port of the March 2002 FOIA release of VistA to run on GT.M on Linux. We are now in the phase of actively testing and validating the system to ensure performance, quality, and robustness. By providing infrastructure and financial support, Medsphere has enabled this process to gain momentum. It has also provided the opportunity for people with VistA knowledge to use their skills and expertise in an economically productive manner.

The “Medsphere 1 Conference”, held from August 1-4 at our headquarters in Aliso Viejo, California, brought more than 40 developers from across the country (including an international contingent from Brazil and Argentina) to work on this project. By bringing in some of the best and brightest VistA developers, as a group we were able to make significant progress. The theme of the Medsphere 1 Conference was “The Revolution has begun…” We believe the entire effort is revolutionary for at least five reasons. First, because it creates a fully integrated healthcare information system that revolutionizes a provider’s ability to care for patients. Second, open-source healthcare software breaks down proprietary barriers and removes the stranglehold of “vendor lock”. Third, the collaborative effort to create, enhance, and maintain this system is also ground-breaking. Fourth, we believe the business model of embracing an open-source strategy and a collaborative software development model is unique in the healthcare industry. Finally, Medsphere (as a company) allows the greater open-source community to financially participate in the success of these efforts through consulting, contracting, part-time, and even full-time opportunities going forward.

Of course, any project of this size requires capital to be successful. We have already attracted sufficient capital to begin operations in anticipation of our initial deployments. We have built Medsphere on the open-source ideals of collaboration, transparency, and cooperation. In conjunction with the WorldVistA non-profit organization, we also invite your participation and support.

We look forward to your comments (online or offline) and participation in these efforts.

Regards,

Steve

==

Steve Shreeve, CEO

Medsphere Systems Corporation

65 Enterprise

Aliso Viejo, CA 92656

949.330.6090 – office

949.584.6264 – mobile

steve.shreeve@medsphere.com

Announcing WorldVistA

Joseph Dalmolin has announced that: ‘…WorldVistA is a non-profit organization incorporated in California with the mission of furthering the cause of affordable health care
information technology worldwide.

Our current efforts are targeted to championing the use of VistA outside the VA [Veterans Administration]. Part of what we hope to achieve is to act as a coordination point for work on VistA done outside the VA, to ensure that all such software changes are available under an appropriate open-source license,
and to feed bug fixes and enhancements back to the VA for consideration
for inclusion in the VA’s VistA. Our goal is to help establish for VistA
the virtuous spiral of open source by bringing together a critical mass
of developers and users…’ The complete text of the announcement is within.

Over the last year, since the release of Sanchez GT.M on Linux, a community of VistA enthusiasts including members of the Hardhats, some of whom were involved in the original creation of VistA, representatives from IBM and HP (Compaq) and other supporters have been gathering on a regular basis to work together to port VistA to GT.M on industry standard x86 GNU Linux open source platform as well as HP Alpha/AXP Open VMS and IBM eServer iSeries (formerly AS/400) OS/400 PASE.

At the OSHCA 2001 meeting in London the idea of forming a not-for-profit organization that would act as the steward for full open-source implementation of VistA was introduced by Rick Marshall, Chris Richardson and K.S. Bhaskar, three members of this community. The original name for the organization “Health Care for Humanity” became WorldVistA and as we wrap up the latest in the series of development meetings, and given the latest discussion thread on VistA, it is both timely and synchronistic to announce the formal incorporation of WorldVistA.

WorldVistA is a non-profit organization incorporated in California with the mission of furthering the cause of affordable health care information technology worldwide.

Our current efforts are targeted to championing the use of VistA outside the VA. Part of what we hope to achieve is to act as a coordination point for work on VistA done outside the VA, to ensure that all such software changes are available under an appropriate open-source license, and to feed bug fixes and enhancements back to the VA for consideration for inclusion in the VA’s VistA. Our goal is to help establish for VistA the virtuous spiral of open source by bringing together a critical mass
of developers and users.

WorldVistA, will not sell services or engage in other revenue generating
project activities. Instead it will help coordinate and facilitate the
efforts of other organizations and individuals in meeting these needs.

We welcome and look forward to comments and suggestions from the broader
open-source health care community in helping WorldVistA evolve.