PatientRunner V1.52 released

PatientRunner V1.52 has been released! PatientRunner is a mental health medical records system. The software features a Windows client software written in Delphi 7 that connects to a MySQL database. The db allows a group of physicians to track progress notes, diagnoses, medications, and scales. User customized templates make note creation easy.

PatientRunner bridges the gap between Linux and Windows. The database server (MySQL) runs on a Linux or Windows box. The client software can easily be compiled under Kylix 3 making the software a powerful cross-platform long term solution to ease the transition to Linux.

Billing, encrypted transactions and other powerful features are under development. growing fast

Good news!, the collaborative pharmaceutical reference database, is going along nicely.

We have achieved official support from the RMIT (Royal Melbourne Institute of Technology) University in the form of 6 advanced computer sciences / engineering students working for for 3 semesters. They will improve our online infrastructure and develop applications for peer review of the database.

We also have indications of similar support from the University of South Australia and the University of Tasmania, details to be negotiated soon.

Furthermore, we have the first two drugs being “adopted” for ongoing database maintenance (Sertraline and Sildenafil) by committed individual doctors, and we have started entering drug-drug interaction information.

Quicken 2004 for the Mac to “Store” Medical Records

8/20 Intuit Press Release: “The Emergency Records Organizer enables customers to store the essential details and location of important documents such (…snipped…) medical records. Customers can print reports containing this important information to share with family members.” I am not able to find any details. The implimentation may be quite simplistic, but it could point towards a further trend of digitized medical records accessed or stored at home. Maybe something for the GnuCash folks?

EHR Collaborative Field Input Meeting Report

I’m fresh from the EHR Collaborative field meeting in Dallas on August 20th. It was an interesting meeting in that there was obviously a great deal of interest in having a standardized health record (nothing new) with high-level political support which is new. The meeting consisted of some presentations along with going over a written functional specification at a very high level and asking everyone if there were suggestions, changes and what functions were considered ‘essential for version 1.0’ The use of Free and Open Source licenses for implementations was not included in the functional specification, but it was suggested by me at this meeting and may have been suggested by others at other meetings.

The final report from the field meetings will be posted August 25th to the site. Balloting for the final revised version will occur on the HL7 web site. The draft ballot can be downloaded for free, but to actually cast a vote will cost $100. Balloting will be closed on September 5th followed by a meeting September 7-12th in Memphis to discuss the results of the vote on the functional specification.

Final Rule for Electronic Submission of Medicare Claims

On August 15, 2003, the Department of Health and Human Services (HHS)
published the Final Rule for Electronic Submission of Medicare Claims.
This rule implements the statutory requirement found in the
Administrative Simplification Compliance Act (ASCA). ASCA requires
(with a few exceptions) all claims sent to the Medicare Program be
submitted electronically starting October 16, 2003.

ASCA was enacted by
Congress to improve the administration of the Medicare program by
increasing efficiencies gained through additional electronic claims
submission. Although 86.1 percent of Medicare claims are submitted
electronically, the volume of paper claims is substantial, and moving
from paper to electronic submissions has the potential for significant
savings for Medicare physicians, practitioners, suppliers, and other
health care providers, as well as for the program itself.

This Rule
sets forth the details for implementation of the Medicare electronic
claims submission requirement and who may be exempt from these

The rule is available at:

Click to access 03-20955.pdf

The regulation requires that all claims submitted to Medicare on
October 16, 2003 and beyond be done so electronically except for certain
circumstances including:

The provider is a small provider

Dental claims

Claims where there is more than one payer primary to Medicare

Roster billing for vaccinations

Claims for Medicare demonstration projects

While these claims may be submitted electronically, they are not
required to be done that way.

Nominations Open for 2003 Linux Medical News Achievement Award

Nominations are officially open for the 3rd annual Linux Medical News Software Achievement Award to be presented at the November 8th-12th AMIA Fall conference in Washington, D.C. Open source software isn’t ‘magic pixie dust’ and there are real people making significant personal sacrifices as well as doing difficult work to make medicine’s free software future a reality. This award is intended to honor the individul who has accomplished the most towards the goal of improving medical education and practice through free/open source medical software. Past recipients have been Tim Cook of Open Paradigms and K.S. Bhaskar of Sanchez Computer Associates.

Individuals can be nominated by themselves or others by sending a 1-2 page essay to on why the individual nominated should receive the award. The award will be given by a panel of judges to the most deserving nominee. Suitable nominees are not limited to software engineers, but can also be project leaders, academics, journalists, documentation writers and any others who have made significant contributions to open source medical software.

The award will be given at the November American Medical Informatics Association 2003 Fall meeting in the Marriot Wardham Park in Washington, D.C. at a date and time to be announced. Attendance is not required to win the award. Deadline for nominations is September 15th, 2003.

Employees of Linux Medical News and their relatives except for my wife Cory are not eligible for the award. Posters to Linux Medical News who are not employed by Linux Medical News are eligible for the award.

OSCAR 1.1 Available

Dr. David Chan announced on the OpenHealth(tm) list: The latest OSCAR is now available on SourceForge. You can now either install automatically after Linux install or do so manually if you want to configure your existing system differently. The new version contains quite a number of new and improved features. Unfortunately, there isn’t really a clean upgrade from v1.0 🙁 The full announcement is within.

The latest OSCAR is now available on SourceForge. You can now either install automatically after Linux install or do so manually if you want to configure your existing system differently. The new version contains quite a number of new and improved features. Unfortunately, there isn’t really a clean upgrade from v1.0 🙁

Another exciting news is that our Brazillian collaborators have been working
with us to produce a Portugese version of OSCAR. I’ll let them tell you
about their demo site. You can also follow their process from our CVS


Yours sincerely,


David H Chan, MD, CCFP, MSc, FCFP

Associate Professor

Department of Family Medicine

McMaster University

The Terabyte Conjecture

I have been a watcher and participant of computing in general and medical software in particular for many years. A hobby of mine is trying to spot trends before they happen. I called the Gigabit ethernet card trend to some friends a few weeks before John C. Dvorak of PC Magazine did. Not wanting to hide under a bushel basket with my prognostications, I give you The Terabyte Conjecture. The conjecture states that when terabyte disk spaces become easily available to the average user, medical computing will fundamentally change.

With 250 megabyte disk drives available on pricewatch for only $230, the time is not far off when a terabyte (1024 gigabyte) single disk drive will be available and cheap. This has several implications.

One is the ability to hold an entire physicians career of patients on one disk. If a patient requires, on average, 40 megabytes of disk space for each patient then a terabyte disk can hold approximately 26,000 complete patient records.

Training, outcomes and feed back for the clinician could be radically changed by this. If a clinician wanted to review some crucial cases in their training, cases from which they truly learned, they can. Currently that information is usually lost after medical school or residency.

Many types of personal analyses of patient data can occur. If a clinician wanted to know how many cases with a certain diagnosis they had seen, or how many cases they gave a certain medication to over the years and what happened, once again, they can. Many point-of-care outcomes data become possible. All of which hold the possibility of improving something that is frequently lacking in medicine: feedback to the clinician on how well treatments work.

Things could get interesting once terabytes of disk space are easily available to clinicians. Can you think of any more implications for medicine?