Next Generation Open Source EHR

The building blocks of TORCH have evolved a great deal over the past couple of years. It is time to take a long hard look at what must be done better and different to produce a comprehensive electronic health record and practice management application.

There has been discussion on the TORCH list regarding upgrading the medication management and other aspects of TORCH.

The 1.x series of TORCH releases are very flexible but are not well documented and difficult to get up and running. Several events have occured recently that clears the way for TORCH design and implementation to be revisited.

It is important to get as much input as possible into the design phase from the future users. With that in mind; Open Paradigms, LLC has set up a living document making it easier to capture contributions than is possible from email archives.

Everyone involved in patient care should contribute to these discussions in order to produce the excellent application we all know this process can produce.

MIT OpenCourseWare Medical Informatics

MIT is publishing its course material on its MIT OpenCourseWare site.

There are several courses at the Harvard-MIT Division of Health Sciences and Technology that may be of interest to the LinuxMedNews audience:

Looks like there are a number of PDF’s of lecture material, reading and project assignments.

Other people doing MIT OpenCourseWare have created study and discussion groups. More on this at Wired, All the World’s an MIT Campus by Kendra Mayfield.

Thanks to I. Valdes for first reporting MIT’s Open Source Education back in 2001.

John Norris

Open Access for Medical Research

Rick Weiss, in the Washington Post, puts up a good article concerning the cost of access to scientific research papers. He goes over the financial, emotional, political, and collaborative aspects of paid versus open access including information about the Public Library of Science‘s attempt at putting up research papers for free access. “Unlike their ink-on-paper counterparts, scientific papers that are maintained in open electronic databases can have their data tables downloaded, massaged and interlinked with databases from other papers, allowing scientists to compare and build more easily on one another’s findings…Sabo’s bill would require research “substantially funded” by the federal government to be in the public domain.”

HIW: Medical Informaticist to MIS: Get out of the Way

Scot Silverstein, MD a past contributor to Linux Medical News writes a particularly hard-hitting article in Health-IT World. His message is simple: traditional MIS and IT personnel are impeding progress in Health-IT and need to move aside for those who are both clinically and IT trained: ‘…Medical informatics, whose professionals are now training at more than a dozen NIH-funded centers, can help, but its professionals generally sit on the sidelines when it comes to true leadership roles. This is in large part due to the MIS culture. Let alone considerable territorial and political issues, the credo “doctors don’t do things with computers” perhaps summarizes the ideology…’

National Health Information Infrastructure Act of 2003

WASHINGTON, D.C. Congresswoman Nancy Johnson today (July 24,2003) introduced the “National Health Information Infrastructure Act of 2003” a measure to dramatically improve health care quality by revolutionizing how providers use clinical information to treat patients.

“The information systems that securely give you 24/7 access to your bank account can be adapted to transform American health care into a 21st Century system,” said Johnson, Chairman of the House Ways and Means Health Subcommittee.

“Development of such a system is being impeded by the lack of comprehensive architectural standards to assure interoperability,” Johnson continued. “No provider wants to invest in an IBM for fear others will invest in a Mac. All systems must be able to communicate with each other. Within that framework, a health information technology infrastructure can develop and medicine can advance to the next level of quality care.”

I would like to ask everyone in the open source healthcare community to make comments here that can be collected and pointed to for reference.

If done correctly the NHII will be wonderful. But if we adopt the attitude in the US that we can build this without reference to the work already done worldwide then this effort will likely end up in the failure bin with the other large healthcare IT efforts.

One thing for certain, it cannot be accomplished without using “truely” open and collaborative processes. The EHR Collaborative (previously reported here) is certainly a step in the right direction.

My 2.5 cents……………..

Medication Management RFC

Dr Rusty Maynard has spent the past several weeks grinding out a RFC document that really analyzes TORCH’s prescription engine. The document is applicable to all EMR/EHR applications and we therefore hope to get participation from all open source projects.

Your participation will help shape TORCH and likely other open source healthcare applications in the future.

Here is his post to the mailing list.

IBM Clinches Security Certification for Linux

According to Reuters, IBM has achieved Common Criteria security certification for SuSE Linux: …they received the highest level of security evaluation used by governments when deciding to use software in their organizations. Linux, running on IBM computers using Intel Corp.’s (Nasdaq:INTC – news) chips, received the Common Criteria certification, a global standard for security features and capabilities of information technology products..’ Thanks to for this link.

OpenEHR Announces Archetype Definition Language

Ocean Informatics is announcing its specification for an Archetype Definition language (ADL). What is it good for? Short version: ‘future-proof information systems can be built’ with it which is handy in medicine. ‘…ADL provides all the syntax for describing constraints on any domain entity whose data is persisted in objects described by an information model (e.g. expressed in UML/OCL). It is primarily useful when generic information models are used for representing all data in a system, for example, where the logical concepts PATIENT, DOCTOR and HOSPITAL might all be represented using the class PARTY, ADDRESS, and related generic classes. Archetypes are then used to constrain the valid structures of instances of these generic classes to represent the desired domain concepts. In this way future-proof information systems can be built – relatively simple information models and database schemas can be defined, and archetypes supply the specific modelling, completely outside the software…