Doctors Raise Doubts on Digital Health Data

The NY Times is reporting on 2 articles to be published in the NEJM. One on a study from the RWJF and the second from the esteemed Mandl-Kohane brain trust out of Harvard. A highlight: “the current health record suppliers as offering pre-Internet era software — costly and wedded to proprietary technology standards that make it difficult for customers to switch vendors and for outside programmers to make upgrades and improvements… encourage the development of an open software platform on which innovators could write electronic health record applications”

JAMA: The Vendor “Hold Harmless Clause” Racket

JAMA has a blockbuster article on Health IT vendor ‘Hold Harmless’ contracts. Linux Medical News readers know is just the tip of the proprietary Electronic Medical Record iceburg such as the interoperability scam, the failed EMR business quandry, and the sustainability conundrum among many other things that has yet to be widely discussed. Courageous and forward-thinking past LMN contributor Scot Silverstein has a number of further analyses here and here. ‘…As a former CMIO/Director of Informatics I would never have signed such a contract. Period. (Of course, CMIO’s and Directors of Informatics don’t generally sign or even see health IT contracts, as they are Chiefs and Directors of Nothing.) Have hospital executives, boards of directors and counsel been violating their responsibilities and obligations every time they’ve signed a healthcare IT “hold vendors harmless, it’s all on your docs” and “shhhh! keep the defects secret” contract? Have they abused their positions of trust?…’ Editor’s note: Unfortunately the knee-jerk solution will likely be to change the proprietary contracts which naturally the proprietary vendors will want more money for. The real answer is education among purchasers to only use EMR software that is Affero General Public Licensed and a law that states that all Electronic Medical Records purchased with federal funds be Affero General Public Licensed.

Fred Trotter On Preventing An Anti-FOSS Policy In Health IT

opensourcereleasefeed has a interview with Fred Trotter on CCHIT certification/HIMSS and the new Health IT landscape with respect to Free/Open Source:

“If you care about FOSS generally, I need you to show up at the HIMSS meeting. If you care about FOSS in Health IT, it is especially important that you be there. I believe that FOSS is the only real hope for untangling the mess that is Health IT. If you find any of these arguments compelling, show up. If you cannot show up, call in. If you cannot call in, then comment on the openhealth mailing list. (http://tech.groups.yahoo.com/group/openhealth/)…HIMSS on the other hand, has consistently refused to consider FOSS players as real constituents. They are essentially a proprietary vendor lobby on par with the Business Software Alliance. My blog post points to some very specific examples of this….I can tell you that in Health IT, FOSS is the future.”

WorldVista on Moka5 player virtual machine

Thanks to the installation script by Ignacio Valdes and the patch by Kevin Toppenburg for his GUI Configuration tool, I was able to install WorldVista on a Moka5 virtual machine based on
PCLinuxOS-2007. I did this for my own interest, and I know there are other demos and virtual appliances available for VISTA, but Moka5 makes it very easy to install and run a pre-configured WorldVista server, so I thought I’d share it, in case anyone else is interested. I also have some links to a pre-configured version of the CPRSChart and GUIConfig front ends that should be able to connect to the server if run on the same machine hosting the Moka5/PCLinuxOS-2007 virtual machine. Here is a link to where it can be downloaded:
http://lab.mokafive.com/ListDetail/WorldVista_EMR_on_PCLinuxOS_2007_lab

Medscribbler Commercial Physician Office EMR Goes Open Source

Medscribbler electronic medical record (EMR) uses handwriting recognition on a Tablet PC for a HIPAA compliant computerized medical practice and document management solution.

CEOMike writes: We are about to release in this coming quarter Medscribbler Open Source, initially on Sourceforge, which will have both code and compiled downloads

Screen shots, videos and no obligation online demos are available

CEOMike writes:

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On Medieval Barbering, Wal-Mart and One Size Fits All With Health IT

From another conversation I had on an AMIA.org members only list that I wrote: Years from now I hope that people will laugh at these debates [Free/Open Source vs Proprietary EMR software] in the same way that today we think the alchemists where misguided. I hope that laugh will happen in just a few years, and not 20. Do you remember the Saturday Night Live Steve Martin <a href=”http://snltranscripts.jt.org/77/77rtheodoric.phtml”>’Medieval Barber'</a> skits in which he does blood letting on customers then starts talking into the camera, lays out the discovery of the scientific method then grins into the camera and says ‘naaaah!’ and continues doing dreadful things? That’s what seems to be going on here a kind of ‘Medieval Barber’ type thing that is occurring with many people in thinking about Health IT. That this proprietary vs. Free/Open Source is even debated just seems so odd to me.

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Patents Being Abused To Put Your Life In Danger

A group called The Open ISES Project (openises.sourceforge.net) created an open source medical dispatch system called Cards 911, a document for use by emergency dispatchers. It gave them a script to follow when an emergency call came in. The answers would lead the dispatcher to different parts of the document using hyperlinks. The entire document was created in OpenOffice Writer. This was a document with hyperlinks in it that helped a dispatcher help the caller as quickly as possible. It was open source and available for free.

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