Medsphere Lands Another Hospital

Full announcement here: FOR IMMEDIATE RELEASE

Nationally Recognized Psychiatric Hospital Selects Medsphere’s Open Source Electronic Health Record to Transform Clinical Care

Silver Hill Hospital Chooses OpenVista to Improve Efficiency and Patient Care

CARLSBAD, California – April 29, 2009 – Medsphere Systems Corporation, the leading provider of open source healthcare IT solutions, today announced a five-year contract with Connecticut’s Silver Hill Hospital for implementation, training and support of the company’s OpenVista electronic health record (EHR) solution.

Testifying on ‘meaningful use’

Fred Trotter writes: I have recently been asked to testify at the NCVHS hearings on meaningful use (see forwarded message below). This is very likely because I have been working as a representative of the FOSS community with CCHIT to resolve the basic incompatibility with current CCHIT certification and FOSS EHR systems. For a decent summary you can read the CCHIT category on my blog or read some of the mainstream blogs: slashdot and ZDnet

Now I will be asked to testify on what ‘Meaningful Use’ of EHR systems means from a FOSS perspective. I am having discussions on what I should cover on both Hardhats (VistA community) and OpenHealth (larger FOSS community). Feel free to email me off-line (fred dot trotter at gmail dot com) or simply reply to this thread, with your thoughts.

OpenEMR releases version 3.0

The OpenEMR project has released version 3.0 on SourceForge. The new release has integrated practice management, improved multi-language support, and E-Prescribing. We have packaged a very easy to install Windows version using Xampp version 1.7.0. Thanks! “Friends of Apache.”

What we have in the works is a Debian package, an RPM package and integration of the HHS required interoperability module, laboratory communication module, and with some infrastructure improvements are hoping to be compatible with CCHIT certification by the end of this summer. Sam Bowen, MD

Towards fair EHR certification

Fred Trotter has a wrap up of the recent HIMSS CCHIT certification meeting on F/OSS. “Take away lessons:


  • Under the current model it is difficult to have the cost and benefit of the certification evenly distributed.
  • There is no way to easily ’share’ the certification
  • There is no maintainable benefit to being the organization that sacrifices to get a certification for a particular FOSS codebase.
  • It is not possible to prevent other organizations to certify a system that has already been certified.
  • Proprietary ontologies, like CPT, are a problem for the distribution of FOSS EHR systems.


Updated open source releases within OpenVista project

Medsphere today announced the release of open source code for recently developed components of the comprehensive OpenVista electronic health record (EHR) solution. Medsphere’s open source release, now available for download at, includes the OpenVista Interface Domain (OVID), the OpenVista Clinical Information System (CIS) 1.0RC1, and OpenVista Server 1.5SP1.

More details on with details posted here.

Some thoughts about the future of health care IT

Tom Munnecke the designer of VA’s Mailman has a remarkable article with some fascinating history of VA’s Mailman, what the future for Health ITcould hold and some warnings of unintended consequences: ‘…Beware Stimulating the Perversity of the Health Care system. Their are huge perverse incentives are “baked in” to our Disease Industrial Complex. The commodity of this industry is disease, not health. Regardless of the good intentions and expectations of individuals, the system forces them into less-than-virtuous behavior. The current stimulus effort runs the risk of unintended consequences of stimulating the perversity of our system rather than the virtues we seek. For example, it would appear that the greatest financial value derived from a universally available health record would be increased malpractice suits, because they would be able to program scanners that could automatically scan historical records with 20/20 hindsight and find some instance of an activity that in retrospect was the wrong path to take. This in turn will lead to an even greater emphasis on defense medical practices…’

HIMSS Day 1: Medsphere

Fred Trotter has a report from HIMSS: “…In reality there is a component of HIMSS that is FOSS-friendly and FOSS runs as an under current at every HIMSS conference that I have attended. It can be hard to find but it is there…Two less people die every day at Midland b/c of the systems in place to handle central-line infections inside OpenVistA. Wow. That means that Medsphere clients are starting to get VA-like improved outcomes. All at a fraction of the cost of the proprietary alternatives…”

Clinical Knowledge Manager Announcement

Dr. Tony Shannon;
Chair, Clinical Review Board, openEHR Foundation

Has released details on the Clinical Knowledge Manager to aide in the development and governance of archetypes (clinical knowledge units). His full announcement is below the fold.

The openEHR Foundation is pleased to announce the public availability of
its Clinical Knowledge Manager (CKM) web portal.

Professor David Ingram, of University College London and Chair of the
openEHR Foundation Board explains “At this time of unprecedented
international change, the openEHR Foundation is pleased to make
publicly available this collaborative CKM environment, to allow the
rich diversity of clinicians involved in informatics internationally to
better collaborate towards solving the grand challenge of Health IT.”
As the healthcare industry begins to tackle the pressures of worldwide
recession, the need for clinical leadership, service improvement and
more efficient means of information management are increasing all the time.
Across the world many clinicians are tackling information management &
technology challenges in their own organisations, yet often ask “surely
this has been done before” or “there must be an easier way”.
Many who have been involved in leading healthcare information projects
for any length of time now realise the challenges of;
-supporting the wide variety of clinical requirements of Electronic
Health Records (EHRs)
-aligning process improvement efforts with the right EHR technology
-linking disparate health information systems together and the complex
challenge of semantic interoperability
-making best use of health IT standards to drive both innovation and
consistency of effort
-supporting a variety of patient journeys with reusable clinical
components to save time, effort and money

The openEHR Foundation is a global not-for-profit Foundation formed in
2000 by University College London and Ocean Informatics Pty Ltd to
promote both best international practice in the design of EHR systems
and the development of open source tools and components to support
health record interoperability. Its public domain specifications are
used world-wide and have contributed to published EHR standards.

The openEHR Clinical Knowledge Manager (CKM) offers the international
clinical community the means to take ownership and control of the
authoring of the key clinical components needed in EHR systems.
Developed by Ocean Informatics, it provides an open online collaboration
environment for the design and validation of those key clinical
components (aka archetypes) for subsequent use by clinical applications,
electronic health record (EHR) systems and eHealth programmes.

Clinical archetypes are formal specifications of the clinical data
structures used within EHRs.
Examples of archetypes include;
-Presenting Complaint, Pulse, Blood pressure, Apgar score,
-Medication order, Imaging request,
-Diagnosis, Problem, Goal,
-Followup Instruction etc etc..
All of which are common clinical concepts that are required across many
health information systems today.
The underlying model for archetypes has recently been standardized
internationally by the International Organisation for Standardization
(ISO). The consistent design and use of archetypes across clinical
communities and countries is key to ensuring that clinical components
and EHR data can be consistently shared and analysed across systems,
thereby supporting evidence based clinical practice and promoting
patient safety both within and across healthcare organisations.

The openEHR CKM provides a tool to enable distributed communities to
draft archetypes for new areas of clinical content and to peer review
draft versions prior to final publication and use.
The early archetypes that have been made available in the CKM have
originated from earlier informatics projects in both Australia (CIC and
GPCG projects) and the United Kingdom (NHS pilot archetype work).
A pilot version of the CKM has been used by the openEHR Archetype
Editorial Group since early 2008.

The openEHR Foundation is now opening up this online collaborative
environment to make it freely available to the international clinical
community to better coordinate their health information improvement
efforts, be they local, national or international in nature.
This pioneering, online, Web 2.0 ready approach is the first of its kind
in the world and offers the potential to help clinicians by saving time
and effort and by harnessing the network effect to improve the quality
of EHR development internationally.

Further details about the openEHR Foundation are available at
Please feel free to visit the openEHR CKM at “”: in order to explore/comment on/contribute to/leverage this resource.

Your interest, involvement and feedback are invited, to begin the
greater collaboration in health information improvement efforts that is
needed across the world today.
Please distribute this important announcement to any/all those who you
feel may be interested/benefit.

Kind regards,

Tony Shannon

Dr. Tony Shannon
Consultant in Emergency Medicine, Leeds Teaching Hospitals
Clinical Lead, Clinical Content Service, NHS Connecting for Health
Chair, Clinical Review Board, openEHR Foundation
Senior Research Fellow, University College London
+44.789.988 5068
[reporter note] Edited slightly to make links clickable and for clarity. Original announcement is here: