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GEHR Project Status

Thomas Beale of the Good Electronic Health Record (GEHR) project writes: ‘The recent silence…does not mean work has stopped
on GEHR! On the contrary, we are hard at it, and are at the stage of
integrating the XML archetype processor (Java; written at the DSTC), the
kernel, the database and the COM interface (developed by ISE in Santa
Barbara). As you can imagine, this represents quite a lot of work…’ Read on for more project status details.

The latest milestone has been to develop object database schemas for the
EHR and ARCHETYPE databases, and successfully store about 15 archetypes,
and a health record (EHR). The EHR contains 3 VERSIONED_TRANSACTIONs, 1
for the patient, 1 for the authorising HCP and one contact transaction.
With a more powerful testing front-end, we can of course make this any
number of patients, transactions etc.

The database being used is the Matisse ODB. We may post some screen
shots of the stored information (it’s always an eye opener to those used
only to relational databases) but the main audience for this would be
developers; the rest of you will want to see sensible output in a
browser. We are accordingly working on XML instance output with an XSLT
translator to HTML and thence to IE or Netscape. Note that this test
browser is separate from the GUIs provided by the participating vendor
companies – they will be using their own GUIs, and communicating to the
kernel via the COM interface.

Probably a lot of you would like to be able to see something more of
what we have done… it’s coming soon! As you can appreciate, with a
back-end development such as this, the last thing that gets done is GUI.

Expect a source update in the next week containing:

– COM interface (alpha release;-)

– Matisse ODB functionality

– the Java archetype initialiser

Please post questions/discussion to gehr-discuss@egroups.com or one of
the more specific GEHR egroups as appropriate.

– thomas beale
(for the GEHR team)

New Leadership for the Littlefish Project

The Littlefish project is announcing a change in project leadership from Chris Fraser to Nicolas Pettiaux

“Eric Raymond states in the Cathedral and the Bazaar: “When you lose interest in a program, your last duty to it is to hand it off to a competent successor. Well I haven’t lost interest but due to pressing personal family issues, it is time to pass the project on to a competent successor.”

Details of Pettiaux’s considerable involvement in open source software follows.

It is therefore with great pleasure that I can officially announce that Mr. Nicolas Pettiaux has agreed to take over the leadership of the Littlefish Health Project. His email
is nicolas.pettiaux@linuxbe.org

Nicolas has solid open source credentials including:

  • Vice-presidency of the French speaking AFUL (www.aful.org), French speaking association of open source and Linux users. Organizer of Open source conferences with Eric Raymond – http://conf.linuxbe.org,
  • A representative of Eurolinux, to lobby politicians, journalists and fellow citizen about the risk of software patents and promote the use of open source in government http://petition.eurolinux.org)
  • Promoter of the use of open source softwares in public schools in
    Belgium (not
    yet documented in any site)…

  • Actively lobbies the EU to adopt fund open source
    projects.

    • As assitant at the Free University of Brussels Fauclty of
    Medecine,
    Nicolas
    has worked in signal analysis (ECG, ballistocardiography,
    breathing
    signals),
    health image processing and 3D reconstruction.
    Nicolas has a PhD in theoretical physics and a complementary
    business education.

    Finally, Nicolas’s wife is a cardiologist that has much interest
    in using a
    software like Littlefish. He is also the happy father of 2
    children,
    Jason (6)
    and Lucie (4).
    Under Nicolas’s leadership , the links that Littlefish has
    between
    the Good
    Electronic Health Record     and members of the Open Source
    Health Care Alliance    , I am reassured that
    the project
    will continue to grow and become available for health services
    everywhere
    to
    improve the health of the global community.

    The Littlefish Trademark will ensure that the project will always
    remain
    open source and Pangaea & Microshare will continue to provide the
    webserver to
    sponsor The Littlefish Health Project.

    Chris Fraser

    Melbourne

    November 2000

    Open Source Advocates to Attend AMIA

    LinuxMedNews will be reporting live from the American Medical Informatics Association conference which begins this weekend in Los Angeles. There will be a Saturday Morning AMIA tutorial, “How Open Source Really Works” as well as many open source medical software project participants and advocates in attendance. I’ll be the bearded short guy passing out light green LinuxMedNews flyers and lurking around the entrance of David Forslund’s ‘Federation of the Person Identification Service between Enterprises’ talk in the ‘Santa Barbara A/B’ room from 3:30-4:00pm on Monday Nov. 6th. Meet me there if you have any juicy information or just want to meet in person. An informal gathering will take place from 7:00pm-9:00pm Monday, Nov. 6th in the Los Feliz room of the Westin Bonaventure hotel. I will be unable to attend the Monday evening get-together as I have to be back in Houston to tend my vast stable of reporters. They get nervous if I’m away too long.

    WHO Applies for .Health

    The World Health Organization (WHO) has applied for a .health Top Level Domain (TLD) in an effort to ensure quality of health-related information sites. The application can be viewed on the Internet Corporation for Assigned Names and Numbers (ICANN) site. ‘…”The creation of a .health TLD will mobilize an international standards
    process for health information, and enable major progress towards
    harmonization of existing standards and measures. Such a standards
    process is likely to require nine to twelve months for completion of the
    initial phase. This proposal gives a picture of how the .health TLD
    might function, once international standards are established and
    operational.’     Thanks to Wayne Wilson for this pointer.

    FreePM Project Status

    Updated: 1/12/2003 FreePM is now TORCH Tim Cook, project leader of FreePM recently wrote on the openhealth-list about the current status of the project. A demo is available online at the FreePM site with login ‘guest’ password ‘abc123’. Excerpts: ‘…Dr. Chason Hayes has been doing some documentation for us…I have been speaking to Dr. Andrew Ho about integration of OIO
    into FreePM or at least supporting the same XML formats for
    sharing forms…Dr. Alex Caldwell continues to provide us with valuable input
    about XML experiences and we are working to maintain
    compatibility between FreePM & TkFP in the formulary and
    prescription modules. I expect that we will be pursuing the same
    compatibility in progress notes. Here we have a crossing with OIO
    as well due to the forms generation…Ron Chichester is working on the default formulary using the
    National Drug Code Directory. After that he will be giving the
    Scheduling module a much needed facelift…Alexander Chelnokov is working on a new set of ICD codes…I have been reorganizing my notes into something I can call
    project management since the tempo is picking up…’

    There have been 22 downloads of 0.5.0b…this is a beta version of the patient registration and prescription modules. This includes the employee (user) creation and the formulary due to the dependencies.

    There are four documents that are key to using these functions:

    Getting Started

    Configuration

    Patient Registration

    Patient Medications

    They are available on the SourceForge site. If anyone needs them
    downloaded and emailed to them then please contact myself or one
    of the project admins listed on the site.

    Remember, that if you do not want to download and install all of
    the required software. You can use the online “demo” at
    http://www.freepm.org. It really isn’t a demo in the true sense.
    You can’t add employees that can actually login but otherwise you
    have the same privileges as if you were a physician logging in to
    an installed system. You can add drugs to the formulary and add
    patients and prescriptions.
    Please feel free to try it out. Then let us know here your
    experience.

    There has been one reported problem installing Zope/other
    products/FreePM. No resolution has been gained there yet as far
    as I know. I did send a message to the list with some pointers to
    installing Zope on various platforms.

    The beta version of the upcoming O’Reilly Zope Book is available
    at zope.org. It looks pretty good. Some of the best Zope
    documentation to date.

    Dr. Chason Hayes has been doing some documentation for us and is
    also going to be adding some javascript in key places to make
    validations smoother. He has also been doing some work on the
    user interface in various places. I especially want to say thanks
    for the very boring job that he did for me cleaning up some code
    that was left over from when I first started using Zope for
    FreePM.

    I have been speaking to Dr. Andrew Ho about integration of OIO
    into FreePM or at least supporting the same XML formats for
    sharing forms. More news about this after meeting with him at
    AMIA.

    Dr. Alex Caldwell continues to provide us with valuable input
    about XML experiences and we are working to maintain
    compatibility between FreePM & TkFP in the formulary and
    prescription modules. I expect that we will be pursuing the same
    compatibility in progress notes. Here we have a crossing with OIO
    as well due to the forms generation.

    Ron Chichester is working on the default formulary using the
    National Drug Code Directory. After that he will be giving the
    Scheduling module a much needed facelift. As it is now, it works
    for employee and resource scheduling. The terminology is geared
    as an event manager vs. a real scheduling module. The patient
    appt. schedule will be dynamically generated from the combined
    physicians personal schedules.

    Alexander Chelnokov is working on a new set of ICD codes. The one
    I currently have in place for testing only has a brief text
    field. Since they use ICD-10 in the Federation of Russia I assume
    he will be working primarily with that version. I’m not certain
    if he is also producing an ICD-9 set.

    I have been reorganizing my notes into something I can call
    project management since the tempo is picking up. If there is
    something that you want to work on let me know. If you want to do
    ‘something’ but aren’t really picky let me know that too (I have
    a long TODO list ).

    OIO (0.9.4) Delivers Visual Analog Scale and Data Mining

    Need more than radio buttons, click boxes, and drop-down menus for your web-based medical system? The latest release of Open Infrastructure for Outcomes (OIO), (Free account/demo here) shows what is possible by using a tiny Java Applet to implement a visual analog scale (5k). Users of the OIO can now incorporate visual analog scales into their web-forms with a few clicks– all without writing a single line of Java. Want to do data mining? Just point and click.

    Following the introduction of XML metadata import and export in 0.9.3, oio-0.9.4 is the newest feature-enhancement release. It now allows the incorporation of Java Applets into web-forms for data input without programming. The new Visual Analog Scale form element is based on this capability.

    The second major enhancement is client-side validation through Regular Expression (template). Now, the entire process of using Javascript to validate user input is automated.

    The third major added feature is data merging and drill-down querying across Forms (and versions). This is the beginnings of adding data mining and statistical tools to future releases of the OIO.

    New Features:

  • Applet integration: Visual Analog scale
  • Regular expression template,
  • Online help for Forms and Patients screens
  • Data merging across forms (and versions)
  • Drill-down data mining
  • Integrated examples during itemtype definition

    The OIO is built with and uses the open-source Zope application server and Postgresql. The OIO download is only 350k and is available from:
    Open-Outcomes.sourceforge.net


    Alternatively, you can get a free public access account from
    www.TxOutcome.Org     to try it first.

    We invite other open and closed source projects to incorporate OIO code and technology.
     By using the OIO and working together, hopefully we can accelerate the evolution towards more flexible and inter-operable systems.

    • MUMPS (M) Compiler and Interpreter GPL’ed

    Kevin O’Kane, PhD wrote in with the news that a MUMPS (M) compiler and interpreter C source code are now available under the GPL on his web site. This removes a major obstacle for adoption and use of Veterans Administration VistA project medical software code. Pro’s and Con’s of VistA were discussed recently on LinuxMedNews and a comment at the time was: ‘…An open
    source entry into VistA would be considered a major event in medical computing.’

    Mozilla Milestone 18 Available

    Updated: Michelle Head has an interview with Mitchell Baker, a Mozilla manager. Mozilla.org has released Milestone 18 of its long-awaited open source web browser. Relase notes say that Java should now work. The production version of the browser is scheduled for release this December-January. This key piece of software will be incorporated into Eazel’s Nautilus file manager, Netscape’s 6.0 browser and will be available to become an integral part of future open source medical software.

    MedAgree.com Seeks Rational Doctor/Patient Relationship

    MedAgree.com has an intriguing idea: ‘…a systematic approach to defining the fundamental elements of the
    health care contract. By this, we mean creating agreement about the essential elements that make the health care
    relationship work: who’s doing what, and how are we steering the treatment ship…
    There exists between doctors and patients certain identifiable patterns of misunderstandings
    which generate unrealistic expectations, adversity and litigation.

    The remedy for these misunderstandings is role clarification and collaborative
    planning…’