Why has Ontario, Canada chosen to link their Smart Systems for Health Agency to the proprietary .NET technologies? I recently was perusing the website for the Ontario, Canada Smart Health initiative and noticed that a lot of the job postings were for .NET technologies. The question I would have is why tax payer money is being spent toward what will amount to a proprietary solution? Are there sufficiently advanced Open Source projects which could be “suggested” to this agency for inclusion in their efforts?

AMA-News has an article on Free/Open Source EMR’s. This article has good information and overview, but is condescending in tone and contains inaccuracies such as: ‘There’s a new pitch for selling electronic medical records software’ The article mentions VistA, Medsphere, OpenEMR and TORCH as well as quotes from physicians using the software. There is also this: ‘…The ranks of open-source EMRs could soon grow by at least one as two foundations created by the settlements of physician class-action lawsuits against Aetna and CIGNA Corp. — Physicians’ Foundation for Health Systems Excellence and Physicians’ Foundation for Health Systems Innovations — are planning to develop and market an open-source EMR to physicians around the country…’ which is news to me. These new organizations are distributing grants, but the first round for submissions was March 1, 2005.

The March 2005 issue of Psychiatric Services has a column by Thomas Good the author of SQLClinic an electronic medical record geared toward Psychiatry which, has been used with other types of practices. This is a mainstream Psychiatry journal so it is good to see a FOSS project getting some press there. From the introduction by the column editors: ‘Open-source software addresses three crucial needs of users: it is easy to customize, it is inexpensive, and the user�s future is not tied to that of a vendor company. Although the software the authors describe in this month�s column is still too formidable for an individual practitioner, moderate- sized organizations should consider it near the top of the list. Let us hope that programmers develop a version tailored for solo and small group practices soon. We will report on it in this column when it occurs…’ There is a factual error in the article in that it states that the Open Source movement began in the early 80’s. Actually, the Free Software movement began in the early 80’s. The Open Source movement began in approximately 1998 and shares many of the goals, but is distinct from the Free Software movement. A short history of both of these movements can be found here.

Newsforge has an article on a pharmaceutical services company that has gone to Linux: ‘…When Siler looked at the potential financial impact and the eight-month timeline involved in setting up and getting trained with Oracle or another big company and compared it with the 60-day setup and greatly reduced license fees associated with Gluecode’s product running on Red Hat Linux, he was easily able to convince his superiors that open source was the way to go.

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Here is a summary of a healthcare panel that discussed Free and Open Source Software in medicine at the 2005 PC Forum: ‘… Larry Augustin, CEO of Medsphere, [as well as being founder of Sourceforge and on the board of OSDL] believes that open source software will play a key role in solving the healthcare dilemma. His company wants to be the Red Hat of healthcare, and has ported software originally from the Veterans Affairs Admininstration to Linux. He said that the vast majority of hospitals can’t afford the high-end proprietary system, and that open source will change the economics.

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NYT Magazine has an in-depth article on different ways of looking at health care reform that take into account that rising health costs also yield more health benefits. Health-IT is mentioned starting on page 6: ‘…Many doctors still write prescriptions and keep records manually, and Cutler says that digitizing the health-care system would save considerable administrative expense and improve quality. It would minimize prescription errors, speed paperwork and make a patient’s medical history portable. But the big kick is what information technology could do for the doctor’s understanding of his own performance.

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JAMA has a research article on how TDS, a closed-source Eclypsis Computerized Physician Order Entry system (CPOE), facilitated some types of medication prescribing errors. Unknown is how this one product compares to other products of the same kind, whether proprietary or free and open source. Medical informaticist and Linux Medical News contributor Scot Silverstein has posted a response to the JAMA article. Thanks to J. Antas blog for these links.

David Wheeler has recently updated his article on Why Open Source Software / Free Software (OSS/FS, FLOSS, or FOSS)? Look at the Numbers! The article has use data for GNU/Linux in general as well as the Apache web server software in particular which continues to far exceed any other vendors market share including Microsoft. Many other metrics are also included in this quantitative paper. Linux Medical News first reported on this article in July 2001. Thanks to J. Antas blog for the link to the update.

J. Antas blog has a commentary and an interesting link to a Linux Journal article on choosing system administrators. In the authors opinion, Linux system administrators are more productive and versatile that Windows NT or Unix system administrators.

Here is the text of the speech by David Brailer, MD PhD National Coordinator for Health Information Technology given February 17th, 2005 at the HIMSS conference in Dallas, Texas: ‘…This year, we will release a complete Strategic Plan, as called for in the President�s Executive Order. This will build upon the Framework for Strategic Action by providing detailed plans and critical steps for who, how, and what will be required to implement the President�s vision. This Strategic Plan will be a guide for key stakeholders in the private and public sectors. In the short term, we are focusing our efforts on the building blocks of EHR adoption, interoperability and streamlined Federal health information systems. We have prioritized these building blocks because they enable the private sector institutions and public organizations that foster a market-based solution, and because they are foundational for downstream efforts like personal health records and state-of-the-art biosurveillance…