Noted PC Magazine columnist John C. Dvorak writes: ‘The sadomasochistic nature of programming, in my opinion, means that open-source software will always be better than commercial software. This is a whopper of a concept, but something has to account for the excellent code coming from the open-source movement. It may seem like an exaggeration, but hear me out on this one…

href=”http://servers.linux.com/article.pl?sid=03/11/26/039241&mode=nested&tid=29&tid=30″>article about installing Linux from a ‘senior Unix systems administrator for Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, where he is team lead for open source initiatives, Lawson Systems Administration, and DNS…’ Hooray, this sounds interesting. Thanks to Adrian Midgley for this link.

Past contributor to Linux Medical News Daniel Johnson, MD has written an article for Healthcare Informatics: ‘…We need a national medical record. Wait a minute. We already have one–VistA, the Department of Veterans Affairs (VA) and Department of Defense (DoD) electronic health record…VistA already encompasses more Americans than any other medical record. It works well, has been around for more than 20 years, and uses proven, reliable database technology…

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…’

Reuters is reporting that: ‘Patient complaints about medical errors in the United States, Britain, Canada, Australia and New Zealand are remarkably similar even though the medical systems vary widely, researchers said on Friday…”The countries are quite different from each other in the way delivery systems are organized and paid for,” she added. So it appears, she said, that advanced industrial nations, no matter what their approach to health care, need to upgrade their systems, especially communications… Thanks to ScotSilv for this link.

Here is a potpourri of articles recently submitted to the OpenEHR list by Thomas Clark. This one is a US report on healthcare quality. Another one, the National Healthcare Quality Report by the Institute of Medicine, and a report on the ‘lack of in-depth research on the content quality of paper and electronic medical records.’ This one is an ‘Interesting discussion on relevance; interesting comments on expert
opinion; probably due to the close working relationships with the law industry that loves inconsistency in medical records.’ This one from Alexander Caldwell is about “The MEDICI Electronic Data Interchange Library” a hot topic recently which was also reported on here, submitted by Bill Walton to OpenEHR.

Here’s a Linuxworld article about developments in my own backyard of Texas regarding Texas Senate Bill 1579: ‘In the war between proprietary and free/open-source software in state and local government over the past two years, Texas has established itself as ground zero. Texas Senate Bill 1579, for example, which seeks to ensure that free/open-source software is given a level playing field when competing with proprietary products in state agencies…’

Gordon Moore, MD is doing what many think is impossible: going without staff, without answering service, in one 150 square feet room. He also delivers superior care and can make more money seeing 12 patients a day than his previous 25-30 in one day at a conventional large practice. Unbelievable? Read this AAFP article to see just how he is doing this: ‘…To provide more reliable care, simply trying harder and reading more articles isn’t going to cut it. Instead, we must begin to embrace information systems that can support our clinical efforts, whether they be electronic medical records, computerized care reminders, online clinical resources, etc…With very low overhead, I don’t need to see hordes of patients each day to make ends meet. Seeing fewer patients, I don’t get that many phone calls. Because I use an electronic medical record and practice management system, making referrals, refilling prescriptions and all those little tasks have become much easier as well. Thanks to Alexander Caldwell for this link.

Newsforge re-visits Largo, Florida in this article which a year ago was the subject of a report entitled “Secretaries use Linux, taxpayers save millions” The odd part is how many of the same things written in the article could/should be said of medicine: ‘…The real strangeness is not that these guys have managed to build such a wonderful, cost-effective system, but that so few others have done the same thing. Everything in the Largo IT ecosystem is off-the-shelf standard goods, from hardware to software to the wires that hook everything together. The innovation here comes in making maximum use of everything, and not necessarily in obvious ways — and in coming up with solutions that are as much social engineering as technical, like the “cybercafe” in the Largo City Hall’s employee break room…’

The American Informatics Association (AMIA) Student Working Group will be discussing Free and Open Source Software in medicine at its business meeting, at the November 2002 Fall Conference. The meeting, with a social event following, will be held at 8:00 pm in the El Mirador room, 22nd Floor, Hilton Palacio del Rio hotel, San Antonio, Texas. There will also be a special session: Careers in Medical Informatics (S27) Hosted by the Student Working Group Monday November 11th, 3:30 pm-5:00 pm Room 008 A/B, River Level