The National E Prescribing Patient Safety Initiative, press release here is an e-prescribing juggernaut aimed at providing ‘free’ e-prescribing for all doctors. ‘…The challenge, according to the eHealth Initiative, is that fewer than 1 in 5 of the nation�s practicing physicians currently process prescriptions electronically. Studies indicate that most physicians have been reluctant to adopt electronic prescribing largely because of the cost of the systems, and a perception that the technology requires too much time to learn and install. NEPSI will help address those barriers by providing physicians simple, safe and secure electronic prescribing at no cost…’ This initiative raises a number of questions currently not answered: Who gets the e-prescribing data? Is this really free? What is in it for Allscripts?

Free Software Magazine has an article by frequent Linux Medical News contributor Fred Trotter on the ‘Tivoization’ of Healthcare: ‘Tivoization is a real threat to users freedom, but only when you consider the appropriate context. It�s not just a question of controlling hardware, more importantly its about controlling data. This issue becomes clearer when you consider health software instead of television software…’

The age of the all-browser based Electronic Medical Record/Electronic Health Record (EMR/EHR) is upon us. Local area network (LAN) based EMR’s upon which older generation EMR’s companies have built their products is dead. This paradigm shift is occurring now. This development threatens Free and Open Source medical software, practitioners and patients as they have never been threatened before.

Prior to all-browser based EMR/EHR’s, proprietary vendors of these softwares have to at least provide binary executables which are somewhat tangible and somewhat owned (depending upon the contract) by the purchaser. Free and Open Source Software (FOSS) vendors of EMR/EHR software are ideal and preferred because they provide the source code as well. With the advent of all-browser based EMR/EHR’s, no binary programs, much less source-code is provided. Only the service is provided. The software is wholly owned by the service provider and is not even distributed.

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Health-IT news articles usually follow a perennial pattern of loud hype followed by quiet failure. If what was at stake were not so important, the never ending raft of optimistic and un-critical press releases and articles about ‘progress’, ‘advances’ and ‘announced plans to’ would be a cause for amusement, guffaws and occasional cavorting at the lemming-like behavior of so many organizations and journalists touting the next big thing. To illustrate, here’s a list of recent news items for your reading pleasure. For further amusement, please use the following 3 ambulance scoring system for each of the projects described: 0 ambulances (succeed), 1 ambulances (fail), 2 ambulances (multi-million dollar fail) and 3 ambulances (multi-million dollar fail with firing) for their likelihood of success or failure. Let the fun begin!

1. Insurers Announce Interoperable PHR Model
2. My(Medical)Space: Social Networks, Blogs Turn To Health Care
3. Proposed Legislation Would Implement Quality Reporting System for Physicians
4. Major U.S. Employers Join to Provide Lifelong Personal Health Records for Employees
5. Vendor to Offer Web-based EHRs to Docs in Exchange for Data
6. RHIOs Will Lead Next Phase of NHIN program
7. Vermont to Announce Statewide
   RHIO
8. HHS Advances Nationwide Health Information Network Initiative
9. VA Moves IT Development, Management Under CIO

This is a must listen too video keynote address to the 2006 Seattle Plone Conference by the Free Software Foundation’s Eben Moglen: ‘…Software can prevent software from being owned. Software itself can lift the software tax. That’s where we are at this moment. On that cusp. In this neighborhood, at this moment, the richest and most deeply funded monopoly in the history of the world is beginning to fail…the very engineering limits of trying to make software that you own work as well as software that the community produces are becoming apparent…’

Free software magazine has an in-depth interview with Fred Trotter about the Medsphere saga, including comments by Richard Stallman: ‘…Medsphere is treated with the kind of respect that you would expect the top FOSS medical software company to receive. In reality, the top medical FOSS company is probably Uversa with their ClearHealth project (Note: Uversa is a friendly competitor of mine). Medsphere does not even warrant the title of �top VistA company�. Blue Cliff is a good example of a company that has a good reputation within the community, but gets far less attention than Medsphere. There are many other FOSS medical companies out there all of whom have contributed more than Medsphere. Yet Medsphere dominates the placement in the mainstream press, probably because they have received considerable funding…’

Columnist John C. Dvorak on PC Magazine writes: ‘In a surprise announcement, Microsoft’s Steve Ballmer seems to be doing a deal with Novell and the SUSE Linux folks. Apparently, the goal is to make Linux interoperable with Windows and perhaps move some apps onto the Linux platform. What could be brewing? Does it make any sense that Microsoft is going to embrace Linux in a big way? After all, Ballmer used to demean it…’

Emrupdate.com is an interesting website that is a: ‘…independent healthcare technology site for a wide range of opinions on the best and worst EMRs as well as heated discussions by thought leaders over government policy, technology trends and other initiatives and the positive or negative impact these will have on the practice of medicine.’

eChannel line reports: ‘According to a newly released IDC study, open source software has spread far beyond Linux and is gaining enormous momentum. The study, which analyzed IDC surveys from over 5,000 developers in 116 countries, finds that developers worldwide are increasing their use of open source. The study declares that open source software represents the most significant all-encompassing and long-term trend that the software industry has seen since the early 1980s. IDC believes that open source will eventually play a role in the lifecycle of every major software category, and will fundamentally change the value proposition of packaged software for customers…’

Bernard Golden has posted a summary of his LinuxWorld session called Open Source Goes Vertical where he talks about the results of his LinuxWorld session. His session discussed the market for open source healthcare software and included several luminaries including our own Will Ross

The results of my session will be forthcoming…
–FT