Both your money and your medical privacy are going to be gone unless a single sentence law is enacted. No less a source than the Congressional Budget Office (page 16 and 17) is saying that the recent Health Information Technology parts of the American Recovery and Reinvestment Act of 2009 will drive the taxpayer into a $17 billion ditch even after 10 years. That’s right, the taxpayer will be paying $30 billion to LOSE $17 billion after 10 years with no break-even point even mentioned. Remember that national ‘investment’ in Health Information Technology is going to catapult us into Health care nirvana in which your data and privacy are secure and the health care system in the United States hums along like a well oiled Internet resulting with all of these great cost reductions and efficiencies? All we really have to do is just spend money on the problem and it will be solved. We need to ‘incentivize adoption’ of health care technology and all will be well. The law as written will achieve anything but that. A single sentence could change that.

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Please let your federal government representative know the following: “The nation is demanding and spending billions to ensure that we have a high-performance Health Information Technology infrastructure. The ARRA of 2009 allows proprietary companies to put up tollbooths and black boxes everywhere at taxpayer expense with little or no guarantees of the ability of the public to audit, innovate, study, fix or extend the software to ensure high performance, privacy, security, fitness, or upgradeablility can occur. Without a ban on federal money for purchasing proprietary Electronic Medical Record software and requirements for licenses such as the Affero General Public License that safeguard public rights and ensures sustainability, we will become a nation of renters of poorly performing health IT software infrastructure that taxpayers paid dearly for, and will pay for again and again.”

Gaetano Fida wrote in to Linux Medical News here with the following plea: “I need access to Dr. Notes. Admin password doesn’t work and we need access to retrive patient data for court hearing. Help. I am the It support for the practice.” Dr. Notes as you may or may not recall is the company that allegedly started cutting off people for non-payment of Electronic Medical Record ‘rent’ even while the company itself was not paying its own rent. This is exactly, precisely a gaping hole in the American Recovery and Reinvestment Act of 2009 which will give breaks (aka money) to doctor’s for implementing Electronic Medical Record software. It has no provision whatsoever for ensuring that those EMR’s are sustainable, much less Free/Open Source licensed. Without a provision requiring Free/Open Source licensing such as the Affero GPL, the American Recovery and Reinvestment Act of 2009 which will spend at least $19 billion on Health Information Technology, could be the biggest lost opportunity in American history.

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The Obama administration has made a pledge to spend $50 billion dollars on Health IT, yet it is unclear how they will come to grips with proprietary health IT software, a problem I will call the ‘Some Dude’ phenomenon. In my now lengthening health IT career, I have frequently come across a remarkably destructive and unfortunately abundant person called ‘Some Dude’. Some Dude is the proprietary license holder of an entrenched piece of health IT software that needs to be interfaced with other software. Some Dude is entirely and in my experience usually capable of: stonewalling, obstructing, fleecing, lying, tollboothing, and ignoring any effort to interface with their proprietary software. There are few to no penalties or consequences to the proprietary license holders for such destruction. There are many real consequences and penalties for patients and practitioners by such obstruction.

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Steve and Scott Shreeve are the recipients of the 2008 Linux Medical News Freedom Award. The two brothers founded Medsphere Corporation and guided its early rise to prominence. They were likely forced to leave the company in 2007 after a $50 million dollar lawsuit was filed against them by the company and which was settled under confidential terms. They remain steadfast in their support of Free/Open Source software ideals in medicine. Congratulations to the Shreeve’s recipients of the 2008 Linux Medical News Freedom award.

The year of the GNU/Linux desktop has been always right around the corner for many years now. Many have been looking for the ‘killer application’ that can only be had on GNU/Linux and that will spur widespread adoption of Linux on the desktop. While fast-booting Splashtop desktops look promising, one killer application boldly going where Windows cannot go is languishing. That killer application is…

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Somewhat off our usual topics, here is a brief roundup of excellent enterprise management software:

• Pentaho business intelligence software.
• Zenoss IT management suite.
• XRMS Customer relationship management.
• Sugar CRM Customer relationship management.
• Plone Enterprise content management system.
• Moodle Courseware, run a one room school house or a major University.

Updated 12/21/07: a PeaceHealth official has contacted me and they are open to licensing this software under a Free/Open Source license. Details as they occur.

Dear Robert Wood Johnson Foundation, PeaceHealth/Shared Care Plan

Recently a version of the Shared Care Plan software surfaced in Houston, Texas. I have read the End User Licensing Agreement (EULA)

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According to this article: “The Washington Post on Friday reported that global measles fatalities had been reduced by two-thirds following stepped-up vaccination campaigns since 2000. Furthermore, this phenomenal success had a helping hand from open source software. Coverage of these measles vaccination campaigns has been carried out using pocket computers running an open-source program, EpiSurveyor, developed by a Washington-based nonprofit, DataDyne…”

Updated: Looks like we are on the other side. Thanks to Chris Withers for some migration code magic.