HL7 has released its Ballot Documentation “EHR System Functional Model and Standard” – you may download a copy at: http://www.hl7.org/ehr/ballot/review.asp

HSC has released the zWebit interface engine under the GNU GPL license. The Linux based interface engine utilizes a web based front end for monitoring interface statuses and was built using C++,php and html. Support for HL7 transactions is included.

Work is currently underway to incorporate the Perl HL7 toolkit with zWebit to provide extensions for end user data manipulation and control.

zWebit has proven stable and reliable in a 250 bed hospital supporting twelve interface connections. zWebit is based on a simple, time proven and well documented design.

zWebit is available on Source Forge at http://sourceforge.net/projects/zwebit

After two years of development, the FreeMED Software Foundation has released a stable version of FreeMED! The new .6 Version has lots of new features including a totally new modular architecture, HL7 support, medical billing functionality, scheduling system, and integrated security system. The new version is also compliant with both the HIPAA privacy and security rules. If you have not looked at FreeMED in a while… now is the time! You can download the new version from www.FreeMED.org
Enjoy!

Fred Trotter, CISSP
FreeMED Board of Directors

FreeMED is one of the oldest Practice Management Projects in existence. From the press release..

FreeMED is at its core a fully customizable electronic medical record. There are discrete interoperable loadable modules with support in both the static and dynamic portions of the program. Available are several switchable templates. FreeMED allows access to its core functions using an XML-RPC backend transport, and is fully HL7 compliant. There are several transports (import and export modules) available. There is record locking support for individual pieces of any patient’s electronic medical record. There are several options for navigation including menu bars, drop down GUI-type menus, which include features such as stored session data, and browseable page and patient histories.
USER ACCOUNTS: There is increased user account security in this version, with authentication being performed through sessions and using MD5 encryption in addition to the HTTPS (secure hypertext) protocol’s available 128-bit encryption. Individual user preferences may be selected and stored.
INTERNAL MESSAGING: There is a functional internal messaging system, which stores and verifies the status of messages to and from staff, physicians and patients. Patient messages are attached to the medical record, and are also accessable when browsing a patient’s record.
DOCUMENT MANAGEMENT: A scourge of medical offices has been the storm of papers which appear for each patient and which must be filed and then re-located. FreeMED uses a DjVu based document storage system for scanning, attaching, marking and retrieving all document forms including images, reports and tracings. The documents can be signed and traced.
SCHEDULING: Scheduling has been expanded and improved. There is now group scheduling, appointment movement, and multiple provider scheduling. There are user options to make multiple changes to the schedule without refresh.
INTERNATIONALIZATION: il8n (internationalization) and l10n (localization) are supported using the XML-based GettextXML format, allowing FreeMED to be viewed in any language that a translation is provided for. FreeMED also stores ISO set data, allowing the ability to store and maintain the demographic database in one language and ISO set, even if viewed in another.
BILLING: There is a working HIPPA-compliant billing system.
IMAGE MANAGEMENT: Images may be attached directly to the EMR or may be stored as part of the document management module. In this fashion such things as a picture of the patient may be attached directly into the medical record portion.

Computer World is running a story about ANOTHER consortium forming to work on an Medical Health Record. The EMR problem is still open… perhaps these folks will be the one to get it right first. It is being backed by IBM. Another article on the same initiative can be found here.

Andrew Fairchild wrote in with news of his multilingual medical dictionary which can be found here along with many links to medical language resources. The dictionary is an Excel file that can be had for a fee beginning at $60. An article about what it took to compile it and its purpose can be found here. The dictionary itself is not Free/Open source, but it sounds like a unique and useful resource so I am reporting on it.

According to this article in the Kansas City Business Journal (free registration required) there’s a turf war brewing between Cerner and rival Meditech if a proposed purchase of Health Midwest to HCA occurs: ‘… Cerner has a 10-year relationship with Health Midwest, which was the medical software provider’s first significant client… But that relationship between two of the largest health care players in Kansas City is threatened if HCA takes over Health Midwest…That’s because HCA uses a Cerner competitor for all of its data record-keeping and medical software needs…’ Oops. In other news, according to the Palm Beach Post, Eclipsys founder and Chairman Harvey Wilson has resigned amid problems with overstating earnings: ‘… Wilson and two other top Eclipsys executives have been accused in a class-action shareholder lawsuit of intentionally issuing misleading earnings forecasts…’ Eclipsys is a major vendor of clinical computing software. Both of these real-world events show how vulnerable medical software is to corporate difficulties. If a changeover occurs from Cerner to Meditech, how many difficulties will this cause? How much time and money wasted? How many deaths or complications from un-familiar software? Isn’t it time to separate the software from the organization that services it?

The Los Angeles Times (free registration required) is reporting that: ‘Cedars-Sinai Medical Center, the largest private hospital in the West, is suspending use of a multimillion-dollar computerized system for doctors’ orders after hundreds of physicians complained that it was endangering patient safety and required too much work…’ According to this they were using Patient Care Expert (PCX) which was likely built by Perot Data Systems using their Digital Health System. Hmm, guess they didn’t read this research article. Thanks to David Derauf, Tim Cook, Molly Cheah and Wayne Wilson and the Openhealth list for the above info and links.