Caldwell: Tk Family Practice Version 50 Released

Alex Caldwell is announcing the availability of the latest Tk_familypractice EMR on Sourceforge. Highlights are an improved installation script and browser interface. The full text of the announcement is within.

I posted a new version – version 50 – of the Tkfp program for Linux on the Sourceforge site at http://www.sourceforge.net/projects/tkfp

Changes:

  • The install script works better. Gives you choice of installing postgres copy (it isn’t needed to run Tkfp) I’ve tried it on 3 different machines and it seems pretty reliable so far.
  • Two new objects for the progress note templates – one is a pop up menu for choosing the day of the week. The other is a menu for choosing various common time intervals.
  • There is a menu in the admin tab for running a set of scripts that back up the data and/or the program.
  • A file chooser dialog added to admin for selecting a scanned signature file for providers. The file is then linked to all the necessary places where the scanned signature appears. Before you had to put this in the right places by hand.
  • There is a button for viewing the fax spool directory. If you click on a file, it will be loaded into an
    editor so you can change the fax message quickly.

  • The demographic form can now be toggled between English, Spanish, French and Portuguese. This is pretty easy to program. If anybody would like to work on other languages, I can send you a file with the lines that need to be translated. You can use any language for which there are Unicode values for the characters. It would be interesting to do Japanese or some other non-latin based languages.

    Stuff I’m working on for next version:

  • Improved Web Browser interface. Using tclhttpd, a powerful web server that is already in Tkfp, I’ve been working on a better Web Browser based interface. It uses frames and has a layout
    somewhat similar to the desktop GUI with a list of names and drugs on the left and a set of menus roughly corresponding to the notebook tabs and data frames on the right. With tclhttpd, you can extend the web server to do all kinds of things by writing code in Tcl. It’s similar to the idea of ZOPE. Using HTML forms you can define URL’s that process the data and output HTML. So most everything you can do in the GUI can be done inside a web browser. HTML forms are more limited than Tk widgets so you can’t have fancy stuff like
    sliders, spinners, tabbed notebooks etc. But the Web Browser interface can be very useful for using the EMR from remote locations.

    Chris Deam is working on a Tk interface for scanning images.

    Alex Caldwell

  • Dvorak: Is Linux Your Next OS?

    No less a personage than John Dvorak has weighed in on the near future of Linux:
    ‘…Unfortunately, the Linux community spends too much of its energy on things such as nomenclature (like the name GNU/Linux versus Linux). I sense that Linux is at a crossroads of becoming very important or becoming a footnote in desktop OS history. Right now, I’m banking on it becoming very important�and I mean on the desktop.’

    Availity.com Uses Proprietary Software to Process Transactions

    The Atlanta Business Journal (free registration required) has an article about Availity.com a company that ‘… uses proprietary software that allows providers to file claims securely online. Specifically, health care professionals can better transact business with Blue Cross and Blue Shield of Florida and Humana through Availity.com’s Web portal…’ The article notes that the company saves a tremendous amount of time and money to process claims: 25 cents versus $2-3 per claim. The major questions in my mind is why has this not occurred long ago among insurers themselves to lower costs and why does this require proprietary software? Despite this, congratulations to Availity.com

    PDA’s May Become Essential

    The Chicago Tribune is reporting that PDA’s such as Palm and others may soon become as indispensible as a stethoscope: “Today when a patient sees his physician consulting a PDA, he may wonder what’s going on,” said Rosenbloom, an emergency room physician at Northwestern Memorial Hospital. “But some day, the patient will wonder what’s happening if his doctor doesn’t consult a PDA.”

    Wired: Medical Textbook ‘Heals Itself’

    An interesting development in medical textbook making is occuring with Medical Approaches. The book is being created online with global participation and discussion. You can download it for free, review it, discuss it and add to it. Wired has a brief article on the book: ‘…Breaking the typical rules for publishing a book, Medical Approaches is a publishing process in itself — with doctors in Great Britain and around the world discussing medical care management in an open forum…’

    Medical Enterprises and Open Source

    Dan Johnson has posted his August 2001 white paper on Medical Enterprises and Open Source:
    ‘We in the health care industry, both software vendors and institutions, need to share code that meets common needs, and work together to develop it. We are wasting precious resources competing with duplicated effort. To share development of code that meets shared needs will spread R & D across the whole industry, and enhance useful competition to meet the individual needs of customers and to provide highest quality service…’ Dan is arguably the patriarch of free/open source software in medicine since he is the author of the earliest known writings (~1986) 1, 2, on the subject.

    MedZope Explained

    Jon Edwards, on the ZoPyMed list (http://maillist.linuxmednews.org/mailman/listinfo/zopymed) explains what MedZope (http://www.medzope.org/) is all about. Click read more for the full post: ‘The initial goal of Medzope was to produce a system that could be used by anyone who can click a mouse, or type with one finger, to build a website and update it regularly – no knowledge of HTML, CSS, DTML, XML, ZPT, etc. required.’

    OK, pour yourself a cup of coffee and prepare for a lengthy explanation!

    The initial goal of Medzope was to produce a system that could be used by
    anyone who can click a mouse, or type with one finger, to build a website
    and update it regularly – no knowledge of HTML, CSS, DTML, XML, ZPT, etc.
    required.

    A good example is at http://www.grimsbypip.nhs.uk – we set up the basic
    structure for them, the practices add the content. (Note: we are a
    commercial business “Pricom”, selling services around the open-source
    software we produce “Medzope”)

    Things have progressed and now Medzope aims to address two areas – Websites
    and Intranets –

    Websites

    – see the description at
    http://www.pricom.co.uk/home/servicesfolder/pcggpfolder of course it’s
    equally applicable to departments within a hospital as to practices within a
    Primary Care Group …or to single organisations

    – we’re expanding the functionality to give more “Customer Relations
    Management” facilities for patients, and to include things like
    online-booking of appointments or ordering of repeat prescriptions.

    Intranets

    – early days, if I describe what we’re doing for Doctor’s Practices, perhaps
    you could say what needs to be done differently for hospitals, or other
    organisations?

    – Teams/Departments (in a practice these might be Doctors, Nurses,
    Reception, Admin, Management) – each has its own “sub-site” (with protected
    access if required) with its own calendar/scheduling, guidelines/protocols,
    news/noticeboard, document-library, contacts list, useful links directory,
    training management area, discussion forums

    – Top level – used for general info that applies to the whole org, and to
    pull together information from the departments. For example “Today’s Events”
    at the top level would list public events from the Calendars of all the
    Teams/Departments, “Today’s Events” in the Doctors’ department would list
    only the meetings, rotas, holidays, appointments for Doctors

    – Workgroups – password-protected areas for cross-function projects/groups
    to collaborate and share information. Examples at a practice might include
    Audit, Clinical Governance, Teen Health, Mental Health, Business Planning

    – Workflow/Scheduling bits – for example, patients phone up requesting home
    visits, (once approved) these get added to a “Pending” list, Doctors can see
    the Pending list on their desktop, they click a button to say “Yes, I’ll do
    that one” and it comes off the list and onto their schedule/calendar, Admin
    staff can see the list of each Doctor’s visits for the day, and have the
    relevant patients’ notes ready.

    – across the whole system you can assign different access levels and
    permissions. So, for example, each Department might have a “Managing Editor”
    with overall responsibility for keeping info up to date. He/she can then
    delegate access to different parts (the calendar/schedule, the document
    library, clinical guidelines) to different people for editing, without
    worrying that they might break other bits, or see something they’re not
    supposed to.

    – each user can have a private “Member’s area” where they can keep stuff
    they are working on, subscribe to newsfeeds and discussions, and see at a
    glance what’s happened recently in the site-sections they are interested in

    – integration with public website – a bit vague, but I’m thinking that when
    a useful article/newsitem appears on the intranet, you should be able to
    click a button to publish it to your public website. Or when a question
    appears on the discussion forum of the website, you can pull it onto the
    intranet, and discuss it internally before feeding a reply back to the
    public site?

    It’s all fairly “generic” intranet functionality, but customised for
    healthcare organisations, to save you the time and hassle of doing the
    customisation yourself!

    > However it
    > is not good for doing inventory, administrative tasks and
    > management tasks.
    > For example, it cannot be used to run the pharmacy, do outpatient
    > scheduling
    > (for now!), to research Evidenced Based Management of the running of a
    > specialised service say for diabetics in a diabetic clinic.

    Apart from the pharmacy (and possibly inventory), which I believe FreePM
    could handle(?), these are exactly the sort of things Medzope could do.

    > It is
    > also not
    > easy to do scoring systems and the like to be implemented in it,
    > which are
    > increasingly part of outcomes management.

    Generally I’d say that anything to do with Patient Information is best
    handled by OIO and/or FreePM. I think this kind of thing would fall into
    that category, but I’m not sure? [:-)]

    > I hope I am making sense [:-(]

    You are, and it’s a very useful discussion, thanks for raising it! [:-)]

    > OK Jon, play ball!!

    You’ll notice I still haven’t addressed how the different systems could
    interoperate.

    That’s partly because this email is already far too long, and partly because
    I need to think about it more! But hopefully, now you have a better idea of
    what Medzope aims to do, lots of synapses will be firing in your brain, and
    the ideas will flow freely! [;-)]

    Generally speaking (and feel free to correct me), FreePM and OIO handle
    anything to do with Patient Information. Medzope handles administration,
    team-working, knowledge-management, workflow. But it’s the areas in-between
    where things get interesting!

    Hope that’s helped to move the discussion along a step?

    Cheers, Jon

    Jon Edwards
    Pricom Ltd
    www.pricom.co.uk

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