FreePM Announces FishBowl

Updated: 1/12/2003 FreePM is now TORCH. In an attempt to make it easier for users to report problems and make suggestions to the Free Practice Management project (FreePM) we are copying Digital Creations’ lead with a FishBowl wiki. In this method of development, all communication, decisions, arguments, and progress are visible as if everyone were working “in a fishbowl”.

Based on the hugely successful Zope FishBowl design process (Zope’s introduction page to fishbowl development here) FreePM, Inc. has installed a
similar system on the demo site.

This is a place where you can easily report bugs and make
comments or suggestions. FreePM has been designed from the
beginning based on suggestions from the FreePM and Openhealth
mailing lists. We hope to extend this community involvement by
making it easier for people to report bugs and make suggestions
while trying out the demo.

You can also enter the FishBowl from a link on the demo main
menu. This link will open a new browser window for easy access
to the FishBowl topics while testing the demo.

Feedback about the usefulness of the FishBowl and any other
FreePM topics may be directed to the FreePM mailing list.

Review: Agenda VR3 Linux powered PDA

I recently got my hands on a developer edition of the Linux powered Agenda VR3 hand held PDA device and am quite excited about it. It runs on an NEC MIPS processor (designed originally for Windows CE devices) that runs the Linux 2.4.0 kernel, XFree86, RXVT, BASH and all your favorite Linux tools. It is available now in developer edition for only $179.

It runs the VR-Linux project’s 2.4.0 kernel and a full XFree86 display on a 160×240 16 level grayscale display. It also sports a serial cable that allows you to set up a TCP/IP connection using ppp to your desktop so you can interact with it with Telnet, ftp, rsync (the most popular way to synchronize files). It has BASH running in an RXVT terminal. There is a keyboard app. with very good handwriting recognition embedded into it. You can redirect it’s X display to your desktop and vice versa. The development environment includes a cross compiler for gcc that allows compiling most Linux apps for it – the MIPS lacks a floating point processor so some changes have to be made when compiling apps for it instead of the X86 architecture. It also has a modem and can send faxes. It has an infrared port for beaming to OBEX compliant devices.

The most exciting thing for me is that Tcl/Tk is ported already to it, as is a version of PERL, PYTHON, and RUBY. You can also use the FLTK – fast light toolkit when programming in C or C++.
Over 100 Linux applications are already ported to it by the Agenda community.

I am working on a Tcl version of a wildly popular drug database for the Palm. I have a college student who is home for the summer working on it. I’m hoping to develop some useful ways to use the Tcl socket library and http to connect to my Tcl data server and web server in the Tkfp EMR.
I already have all the drugs starting with the letter “a” ported to it. It has it’s own icon in the launch pad along with the default apps provided by Agenda computing.

More info on the VR3 Linux powered PDA at http://www.agendacomputing.com
The developer edition has 8mb of RAM and 8mb of flash RAM and costs only $179 with the cradle and serial cable. The Modem costs $99. There will soon be a consumer version released with a somewhat more polished interface and more applications.

My wish list for it includes a way to connect into an ethernet jack so you could use say DHCP and move from exam room to exam room with it and say connected to your network.

The display is sometimes a little hard to see in subdued lighting conditions. Maybe my cataracts have something to do with that, my kids don’t seem to have any problems with it.

The software that ships with the developer version is not the latest version. You have to carefully read the excellent instructions provided on the developer web site and reflash it with the newest kernel and romdisk image to get the latest handwriting recognition.

Red Hat Linux to Drop Netscape Browser When Mozilla 1.0 Ships

Red Hat�s Melissa London in MozillaQuest Magazine says that Red Hat�s plans are “to drop the Netscape browser as soon as Mozilla has equal functionality.”

The Linux desktop battlefield seems to be Netscape� last stand. There is no Microsoft Internet Explorer browser to compete with Netscape for the Linux desktop

When and if more Linux distributors drop Netscape, Netscape will have lost its last stronghold and will have lost the browser wars.

LMN Questions: Touch Screen Patient Registration Software?

Streamlining is the big buzz word. I supoprt a clinic that wants to have patients who are so inclined to type in their own registration information (name, address, coverage, med history (via check boxes)) using a touch screen station(s) in the waiting area. Is there an open-source product that does JUST that and provides a backend to talk to an EMR system? Is this a good idea? Would most patients do this?

Getting There: Mozilla 0.9 and Medicine

Mozilla 0.9 (release notes: here, download here) has been released. Mozilla is a web browser that is the open source base code for Netscape Communicator 6.x. This release now clearly surpasses the creaky old Netscape 4.7x program in most areas and is rapidly advancing on Microsoft’s Internet Explorer in terms of features, usability and performance. It appears on track for a 1.0 release this year. This is significant to medicine for several reasons.

1) Once again proves open source development works and works under harsh conditions (can you say medical computing?) The project has endured several years of adversity but is closing in on developing the real thing. Other development methods such as closed source methods would have likely folded by now, come up with a product that missed the mark or be short on features. This wasn’t a toy program by any means, neither is clinical computing. Score a big one for open source.

2) Open source means it is likely to have more adaptability and security as well as carry on even if individual players stop participating. Medical applications that depend upon it will not get stranded. Wouldn’t it be great to have a guarantee that clinical computing software will never get stranded if a company folds or is bought out? Contrast with the current medical computing landscape.

3) Convergence is beginning to happen on several fronts: the Nautilus file manager is likewise moving along rapidly and will make the Linux desktop interface as good or better as any other. Anti-aliased fonts I predict will be widely available by years end further enhancing the user experience. The only question mark is whether the front-running office suite StarOffice will be able to deliver 6.0 this year. Adoption of it would result in a likely huge cost savings for medicine.

Prediction: December 2001 will likely be the month Linux comes of age on all fronts: server, desktop, commercially and possibly in medicine. This release of the Mozilla web browser performs well and has a rich feature set. It could be a bellweather for things to come in medical open source.

NYTimes: Cryptography Not the Answer

The NY Times (free login required) has an article on encryption and safety of computer data. They are pessimistic: ‘…
“Can encryption safeguard the Internet?…Clearly the answer is no,” said Whitfield Diffie, the inventor of public key cryptography, a method of encoding communications sent on the Internet. “Cryptography is a long way from where the real security problem is…technology alone would not bring about privacy protections. “It really isn’t an issue about encryption and having secure communications,” said Michael Rabin, professor of computer science at Harvard. “The main issue is how is our personal data handled and how is it protected…” Former White House chief of staff John Podesta stated: ‘…this year is the 125th anniversary of the gummed envelope…Podesta noted that this invention had provided “pretty good privacy.” Not because the technology of licking and sealing an envelope was particularly secure, he said, but because “there was a legal, moral and cultural agreement” binding those involved in its transit…’

The Globe: HMO aims to improve with e-prescriptions

Yet another article, this time by the Boston Globe, in the continuing media coverage of companies and healthcare entities promoting e-prescribing: ‘…Tufts Health Plan will give 200 of its physicians hand-held computers on which to write and transmit prescriptions – a program the health plan hopes will eliminate handwriting errors, lost orders, and other pharmacy hassles…’

CPT Code Ownership Controversy

Thanks to John S. Gage for this link. MyHealthScore.com a site that bills itself as ‘Healthcare Quality Information for Consumers’ has an article and active discussion about the American Medical Associations ownership and rigorous defense of that ownership of CPT Codes: ‘…Imagine a restaurant patron sitting down for lunch. The waitress approaches and requires the diner to pay a $10.00 fee to look at the menu before ordering! This reflects the American Medical Association (AMA) policy for charging patients to view the treatment codes and descriptions employed by all the physicians in this country using the MyHealthScore.com (formerly MECQA) web site. Under these conditions, most of us would take our business elsewhere, if there was another choice…’ This also effects open software engineers since costly access to these codes restricts developer participation and introduces the requirement for proprietary intellectual property for the functioning of open software systems.

Reuters: Prescription Systems Cut Error Deaths

Reuter’s health is reporting that: ‘…Computerized prescription monitoring systems could drastically cut down on the number of medical errors in American hospitals, potentially saving tens of thousands of lives each year, a Harvard Medical School (news – web sites) official told health care executives Thursday. Computerized physician order entry (CPOE) systems have helped two Harvard hospitals more than halve their prescription error rate and have saved the facilities between $5 million and $10 million, according to Dr. David W. Bates, the chief of general medicine at Harvard’s Brigham and Women’s Hospital in Boston…’

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