Escaping the Clinic: Providers as Developers of Medical Software Applications

Many health care providers, seeking to escape the long hours, diminishing pay and endless paperwork associated with managed care, are continuing to leave clinical practice for careers as medical informatics developers. Linux represents a terrific opportunity, as what is presently available software application-wise for the medical field is sparse, as compared to the catalog for the M$ Windows platform.

One of the best examples of health care providers that successfully developed software applications to meet market demand are the folks at Mad Scientist Software. Mad Scientist provides educational software for emergency medicine practitioners. The software proved to be very popular with fellow EMT’s, when I introduced the company’s software applications as part of a continuing education program. It’s a pretty safe bet that there is presently a demand for Linux-based EMS software. Emergency medicine practitioners with an interest in software development should take note of this opportunity.

Free Software Runs LinuxMedNews-Announce List

In a constant effort to keep you informed of breaking news on the site that is ‘Revolutionizing Medical Education and Practice’. LinuxMedNews laboratories brings you the LinuxMedNews-Announce list. This is an announcement service which will send you an e-mail when a critical mass of new items appears on LinuxMedNews as determined by our highly sophisticated artificial intelligence engine (me). You can subscribe through our web interface located here. This list will not be sold to third parties, and announcements can only be posted by LinuxMedNews. In case you were wondering, Mailman the software running the list is 100% free and open source.

Discussion: Is Linux Penetrating the Healthcare Environment?

Open source advocate and British Medical journalist Douglas Carnall is developing three articles for publication in the dead tree world. He’s looking for specific projects in health care settings that have used open source software as part of the solution. This could be anything from a professional systems administrator implementing a Linux/Apache webserver for a large commercial HMO, or a lone generalist devising his own unique electronic medical record. Is Linux penetrating the healthcare environment? What are the examples out there?

But What About Speech Recognition?

An informal poll of practitioners is likely to reveal a ‘pre-acceptance’ of voice recognition technology in medicine. Doesn’t the open source model fail in such a prorietary area with high lucrative potential? How does open source do on this important technology? Very well, thank you. Carnegie Mellon’s voice-recognition Sphinx project is open source. The currently available Sphinx2 is described as a ‘…candidate for handheld, portable, and embedded devices, and telephone and desktop
systems that require short response times.’
Sphinx3 which should be available ‘in 2000’ is described as a ‘…slower, yet more accurate recognizer used, for example, for broadcast news transcription…

Putting It All Together

Www.JimIntriglia.com Refers to an example of making disparate clinical computing software work over a web browser in Using the Web to extend patient
care
. Intriglia writes:

[This article] explores how CareGroup, a
network of hospitals in the Boston
area, developed a web-based
system to enable providers to access clinical
records any of the six area CareGroup hospital
databases. The challenge faced by developers was
to enable data access via a common web browser
to clinical information stored on dissimilar and
proprietary clinical information systems. A
Java/XML based system solution, developed by
the MIT W3 EMRS project group, was the key to
the infrastructure problem that CareGroup
developers faced. The University of Michigan
maintains a CareWeb demo where you can learn
more about the CareWeb architecture and
capabilities.

Wearable PC’s in Your Future?

This article on eWeek examines the latest developments in wearable computers and discusses a pioneer in the field Steve Mann’s computer:

‘Mann’s computer incorporates…”eye-tapping” which is laser-based technology that…allows the eye to function simultaneously as if it were a display and a camera.’

Mann is quoted as saying that Windows is not the operating system for a wearable computer. That his wearable computer is based on GNU Linux. This should separate the true geek practitioner from the posers. My lab coat already holds about 4 meg of data: Palmpilot, Sanford and Pharmacopeia. Think about a 20 gigabyte lab coat.

New Release of the Bluefish HTML Editor for Linux

For those that support the use of open source software for medical web site development, check out the new release of the Bluefish HTML editor.
I have been using Bluefish for over a month and find it to be the best free HTML editors thus far. An RPM package is available for easy installation on Red Hat Linux systems. Many other distributions are supported, or you can “roll your own” and go with a source tarball install instead.

Mission Critical Status In Your Palm

www.MissionCriticalLinux.com has announced the ability to monitor Linux systems using a PalmPilot(tm). It ‘…lets Mission Critical Linux and customers remotely monitor Linux systems…without compromising the integrity of those systems’ security…quickly and expertly apply fixes to these systems if a problem arises. Nifty, I’m sure it wouldn’t be too difficult to adapt this to the Personal Bedside Server(ntm)for healthcare use.

PalmPilot is a trademark of Palm, Inc. Personal Bedside Server(ntm) is not a trademark of anything I know of, I made it up.

Linux and Windows Under Pressure

Is Linux for real in medicine? How does it fare against (reality: with) Windows in a real computing environment? Having recently set up a hospital network with RedHat Linux under demanding circumstances. A technical analysis is in order. Read on.

The central question: How did it fare against Windows? Two thumbs up, it worked very well. But the reality is that it has to work with Windows for now. Even in Guatemala they had two Windows machines already in place and running, although not networked. With regard to interoperability, the usual Linux issues surface: it isn’t easy to set up Samba for the beginner, but once in place it works very well. However, Windows is in trouble on this issue. Setting up a modem to connect to an ISP with RedHat Linux 6.2’s Usernet took less than five minutes. Less than five minutes. The Windows side was a confusing mess of ‘Can’t find !@#$%.inf, file’ messages which were in a word obnoxious since I had not only the manufacturers driver disk, but also the Windows 98 CD in the drive and still couldn’t find things. It was was very shabby in comparison to Linux. Kudzu found the modem on the first try, and the Usernet setup utility was simple and fast.

A network card swap done side by side on a Linux and Windows server also found Linux to be superior. Linux noted that the old card was missing, asked to remove the old card configuration, and then asked to install the new card configuration which it accurately found on its own. It was shockingly easy.

On the networking side, Linux won hands down as far as being able to know crucial, specific information such as if a computer was actually up on the network and understanding what was going on. Windows was frequently a mystery as to why something was (or wasn’t) working. I found a four hour long loose connector problem by pinging through Linux. I’m sure this utility is available on Windows, but its GUI ‘Find Computer’ equivalent doesn’t give detailed information.

An important point in Windows favor was its ‘Network Neighborhood’ desktop program. This was superior to RedHat Linux in easily visualizing and using network disks and printers for beginners and novices. Even ‘Network Neighborhood’ is difficult for some users to understand. Command line? Forget it.

Linux also outperformed Windows in three respects: security, low vulnerability to viruses and boot-up time. Windows security is simply not there. There is no question of compromising a Windows system, you can consider it done just by turning on the machine. The flip side of this is viruses. Hermano Pedro Hospital’s small Windows based network on the administrative side was actually completely off the Internet for fear of viruses. This is a good idea, but inconvenient. Linux users are less vulnerable and the recent ‘I Love You’ virus problem is merely another example of this. Finally, a major slowdown in boot-up time with Windows (and you boot up ALOT) is that it frequently has virus scanning software installed that dreadfully slows boot-up time on these machines. The machines I worked with in Guatemala were no exception and is a performance hit that is frequently overlooked in Linux to Windows comparisons.

Windows major advantage is that it is entrenched, it’s office suite is easy to use, many, many people have used it and feel familiar with it. There is a definite yuck factor to overcome for many users until they see Linux benefits for themselves.

In summary, Linux will have to co-exist with Windows in most organizations for the near future. While more technical, Linux has big advantages in the area of security and performance, while Windows frequently has more familiarity and ease of use. The final verdict: Under harsh circumstances, Linux is a winner and is likely to move ahead of Windows in all or most areas within the year.

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