Scot Silverstein, MD a past contributor to Linux Medical News writes a particularly hard-hitting article in Health-IT World. His message is simple: traditional MIS and IT personnel are impeding progress in Health-IT and need to move aside for those who are both clinically and IT trained: ‘…Medical informatics, whose professionals are now training at more than a dozen NIH-funded centers, can help, but its professionals generally sit on the sidelines when it comes to true leadership roles. This is in large part due to the MIS culture. Let alone considerable territorial and political issues, the credo “doctors don’t do things with computers” perhaps summarizes the ideology…’

Reuters is reporting that: ‘Patient complaints about medical errors in the United States, Britain, Canada, Australia and New Zealand are remarkably similar even though the medical systems vary widely, researchers said on Friday…”The countries are quite different from each other in the way delivery systems are organized and paid for,” she added. So it appears, she said, that advanced industrial nations, no matter what their approach to health care, need to upgrade their systems, especially communications… Thanks to ScotSilv for this link.

Here is a potpourri of articles recently submitted to the OpenEHR list by Thomas Clark. This one is a US report on healthcare quality. Another one, the National Healthcare Quality Report by the Institute of Medicine, and a report on the ‘lack of in-depth research on the content quality of paper and electronic medical records.’ This one is an ‘Interesting discussion on relevance; interesting comments on expert
opinion; probably due to the close working relationships with the law industry that loves inconsistency in medical records.’ This one from Alexander Caldwell is about “The MEDICI Electronic Data Interchange Library” a hot topic recently which was also reported on here, submitted by Bill Walton to OpenEHR.

Here’s a Linuxworld article about developments in my own backyard of Texas regarding Texas Senate Bill 1579: ‘In the war between proprietary and free/open-source software in state and local government over the past two years, Texas has established itself as ground zero. Texas Senate Bill 1579, for example, which seeks to ensure that free/open-source software is given a level playing field when competing with proprietary products in state agencies…’

Gordon Moore, MD is doing what many think is impossible: going without staff, without answering service, in one 150 square feet room. He also delivers superior care and can make more money seeing 12 patients a day than his previous 25-30 in one day at a conventional large practice. Unbelievable? Read this AAFP article to see just how he is doing this: ‘…To provide more reliable care, simply trying harder and reading more articles isn’t going to cut it. Instead, we must begin to embrace information systems that can support our clinical efforts, whether they be electronic medical records, computerized care reminders, online clinical resources, etc…With very low overhead, I don’t need to see hordes of patients each day to make ends meet. Seeing fewer patients, I don’t get that many phone calls. Because I use an electronic medical record and practice management system, making referrals, refilling prescriptions and all those little tasks have become much easier as well. Thanks to Alexander Caldwell for this link.

Newsforge re-visits Largo, Florida in this article which a year ago was the subject of a report entitled “Secretaries use Linux, taxpayers save millions” The odd part is how many of the same things written in the article could/should be said of medicine: ‘…The real strangeness is not that these guys have managed to build such a wonderful, cost-effective system, but that so few others have done the same thing. Everything in the Largo IT ecosystem is off-the-shelf standard goods, from hardware to software to the wires that hook everything together. The innovation here comes in making maximum use of everything, and not necessarily in obvious ways — and in coming up with solutions that are as much social engineering as technical, like the “cybercafe” in the Largo City Hall’s employee break room…’

The American Informatics Association (AMIA) Student Working Group will be discussing Free and Open Source Software in medicine at its business meeting, at the November 2002 Fall Conference. The meeting, with a social event following, will be held at 8:00 pm in the El Mirador room, 22nd Floor, Hilton Palacio del Rio hotel, San Antonio, Texas. There will also be a special session: Careers in Medical Informatics (S27) Hosted by the Student Working Group Monday November 11th, 3:30 pm-5:00 pm Room 008 A/B, River Level

“Open Source: A Case for e-Government” conference will be held in Washington, DC, USA, October
16 – 18, 2002. The aim of the conference is to raise awareness and to share experiences among policy makers, donors, users/consumers, universities, and industry specialists in Open Source, e-Government and related fields. The conference will draw participants from local, national and international organizations from both the public and private sector.” Full text of the announcement is within.

Open Source: A Case for e-Government
Washington, DC
October 16 – 18, 2002
October 16, 2002 Marvin Center George Washington University Grand Ballroom
800 21st St. NW (on the corner of 21st and H Sts. NW)
October 17 and October 18, 2002 The World Bank IFC Auditorium
2121 Pennsylvania Avenue

The Information for Development program (infoDev) of the World Bank, the
Cyberspace Policy Institute of The George Washington University, and the
Sustainable Development Networking Programme of the United Nations
Development Program are pleased to invite you to a conference on “Open
Source: A Case for e-Government” to be held in Washington, DC, USA, October
16 – 18, 2002. The aim of the conference is to raise awareness and to share
experiences among policy makers, donors, users/consumers, universities, and
industry specialists in Open Source, e-Government and related fields. The
conference will draw participants from local, national and international
organizations from both the public and private sector.

The core sessions of the conference will focus on:

� Keynote by Congressman Rick Boucher, co-founder of the Congressional
Internet Caucus
� Open Source and e-Government in the U.S., Europe and developing
countries (how governments and local authorities are benefiting from using
Open Source)
� Open Source vs. Proprietary Software (what is the proper role of each
in e-Government)
� Demonstrations of Open Source Projects (LinuxTM, OpenOffice,
MozillaTM, GNOME, MySQL)
� Meet the Open Source Vendors
� Open Source and the Security of the Critical Infrastructure
� Business Cases: The Economics of Using Open Source Software and Total
Cost of Ownership

Please visit the website http://www.egovos.org for further information. As this is an invitation only event, you must be registered to attend. You may
register online by visiting the conference website and kindly note that all
registrations must be received no later than October 11, 2002. There is no
registration cost for the event.

We hope that you will join us for what promises to be an exciting event.
Please complete the registration form as per the instructions in the
conference website. Feel free to contact us in the case of any questions or
concerns at (202) 994-5513.

Forbes has a wide ranging discussion with senior editor Robert Langreth about IT in health care and why it largely hasn’t happened.

Interesting article over at Wired about assisting those with cognitive deficits using AI: ‘…”Dementia is the loss of problem-solving skills,” said Dr. Eric Tangalos, co-director of the Mayo Clinic’s Alzheimer’s Disease Research Center. “But we should be able to use technology to fill in the gaps…’