

Open source, not $19 billion, may be best health care stimulus - edw519
http://news.cnet.com/8301-13505_3-10316621-16.html?part=rss&subj=news&tag=2547-1_3-0-5

======
sachinag
For fuck's sake, the code is out there:
<http://sourceforge.net/projects/openvista/> EDIT: apparently the main project
is at WorldVista now: <http://sourceforge.net/projects/worldvista/>

There are for-profit companies selling install/support services around it:
<http://www.medsphere.com/> (And here's their .org for their OpenVista
repository: <http://medsphere.org/index.jspa>)

Yeah, VistA is a PITA. What we need are _data standards_ for non-imaging data
(where DICOM has been a raging success). I've long suggested that all records
have to be readable in VistA - it doesn't force people to use Medsphere, but
it means that there's a lowest common denominator FREE software package that
works.

~~~
siculars
agreed. i'll just paste my comment from an article on the oreilly radar blog,
[http://radar.oreilly.com/2009/05/who-will-cut-the-gordian-
kn...](http://radar.oreilly.com/2009/05/who-will-cut-the-gordian-knot.html) .

In my opinion, one thing that government can do to accelerate electronic
record keeping in the healthcare arena is mandating that solution providers
must make means available to both import and export data to/from their
systems. Mandating a specific format is less of an issue and should not be the
main goal.

If vendors were obligated to open their systems and encouraged to do so via
some [fiscal/tax] incentive then the problem would solve itself. IT
professionals either on their own or contracted would create solutions that
connected the hodgepodge of systems out there.

These systems are infinitely difficult to implement on any scale (by scale I
mean number of people using the system - not technical challenges). At the
moment I am tangentially involved in a major enterprise installation at a very
well known institution. From my vantage point one of the major stumbling
blocks is the difficulty in which the many, many systems already in place will
interact with the new system (and with each other). The inability of these
systems to interact with each other directly affects the cost of doing
business in the modern day hospital.

Many of the people in positions to make purchasing decisions are not fully
cognizant of the concept of "vendor lock in" and "data portability". These
poor decisions are paid back many fold not only in cold hard cash but also in
opportunity cost over the lifetime of the system purchased, which may very
well be decades. Government can make this all go away by simply requesting
that all players in this space provide mechanisms for programmatic, unfettered
data access. Providing fiscal incentive will all but ensure that those
providers in compliance will be preferred.

Mandating a specific system, or data exchange format is not the solution or,
frankly, the "American way". Evening the playing field by ensuring openness
through financial incentive is much more palatable to a broader spectrum of
participants. The market place will ultimately decide and coalesce around its
own standards and formats.

~~~
sachinag
See, I fundamentally disagree that mandating data formats in un-American or a
violation of market principles. We had an Interstate Commerce Commission (the
first independent commission) because interstate markets fail sometimes.

And it's not healthcare specific for me: if the federal government picked one
between MPEG and Ogg for the <video> tag in HTML5, I'd be perfectly happy.

------
blhack
The fact that "stimulus" has entered your standard issue citizen's lexicon as
something that the government gives to a failing industry to keep it from
failing is one of the most horrifying things to come out of the 2008 election
cycle.

 __WHY __is this looked at as okay? I get that the headline was a joke...but
why is it even funny?

I'm sorry, I know this is off-topic (and more appropriate for a political
forum like reddit), but I'm 22 years old. Fuck _you_ , to the government that
is taking away money that I haven't even had the chance to EARN yet so that
companies that I have no interest in can continue existing. How did we get to
a point where this is looked at as acceptable? Won't somebody please actually
think of the children? You, government, the very people who are supposed to be
looking out for me, are robbing from me in broad daylight, then having the
audacity to tell me that it is for _my_ own good?!

What the hell is happening?!!?

~~~
RyanMcGreal
When a large finance company goes down, an awful lot of innocent people are
dragged down with it. When enough large finance companies go down at the same
time, the entire economy goes down with them, leading to massive suffering.

The bailout sucked. Not doing the bailout would have sucked far more.

~~~
blhack
I agree with you, which is why I was 100% behind the troubled asset relief
package. That was to help out the banks, which needed to remain liquid. I was
extremely extremely vocally for TARP...

This is something else entirely.

------
bebop
VistA is an extremely complex piece of software written in a time that
readability was not a top priority. Not to mention that there were file size
limits, which spread modules over many different files, and the fact that most
of the MUMPS keywords can, and are abbreviated adds to challenge of
understanding and translating.

On top of the often hard to read modules, most of the real work is stored in
"Globals" basically persistent sparse arrays. So if you really want to trace
the code you have to spend half your time reading code and half your time
looking through the "Database" for the rest of it.

I guess what I am trying to say is its a really hard job to bring VistA to a
different platform without a large sum of money and some really smart people.

------
bavcyc
$125 million to translate from one computer language to another. I'm
underpaid.

~~~
yellowbkpk
The general rule with medical software is to estimate the cost in money and
time and multiply it by 100.

