Feature Articles

How Citizens Become Scientists with Open Hardware

Eymund Diegel, a research coordinator for Gowanus Canal Conservancy, shares this tidbit during the first clip of the new Open Source Stories documentary, "The Science of Collective Discovery." He's setting out in a canoe on an inner-city canal that is polluted and struggling to get the help it needs. That's the theme of citizen science it seems: people and places in need who are not getting the help and resources they deserve taking matters into their own hands. Why are they not getting the help they need in the first place? The reason is shockingly simple yet a typical problem: Where's the evidence?

Challenges to Expect When Open Sourcing your SaaS Business

In my previous article, I walked through scenarios to help you determine whether to open source your SaaS solution, and discussed the cost-benefit analysis that goes along with this decision. From an open source point of view, there's no point in just chucking code over the wall, slapping on an open source license, and calling it a day. You want to create an inviting community where people want to collaborate and spend time-even socialize!-with you. Chucking code over the wall accomplishes nothing, besides giving others insight into how you do things. Although that may be interesting and beneficial for them, you don't get much benefit unless you create the pathways of collaboration and communication that unlock a thriving community. Thus, you have an inherent interest in doing this The Right Way™.

Read More »

How to Decide Whether to Open Source Your SaaS Solution

Should a SaaS provider open source its primary platform, and if so, what is the best way to do it? The decision to open source code requires a fair bit of planning if you want to do it right, especially when it comes to user support and documentation. In the case of SaaS, the required planning is different, although it shares some factors with any open source effort. In my series, How to Make Money from Open Source Platforms, I focused on software that exists solely to be deployed on a computer, whether on a local machine, in a data center, or in a cloud platform (yes, I know the last two are redundant).

Read More »

12 Students Picked to Work on OpenMRS Projects as Part of the Google Summer of Code 2018 Program

Congratulations and a warm welcome to the 12 students selected for Google Summer of Code 2018, and extended thanks to our fantastic group of OpenMRS project mentor volunteers, as well as all students that submitted applications this year! A total of 1,264 students from 64 different countries have been accepted to work with more than 200 open source projects for GSoC 2018. Since 2007, OpenMRS has enjoyed participating in this great program, and we’re thrilled to be involved again this year, marking our 12th year of participation. We’re looking forward to working with a diverse set of students and mentors across a range of exciting and impactful projects.

Read More »

On the Need to Improve User-Centered Design (i.e. Design Thinking) for Healthcare IT Usability

The lack of usability of electronic health records (EHRs) and healthcare IT applications, in general, has been in the news a lot again. This time it is a research report published in the Journal of the American Medical Association (JAMA) on March 27. The study analyzed voluntary error reports associated with EHR systems and found that problems with EHR usability may have directly resulted in patient harm. Unfortunately, this situation is all too common in the healthcare industry. Numerous health care systems are designed and created ad hoc, or with a very engineering-centric approach. End users are dissatisfied and often systems or workflows are abandoned and/or dangerous work-a-rounds created. A lot of people are saying Healthcare IT needs a disruption. What HealthIT needs is to begin to learn about and understand the needs, goals, and methods of the actual end-users, like doctors, nurses, medical assistants, etc.

US Core Data for Interoperability Task Force Delivers its Recommendations

On April 18, 2018 the HHS Health Information Technology Advisory Committee (HITAC) US Core Data for Interoperability Task Force delivered its recommendations on the draft US Core Data for Interoperability (USCDI) and Proposed Expansion Process which had been published for public comment back in January 2018. HITAC promptly accepted the Task Force’s recommendations. The Task Force focused almost exclusively on the process for identifying the USCDI rather than the proposed USCDI data itself. I especially appreciated their introduction of some key concepts related to how USCDI should be organized and understood.

Read More »

Why the VA Should Stick with VistA and Not Waste $16 Billion on an Attempt to Replace It

This VA leadership lull provides an opportunity for reflection. Specifically, it’s worth asking while we have the time whether Cerner is the right path for the VA to take. While the decision may seem like a no-brainer to some, the VA’s situation is unique and arguably calls for a singular approach to both existing organizational issues and a major healthcare IT decision. Specific to the Cerner decision, what should the new VA secretary consider?

Read More »

Signatures are No Longer Required for Credit Card Transactions...How Come Most Medical Records Exchanges Still Require Fax Machines?

If you live in the U.S., you've probably had the experience of paying for a meal using a credit card. The server takes your card, disappears to somewhere in the back, does something with it that you can't see, and returns with your card, along with two paper receipts, one of which you need to sign. Everything that happens to me, I think, what is this, the 1960's?As of last week, the major credit card companies -- American Express, Discover, Mastercard, and Visa -- are no longer requiring that signature. As a Mastercard person told CNET, "It is the right time to eliminate an antiquated practice."

Read More »

Healthcare Has Cost Problems, but IT and EHRs Do Not Have to be One of Them

I’m proud to lead a group of intelligent and energetic technology professionals committed to developing a robust healthcare IT system that is (1) easy for clinicians to use, (2) improves patient health and (3) doesn’t bankrupt hospital budgets. We think any sustainable system must have those three key requirements. And how is healthcare doing thus far? The EHRs available today are developing rapidly. Vendors are making frequent and impactful improvements to improve system usability. Clinicians are getting better at maximizing the contribution healthcare IT makes to patient health and safety. It’s not hard to see how healthcare IT can meet the first two requirements and broadly contribute to improved healthcare.

Read More »

Mainstream Academia Embraces Open Source Hardware

Twenty years ago, even staunch proponents of free and open source software like Richard Stallman questioned the social imperative for free hardware designs. Academics had barely started to consider the concept; the number of papers coming out annually on the topic were less than could be counted on someone's fingers. Not anymore! Not only has the ethical authority of Stallman embraced free hardware and free hardware design, but so has the academic community. Consider the graph below, which shows the number of articles on open source hardware indexed by Google Scholar each year from 2000 to 2017. In the last 17 years, the concept of open source hardware has erupted in ivory towers throughout the world. Now more than 1,000 articles are written on the topic every year.

Feature Overlaps Between Immunization Information Systems and EHRs

Immunization Information Systems (IIS) have been around for nearly twenty years. Their functionality, completeness, and usefulness have all increased over this time. IIS and electronic health record (EHR) systems have always had unique features, as well as some overlapping features, and the deployment of EHRs has enhanced the local immunization capabilities of clinician practices. Several critical clinical features that are considered to be core functions of IIS are beginning to be supported by EHRs. This article will review and discuss five such critical features: online data entry, clinical decision support for immunization, reminder-recall, practice-level assessment of up-to-date status, and patient access to their immunization data.

Read More »

New Modalities for Technical Assistance Consulting

Technical assistance (TA) is provided by expert consultants to public health systems projects in order to improve their performance against functional standards or to help solve recurring or one-time problems or issues. Unlike other forms of training or support, TA is usually focused or tailored to a specific circumstance or situation. Common examples of TA include assistance to a jurisdiction in migrating from one product to another, consultation related to a specific programmatic initiative such as school immunization health compliance, EHR interoperability implementation, or data quality review.

Read More »

Healthcare's Death Star Thinking vs. Human Centered Design

I missed it when it first came out, but a providential tweet from the always perceptive Steve Downs tipped me to a most interesting article from Jennifer Pahlka with the wonderful title “Death Star Thinking and Government Reform.” The article is not directly related to healthcare, although it does include healthcare examples, but Ms. Pahlka’s central point very much applies to most efforts to reform healthcare: The need to believe that a Death Star-style solution is at hand — that we have analyzed the plans and found the single point of failure — runs deep in our culture.

Read More »

Report on the Global OpenMRS Community Meeting in Malawi - Towards Evidence Based Health Service Delivery and Interoperability

One hundred seventy five members of the worldwide OpenMRS community–representing 20 countries–met in Malawi this past December for the 2017 OpenMRS Implementers’ Conference. This event was the second consecutive year a national government sponsored this global meetup, with Uganda hosting and sponsoring this meeting the previous year. The December conference was hosted by Malawi’s Ministry of Health and key-noted by ministry officials and leaders such Maganizo Monawe, Senior HIS Technical Advisor; and Anthony Muyepa, Director General at National Commission for Science and Technology.

Read More »

Medicity's CEO's Thoughts on Interoperability

Last week I had the esteemed privilege of attending the EHR Interoperability Meeting at the White House with Seema Verma, CMS Administrator, and Don Rucker MD, National Coordinator at ONC. The attendees represented payer organizations, and the discussion was focused on the barriers to interoperability and how we can band together to overcome them. Below are my responses to the major questions asked of each payer. As you read through this information, I hope it further clarifies our position on these topics.

Read More »