Feature Articles
VistA, AHLTA, CHCS: An Evolving Alternative Roadmap to the Future
The obstacles to continue moving U.S. Department of Defense (DoD) and Department of Veterans Affairs (VA) in a common direction with regard to their clinical IT systems are fairly well-known. Having made that statement, it may therefore seem strange that this blog suggests that a conceptually simple technical approach may have the potential to untie the Gordian knot that has defeated many previous efforts. The proposed approach is not some yet-to-be-developed technology that exists only on Powerpoint slides. In fact, the proposed approach is based on technology that has already been validated by the-powers-that-be – at taxpayer expense – and the official conclusion in the official report on file at the DoD(1) states unambiguously and explicitly that the technology works as claimed is scalable, and can handle very large M/Caché systems.
Case Study: MD Anderson Successfully Implements Tools to Migrate Clinical Research Data from MUMPS to Oracle
The University of Texas MD Anderson Cancer Center has successfully completed the initial stages of a major migration of their MUMPS-based Clinical Trials Databases to Oracle as one of the critical stages in MD Anderson’s multiyear eResearch project to modernize management of Clinical Trials. The MD Anderson Cancer Center chose CAV Systems' Evolve Suite to carry out the migration. The institutions have produced a case study outlining the background and results of this extraordinary project. Read More »
Mobile Health IT Solutions for Healthier Aging
A report entitled "Using Mobile Technologies for Healthier Aging" was released in March 2013. The report, written by Ada Kwan, was co-sponsored by the mHealth Alliance , United Nations Foundation, and Pfizer. The stated objective of this report was to provide momentum and spur further conversation on ways mobile technologies can help people age better and remain in reasonably good health. Read More »
VistA as an EHR System Core for DoD
Here is a copy of the full text of the proposal submitted by the US Department of Veterans Affairs (VA) to the Department of Defense in response to the Request for Information for an electronic health record (EHR) solution that can replace the existing DoD EHR system. This is the approach that makes the most sense as the current core EHR that the Department of Defense (DoD) uses is based on a 30-year-old version of VistA. The current EHR crisis facing DoD stems from the inability to upgrade this older version of VistA. What the VA is proposing is basically an upgrade to DoD's existing core EHR. Read More »
The Value of EHR Interoperability that Money Can't Buy
There seems to be something missing in our national debate about health care and the use of health information technologies (IT) in this marketplace. Do we want a more 'open' healthy society, or a more closed system? What role should markets play in public health and medical sociology? How do we decide which EHR solutions to acquire? Should we be looking more closely at open source alternatives versus proprietary programs. Should money, quality of care, or some other non-market values determine what's best for the patient? This cuts to the heart of the debate. Consider the hospital that chooses to not pay an expensive proprietary EHR vendor for the enhanced code required by a doctor in order to get the latest real time knowledge for treating a patient's disease.
Open Source Business Models - A More In Depth View
A quick Google search on "Business Models for Open Source" brings up numerous articles and studies on the topic that proclaim there are anywhere from five major business models to over eighty possible examples. We have compiled a list of approximately 15-20 business models or strategies for open source, depending on the mission, goals, licensing, context, and numerous other factors. While we would like to come up with as short a list as possible, the truth seems to lie somewhere in between. We have ended up with a list of approximately 15-20 business models or strategies for open source, depending on the mission, goals, licensing, context, and numerous other factors or variables, e.g. geography, competition, market.
The 'Open Source Maturity Model'
The following is a description of the Open Source Maturity Model as defined by Open Health News (OHNews). It lays out the six major phases open source systems may go through during their systems life cycle – from the birth of an idea to a mature global solution....The conceptual stage begins with some ideas being kicked around by an individual or a small handful of people, who in this case are convinced that developing an open source solution may offer the best approach to collaborate and rapidly produce high quality, a low-cost shareable solution that may be of benefit to many others. The following items characterize some of the major steps in this initial phase of the maturity model and systems development life cycle...
Peter Suber on "Opening Access to Research"
Why remove any restrictions at all? The answer is to share knowledge and accelerate research. Barrier-free access helps readers find and retrieve the research they need, and helps authors reach readers who can apply, cite and build on their work. Knowledge has always been a “public good” in the theoretical sense that consumption doesn’t deplete it (it’s “nonrivalrous”) and consumption is available to all (it’s “nonexcludable”). OA makes knowledge a public good in practice.
EHRs: Buy vs. Build, or the Best of Both
In the electronic health record (EHR) market, even though an enterprise solution is not an operating system, the parallels are clear. Healthcare organizations use expensive and complex proprietary systems that are difficult to maintain. The leading systems have prohibitive total costs of ownership. Ownership is undermined by vendor lock. The most important and valuable enhancements are held back for the next chargeable upgrade. Lack of interoperability is a business model.
How Andrew Krzmarzick Uses Open Source To Empower Citizens In Government
As the Community Manager of GovLoop—a highly active online community connecting more than 50,000 public sector professionals, including Federal CTO Todd Park—Andrew Krzmarzick suspects his role is pretty similar to leading an open source project. The open source way guides the company's decisions, communications, and interactions. And open source solutions enable them to empower citizens around the country (and the world!) who don't want to wait for their cities to make updates to a page or build apps and resources that makes their lives easier. Read More »
My HealtheVet & Secure Messaging
The My HealtheVet portal created by the U.S. Department of Veterans Affairs (VA) enables veterans to create and maintain a web-based Personal Health Record (PHR). It also provides access to health education information and resources, comprehensive self-entry health journals, self assessment tools, and other electronic services for interacting with the VA such as online prescription refill requests, health and wellness reminders, and secure messaging. Read More »
HealtheMe: Personal Health Record & Wellness Management System
The open source HealtheMe personal health record (PHR) solution, developed by KRM Associates for use in many rural healthcare facilities across West Virginia, has just been turned over to the Open Source Electronic Health Record Agent (OSEHRA) for release to the VistA and global healthcare communities. HealtheMe was designed to be an open source alternative to the U.S. Department of Veterans Affairs (VA) My HealtheVet PHR system. It contains all of the major features of My HealtheVet and more.
Predictive Medicine & Health IT Systems
Predictive medicine is the emerging field of medicine that entails predicting the probability of disease and taking proactive steps to either prevent the disease altogether or significantly decrease its impact upon the patient. What follows is a short, high level overview of predictive medicine for managers and health IT specialists new to this area. Read More »
FrontlineSMS V2.0: A Powerful Tool for Achieving Positive Social Change and Health Improvement in Developing Countries
Good news from the software sector: FrontlineSMS Version 2 is here at last! Two years in the making, the updated version is simpler, more intuitive, and easier to utilize. It also adapts more easily to individual needs and systems, and has already met an enthusiastic response from the SMS community. And with all it has to offer, the new software should prove a valuable contribution in the effort to achieve positive social change in developing countries around the world. Read More »
Open Source Hardware-The Next Frontier
You've heard of open source software. Open data. Open access. Open knowledge. With the origin of open source software, an entire culture with a distinct ethos and community of “openness” was born. But what exactly is open source hardware? Read More »