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Postmodern EHR: Solving the feral systems dilemma

Feral systems are software solutions developed by individuals or groups to help with day-to-day activities. They are called feral (or “wild”) because they are used in addition to core IT systems, working around key system architecture – more often than not without the blessing of management. I was first made aware of this expression a couple of years ago by Ewan Davis, who wrote a blog post about it stating: “The hundreds of “Feral Systems” in an average large hospital represent a goldmine of knowledge and innovation that could be harnessed in the design of digital systems that really work, but as they are today they also create a massive technical debt and create safety, governance and reputational risks for the organisation in which they are used.”

Living in a Retro Health Care System

EHRs are a perfect example of how we took something that should revolutionize health care, and turned it into something that not only no one is happy with but that many feel often impedes care, to the point some want to go back to paper records.  That's not retro, that's just stupid.  We didn't do the wrong thing with EHRs, we just are doing it wrong. As I've written before, we should be thinking big and bold about how we want our health care system to work in the 21st century.  We should be setting tough goals for how effectively it works for us -- and expecting to achieve them.  We should be looking forward, not backward...

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Halamka's Advice to the Trump Administration

As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with healthcare IT expertise has yet been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration - so far, no one has been asked anything by anyone related to healthcare IT. At this early time in the administration, it’s important to offer advice as to the priorities ahead for the next few years. What would I recommend to the new administration?

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Open Medical Records Community Supports New System In Mozambique

The southern African country of Mozambique suffers under the most extreme challenges for resource-poor countries: economic instability, political strife, civil unrest, corruption and crime, unreliable infrastructure (such as transportation and telecommunications), and a large-scale HIV epidemic that has yet to be declared under control...The nation has enormous need and opportunity for improving its healthcare system and the lives of its residents. In the face of their crisis, Mozambique is working to equip its medical clinics across the nation with an electronic medical records system (EMR). Mozambique believes an EMR can empower clinicians to give high-quality and consistent care to those most in need, while allowing the country to reap the insights of comprehensive reporting for responsive public health decision making...

Open Source and the Software Supply Chain

Grasping the nuances of hardware supply chains and their management is straightforward—you essentially are tracking moving boxes. Managing something as esoteric as resources for building software with a variety of contributions made by the open source community is more amorphic. When thinking about open source platforms and supply chains, I thought of the supply chain as a single process, taking existing open source components and producing a single result, namely a product. Since then, I’ve begun to realize that supply chain management defines much of the open source ecosystems today. That is, those who know how to manage and influence the supply chain have a competitive advantage over those who don’t do it as well, or even grasp what it is...

7 Notable Legal Developments in Open Source in 2016

In 2012 the jury in the first Oracle v. Google trial found that Google's inclusion of Java core library APIs in Android infringed Oracle's copyright. The district court overturned the verdict, holding that the APIs as such were not copyrightable (either as individual method declarations or their "structure, sequence and organization" [SSO]). The Court of Appeals for the Federal Circuit, applying 9th Circuit law, reversed, holding that the "declaring code and the [SSO] of the 37 Java API packages are entitled to copyright protection." The U.S. Supreme Court declined to review the case, and in 2016 a closely watched second trial was held on Google's defense of fair use. In May 2016 the jury returned a unanimous verdict in favor of Google...

2017 Prediction: Some "Oops" Ahead

Predictions for 2017 are everywhere this time of year, and it is no wonder.  There are so many technological advances, in health care and elsewhere, and a seemingly endless appetite for them.  We all want the latest and greatest gadgets, we all want the most modern treatments, we all have come to increasingly rely on technology, and we all -- mostly -- see an even brighter technological future ahead. Here's my meta-prediction: some of the predicted advances won't pan out, some will delight us -- and all will end up surprising us, for better or for worse.  Like Father Time and entropy, the law of unintended consequences is ultimately undefeated...

Top 10 Linux News Stories of 2016

They grow up so quickly. It's hard to believe that 25 years ago Linus Torvalds announced to the comp.os.minix Usenet group that he was "doing a (free) operating system (just a hobby, won't be big and professional like gnu) for 386(486) AT clones." Since 1991, Linux has grown beyond even Torvalds' dreams. It's not a stretch to say that Linux is everywhere. Corporations large and small use Linux, and it powers computers, mobile devices, and connected hardware. Critical infrastructure relies on the stability and flexibility of Linux...

Hot Programming Trends from 2016

Technology is constantly moving forward—well, maybe not always forward, but always moving. Even for someone who keeps an eye on the trends and their effect on programmers, discerning exactly where things are headed can be a challenge. My clearest glimpse into open source programming trends always comes in the fall when I work with my fellow chairs, Kelsey Hightower and Scott Hanselman, and our fantastic programming committee to sculpt the coming year's OSCON (O'Reilly Open Source Convention). The proposals that we get and the number focused on specific topics turn out to be good indicators of hot trends in the open source world. What follows is an overview of the top programming trends we saw in 2016...

Kids on Computers Establishes Computer Labs in Five Countries

Linux and open source software are not just fueling charities, they are gifting the freedom of education and knowledge to the people the charities are helping because of the low cost, yes, but also the exceptional technology. This sentiment is proven when you look at the work the Linux Foundation does supporting a variety of community initiatives and organizations that are using Linux and open source software. While attending LinuxCon NA 2016 in Toronto I learned of Kids on Computers, one such organization...