Feature Articles
Top 10 Open Source Legal Developments in 2015
In 2015 there were a variety of legal issues of importance to the FOSS (free and open source) community. Continuing the tradition of looking back over the top ten legal developments in FOSS, my selection of the top ten issues for 2015 is as follows:
- Settlement of Versata cases interpreting General Public License version 2 (GPLv2)
- First decision interpreting General Public License version 3 (GPLv3)
- Linux programmer sues VMware for violation of GPLv2 for Linux
- Community GPL compliance
- European Commission antitrust investigation of Google and its Android operating System (Android OS)...
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?
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...
VA's Office of Information and Technology (OI&T) Has Announced New Veteran-focused Integration Process (VIP)
The Office of Information and Technology (OI&T) of the U.S. Department of Veterans Affairs (VA), has announced a new Veteran-focused Integration Process (VIP) to replace the Project Management Accountability System (PMAS) for the development and management of IT projects. The Veteran-focused Integration Process (VIP) is a Lean-Agile framework that services the interest of Veterans through the efficient streamlining of activities within the VA enterprise. It is designed to increase the speed of delivery of high-quality, secure IT capabilities to Veterans. Read More »
Science Organizations Sign Open Data Access Accord
Four leading international science organizations have announced a global accord proposing principles and practices for open access to research data. The accord titled Open data in a big data world was announced last month (December 9) during Science Forum South Africa held in Pretoria. "Maximizing public benefit from the data revolution in both developed and developing countries is a priority, … [and] needs a global, coordinated response from the scientific community,” says Geoffrey Boulton, president of the International Council for Science (ICSU)’s Committee on Data for Science and Technology (CODATA) and leader of the working group that developed the accord.
Halamka's 2016 Predictions for Health IT
As the year ends and we archive the accomplishments and challenges of 2015, it’s time to think about the year ahead. Will innovative products and services be social, mobile, analytics, and cloud (SMAC)? Will wearables take off? Will clinicians be replaced by Watson? Here are my predictions...Apps will layer on top of transactional systems empowered by FHIR...a better approach is crowdsourcing among clinicians that will result in value-added apps that connect to underlying EHRs via the protocols suggested in the Argonaut Project (FHIR/OAuth/REST). One of our clinicians has already authored a vendor neutral DICOM viewer for images, a patient controlled telehealth app for connecting home devices, and a secure clinical photography upload that bypasses the iPhone camera roll. That’s the future.
2015 Was a Good Year for Creating the World's 'Missing Maps' with OpenStreetMap
The Missing Maps project, which launched in 2014, aims to literally and figuratively put more than 20-million at-risk people on the map using OpenStreetMap (OSM) as a platform. We need to fill in "missing maps" before the next disaster strikes, ensuring the maps have detail sufficient for emergency responders to hit the ground running. OpenStreetMap is an open and free source of geographic data. Anyone with a username can add, edit, or update data, so the Missing Maps project is community driven and focuses on local knowledge. Remote volunteers around the world use satellite imagery to trace features, such as roads and buildings. Community members and volunteers in the area then use the base map to add local data to these shapes, including street names, addresses, building types, and points of interest. As we look back at 2015, here are a few success stories from the Missing Maps project...
The Postmodern EHR: What can Health IT Learn from the Evolution of the ERP Market?
It seems the pattern is clear. From best of breed to integrated (mega)suite to a new world of innovative, agile, mostly cloud based and multivendor solutions. This is what Gartner calls “Postmodern”. According to Christensen, disruption like this becomes possible when the established players start exceeding the requirements and expectations of their customers, providing only sustaining innovation – i.e. adding more and more features to their products. This is what was happening in the personal productivity space with the Office products. Similarly, the ERP market today has well defined requirements and this allows the newcomers to disrupt, meeting the base expectations and adding innovation and agility while lowering costs.
Using Blender to Prepare for Orthopedic Surgeries
The planning of orthopedic surgeries is a difficult process. In a lot of ways, it's like working while wearing a blindfold; a surgeon can't see the bone that needs to be worked on until during the actual surgery, when time is most critical. Even with X-rays and CT scans, the raw data can be difficult to interpret correctly. Fortunately, open source software can (and does!) help reduce the guesswork. At the 2015 Blender Conference, Vasily Shishkin gave a very interesting talk on his research project and use of Blender and 3D printing in the planning and guiding of orthopedic surgery...You may find yourself thinking, "Wait a minute. Blender? The same Blender that's used for making pretty images and animations? That Blender?" Yes. That Blender...
Python-based Open Source Eye Tracking Tool
I have a deep interest in educational psychology, and so I was fascinated by what I read about PyGaze—an open source toolbox for eye tracking in Python. The website told me that it runs on Linux, but I wanted to learn more about eye tracking and the role it plays in psychological research. I also wanted to know more about the project and how it is contributing to research and its implications for open source. In this interview, the lead developer for the project, Edwin Dalmaijer, who works at the University of Oxford's Department of Experimental Psychology doing research and programming, provides a fascinating description of PyGaze and the significance of eye tracking in research...
On A Mission To Make Linux As Accessible As Possible
This article details the circumstances behind my switch away from proprietary operating systems and my switch to Linux. Like many, I switched out of frustration with other operating systems and not directly because of Linux's open source model. I developed my passion for that after the switch was made. It was August 18, 2011. I had just completed the umpteenth restoration from factory of Windows 7 on my HP laptop. I had just installed the open source screen reader I was using at the time, NVDA, as well as some of the applications I used on a daily basis, such as the Mush-Z MUSHClient...
Bingo Medicine: Are EHRs Oppressive Straightjackets?
For several decades, software builders have tried to help doctors practice medicine more efficiently and more effectively. As is often the case with good intentions, the results turned out to be a mixed bag of goods, with paternalistic overtones from the helpers and mostly resentment and frustration from those supposedly being helped. Whether we want to admit it or not, the facts of the matter are that health IT and EHRs in particular have turned from humble tools of the trade to oppressive straightjackets for the practice of medicine. Somewhere along the way, the roles were reversed, and clinicians of all stripes are increasingly becoming the tools used by technology to practice medicine.
How Do We Balance Civil Liberties With Treatment Of The Mentally Ill?
In January of this year, political analyst Norman Ornstein lost his 34-year-old son, Matthew, to accidental carbon monoxide poisoning. While Matthew’s death was a tragic blow to family and friends, it was not the kind of out-of-the-blue shock that comes with absolutely no forewarning. Matthew, as Ornstein says in a New York Times op-ed published last month, had struggled with mental illness for 10 years, which contributed to poor decision making and his untimely death. A resident scholar with the American Enterprise Institute and writer for The Atlantic and Washington Post, Ornstein says that perhaps the most difficult aspect of Matthew’s death was the inability of family and friends to help treat Matthew’s mental health challenges after he had his initial psychotic break.
Halamka: 2015 In Review
It’s now December and as each year ends, I always look back on the challenges and achievements of the past 12 months. Here’s my sense of 2015. ICD10 - billions were spent, countless other projects were delayed, and the transition occurred on October 1 without a major incident...Did we get our money’s worth? I have argued and will continue to assert that ICD-10 benefited no one. The diagnoses used are more variable so there is less precision in their use. Clinical documentation (in general in the industry) does not have the specificity needed to justify the more granular ICD-10 codes. The notion that quality measures can now be computed more accurately from ICD-10 coded administrative data is just not true...
How I Ended Up Working in Open Source Healthcare
These days I am one of a small handful of core committers to OpenEMR, but more importantly I am the visible face of the project through my role as the current president of the OEMR.org 501(c)(3), standing on the contributions of a respectable, worldwide, community of active users, contributing developers, and vendors. We have done some seemingly impossible things, like get the OpenEMR project through the ONC's "Meaningful Use" Certification, without which it would have all but died out in the United States. Now, with the project 14 years old and about to be recertified under Meaningful Use Stage 2, it's time to reimagine and reengineer the core without losing the goodness we have and the good will of the community...