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I don't know what exactly medisoft does, but I read somewhere that VistA may be what you're looking for. There is also work going on to get it into Debian.

Retrieving the data on the tapes would require knowledge of and access to specific hardware and software and knowledge of the system and data structure

-Who wants to bet that all you need to pull the data out is something like: dd if=/dev/tape | strings, perhaps with conv=ascii given to dd... and maybe gunzip or bunzip2. Sigh. Specific hardware: tape drive and a scsi card. Software: any recent unix would do. Knowledge of data structure: they obviously Huffman-coded all their SQL dumps, right? Haha.

I'd take that bet.

Its not Unix, its OpenVMS.
The software is written in MUMPS.
When code looks like this http://www.hardhats.org/history/chcs4.htm you certainly do need to have specific knowledge of the system and datastructure.

Again, assuming this is the old system that has been in place for 30+ years because with the new system all data is sent to DISA Alabama.

No, MS is simply going after VistA. Now that the MS marketing engine has had a year to Google-bomb them out of existence. After all, if it doesn't exist in Google then it's not on the net, right?

With somewhat more than a year of MS' loyal media outlets yammering about MS Windows Vista and 'turfers and Gold Partners setting up blogs and fake websites about MS Windows Vista, the real VistA should be long gone from even the caches. Don't even get me started on the corporate PR playground that is Wikipedia.

So now, when administrators decide to investigate what's the most widely used medial record system, they won't likely find it on the net. Nor will they find out that it is modular, standards, based and like most software, VistA is Open Source *.

(OK, technically it's public domain, but you do get the source under a Crowley-style license as a result.)

Long time lurker - never had an account. Sorry for the A.C. bit...

There of course IS a software product called vista (or more accurately VistA): VistA's hardhats site

This is probably my biggest beef with Epic and other Mumps-based apps that use a bloated client. There's just no need for it. IDX http://www.gehealthcare.com/usen/hit/products/cent ricity_business/index.html has a very nice Web front-end that does everything in a browser (albeit with unnecessary IE dependencies). Epic has a thick VB6.0 client and CPRS (The VAs VistA GUI http://www.hardhats.org/) is massive.

I know it's a lot of code to re-write, but it's not like vendors need to throw out the database code. Just fix a mistake made 10 years ago, not the one from 1964. Cache allows for some nice things in a browser based app (XEN? SVG?). Having that kind of UI really helps to manage desktops in a distributed environment like a hospital.

Actually it already is public domain (warning for PDF). Or which countries where you talking about? If you don't have it, you can download it and set it up.

Because it took a chunk out of Open Office's Google ranking starting the very same day MS announced the new name. The same reason that the next MS boondoggle got named Vista, after our esteemed Chairman Gates decided to turn his guns on healthcare systems. He even took a try at RMS.

I realized that I should have elaborated on the Vista I was talking about (figured the 'healthcare' would be a clue, but you know this crowd).

I see that others have a similiar idea.

I worked at the VA for a number of years supporting this system at one of the medical centers. A lot of very talented and very dedicated VA employees built this system side by side with their users. Every software package had input from their users every step of the way, version by version. The doctors, nurses, social workers, etc. continuously went back and forth with the developers fine tuning what features they needed etc. Their users loved it so much that they went to bat for it when the mainframe folks at VA tried to kill it years ago. (See my link below for more info on this.) Originally it was called DHCP, or Decentralized Hospital Computer Program, and later named VISTA. This system is written by federal employees using a language called M (or MUMPS.) MUMPS is like PERL in that it is not stored compiled, can be run from a command line, etc.

Later on SAIC wrote VA and got a copy of all this software for the cost of the media and sold it back to DoD as CHCS, or Composite Health Care System, to run the DoD hospitals, FOR TWO BILLION DOLLARS US$. ANYONE can write to the VA under the FOIA and get a complete set of the software for the cost of media and shipping.

This software is used by a number of other institutions, including Indian Health Service (IHS), and even a country in Europe (can't remember the name off the top of my head) runs their entire national health care system on it. Some VA folks even flew out on their own vacation time and set it up for them.

The VA has been ahead of the private sector hospital industry in medical data processing for years (DHCP is nothing new - has been around for a long time developing into its current state.) For example, VA had paperless medical charts long before any private sector hospital did.

If you want to know more about the real story behind this, go to www.hardhats.org and read about the community supporting this. This website has been up for quite a while now. Combine this with the worldvista site and you will have a pretty good picture of the project and how it came to be.

You probably should know a little M or Caché to do this I would think...

I've been following this story for some time now. For me, the cool thing about this quasi-open-source project is that it will be built using source code that was released to the public thanks to the US FOIA (Freedom of Information Act).

This software was built years ago by the Department of Veterans Affairs for its hospitals and clinics. Similar commercial software is easily sold for over US$1 Million. I would love to see more software developed by the US government with taxpayer money released into the public so that the open source community can benefit. If you know of any government software that could be useful, file a FOIA request! (Assuming of course that it does not violate national security, yada, yada.)

For more info on this software and other open source stuff going on in the healthcare world, see these links:

• Pacific Telehealth and Technology Hui
• WorldVista
• Hardhats
• LinuxMedNews

Bah. Use MUMPS, like the US Veterans Administration. It has all the power of BASIC with the transparency of INTERCAL. Who could ask for more?

Instead of re-inventing the wheel, get involved in open-sourced solutions. You can find a good list here.

From this list, I have personally only seen VistA which has been used by the Veteran's Affairs Department for a very long time. Certainly long enough to mature. It's scalable and will work with groups of hospitals. It's designed by Doctor's to fit the way they work and it's easy to use (so Doctor's have told me). It's open source, and there's a community web site.

There are cons though: It uses a little-known programming language called M, and although otherwise complete, does not have a module for paediatrics (it's very hard to find child veterans!). The people I have met have been extremely helpful, however, and will help you with any customization or new capabilities.

I forgot to include some links to the open source community for the VistA software:

• Pacific Telehealth and Technology Hui
• WorldVista
• Hardhats

The VA did a lot more than just creating VA FileMan. They developed and continue to improve a complete suite of applications to manage every aspect of a Hospital or Clinic.

And since this is written by public employees, it is in the public domain, as in FREE. Since it is written in M(aka MUMPS) you are provided with full source code.

The DoD liked the code so much they bought it from a company called SAIC (who got the code for free) and paid SAIC $2B (two billion dollars) for it.

The VA calls it VISTA (used to be called DHCP) and DoD calls it CHCS. you can read about it at www.hardhats.org.

One of the things that make this software unique is that from day one, all of the features have been driven by the various specialists (i.e. doctors, nurses, lab techs etc.) making it highly relevant to their respective jobs.

This package includes a paperless medical record (which was implemented in a number of VA facilities several years ago), full HIPPA compliance, full ability to bill Medicare, other insurance companies, etc. using HICFA forms and DRG/ICD9/CPT codes with analysis and optimization. This same software is used by at least one country in Europe to run their entire medical care system.

This software has been in development for many years and was started long before the private sector even began to look at comprehensive computerization of hospital/medical care.

I am not aware of any that are open source,

You are a bit late. The Department of Veterans Affairs (VA) has been developing a fully integrated suite of applications to run its entire system of hospitals for years, and since it was done by public employees, it is available for free to anyone. It is written in M (or MUMPS) so you always get the source code. This package, called VISTA (used to be called DHCP) runs every aspect of their hospital system, from counting calories in your breakfast to full reporting to Washington, DC, and includes a true paperless medical record. The package has had HIPPA in mind for several years, long before the private sector started becoming concerned with it. And yes, it can bill Medicare as well as insurance companies using DRG's, CPT, etc. In fact, SAIC got a full copy of everything from the VA a few years ago and sold it back to the Department of Defense for $2B (two Billion dollars) and called it CHCS (Composite Health Care System.) If you want to find out more about it go to http://www.hardhats.org/ and all the info is there, including links to get the software from the VA. The package is so good, there are other countries which use it for their national health care system. This suite was driven from the bottom up by the users in each area of the hospital, so the Nurses decided what the Nursing package needed, the Psychiatrists decided what the Psychiatry package needed, etc. Read the site - it is impressive!

I must say that while working at a VA hospital last year I was very much impressed with their computer system.

The VA is the largest healthcare organization in the US, so they have the resources to build their own system. Contrary to what I was expecting, it is intuitive, just plain works, and IMHO blows away the stuff from Cerner or Meditech.

They have been working on it for twenty years, so it has the advantage of maturity, but even the newer bits such as windows interfaces running on Citrix are nice and stable.

Some background on the system can be found here.

Seems that is is mostly implemented in MUMPS so they score poorly in the buzzword complience department.

Anyways, I was just surprised that the government sometimes does seem to "get it".

One of the interesting uses of FOIA that I have seen has been the release of VistA, the software that runs the hospitals for the department of Veterans Affairs.

VistA is a huge suite of programs, and something that would not normally otherwise make it into the public domain. Billions of dollars of investment have gone into this, and there is hope that it can be used more widely.

VistA is written in "M" (sometimes called "Mumps" and with the GPL of the Linux version of GT.M, a compiler and database server for "M" by Sanchez, the whole shooting match is doable on an open-source platform.

More information about VistA hardhats.org and sourceforge and VistA Documentation Library

The level of functionality available from this project is incredible, and in some areas is unmatched by commercial offerings costing hundreds of millions of dollars.

Nearly all of the VISTA software is written in the Mumps programming language, with which comparatively few programmers are familiar these days (that's my impression -- I could be wrong).

Nearly all of the VISTA software is written in the Mumps programming language, with which comparatively few programmers are familiar these days (that's my impression -- I could be wrong).

There's been some heated discussion about M[UMPS], and somebody lamented that the Department of Veteran's Affairs system, known as VistA, ought to be available for free. It is. See Hardhats.Org.

The VistA software is written in M[UMPS], and is available via the Freedom of Information Act (FOIA).

There are a couple of versions of MUMPS under Linux. I also know of one that works under FreeBSD (The M system under FreeBSD isn't free, but neither is Oracle, which has been mentioned as the database for a few systems mentioned in response to the query!)

VistA Strengths:
It's just about free.
It is used in hospitals worldwide. I know of implementations in Arabic, Finnish, and German.
There are modules for most of the major clinical functions.

VistA Problems:
Modules lacking: 1) billing (this is a real problem - see other posts on the complexity of rules and regulations generated by 50 states and dozens of insurers.) 2) pediatrics.
VistA does not have a centralized "Patient Record". This has caused me some pain, because I've written code to archive medical data from this system.
Some of the modules have really poor code. Lab is infamous.

Although VistA has been around for a long time, there are always new developments. There is work going on to create a Patient Record, and there is now a CORBA ORB available to extract data from the system and make it available to object based systems.

I'm biased; I've worked with the system off and on for years, and yes, I'm one of the HardHats. There are many of us; we promote and support the use of VistA worldwide./