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U.S. Government Crafted OSS
matthewg writes "According to the New York Times the federal government has developed an open-source medical records system. It was originally developed for the Department of Veterans Affairs, and doctors started obtaining it under FOIA requests. Some good information on the process of converting it from an internal project to a deployable system exists, and how its open nature has made the system better is available at the WorldVista site." From the article: "Medicare has not estimated what its software giveaway is worth. But Duncan Pringle, chief Vista technologist at Perot Systems, said that each doctor in a practice paid about $20,000 to $25,000 to get started with a commercial system, including costs of software, a license fee charged to each doctor, installation and servicing."
MUMPS is line-oriented, like old-school BASIC
Evaluation is strictly left-to-right, so 3 + 4 * 5 Doesn't yield the result you think.
There are no local variables. Everything is global, except for "globals", which are persistent, and stored in a hierarchical file on disk.
I'm working in this field.
It's not exactly an install-and-forget situation -- not remotely. The hardware is expensive, the support is labor-intensive (and most often involves sending people on-site to fix things that don't belong to us), and the set of 3rd-party software we need to write integrations for is massive.
Oh -- and from what I hear, this particular system is much despised by most of the MDs who use it. Certainly, the ones we have on staff have little but contempt (granted, we're a competitor) and one of my coworkers who's spent some time as a VA patient has repeatedly heard similar sentiments.
Which means it can be any license you'd like, including GNU GPL. RMS weighed in on this topic on Linux Medical News some years back: http://www.linuxmednews.com/974769856/index_html
BTW, VistA has been developed over decades within the VA despite multiple efforts to kill it. It is just now gathering recognition, momentum and federal dollars as well as support of lawmakers to be deployed privately. It has always been available by FOIA (Freedom of Information Act). However, the previous stance by VA and the federal government with regard to privatizing it has been neutral to hostile (how does this help veterans?) to it is okay to think about privatizing it to actively encouraging it.
Fantastic that is now getting the recognition, and hopefully widespread deployment, it deserves.
-- IV
http://www.LinuxMedNews.com Revolutionizing Medical Education and Practice.
There is a complete open source stack of VistA on GT.M on Linux. You can download a ready to run Linux live CD from the WorldVistA site at Source Forge (http://sourceforge.net/projects/worldvista). Grab a 512MB / 1GB USB flash drive, download and burn a CD image, and you're good to go.
It's public domain for starters, and Vista has existed in some form or another since the late 1960's. And how the Veterans Department releases it isn't actually in a functioning form./ m.compiler/compiler/index.cgi
It's an interesting (and really very solid) system, but unless the MUMPS language it's written in gets some serious support behind it, it's lack of portability and available toolkits will doom it to further oblivion.
I did some investigation into it a few months back as one of my customers is a small rural hospital who is shelling out a large sum of money to both IBM and a small software vendor for their management software/hardware.
The biggest knock on Vista is that its written in MUMPS, a rather obscure programming language dating to the late 60's. It's a really interesting language, but altogether it's something of a pain to deal with, and the only two open source implementations of it are the Sanchez GT/M stuff that WorldVista uses (which I'm not even sure *IS* open source, the licensing isn't very clear on it, further, alot of it is written in assembler which means its effectively non-portable), and another MUMPS->C translator developed by a guy at the University of Northern Iowa. http://math-cs.cns.uni.edu/~okane/cgi-bin/newpres
Oh -- and from what I hear, this particular system is much despised by most of the MDs who use it.
Which is the reverse of what I hear. I was at a medical conference recently trying to pitch our own wares, and it seemed to me that half the people at the conference were from the state penitentiary system and used the state's software, and the other half were from VA hospitals and used Vista. I was told fairly consistently by the VA docs that they loved the system and that they'd never use anything else. Of course, the hospital set it up for these doctors, so they never had to deal with any of the guts.
Looking at the system myself, it looks like 99% of the headache is in setting it up. Once it's configured correctly, that's when you get the doctors praising it like it was the best thing since sliced bread.
The most interesting thing about the article is that the software's been Free all along, some group issued a FOIA request for the source code and got it, and it's been an opensource project for at least a year now.
If I have been able to see further than others, it is because I bought a pair of binoculars.
The Army reading list
While I happen to agree with you, the Feds don't. In 1980, Congress passed the Bayh-Dole Act, which allowed government-funded institutions to own the IP rights of the things they created (using public money).
The Feds are also increasingly using contractors to assemble and produce various sensitive information and products - a legal loophole that makes sure that the FOIA doesn't apply.
Just FWIW.