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Switching Hospital Systems to Linux
jcatcw writes "Health care software vendor McKesson Provider Technologies is focusing on ways to cut IT costs for customers, including hospitals and medical offices. The cure is moving many of McKesson's medical software applications to Linux, which can then be used on less expensive commodity hardware instead of expensive mainframes. A deal with Red Hat allows McKesson to offer its software in a top-to-bottom package for mission-critical hospital IT systems."
the cure are doing what now?
If this catches on, health care will become a little more affordable. 60% of IT costs is quite a bit of money for hospitals to save.
Seek and ye shall find.
If you use McKesson's software every day like I do, you would be amazed at its expense, sluggishness, and irritability. Lab systems that insist on running on Internet Explorer 6 and resizing to fit your whole screen aren't a big surprise - however mediocre. But mission critical systems that routinely crash with Java errors, can't run reliably remotely, require large IT departments to maintain, are slower and more difficult to use than the tty-based systems they replaced, can't trend labs, can't reliably wildcard search patient names, and die miserably if the wind blows more than 5 miles an hour or the moon is waxing - this is truly sad.
I wish our hospital system could dig its way out of it. I don't think running on top of Linux will help much. See if you can get a screenshot of their software on their website - I can't - they don't promote this stuff to the physicians and nurses who use it - it gets sold to the suits. There's a goldmine out their awaiting some entrepreneur who could really take pride in writing good software of this sort, and though I love Linux, I don't really care what it runs on top of.
If that isn't the parable of the broken window if I have ever heard it! Efficiency to any market is a good thing. The more unnecessary cost involved in the healthcare industry, the more dollars it needlessly sucks out of the rest of the economy. Sure, you can make the argument that healthcare is a capital purchase in that it increases your viability in the labor force, but that is a stretch. Cutting bloat is never a bad thing. We need to cut some serious bloat out of the industry, and we should start with beaurecracy and go all the way down to reforming the insurance industry. There needs to be some kind of oversight on cost to quality ratios, as this hybrid government backed/privately funded monster is the model of inefficiency. I like to argue for social justice so I'm naturally wary of any solely private system, but a well-designed private system would be ten times better than what we have now.
I got a catholic block.
I think the market could find something much more efficient than health care that would more than offset the effect on the economy. Your argument reminds me of the broken window fallacy. Wasting money in health care is like breaking windows and saying that it's providing jobs. Sure, but fixing that window is just taking resources away from better endeavors.
/br
AMEN BROTHER! I'm a doctor in a hospital that just deployed an electronic health record system that is slower than the system it replaced - which was slower than the TTY system it replaced - that refuses to search patient names if you can't provide a first initial. I'm an anesthesiologist, so I see people I don't have long relationships with, and remembering someone's first name is just damned hard when you remember their medical conditions better than their name. The one piece of medical software I've seen that is really fantastic - and no, I don't own a piece of the company, I just wish I did - is our radiology system, Stentor iSite (now bought by Phillips, I think). It's very easy to use, yet the advanced user can access all sorts of features that improve the experience.
We're in beta testing with actual patients now and my boss is bankrolling us into starting a company to sell the software and other medical-related IT solutions to local doctors (many of whom have horribly inefficient offices and don't fully realize it). I'm hoping we can expand beyond just local doctors, because it is a huge market and the best anyone else seems to be doing (around southern Ontario at least) is holding seminars to talk about how technology could be used to enhance medical practice someday.
I actually think you're the redhat newbie and not the parent. RedHat in recent (3-4 years?) has been very stable. All the stuff gets seriously stress-tested on Fedora first, so by the time it makes it into a stable RedHat, things are stable--i.e. the packages don't "suck". Additionally, because things are "tested" on Fedora first you get this kind of intrinsic QA for things making it into RedHat stable. Next time you decide to squeeze milk through your sinuses, at least do it for something funnier ;-)
No, the spending wouldn't decrease at all. They would just reapportion the funds to equipment such as the latest digital X-Ray machines. Or the newest CAT scanner. Or the latest robotic surgical nurse.
You get the picture. In fact, in most of health care, that's just what happens already. They spend as little as possible on IT and reapportion the cost to areas of service that will directly benefit their ability to attract doctors and customers and therefore generate greater revenues.
Those reading this might think I'm kidding, but let me tell you this: I once replaced a token ring network with an ethernet network connecting Pentium IIs and IIIs. In 2005.
-- A former healthcare IT worker.
If Murphy's Law can go wrong, it will.
Glad to see someone else saw this glaring piece of obviousness.
Just because a product wasn't plug-and-play in 1997 when you last used it, doesn't mean it still sucks a decade later.
The amount of testing/development that takes place in the fedora community all funnels directly into a more stable and usable product(i.e. RHEL). That subscription to RHN ensures those engineers bust their ass to fix whats wrong and get it delivered to you: it also means that if your the IT staff in said hospitable and something doesn't make 100%, you can call someone who it does make 100% to and get an answer/fix instead of diagnosing it for 45 minutes while a doctor needing to do a simple task breathes down your neck and wastes both their time and yours.
Trackball users will be first against the wall.
I was going to make my own McKesson sucks comment, but instead I'll just second yours. They write Crap. Period. End of story.
I remember sitting in on a presentation they once made to one of our directors regarding some new patient records management system they were trying to pitch to us. Not one single screen shot was shown nor were any technical people on hand so that I could ask the difficult questions. In the end, when she asked me my opinion, the conversation went like this:
Me: Remember application X that you used to use at hospital Y?
Her: Uh... yes.
Me: They wrote it.
We didn't buy the software.
If Murphy's Law can go wrong, it will.
OpenVista is the open source version of the VA's VistA program, deployed at over 1500 sites worldwide. You can also grab it for free from http://sourceforge.net/projects/openvista.
Yes, you can get professional training, installation and ongoing support for it:
http://medsphere.org/
The janitor will come by, type a few random key strokes into the terminal, and boom, no more linux box. *nix computers are just too easy too kill.
Yeah, that's the major flaw of Unix operating systems, and it still hasn't been solved in the 35 years Unix has been around.
If only there was some sort of system under which some special user with special powers could create user accounts deprived of these special powers so that they wouldn't be able to break everything...
You just got troll'd!
I'm a doctor in a hospital that just deployed an electronic health record system that is slower than the system it replaced - which was slower than the TTY system it replaced - that refuses to search patient names if you can't provide a first initial.
Pay attention here, IT freaks. Notice that the user here (possibly your doctor) says nothing about the OS. This is simply abysmal design and implementation. Unix/Linux/Windows/OSX/Oracle/Postgres/MySQL/MSSQL....ALL could end up thusly. Or all could end up not too bad. Design it right, and build it right. Think about what your user is actually trying to accomplish.
I saw some comments upthread about RedHat this and Linux that...Bullshit. The user interface is (most of) the key. If you screw that, the backend matters little.
Yes, if you start from a stable base, it is easier. But no matter what the base is, if you fuck up the actual program and interface the that user, in this case a doctor or nurse, uses....everything else is irrelevant. They will hate it. And still not care what the base OS is.
well you are right but when you talk about the domain of healthcare or biomedicine in general, the complexity of data and processes is so high that to develop a software system you need "extra" data-structures/information models such as HL7 standards, ontologies etc. to meet the requirements of the application. So somehow I tend to think that X (health care domain-specific) language would a superset of a general purpose language that simply provide basic programming elements (say OO, loops, variables etc). Not sure about verbosity though.
In mathematical terms:
A = {basic set of programming artifacts}
B = {domain-specific structures and computable knowledge elements}
X = {A U B}
and Y = {A}
If you ask why, or even worse, try to reduce your consumption, you are directly challenging the personal validation system of the more conformist consumers. If someone measures their self worth on the amount of money they earn, or the expensive toys they have, then you are questioning their status in the social pecking order.
It is difficult to get a man to understand something when his job depends on not understanding it.