I will go as far and say that it isn't the hospitals fault either, it seems every system is proprietary, especially the older systems. What needs to occur is an open records format that is legislated.
You can't really do that. Let me explain.
I develop an electronic medical record system specifically designed for hospices. I have extensive experience modelling clinical documents into electronic records. Each type of document has it's own set of required data points. On top of that, each federally issued mandate actually allows for some degree of interpretation, so each vendor may tailor their data collection to the needs of the clinicians and customers (this is a good thing). This allows me to add or remove data points. For example, I generally don't need to document data for pediatrics in hospice work. (OH: Pediatric hospice. Sad panda.)
I already implement changes to follow CMS regulations several times a year -- usually for billing purposes. This doesn't guarantee that when CMS mandated that each nurse's visit a patient received in a billing statement is the same kind of nurse visit that some other software vendor records. We both record a nurse visit in some capacity, but i'm certain that my visit is more relevant for my customers than software for optometrists.
By forcing me to use a mandated format, i would have to (potentially) rewrite my application to fit the data, migrate all of my data into the new format (which may or may not be efficient), fix reports that depend on those data pieces... The list keeps growing. This would require some amount of time (cost) that i would provide directly to my customers (read: price increase for everyone).
Once i do have my data migrated, why would my customers keep using my software? Why would they not just write their own and open source it? It could lower costs, for sure. Just cut out the software cost, right? You could use something like OpenEMR (http://www.oemr.org/)... but that is not suited for my clients. It's suited for a hospital. My clients work with patients in their homes and in various medical facilities (hospitals, nursing homes, long term care facilities, etc). The expression cutting flowers with chainsaw comes to mind. This is not to say that my software is as simple as a pair of scissors, just that the tools are appropriate for the job at hand.
Each software provides it's own data set. Forcing us to use one set of data would be absolute chaos and it would in the end creating a monopoly on the medical software industry. It would reduce innovation not only because of monopolistic tendencies (american broadband, anyone?), but also due to constraints on the data format (you can't change it, now). I prefer to have a choice between Ford and Ferrari. I don't want to just settle for a Toyota Camry simply because it was the last one left standing after regulation legislated everyone into irrelevance. Legislating a data format would undermine every free market principle of our economy -- especially since the data format is an integral part of the software industry. My data format is kind of why my clients pick my software and not G.E. or McKesson or AllScripts or Misys. That, and my support team rocks my customers' faces off daily.
It seems like an easy way to have the stories distributed in a fashion guaranteed to come from these guys is to use something like Konspire2B (http://konspire.sourceforge.net/)
It supports sharing of files through "channels" and you are always guaranteed that files received through a particular channel because of public/private key encryption.
Sorry, my mistake... I have never owned or used an 85/82 extensively... I only know what i have picked up installing shells and games on other people's calcs (they all seem to come to me, because i am the only person with a graph link willing to put crap on thier calcs:)... oddly enough, i still know more about their calcs, and i don't use them... hell, i don't even use my 89 since i got my 92+.
Who cares abou the Groebner bases and indefinite integrals... Where are you going to do that? MIT? I'm not going there, so it doesn't bother me... So what if the majority of the world uses windows, it's not like a TI calc... Windows has back doors, security flaws, unsupport to 3rd party programs, and corruption of data, no wait, never mind, that is like the whole problem with 89/92+ and the HW1/HW2 issue, never mind... In a comment somewhere above my first, someone said Linux:DOS::HP:TI... this is somewhat true, i think that Linux:HP::Macintosh:TI... everybody sez that Macs are so easy to use, and easy to learn, and, they are:) (just like the TI's) if ya goin for ease of use, get a TI, if you are going for BRUTE FORCE AGAINST INDEFINETE INTEGRALS, which, in high school algebra, will most definetly NOT happen, get a nice cheap TI:) well, no, the casio's are a lot cheaper, but they are no good... maybe for basic basic basic getting something-that-graphs-quicker-than-my-left-foot but, you decide.
Let's look at the TI's for a moment... When the 82 first came out, there were no ASM available... then some smart bastard found out to modify the CSTM pointers in a backup file to point to Ash shell. Then when the 85 came out, they could do the same thing... Then along came Mr. TI-92. Mr. TI-92 didn't like having his CSTM pointers modified. He would not accept it. Then some smarter dude found out, to make the backup file larger, with the excess data spilling over to modify the CSTM pointers anyways, so Mr. TI-92 didn't know of this new way to modify them, so he liked it.:) Then, some smart guy figured out how to make a 512Kb RAM card to plug in like a probe, into the calculator, acting just like the Flash Archive memory in the new calcs... (89/92+, oh yeah, the pansy 83+ too) Now, it is said that there are expansion slots for sound cards, modems, and so on and so forth for an HP, correct? now, if it has expansion slots, that, in my mind, directly qualifies an HP as being more of a computer than the 92/92+... so, to heck with the HP's... GO FOR THE REAL THING BABY! you can get by with a TI-86, but i really really looooove my 89, and today, i just got my 92+ in the mail:) Besides, all the cool games are for the TI's anyways... If the majority of the world is using a TI, then the majority of the programs that are ever created that are decent, will more likely be created for the TI... Besides, who can live without SuperCar II and Street Fighter?:)
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I will go as far and say that it isn't the hospitals fault either, it seems every system is proprietary, especially the older systems. What needs to occur is an open records format that is legislated.
You can't really do that. Let me explain.
I develop an electronic medical record system specifically designed for hospices. I have extensive experience modelling clinical documents into electronic records. Each type of document has it's own set of required data points. On top of that, each federally issued mandate actually allows for some degree of interpretation, so each vendor may tailor their data collection to the needs of the clinicians and customers (this is a good thing). This allows me to add or remove data points. For example, I generally don't need to document data for pediatrics in hospice work. (OH: Pediatric hospice. Sad panda.)
I already implement changes to follow CMS regulations several times a year -- usually for billing purposes. This doesn't guarantee that when CMS mandated that each nurse's visit a patient received in a billing statement is the same kind of nurse visit that some other software vendor records. We both record a nurse visit in some capacity, but i'm certain that my visit is more relevant for my customers than software for optometrists.
By forcing me to use a mandated format, i would have to (potentially) rewrite my application to fit the data, migrate all of my data into the new format (which may or may not be efficient), fix reports that depend on those data pieces... The list keeps growing. This would require some amount of time (cost) that i would provide directly to my customers (read: price increase for everyone).
Once i do have my data migrated, why would my customers keep using my software? Why would they not just write their own and open source it? It could lower costs, for sure. Just cut out the software cost, right? You could use something like OpenEMR (http://www.oemr.org/)... but that is not suited for my clients. It's suited for a hospital. My clients work with patients in their homes and in various medical facilities (hospitals, nursing homes, long term care facilities, etc). The expression cutting flowers with chainsaw comes to mind. This is not to say that my software is as simple as a pair of scissors, just that the tools are appropriate for the job at hand.
Each software provides it's own data set. Forcing us to use one set of data would be absolute chaos and it would in the end creating a monopoly on the medical software industry. It would reduce innovation not only because of monopolistic tendencies (american broadband, anyone?), but also due to constraints on the data format (you can't change it, now). I prefer to have a choice between Ford and Ferrari. I don't want to just settle for a Toyota Camry simply because it was the last one left standing after regulation legislated everyone into irrelevance. Legislating a data format would undermine every free market principle of our economy -- especially since the data format is an integral part of the software industry. My data format is kind of why my clients pick my software and not G.E. or McKesson or AllScripts or Misys. That, and my support team rocks my customers' faces off daily.
Not only that, but the last time data formats were mandated, look at the fucked up repugnant shit we ended up with:
http://en.wikipedia.org/wiki/HL7
http://en.wikipedia.org/wiki/ASC_X12
It seems like an easy way to have the stories distributed in a fashion guaranteed to come from these guys is to use something like Konspire2B (http://konspire.sourceforge.net/)
It supports sharing of files through "channels" and you are always guaranteed that files received through a particular channel because of public/private key encryption.
Cheers (:^)
Sorry, my mistake... I have never owned or used an 85/82 extensively... I only know what i have picked up installing shells and games on other people's calcs (they all seem to come to me, because i am the only person with a graph link willing to put crap on thier calcs :)... oddly enough, i still know more about their calcs, and i don't use them... hell, i don't even use my 89 since i got my 92+.
Who cares abou the Groebner bases and indefinite integrals... Where are you going to do that? MIT? I'm not going there, so it doesn't bother me... So what if the majority of the world uses windows, it's not like a TI calc... Windows has back doors, security flaws, unsupport to 3rd party programs, and corruption of data, no wait, never mind, that is like the whole problem with 89/92+ and the HW1/HW2 issue, never mind... In a comment somewhere above my first, someone said Linux:DOS::HP:TI... this is somewhat true, i think that Linux:HP::Macintosh:TI... everybody sez that Macs are so easy to use, and easy to learn, and, they are :) (just like the TI's) if ya goin for ease of use, get a TI, if you are going for BRUTE FORCE AGAINST INDEFINETE INTEGRALS, which, in high school algebra, will most definetly NOT happen, get a nice cheap TI :) well, no, the casio's are a lot cheaper, but they are no good... maybe for basic basic basic getting something-that-graphs-quicker-than-my-left-foot but, you decide.
Let's look at the TI's for a moment... When the 82 first came out, there were no ASM available... then some smart bastard found out to modify the CSTM pointers in a backup file to point to Ash shell. Then when the 85 came out, they could do the same thing... Then along came Mr. TI-92. Mr. TI-92 didn't like having his CSTM pointers modified. He would not accept it. Then some smarter dude found out, to make the backup file larger, with the excess data spilling over to modify the CSTM pointers anyways, so Mr. TI-92 didn't know of this new way to modify them, so he liked it. :) Then, some smart guy figured out how to make a 512Kb RAM card to plug in like a probe, into the calculator, acting just like the Flash Archive memory in the new calcs... (89/92+, oh yeah, the pansy 83+ too) Now, it is said that there are expansion slots for sound cards, modems, and so on and so forth for an HP, correct? now, if it has expansion slots, that, in my mind, directly qualifies an HP as being more of a computer than the 92/92+... so, to heck with the HP's... GO FOR THE REAL THING BABY! you can get by with a TI-86, but i really really looooove my 89, and today, i just got my 92+ in the mail :) Besides, all the cool games are for the TI's anyways... If the majority of the world is using a TI, then the majority of the programs that are ever created that are decent, will more likely be created for the TI... Besides, who can live without SuperCar II and Street Fighter? :)