It would be nice if they provided a way to export my health information to their CCR/G format so I could save it locally.
I also find it interesting that they are ready, willing and able to share my information with anyone THEY chose.
From the Agreement:
'11.2 You agree that this licence includes a right for Google to make such Content available to other companies, organizations or individuals with whom Google has relationships for the provision of syndicated services, and to use such Content in connection with the provision of those services.
11.3 You understand that Google, in performing the required technical steps to provide the Services to our users, may (a) transmit or distribute your Content over various public networks and in various media; and (b) make such changes to your Content as are necessary to conform and adapt that Content to the technical requirements of connecting networks, devices, services or media. You agree that this licence shall permit Google to take these actions.
11.4 You confirm and warrant to Google that you have all the rights, power and authority necessary to grant the above licence.'
This along with the obvious lack of standardized vocabulary use in their user input choices; i.e. two separate yellow fever vaccines just because of a misspelling, doesn't give me a "warm fuzzy" feeling about putting any REAL Personal Health Information (PHI) on their site.
I get the impression that they have decided that they know all about IT design and failed to learn from the many years of research that has gone into the complexities of healthcare information systems.
I have to agree with this. Dvorak has been posting crap since the mid-1980s. He was on RIME and FidoNet then and still keeps attracting attention. How do these guys do it? It certainly isn't out of any great technical knowledge.
Though VistA is public domain, there is an open source version of it that has been converted for use in clinics and is now called WorldVistA EHR VOE see: http://www.worldvista.org/
The "obscure" language is MUMPS now called M and has been around since the early 1970's when it was written specifically for health care and is used throughout the health care industry as well as many major financial applications.
VistA does have some of it's front end written in Delphi. Much of it can be ported to be used as a web application if the effort is put into doing it.
The problem with VistA as well as any other stand alone application is that they lack any real way of exchanging information with other applications. This is where selecting openEHR can be a benefit. In fact there are discussions going on about retro-fitting VistA to use openEHR archetypes. We'll see how that goes.
Remeber that openEHR is not an application but a set of specifications that can be used by anyone.
You correctly point out some of the complexity here. But, it is NOT impossible to create systems that use terminologies (like LOINC and SNOMED-CT) that are computable. Frankly, NLP just isn't there YET. Even using proximity rules etc. it is just too imprecise to develop a context from natural language from a document (like PDF) that can be used for analysis, decision support, etc.
The question that brought about the guest blog was; "why aren't primary care physicians adopting electronic health records?" The answer is (primarily) because of misaligned incentives. Open specifications can help solve that problem. Especially ones that are implementable (some specifications are known to be developed in a committee room without being tested in software).
But the above post exposes a truth. Many proprietary companies are making money off of a few customers using the same old "upgrade tax" imposed by some operating system vendors. This is why applications based on truly open specifications can be marketed as being something different.
This is a very complex area with complex issues that vary around the world. However, the two level modeling approach used in the openEHR specs are being used in many places. Are we *brave enough* in the US to use something "not invented here"?
I send documents all over the world and I use Open Office formats exclusively for saving my masters. However, if I intend it to be read only I send a PDF. If it is for collaborative editing I send an OOo file with a link in the email to download Open Office. If they complain (happens very seldom anymore) then I send them a different format as they request. Usuall a M$ format.
Actually there are several projects in progress. What he needs to do is check the list at minoru. They maintain the most up to date list in one place.
There was a world wide organization formed this summer (OSHCA) to promote the adoption and funding of opensource in the healthcare field.
If he is particularly fond of Python/Zope and wants something patient centered he can stop by and see the FreePM site.
The mailing list at openhealth.com is probably the center of activity. From there you can branch out to a particular project.
There is simply NO REASON to lose classified materials. There are very SIMPLE but STRICT guidelines for handling these materials under virtually any circumstance. If it's lost, somebody didn't do their job. First Hand Experience as a Classified Materials Manager, US Marine Corps. Yes, it's an ancillary duty, aka. part-time job. It doesn't mean it's not important though.
Gee, where have we seen this process before!? Are shoppers too impatient to wait the extra 2 minutes or so? In the US, probably. But it's a great post anyway.
The Advocates for Self Government have posted this quiz on their website. There's only 10 questions. But think seriously about them before answering. It'll help you be more certain when it's time to pull the lever.
Remember that local elections are as, or more important than the Presidential election. Vote wisely. It's your duty!
[FULL DISCLOSURE] I am a county chairman of the third largest national party, so you may find my views biased. I hope you do .
They don't remove addresses when called, multiple times. I think we should bring a class action suit against them and make them pay 10% of all future earnings to the FSF!
Serves them right for keeping me (and many others) from getting network access via C-Band. These small stations need to realize that it's Darwinian. Spend the bucks to keep up or get out of the business.
My parents generation (now in their 60's) did this to us. It was easier for them to throw money at things and turn over their problems to the government. I'm not sure how easy it will be to fix at this point, but it will have to be from the inside out at the grass roots level. There are sad days coming if US citizens do not step up and take back their country from this out of control corporate run government.
MSgt. USMC, Retired Obion County Chairman, Libertarian Party of TN. ... and an all around nice guy.
So now employers will be forced to hire workers that fit a specific height requirement. Then the vertically challenged (I just love being P.C.) will sue because they were discriminated against.
I'm sure there were well intended purposes for this but unless it's tightly regulated it'll be another out of control loop hole for the 'lawsuit lottery'.
As humorous as this post is, our litigious society here in the US, very well could see "recovery" in a case like this. Remember the 'duh woman' suing McD's over hot coffee?
Slashdot Mirror
Exactly. Now do this with your health records. ????? I think not!
http://www.linkedin.com/in/timothywaynecook
>>
Just a Pratchett fan.
After all these years. Now I know what is REALLY weird about you!
It would be nice if they provided a way to export my health information to their CCR/G format so I could save it locally.
I also find it interesting that they are ready, willing and able to share my information with anyone THEY chose.
From the Agreement:
'11.2 You agree that this licence includes a right for Google to make such Content available to other companies, organizations or individuals with whom Google has relationships for the provision of syndicated services, and to use such Content in connection with the provision of those services.
11.3 You understand that Google, in performing the required technical steps to provide the Services to our users, may (a) transmit or distribute your Content over various public networks and in various media; and (b) make such changes to your Content as are necessary to conform and adapt that Content to the technical requirements of connecting networks, devices, services or media. You agree that this licence shall permit Google to take these actions.
11.4 You confirm and warrant to Google that you have all the rights, power and authority necessary to grant the above licence.'
This along with the obvious lack of standardized vocabulary use in their user input choices; i.e. two separate yellow fever vaccines just because of a misspelling, doesn't give me a "warm fuzzy" feeling about putting any REAL Personal Health Information (PHI) on their site.
I get the impression that they have decided that they know all about IT design and failed to learn from the many years of research that has gone into the complexities of healthcare information systems.
I have to agree with this. Dvorak has been posting crap since the mid-1980s. He was on RIME and FidoNet then and still keeps attracting attention. How do these guys do it? It certainly isn't out of any great technical knowledge.
Which article are you referring to? My blog post does not suggest those things at all.
Though VistA is public domain, there is an open source version of it that has been converted for use in clinics and is now called WorldVistA EHR VOE see: http://www.worldvista.org/
The "obscure" language is MUMPS now called M and has been around since the early 1970's when it was written specifically for health care and is used throughout the health care industry as well as many major financial applications.
VistA does have some of it's front end written in Delphi. Much of it can be ported to be used as a web application if the effort is put into doing it.
The problem with VistA as well as any other stand alone application is that they lack any real way of exchanging information with other applications. This is where selecting openEHR can be a benefit. In fact there are discussions going on about retro-fitting VistA to use openEHR archetypes. We'll see how that goes.
Remeber that openEHR is not an application but a set of specifications that can be used by anyone.
You make some good points. However, oemr.org is far from the only player in this arena. Check out the following sites:
Linux Medical News http://www.linuxmednews.com/
OSHCA http://www.oshca.org/
Openhealth mailing list openhealth@yahoogroups.com
There you will find that there are several ongoing projects as well as companies providing support.
Still the issue remains (in the US) around who is paying and who is benefiting.
Once the various vendors (open or proprietary) realize that they MUST work together then and only then will there be serious uptake in EHR usage.
Security is an important implementation matter but has nothing to do with information exchange standards.
You correctly point out some of the complexity here. But, it is NOT impossible to create systems that use terminologies (like LOINC and SNOMED-CT) that are computable.
Frankly, NLP just isn't there YET. Even using proximity rules etc. it is just too imprecise to develop a context from natural language from a document (like PDF) that can be used for analysis, decision support, etc.
The question that brought about the guest blog was; "why aren't primary care physicians adopting electronic health records?"
The answer is (primarily) because of misaligned incentives. Open specifications can help solve that problem. Especially ones that are implementable (some specifications are known to be developed in a committee room without being tested in software).
But the above post exposes a truth. Many proprietary companies are making money off of a few customers using the same old "upgrade tax" imposed by some operating system vendors. This is why applications based on truly open specifications can be marketed as being something different.
This is a very complex area with complex issues that vary around the world. However, the two level modeling approach used in the openEHR specs are being used in many places. Are we *brave enough* in the US to use something "not invented here"?
I send documents all over the world and I use Open Office formats exclusively for saving my masters.
However, if I intend it to be read only I send a PDF. If it is for collaborative editing I send an OOo file with a link in the email to download Open Office. If they complain (happens very seldom anymore) then I send them a different format as they request. Usuall a M$ format.
I am interested in why you see this as "funny"?
Cheers,
Tim
then decide on t the platform and data model. Physician's offices are not the same as hospitals.
http://www.openehr.org and follow all the references.
Cheers,
Tim
Actually there are several projects in progress. What he needs to do is check the list at minoru. They maintain the most up to date list in one place. There was a world wide organization formed this summer (OSHCA) to promote the adoption and funding of opensource in the healthcare field. If he is particularly fond of Python/Zope and wants something patient centered he can stop by and see the FreePM site. The mailing list at openhealth.com is probably the center of activity. From there you can branch out to a particular project.
There is simply NO REASON to lose classified materials. There are very SIMPLE but STRICT guidelines for handling these materials under virtually any circumstance. If it's lost, somebody didn't do their job.
First Hand Experience as a Classified Materials Manager, US Marine Corps. Yes, it's an ancillary duty, aka. part-time job. It doesn't mean it's not important though.
Gunpowder!
There isn't anything else that needs to be said about this one.
Gee, where have we seen this process before!?
Are shoppers too impatient to wait the extra 2 minutes or so? In the US, probably. But it's a great post anyway.
The Advocates for Self Government have posted this quiz on their website. There's only 10 questions. But think seriously about them before answering. It'll help you be more certain when it's time to pull the lever.
Remember that local elections are as, or more important than the Presidential election. Vote wisely. It's your duty!
[FULL DISCLOSURE]
I am a county chairman of the third largest national party, so you may find my views biased. I hope you do .
They don't remove addresses when called, multiple times. I think we should bring a class action suit against them and make them pay 10% of all future earnings to the FSF!
Serves them right for keeping me (and many others) from getting network access via C-Band. These small stations need to realize that it's Darwinian. Spend the bucks to keep up or get out of the business.
My parents generation (now in their 60's) did this to us. It was easier for them to throw money at things and turn over their problems to the government. I'm not sure how easy it will be to fix at this point, but it will have to be from the inside out at the grass roots level.
There are sad days coming if US citizens do not step up and take back their country from this out of control corporate run government.
MSgt. USMC, Retired
Obion County Chairman, Libertarian Party of TN.
... and an all around nice guy.
Exactly. Remeber the uproar over the Yahoo/Geocities disclaimer? It may just be a case of lawyer ignorance.
So now employers will be forced to hire workers that fit a specific height requirement. Then the vertically challenged (I just love being P.C.) will sue because they were discriminated against.
I'm sure there were well intended purposes for this but unless it's tightly regulated it'll be another out of control loop hole for the 'lawsuit lottery'.
As humorous as this post is, our litigious society here in the US, very well could see "recovery" in a case like this. Remember the 'duh woman' suing McD's over hot coffee?
What does RedHat do? (Think about it).