Comments for Medsphere Systems Corporation http://blog.medsphere.com Transforming Healthcare Through Open Source Fri, 01 Mar 2013 21:58:01 +0000 hourly 1 http://wordpress.org/?v=3.4.1 Comment on It’s the System, Stupid: Reversing the Law of Unintended Consequences by Jens Kristian Villadsen http://blog.medsphere.com/its-the-system-stupid-reversing-the-law-of-unintended-consequences/#comment-118 Jens Kristian Villadsen Fri, 01 Mar 2013 21:58:01 +0000 http://blog.medsphere.com/?p=183#comment-118 - great piece of work - great piece of work

]]> Comment on Is HIT interoperability in the nature of healthcare? by John Lynn - EMR and HIPAA http://blog.medsphere.com/189/#comment-117 John Lynn - EMR and HIPAA Thu, 28 Feb 2013 22:39:52 +0000 http://blog.medsphere.com/?p=189#comment-117 I guess that is why I asked. If I get a chance, I'll be sure to ask the same question at the Cerner/McKesson press event, "Will you open this up to other EHR vendors as well?" If they spout a spirit of openness and collaboration, and then say no they won't, that will be very telling. I guess that is why I asked. If I get a chance, I’ll be sure to ask the same question at the Cerner/McKesson press event, “Will you open this up to other EHR vendors as well?” If they spout a spirit of openness and collaboration, and then say no they won’t, that will be very telling.

]]> Comment on Is HIT interoperability in the nature of healthcare? by Edmund Billings, MD http://blog.medsphere.com/189/#comment-116 Edmund Billings, MD Thu, 28 Feb 2013 22:03:11 +0000 http://blog.medsphere.com/?p=189#comment-116 Hi, John. For true industry-wide interoperability, we’ll probably be doing some kind of coordinated flash mob samba instead of the tango. As many have said already, the expected Cerner/McKesson deal is an attempt to create an Epic-killer. In reality, it simply combines the proprietary energies of two companies pursuing the same monopolistic goals as Epic, which won’t benefit healthcare and will lead to more HIT-related bankruptcies. Medsphere is trying to do something different with OpenVista--something that's truly open. Hi, John. For true industry-wide interoperability, we’ll probably be doing some kind of coordinated flash mob samba instead of the tango. As many have said already, the expected Cerner/McKesson deal is an attempt to create an Epic-killer. In reality, it simply combines the proprietary energies of two companies pursuing the same monopolistic goals as Epic, which won’t benefit healthcare and will lead to more HIT-related bankruptcies. Medsphere is trying to do something different with OpenVista–something that’s truly open.

]]> Comment on Is HIT interoperability in the nature of healthcare? by John Lynn - EMR and HIPAA http://blog.medsphere.com/189/#comment-115 John Lynn - EMR and HIPAA Wed, 27 Feb 2013 22:52:42 +0000 http://blog.medsphere.com/?p=189#comment-115 Unfortunately it takes 2 to tango (or should I say ineroperate), but it seems like healthcare IT is allergic to it. We'll see if the Cerner-McKesson announcement at HIMSS breaks ground in this regard. Can VistA get in on that announcement? Unfortunately it takes 2 to tango (or should I say ineroperate), but it seems like healthcare IT is allergic to it. We’ll see if the Cerner-McKesson announcement at HIMSS breaks ground in this regard. Can VistA get in on that announcement?

]]> Comment on Is HIT interoperability in the nature of healthcare? by Edmund Billings, MD http://blog.medsphere.com/189/#comment-114 Edmund Billings, MD Wed, 27 Feb 2013 20:57:07 +0000 http://blog.medsphere.com/?p=189#comment-114 Thanks for engaging in the dialogue, John. There are some VistA initiatives focused on extending the platform, but they are pretty VistA specific. To extend the clinical support capabilities of OpenVista, our VistA-derived solution, Medsphere developed a Java-based API layer with a tool set for building Web Services. We call this layer the <a href="http://www.medsphere.com/ovid-white-paper" rel="nofollow">OpenVista Interface Domain (OVID)</a>, and it does enable APIs built by Medsphere and others. We know that other non-Medsphere developers have used OVID for its Java-enabled flexibility to extend the capabilities of VistA and OpenVista. In terms of open development and data access more broadly, we’ve also developed a tool for the MUMPS database called FM Projection that enables structured SQL views of OpenVista data for various uses. OpenVista is also bundled with the open source MIRTH Connect interface engine, enabling easier and more affordable interfacing than proprietary options. There are no industry-wide API standards, so Medsphere has not developed specific APIs that are applicable to other platforms and systems. But we’re trying to enable that level of collaboration and promote the idea that broad standards are necessary or health IT will remain badly fractured and we won’t even be able to see true interoperability from where we’re standing. Thanks for engaging in the dialogue, John. There are some VistA initiatives focused on extending the platform, but they are pretty VistA specific. To extend the clinical support capabilities of OpenVista, our VistA-derived solution, Medsphere developed a Java-based API layer with a tool set for building Web Services. We call this layer the OpenVista Interface Domain (OVID), and it does enable APIs built by Medsphere and others. We know that other non-Medsphere developers have used OVID for its Java-enabled flexibility to extend the capabilities of VistA and OpenVista.

In terms of open development and data access more broadly, we’ve also developed a tool for the MUMPS database called FM Projection that enables structured SQL views of OpenVista data for various uses. OpenVista is also bundled with the open source MIRTH Connect interface engine, enabling easier and more affordable interfacing than proprietary options.

There are no industry-wide API standards, so Medsphere has not developed specific APIs that are applicable to other platforms and systems. But we’re trying to enable that level of collaboration and promote the idea that broad standards are necessary or health IT will remain badly fractured and we won’t even be able to see true interoperability from where we’re standing.

]]> Comment on Is HIT interoperability in the nature of healthcare? by Bob Fenton http://blog.medsphere.com/189/#comment-107 Bob Fenton Sun, 17 Feb 2013 01:42:24 +0000 http://blog.medsphere.com/?p=189#comment-107 I agree there are some real problems, but I wonder also how this is going to affect what this article is talking about in remote patient monitoring (RPM) - http://www.medscape.com/viewarticle/779399?src=rss. Something is going to get kicked to the curb if HIT does not improve interoperability soon. I suspect that HHS and CMS will start penalizing HIT systems. Thank you for your insightful blogs. I agree there are some real problems, but I wonder also how this is going to affect what this article is talking about in remote patient monitoring (RPM) – http://www.medscape.com/viewarticle/779399?src=rss.

Something is going to get kicked to the curb if HIT does not improve interoperability soon. I suspect that HHS and CMS will start penalizing HIT systems.

Thank you for your insightful blogs.

]]> Comment on Is HIT interoperability in the nature of healthcare? by John Lynn - EMR and HIPAA http://blog.medsphere.com/189/#comment-103 John Lynn - EMR and HIPAA Wed, 13 Feb 2013 21:57:33 +0000 http://blog.medsphere.com/?p=189#comment-103 How does Medsphere and Vista handle interoperability. Sure, the code is open source, so anyone can go in and extend it as they please, but are there some initiatives in the Vista software to make an open API possible without having to dig into the software code? How does Medsphere and Vista handle interoperability. Sure, the code is open source, so anyone can go in and extend it as they please, but are there some initiatives in the Vista software to make an open API possible without having to dig into the software code?

]]> Comment on The RAND Report: Are healthcare and health IT in a dysfunctional relationship? by Dr. Steven Dain http://blog.medsphere.com/the-rand-report-are-healthcare-and-health-it-in-a-dysfunctional-relationship/#comment-95 Dr. Steven Dain Mon, 04 Feb 2013 01:50:44 +0000 http://blog.medsphere.com/?p=177#comment-95 We have put the cart before the horse! There are no good Health Informatics Standards and too many Standards Development Organizations (SDO) each with they own vested interests attempting to rapidly write standards, often with overlaps and cross purposes. They read like alphabet soup--IHTSDO, HL7,IEEE,IHE, ISO,IEC, WHO, ICD-10 not to mention each countries national organizations. All of these groups need to cooperate and produce informatics standards for the 21st century and not ones mired in the past. HL7 is not sufficiently granular to be a serious standard for all healthcare needs. We need to look at real-life clinical and business scenarios, and then determine what we need to meet these goals, and write standards that solve these problems. We need to take a step backwards, take a big breath, and then write a proper medical controlled vocabulary (SNOMED CT, ICD-10 and others) and then write a proper XML based data communications standard based on open proven standards such as Data Distribution Services (http://dds.omg.org/) Once we have sufficiently completed this task, should we them move forward. We have put the cart before the horse! There are no good Health Informatics Standards and too many Standards Development Organizations (SDO) each with they own vested interests attempting to rapidly write standards, often with overlaps and cross purposes. They read like alphabet soup–IHTSDO, HL7,IEEE,IHE, ISO,IEC, WHO, ICD-10 not to mention each countries national organizations.
All of these groups need to cooperate and produce informatics standards for the 21st century and not ones mired in the past.
HL7 is not sufficiently granular to be a serious standard for all healthcare needs.
We need to look at real-life clinical and business scenarios, and then determine what we need to meet these goals, and write standards that solve these problems.
We need to take a step backwards, take a big breath, and then write a proper medical controlled vocabulary (SNOMED CT, ICD-10 and others) and then write a proper XML based data communications standard based on open proven standards such as Data Distribution Services (http://dds.omg.org/)
Once we have sufficiently completed this task, should we them move forward.

]]> Comment on The RAND Report: Are healthcare and health IT in a dysfunctional relationship? by Stephen Farber http://blog.medsphere.com/the-rand-report-are-healthcare-and-health-it-in-a-dysfunctional-relationship/#comment-91 Stephen Farber Mon, 28 Jan 2013 14:23:18 +0000 http://blog.medsphere.com/?p=177#comment-91 The real value in Health IT will be seen when we efficiently utilize data, and improve workflow for all constituencies. Under our current system, neither can be achieved. The short-term profitability and success of existing vendors is dependent upon carrying on in a traditional fashion, while new market participants must straddle trying to provide solutions which address where the market wil eventually go, versus what the market demands today. Further, the current pay for service approach contradicts the objective of minimizing the life-cycle cost of healthcare. I am confident that we will eventually improve our system, but we will make significant investment in interim steps and solutions on the path to improvement. Building solutions for a dysfunctional system can never be efficient, but politically may be the only path. The real value in Health IT will be seen when we efficiently utilize data, and improve workflow for all constituencies. Under our current system, neither can be achieved. The short-term profitability and success of existing vendors is dependent upon carrying on in a traditional fashion, while new market participants must straddle trying to provide solutions which address where the market wil eventually go, versus what the market demands today. Further, the current pay for service approach contradicts the objective of minimizing the life-cycle cost of healthcare.

I am confident that we will eventually improve our system, but we will make significant investment in interim steps and solutions on the path to improvement. Building solutions for a dysfunctional system can never be efficient, but politically may be the only path.

]]> Comment on The RAND Report: Are healthcare and health IT in a dysfunctional relationship? by Dr George Margelis http://blog.medsphere.com/the-rand-report-are-healthcare-and-health-it-in-a-dysfunctional-relationship/#comment-89 Dr George Margelis Fri, 25 Jan 2013 02:37:58 +0000 http://blog.medsphere.com/?p=177#comment-89 The problem is the order in which things have been done. By stimulating the use of IT on a dysfunctional healthcare system we have automated and embedded a dysfunctional system. What was needed was healthcare reform first and then embedding it with technology. It has not been a total waste, but I suspect in hindsight the US will look upon it as a wasted opportunity. Maybe if they had been more willing to give healthcare reform a chance back in Bill Clinton’a day they would now not be in such a dire situation. Other countries such as Australia and the UK can’t be too smug either. Failure to first implement the required system change before using technology to embed it is a major failing. It doesn’t need to be centrally planned, but it does need physician involvement and it does need to be courageous enough to change the status quo with a long term view. Payment reform is at the center, but quality and safety need to be intrinsic goals as well. The problem is the order in which things have been done. By stimulating the use of IT on a dysfunctional healthcare system we have automated and embedded a dysfunctional system. What was needed was healthcare reform first and then embedding it with technology.
It has not been a total waste, but I suspect in hindsight the US will look upon it as a wasted opportunity. Maybe if they had been more willing to give healthcare reform a chance back in Bill Clinton’a day they would now not be in such a dire situation.
Other countries such as Australia and the UK can’t be too smug either. Failure to first implement the required system change before using technology to embed it is a major failing. It doesn’t need to be centrally planned, but it does need physician involvement and it does need to be courageous enough to change the status quo with a long term view. Payment reform is at the center, but quality and safety need to be intrinsic goals as well.

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