The Pirate Bay IP Addresses Point To Prosecution Lawyers

Bill Introduced For Open Source Health Records... But That's Only A Start

from the would-it-even-be-possible dept

Mon, Apr 27th 2009 5:42am — Mike Masnick

Senator Jay Rockefeller, who recently wondered if the world would be better off had the internet not been invented has now introduced a bill that would encourage the use of open source technologies for healthcare records. It's nice to see that he's not entirely anti-technology. Still, this is a lot easier said than done. As we recently saw, an attempt to create open source technology for emergency dispatch was forced to shut down after a proprietary vendor threatened the open source project with patent infringement. You can pretty much bet that any open source healthcare solution would likely face the same sort of problem. Would anyone in the Senate like to protect such open source projects from those who abuse the patent system to block such projects?

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Filed Under: health records, jay rockefeller, open source, patents

17 Comments

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Tgeigs, 27 Apr 2009 @ 6:16am

Dammit
As part of a family that owns a great majority of the pharma industry, I'm just going to blanketdly oppose any legislation proposed by Mr. Rockefeller Robber Baron pickle kisser that has ANYTHING to do w/the medical industry.

Sorry, I hate your family, and that bill proposal that would give the Prez the power to switch off the internet in case of emergency? Yeah, dude, we get it. You're evil.

http://www.sourcewatch.org/index.php?title=David_Rockefeller
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Overcast, 27 Apr 2009 @ 6:30am

It's nice to see that he's not entirely anti-technology.

I wouldn't go that far - I'm sure there's some other agenda at hand.
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Simon Cast, 27 Apr 2009 @ 6:31am

Open Data Formats would be better
I think rather than worry about open source software the key to drive adoption and competition in electronic health records is an open data structure.

Define a standard format for eHealth Records (probably XML based) that all health systems have to be able to import and export. How it is stored internally is immaterial, what matters is the information can be retrieved using standard format and potentially a standard API calls. Make it an open protocol.

The actual software isn't the key its the data. Make that open then proprietary lockin is avoided and data can move around various systems as needed.
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Whisk33, 27 Apr 2009 @ 6:48am

Re:
Hand goes into puppet
Arm follows Hand
Hand controls mouth
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bbbbb, 27 Apr 2009 @ 6:56am

Re: Open Data Formats would be better
This already exists. it is called HL7, and it's current version is XML based.
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bbbbb, 27 Apr 2009 @ 6:59am

An open source healthcare platform already exists
It is called vista.

http://www.linuxjournal.com/content/other-vista-successful-and-open-source

http://world vista.org/AboutVistA
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R. Miles, 27 Apr 2009 @ 7:51am

Excuse me, but where is this info on the bill itself?
I've tried to read the bill's information, but no where does it state using open source technology as it is currently written.

Is this just word of mouth from Senator Rockefeller?

Because until it's formerly written as such, I don't get the reason people are voting on the bill when it hasn't even been introduced yet.
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Tgeigs, 27 Apr 2009 @ 8:03am

Re: Excuse me, but where is this info on the bill itself?
Didn't you know? The word of a Rockefeller IS law. No need to waste paper and ink....
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Anonymous Coward, 27 Apr 2009 @ 8:34am

Would anyone in the Senate like to protect such open source projects from those who abuse the patent system to block such projects?
Because that's EXACTLY what we want: gov't regulated medical records and more exceptions to the (poorly written) rules!
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Anonymous Coward, 27 Apr 2009 @ 9:45am

Re: Re: Excuse me, but where is this info on the bill itself?
Didn't you know? The word of a Rockefeller IS law. No need to waste paper and ink....

True, I just wonder if this is meant to be a shot over the bow aimed towards some major technology company with ties to the Rockefeller Foundation that enjoys not using OpenSource. Probably some related link to a Seed Vault, or Health Vault or something.
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Anonymous Coward, 27 Apr 2009 @ 9:45am

Too bad open source eMR's won't increase health any more than closed source eMR's.

eMR's consume more time for both the hospital and the doctor. That means that treatment times in emergencies will be slower. How do they save money? Well, by making it easier to deny claims/service of course.
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Ryan, 27 Apr 2009 @ 10:25am

Re:
Say what? How do they "consume more time"? Are you referring to new users that are unfamiliar with the interface? Because that is rectified pretty quickly. Communication between medical staff is instantaneous and the patient record can be immediately pulled up anywhere with appropriate access, and of course a lot of time is spared by electronically recording/completing forms as opposed to manually writing them.

Furthermore, EMRs greatly cut down on medical errors(i.e. administering the wrong dosage), which saves money in itself, as well as eliminating a lot of paper storage issues. EMRs pretty clearly improve health outcomes.

The only issue I see with open source as opposed to closed source is that the margin of error is pretty small. If there's a problem, it needs to be fixed quickly, and a lot of hospitals, providers, etc. are on completely different timetables being that they're pretty resistant to change. Paying somebody to take responsibility for the records may be more necessary in the medical field than in others. Although I'd venture to guess that open source will eventually be adopted everywhere, provided that incumbents don't at some point attach the same stigma to that as they do currently to file sharing.
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Paul G, 27 Apr 2009 @ 10:54am

Go for it
Make it a Government project. A proprietary vendor will threaten the open source project with patent infringement. The cost of fighting the case will be huge.

Once it is over - use the facts to stick it to the idiots who passed the legislation that screwed up the patent system.
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Anonymous Coward, 27 Apr 2009 @ 11:15am

Ryan, eMR's do make more time by its users.

Which is quicker, a doctor scrolling down a list of drugs to prescribe or writing out the prescription down on a script pad? Which is quicker, scrolling through a list of ailments or writing in the ailment?

Also, it will reduce some errors but introduce other errors. the health benefits are greatly over rated, the cost savings are where? How much money did the UK put into it for a system that doesn't work? How much money did Kaiser put into one for another system that doesn't work?
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Ryan, 27 Apr 2009 @ 12:28pm

Re:
You sound like you have experience with one; it doesn't sound like a very good one, though. If the end users are forced to scroll through long lists of options each time they need to complete a particular workflow, then the EMR software is cluttered and inefficient.

However, the system in general enables greater efficiency. For example: the doctor can immediately pull up your latest x-rays from a month ago without having to send for them, then write an electronic prescription that goes immediately to the pharmacy. By the time you've walked to the pharmacy, the medication is ready for you.

What errors do you EMRs introducing? There will be software bugs, of course, but any good software will have safeguards in place to prevent interface issues from becoming medical issues. EMRs have an exceptionally good record of cutting down on actual harmful medical errors, thereby reducing malpractice premiums. And like I said, maintaining a paper database is more expensive than maintaining an electronic database; the latter is also much more accessible and easier to back up.

The issue becomes saving enough to make the initial investment worth it. Here is where greater competition in the private sector will help out. This was a good read bringing up some of the examples you raised:
http://www.managedcaremag.com/archives/0411/0411.emr.html

Excerpt:

For many of the big provider groups that are acquiring systems, though, the investment is worth the gain in quality alone, because whether the subject is CPOE or EMRs, a stack of authoritative reports shows clear statistical data substantiating the link between digital records and better outcomes.

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Anonymous Coward, 27 Apr 2009 @ 12:48pm

Ryan, I agree, it has some value, but is it worth it and does it actually improve health?

Sure, e-prescribing would be nice, but do you realize that about 50% of all patients are never picked up? What happens to those? The drug companies love the idea (more product sold) and the payors hate the idea (more payouts)

Where will the errors be? How easy is it to change an error in your medical record today if it is paper based? How difficult is it to change something in a database? I know companies that still mail my bills to my old address, and I have not lived there for 5 years.

What happens when someone puts the wrong drug in the wrong bin? A nurse goes in, scans the drug and then pops it into the patient.

The errors won't come from the system but from the process. A bad process is a bad process and automation will just speed up the damage. How well have companies done to work on their SAP packages in terms of training and process remapping?

The savings will be had by the payor (and that looks to be the big insurance companies or the govt.)

Has the UK's system improved health outcomes in the UK? Has any system put in place anywhere else improved health? The US is really a late adopter of this, we have lots of other projects to look at, have any of them done well? Any of them?

What makes us think it will be different with our system?
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Anonymous Coward, 27 Apr 2009 @ 1:30pm

The solution to eMR is a nice, long vacation once in a while
When I establish a relationship with a primary care physician, it tends to go on forever. Why? Because most people have established a doctor-patient relationship, and that relationship is key to receiving good medicine.

I've often wondered why HIPAA came into esistence. eMRs only appear to extend HIPAA, and attempt to devaluate the doctor-patient relationship beyond recognition. I can see how eMRs may be helpful for emergency cases where people on strong drugs such as anticoagulants, MAOIs, SSRIs, TCAs, or MAOI inhibitors may present a detrimental effect to recieving certain types of care in an emergency situation.

Most people I imagine, are not allergic to penicillin or any drug for that matter. In fact, less than 1% of general population even claim a penicillin allergy, and study in 2001 notes that possibly less than 20% of that 1% who believe that they have a penicillin allergy are truly allergic to penicillin. So it seems allergy is not a driving force.

Instead, it seems knowledge of other therapy drugs, possibly such as MAOIs, SSRIs, TCAs, MAOI inhibitors, or anticoagulants, are to blame. Perhaps the nutjobs receiving such therapy should be required to wear a Life Alert Bracelet or carry a card in their wallet while recieving such therapy. But of course, the nutjob mentality doesn't bode well for ideas surrounding personal responsibility.
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