e-HealthExpert.org - Primum non nocere

SEEDIE and EXTORMITY are a parody to some of the so called "Health IT Standards Organizations" and to their satellite "Health IT Solutions" vendors.

SEEDIE is a new kind of healthcare IT Standards Organization:

• True, it is a bit far from being an Open Standards Organization.
• And it is in no way like, for instance, HL7.
• But it certainly deserves a visit: SEEDIE Home page

EXTORMITY is the first SEEDIE certified EMR/Health IT Software Suite:

• Much better and reassuring than those pesky Open Sourced applications.
• Check the EXTORMITY site at: EXTORMITY Home page

Did you also got that déjà vu feeling?


Related and also interesting: Scot's Blog about SEEDIE, VistA and Health IT

Squid is a caching Web proxy supporting HTTP, HTTPS, FTP, and other protocols.
It reduces bandwidth and improves response times by caching and reusing frequently-requested web pages.
It runs on Unix and Windows and is licensed under the GNU GPL.

This page describes howto install and configure Squid to run in a Ubuntu Linux platform.

Install Squid:

sudo apt-get install squid

Configure Squid:

sudo cp /etc/squid/squid.conf /etc/squid/squid.conf.orig

sudo nano /etc/squid/squid.conf

• Inside the file /etc/squid/squid.conf find the http_access section, uncomment the following 2 lines and add your network (lets assume that your network is 10.10.10.0/24):

acl our_networks src 192.168.1.0/24 192.168.2.0/24 10.10.10.0/24
http_access allow our_networks

• Find the visible_hostname section and after the lines:

#Default:
# none

• add:

visible_hostname localhost

Restart Squid:

sudo /etc/init.d/squid start

Done. You should now be able to use Squid to speed up repetitive web connections.

Howto's, Manuals and Documents about Software installation, setup and configuration

This is the archive of software packages known by the e-HealthExpert.org members.

All entries should at least include:

1. Software name and version,
2. An abstract of what it does,
3. The type of license under which it is released,
4. The software homepage address,
5. A rating value from 1 to 5 [1 (lousy), 2 (mediocre), 3 (average), 4 (good), 5 (very good)],
6. Submission author's name.

This new area of e-HealthExpert.org site is also meant to be a repository of the most relevant software that appears at our [sw-hw] mailing list.

The [sw-hw] mailing list is an open forum in which any member can freely review, evaluate and talk about any subject related to systems architecture, software, hardware and, more in general the usage of IT technology to support all the activities of a Healthcare Organization. List guidelines and subscription application forms are available from: [sw-hw] mailing list usage guidelines.

Jakob Nielsen is well known author that has been writing about computer usability for years. His "Top Ten Web Design Mistakes" article series is by now well known and appreciated globally.

In April 2005 he wrote a small article on Medical Software Usability, named "Medical Usability: How to Kill Patients Through Bad Design". The following was taken from that article:

"A field study identified twenty-two ways that automated hospital systems can result in the wrong medication being dispensed to patients. Most of these flaws are classic usability problems that have been understood for decades."

That article's full text is available at: http://www.useit.com/alertbox/20050411.html and the full list of Nielsen's "Alertbox" articles on usability are available at: http://www.useit.com/alertbox/

Is the enterprise software licensing business dying? Is anybody out there buying new licenses?
Based on news from the past few weeks, it seems that there are very few buyers.
The collapse of new licensing revenue isn't news -- it started five years ago -- but the latest news makes it look like a permanent and accelerating fact of life for software vendors.
The article, titled IT Execs to Vendors: Your Software Stinks, sets the tone for the industry's most recent quarter. Ouch! It contains the astonishing claim by the CIO of British Petroleum that out of a $2B IT budget, only $30M is allocated for new software licenses.
Source: [IT Manager's Journal]

Standards are a critical subject in any activity. Healthcare has been pestered for years by a Babel tower of proto-standards and lousy standardization efforts.

It seems that a long time offender - HL7 - is showing some activity at the (long dued) effort of moving from the fuzzy and profit centered HL7 2.x to a more up to date Web Age XML-based and Clinically-Centered standardization effort (HL7 3.x).

At the HL7 organization's web site you may find a recent update (2005.03.23) of the: Clinical Document Architecture (CDA) Ver. 2.0 proposal.

But, for anyone that has been following the HL7 soap opera from 1987, a thought come to mind:
How much of this is "the true standard" and how much of it is "more of the same", just to cope with the USA market and with the recent US Government HIPPA enforcement?

A heterogeneous group of people from the MIT, Tufts NEMC, Childrens Hospital (Boston) has been working in a very interesting project named the Guardian Angel Personal Lifelong Active Medical Assistant.
The BMJ has an 2001 article from that group named Public standards and patients control how to keep electronic medical records accessible but private, which is freely available for download, in .pdf format, from: Public standards and patients control.
The "Guardian Angel" project has threee main areas of development: PING (Personal Internetworked Notary and Guardian), HealthConnect and W3-EMRS (World Wide Web based Electronic Medical Record System).

The European Interoperability Framework (EIF) is the reference interoperability document for the development and delivery of e-government services (including e-Health and Health IT related services) at pan-European level. The EIF provides:

• a set of guidelines and recommendations to enable interoperability of government systems and processes with a view to delivering pan-European e-Government services (PEGS),
• identifies a number of general principles that should be considered for any e-government service to be set up at a pan-European level: accessibility, multilingualism, security, privacy, subsidiarity, use of open standards (adopted and maintained by an open not-for-profit organization and freely available on a royalty-free basis), assessing the benefits of Open Source Software, and use of multilateral (or 'many-to-many') solutions.

Based on these principles, the EIF addresses three distinct interoperability levels that need to be considered: organisational interoperability, semantic interoperability, and technical interoperability.
For each of these levels, the EIF provides a number of recommendations.

You may download the full specification at: European Interoperability Framework