21–30 of 119 posts
While this is a good idea, how are the health compliance requirements enforced?
Regulatory compliance is secondary to having an hospital information system at all - remember that this software aims at the developing world.
If they are followed is another matter.
This is great. I recently had to create a prototype application for a charity with offices in a developing country and this would have been a perfect fit. I don't have access to GitHub at the moment but I wonder how far along their implementation of the 'off-line first' sync mechanism is, this is a non-trivial thing to implement. I had a quick look at the demo and it looks like the development is in the early stages-…
> I wonder how far along their implementation of the 'off-line first' sync mechanism is, this is a non-trivial thing to implement. The are using PouchDB + CouchDB for offline first / syncing which is how I came to notice it (I am a maintainer for PouchDB). So their ability to sync should be reliable and well tested and if not then its bugs for us to fix :)
While this is a good idea, how are the health compliance requirements enforced?
I'm struggling to understand the question - by testing for compliance like other software? I'm assuming there'd need to be a services business installing and maintaining the software, and adding improvements particular customers need.
You cannot just install some software and start putting patient data into it.
Each country has a regulation process how the said software can be used and there are international standards as well.
This area is known as "Electronic Health Record" and "Health information technology" systems
Earlier quoted context omitted.
I'm struggling to understand the question - by testing for compliance like other software? I'm assuming there'd need to be a services business installing and maintaining the software, and adding improvements particular customers need.
Health related software is bound to a certification process. You cannot just install some software and start putting patient data into it. Each country has a regulation process how the said software can be used and there are international standards as well. This area is known as "Electronic Health Record" and "Health information technology" systems
For example, for devices : ISO IEC 62304 Medical device software – Software life cycle processes
I guess this kind to enforce on an Open Source projects with "open contributions".
While this is a good idea, how are the health compliance requirements enforced?
I'm struggling to understand the question - by testing for compliance like other software? I'm assuming there'd need to be a services business installing and maintaining the software, and adding improvements particular customers need.
Medical software is a different beast, compared to, say, your next online shop or bloggin plattform.
Bugs in medical software can (and will) kill people. My work takes me to medical software development courses on a regular base and they usually consist of looking at the ways, medical software can kill people; sadly often enough by example.
One case for example was a PACS system where due to a bug in the way the database managed timestamps only the very first of a series of pictures was shown to the user. And since once could not navigate the pictures via "previous" and "next", but one always had to go through a purely text based menu (this was in the mid 1990-ies, where memory was scarse) it was not immediately apparent that only the first image in a time series was shown. Enter the patient with a tumor; when it was finally realized the images the medtech took were not the same the specialist saw it was already too late for the patient and tumor growth progression too far advanced.
So your medical database software kills someone (prescription error due to wrong dataset shown or such), how do you determine whose liability it is/was? Medical software certification is in large part about identifying what harms to a patient could be done and which parts of the software may cause it. You don't even rule out in a "this can't happen" way, but it goes like:
- patient dies: no matter how well it was tested, these are the possible offenders in the program - patient gets seriously harmed: no matter how well it was tested, these are the possible offenders in the program - patient gets injured: no matter how well it was tested, these are the possible offenders in the program
The bottom line is you're ending up with something that is either close to or outright is waterfall.
And even more important: These are the components a program uses, what possible failure modes are there that could harm patients. So they're using CouchDB? Well, is CouchDB medically certified (AFAIK not), so this is considered SOUP (Software Of Unknown Pedigree) which means that to legally use this in medical applications you have to certify the SOUP yourself.
Oh and putting medical records into the Cloud? What could possibly go wrong…
Earlier quoted context omitted.
Health related software is bound to a certification process. You cannot just install some software and start putting patient data into it. Each country has a regulation process how the said software can be used and there are international standards as well. This area is known as "Electronic Health Record" and "Health information technology" systems
And often the compliance also defined how the SW should have been developed. For example, for devices : ISO IEC 62304 Medical device software – Software life cycle processes I guess this kind to enforce on an Open Source projects with "open contributions".
This is great. I recently had to create a prototype application for a charity with offices in a developing country and this would have been a perfect fit. I don't have access to GitHub at the moment but I wonder how far along their implementation of the 'off-line first' sync mechanism is, this is a non-trivial thing to implement. I had a quick look at the demo and it looks like the development is in the early stages-…
> I wonder how far along their implementation of the 'off-line first' sync mechanism is, this is a non-trivial thing to implement. The are using PouchDB + CouchDB for offline first / syncing which is how I came to notice it (I am a maintainer for PouchDB). So their ability to sync should be reliable and well tested and if not then its bugs for us to fix :)
The epitome of "User Needs"
In the next couple of weeks when it opens I aim to join the UK governments "Digital Services Framework" where UK government software is expected to be written as open source.
The hope and intention is that development of a UK government solution (that say relies upon CouchDB) and so will have taxpayer money delivering bug fixes to users in the less well off parts of the world.
It's the right approach - and one that will have long term benefits not just for end users of software, but subtle benefits for UK / western countries.
We are getting better at this as a species - slowly. And it's attitudes displayed here that will deliver the most value in the world - even if you might not be the one to capture the cash...
Well done
Imagine if this got better than systems that are on offer when this requirement goes out to tender for the NHS institutes in the UK? So long as it doesn't do over night batching, it's already decades ahead. I wish I was joking.
Because I'd believe that you can't just make something that looks better and sell like you'd sell a typical SaaS product, there must be tons of regulations.
On other hand, while studying in the UK, I briefly met a PhD student who was making offline-first web apps to calculate the dosage of the medicine etc and hospitals in the UK where actually using them (and paying him to develop).
This is a great initiative, I logged in the beta and tried a few things, which mostly worked, although somewhat slow. Probably a lot of hospital administrators active now :-) What surprised me most is that the UI does not seem to be mobile responsive, and does not work well on smartphones. I would have guessed that in developing countries mobile use would be hugely important?
Earlier quoted context omitted.
> I wonder how far along their implementation of the 'off-line first' sync mechanism is, this is a non-trivial thing to implement. The are using PouchDB + CouchDB for offline first / syncing which is how I came to notice it (I am a maintainer for PouchDB). So their ability to sync should be reliable and well tested and if not then its bugs for us to fix :)
We recently used Kobo Toolbox ( http://www.kobotoolbox.org ) for a health related survey in a developing country... The Ministry of Health required the data stored locally to be encrypted on the device and during sync (not just over https), which caused some problems for deployment. That will be an absolute requirement from any gov that looks to adopt the tech. Not sure if it was a PouchDB or Kobo shortcoming.
https://github.com/calvinmetcalf/crypto-pouch https://github.com/nolanlawson/transform-pouch