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GNU Health

gnuhealth.org

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Re: GNU Health

#71

Post by zkmon »

nradov wrote: post #57
zkmon wrote: post #26

Nice to see support for Open source. I have seen selling of healthcare data, including medicare and medicaid data to private companies which sliced and diced it and sold to academic and drug research institutions via data marts. ETL jobs would run for months. The data included prescriptions, scans, visits, employee plans etc, for about ~200 millions of American patients. It is anonymized data, but still I always wond…

HHS publishes clear guidelines for de-identifying healthcare data (PHI). Once it has been properly de-identified (anonymized) it is no longer subject to any special controls. I am aware that some researchers have claimed that it could be theoretically possible to re-identify certain records but so far no one has been able to do so in practice so concerns seem to be overblown. https://www.hhs.gov/hipaa/for-professiona…

https://ghdx.healthdata.org/record/united-states-marketscan-...

It shows some medicare data as owned by a private company.

Re: GNU Health

#72

Post by tomrod »

headsman771 wrote: post #18
throw-the-towel wrote: post #10

Earlier quoted context omitted.

Can you name one open-source project "used by millions" that does not have corporate sponsorship?

This implies corporate sponsorship is a requirement for, as opposed to result of, a projects usefulness. That has not been the case for most valuable open source software.

Who sponsors curl?

Re: GNU Health

#73

Post by nradov »

zkmon wrote: post #71
nradov wrote: post #57

Earlier quoted context omitted.

HHS publishes clear guidelines for de-identifying healthcare data (PHI). Once it has been properly de-identified (anonymized) it is no longer subject to any special controls. I am aware that some researchers have claimed that it could be theoretically possible to re-identify certain records but so far no one has been able to do so in practice so concerns seem to be overblown. https://www.hhs.gov/hipaa/for-professiona…

https://ghdx.healthdata.org/record/united-states-marketscan-... It shows some medicare data as owned by a private company.

That doesn't look like Medicare data. It comes from Medicare Supplement health plans offered by commercial payers (not a government program).

Re: GNU Health

#74

Post by bjoli »

leakycap wrote: post #2

Heath centers pay unreal amounts of money for these kinds of commercial products, but in my experience the health centers themselves have very few technical resources. So the real "value" being delivered by the commercial software providers is often the setup, support, and hand-holding provided to customers who pay the crazy amounts. I imagine there will be a niche but high-paid market integrating these GNUHealth pro…

I wonder what would happen if EU harmonized the legislation so that the EU states could go together and develop an OSS journaling system. The amount of money saved would be astronomical.

Re: GNU Health

#75

Post by tomrod »

nradov wrote: post #55
john61 wrote: post #24

Earlier quoted context omitted.

This is meant to be used in hospitals. Where I live no hospital personal uses phones to manage healthcare data. They have PCs.

You seem to be living in the past. While EHRs are still primarily used from desktop PCs, all of the major ones have native mobile apps now. Clinicians appreciate being able to review patient charts and action alerts while away from a PC cart.

Better to make it a web app, so you don't have to mess with Apple or Google's broken economics.

Re: GNU Health

#76

Post by nradov »

vincent-manis wrote: post #69
cyberax wrote: post #56

Earlier quoted context omitted.

Vista is ancient, and it's written in MUMPS, an evil twin of COBOL.

No, MUMPS (or M) is a remote descendant of JOSS, an interactive language of the 1950s. JOSS has all sorts of variants (DEC's FOCAL language of the 1960s was a dialect), but I think MUMPS is the only living one. MUMPS code is mostly unreadable, as the commands can be, and often are, abbreviated to the first letter. As a result, it looks a lot like line noise. Regardless of its many warts, Cobol cannot be accused of be…

MUMPS was originally developed in the 1960s for use on minicomputers that had maybe 64KB RAM. At the time it was a lot more important to keep code size small, hence the single letter commands. Readability wasn't a concern then but it sure looks like a mess today.

Re: GNU Health

#77

Post by bonsai_spool »

leakycap wrote: post #54
doctorpangloss wrote: post #46

Earlier quoted context omitted.

No… hospitals use EHR to maximize billing. That is the value. Private practices are generally shrinking in number, so there IS NO EHR that is growing in the long term to serve them, so there CANNOT BE a trend where hospitals are exceptional, their IT buying trends are the NORM and their purpose is to code for billing. It is NOT about having or not having IT resources strictly speaking.

Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social. > hospitals use EHR to maximize billing As a person who has worked extensively with hospitals and CHCs helping them integrate technology, this is false. EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from…

> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.

Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.

Re: GNU Health

#78

Post by nradov »

throwaway173738 wrote: post #64
gjsman-1000 wrote: post #4

Earlier quoted context omitted.

The problem open-source, and social media, and everything digital, has never overcome is accountability . Who do I sue, and who has insurance, if something goes wrong? Combine that with most small businesses having more money than time (just pay Gmail, don’t spend the required amount of time to self host), and open-source is stuck at being hobbyists if there is no corporate sponsorship.

You sue the developers. It’s how it works in general. So basically you’d comb the commit history for the project and name everyone in the lawsuit that you could.

It's possible that some FOSS developers have been hit with nuisance lawsuits but in general they have no contractual relationship with the users and thus no liability under US law.

Re: GNU Health

#79

Post by nradov »

bonsai_spool wrote: post #77
leakycap wrote: post #54

Earlier quoted context omitted.

Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social. > hospitals use EHR to maximize billing As a person who has worked extensively with hospitals and CHCs helping them integrate technology, this is false. EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from…

> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source. Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who h…

Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.

Re: GNU Health

#80

Post by nradov »

tomrod wrote: post #75
nradov wrote: post #55

Earlier quoted context omitted.

You seem to be living in the past. While EHRs are still primarily used from desktop PCs, all of the major ones have native mobile apps now. Clinicians appreciate being able to review patient charts and action alerts while away from a PC cart.

Better to make it a web app, so you don't have to mess with Apple or Google's broken economics.

You're really missing the point. The EHR vendors aren't charging customers for those apps through the Apple or Google app stores so "broken economics" are irrelevant. The app stores are only a distribution mechanism and work fine for that.
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