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Re: HL7 too expensive, too complex and inconsistent
Hi Carola,
Dr Carola Hullin Lucay Cossio wrote:
As discussed by many of you and readers of these comments, the time is now
to move forward safely with these initiatives.
The level of evolution is not necessarilly required from the creators of
this innovation but the manner OpenEHR is used on the ground level. I see
many factors need clarification and introduction of new dimensions to move
forward...
Such as:
Open source is a burning issue for developing countries...and specially the
space do not have the resources to contract experts from the north to
introduce these innovations to the operational level.
The more I think about it, the less I am convinced for the health arena
- here I am talking about specialised applications, not Linux or other
infrastructure stuff. And let me point out that I am broadly an open
source advocate. Firstly, there are unavoidable costs of deployment, of
validation of software, validation of archetypes and other knowledge
resources; costs of training, costs of change management and many other
costs. While the wage rate or currency may be lower in some places,
mostly we are talking about people from higher wage categories, so these
costs won't be trivial. Now, in a world where software is being offered
more as a service rather than a product, the way of charging is
different - it is a rental model. So large up-front costs for a software
product are starting to diminish even among commercial suppliers. Then
if we look at what is really valuable to clinicians, and a country in
general, it is the data, not the software. If there are guarantees of
data openness within a strict privacy framework, then automated billing
can be implemented, not to mention public health and research uses of
the data.
There are some arguments for access to the software source code, but
over the last few years I have come to the conclusion that they are far
less compelling than access to standardised data, and also standardised
service interfaces in an open platform.
For clinicians the ACCESS TO INFORMATION what is matters, specially for the
countries where a computer is a luxery.........even a well model of
information in paper is a progress for current documentation. So the fast
changes in developing template and exchange of data may be as critical for
developed countries but in poor countries this expertise does not
exist........they do not see the differences between GOOD QUALITY data
elements and what is the power of STANDARDS....that is the strenghts of
OpenEHR.....
exactly...
- thomas beale
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