Re: [GPCG_TALK] [Gnumed-devel] [GPCG_TALK] Gnumed

[Tim Churches]

Ian Haywood wrote:
> Tim Churches wrote:
>> (If anything, I feel that GnuMed is in danger
>> of becoming over-designed and over-engineered, and that the absolutely
>> excellent has become the enemy of the good enough, but that's just my
>> opinion).
> 
> This is fair criticism to some extent.
> One of the problems we have is Gnumed is not like most other FOSS projects.
> Most other projects their design documntation is "we are writing a free
> equivalent of X"
> where X is UNIX kernel, Microsoft Word, PGP, etc.
> If Gnumed was "we are writing a free equivalent of Medical Director", we
> would already
> be finished. However, MDW isn't even "good enough", so we become bogged
> down in design issues, we make a system
> that is configurable to the nth degree, etc., but in the long run I
> think this extra effort is worth it.
> 
>> My gut feeling is that full-time work by a team of three
>> or four people for 4 to 6 months might do it (plus continuing input from
>> volunteers). A full-time team is important,
> 
> There are professional "Python shops" here in Australia.
> However, most professionals would, I suspect, want a defined project
> of their own, I'm not sure you could give someone a paycheque and a CVS
> password
> and say "get to work with want we've got".

I think that dispassionate outsiders may want to take a knife to at
least some of the code in an effort to reign in the complexity. However,
with open source, nothing is ever wasted, because they could work on
forked version of the existing code, so the original work would still
remain and could be worked on over a longer timeframe by its original
authors. It's not either-or.

> Once we have a basic demonstrable system (in Australia this means notes,
> path. requests, path. results, plus simple prescribing)
> with defined structure, documented internal APIs, etc, it becomes more
> interesting.

Horst says that gnumed-mini can already do a superset of that, in
day-to-day use in his practice:
<quote from Horst>
> (meaning you can add, view, edit, delete demographic information, add
> and view simple progress nodes, code diagnoses and associate them with
> progress notes, record and browse family and social histories and risk
> factors, record and browse a few observations, import, comment and
> browse pathology results, and, view and administrate simple recalls,
> prescribe medication incl. viewing context sensitive reference
> information, browse medication history.
</quote from Horst>

> Isolated mini-projects can be generated
> (such as decision support) which can be contracted and funded by
> external parties.

Yes.

> Porting to e-smith and generally making installation painless is such a
> project, too.

Yes.

> Personally, I am keen to do an RACGP research job somehow involving
> gnumed, but, again, I need somehow a defined 6-month project.

Would be a VERY worthwhile project. RACGP: please support Ian in his
wish to do this!

> As far as I can tell, VistA is closed-source and Windows-only on the
> client, with the client-server protocol kept under wraps
> for "security reasons", can anyone clarify this?
> Otheriwse, VistA is very interesting.

I am not at all certain about this - expert advice has been sought on
issue. Also, I gather that the GUI front end is being reworked for Vista
Office, and that it may be more platform independent that the GUI for
the existing for-hospitals version of Vista. However, nothing is quite
clear at this stage - the US govt organisations who are behind Vista
Office are keeping their cards close to their chest.

Tim C