Conmergence

Sarah Knoop Provides an Open Healthcare Framework Update

I think we also owe this list [Open Healthcare Framework Mailing list] a summary too - though IHE-related activity has been quite active on the newsgroup - so check that out too.

Over the fall of 2007, we updated the OHF code for the edits and a few new IHE profiles implementations for 2008. We now have a brach for the code for the 2007 and prior version of the IHE profiles. This branch will see no more new features, only bug fixes. Documentation can be found on the wiki at: http://wiki.eclipse.org/OHF_IHE_2007_BRANCH

The main branch now features code compilant with the 2008 IHE profiles. Most notable new additions are that of XDS.b and XUA support. The XDS.b profile is a more pure web-service method for sharing clinical documents. The original XDS functionality is still supported (at both the plugin and bridge) and is now referred to as XDS.a. XUA is a profile for the management of user assertions (ie. SAML or WS-TRUST).  API for this profile is available at the plugin and bridge level. Updates regarding the main branch can be found at: http://wiki.eclipse.org/OHF_IHE_MAIN_BRANCH

In January 2008, OHF was well represented at the North Americal IHE Connectathon in Chicago, IL, USA. For the first time ever, the OHF Bridge was allowed to test as an individual component and passed with flying colors. OHF technology was used by 8 companies and we additionally congratulate them on their success at this event - with some systems surpassing 100 valid interoperabiltiy tests. For more information about OHf and the IHE connectathon see our wiki: http://wiki.eclipse.org/IHE_Connectathon_2008

We are now at the European Union Connectathon in Oxford, UK in support of several European companies using OHF technology for their IHE interfaces. After this event we will be resolving any open Connectathon related issues and creating another CVS tag and a new post-Connectathon build - something for our community to look forward to.

Regards,
Sarah Knoop

Healthcare Systems Research Manager
IBM Almaden Research Center
650 Harry Rd.
San Jose, CA 95120-6099
email: seknoop@us.ibm.com
phone: (408) 927-2622  (tie 457-2622)

Dan Ford, IBM Almaden Research Center, Provides an Update on the Spatiotemporal Epidemiological Modeler (STEM) Work of the Eclipse OHF Project

I haven't seen a lot of activity on the dev list lately and I  know that that doesn't reflect the high level of activity in the OHF project.  To jump start our communication channel a bit I've written a short summary of the status of the STEM project (http://www.eclipse.org/ohf/components/stem/) which is developing an open platform for disease modeling based on Eclipse.

Some highlights:

We recently (last week) hired a technical writer for the project who will be helping us with documentation, wiki, etc.

We received multi-year funding from the USAF to incorporate features for disease model validation.  The implementation of those features is going well.

We recently extended the core modeling framework to add an additional component called an "Experiment" which is a container for the specification of multiple simulations all based on a single root Scenario.  This is a powerful addition to the STEM representational framework as it allows a base model to be modified in specific ways to explore the potential effects of different public policy decisions.  It also enables the process of disease model validation by making it easier to explore the variations in disease models and compare them to known data sets.

The development team is migrating from Eclipse3.4M5 to Eclipse3.4M6.

The STEM build process has been automated.  Though there is still some work here to complete the job.  Right now the process builds STEM for Windows, MAC and Linux, but it does not yet deploy the builds to the download site.  Consequently, the last available build was in December.  This needs to change.

We're working with the legal department to clear our geographic datasets.   

The MapView graphics can now display the edges connecting geographic regions.  This was literally an "eye opener" as it made several mistakes in our common border edge data sets blindingly obvious.  There were errors in the USA county border connects and others in Africa and China.  This wasn't too surprising as the connections were generated automatically by examining region Lat/Long border data, but even 99.99% correct isn't good enough.

We're rewriting the EMF generated editors.  The EMF editors work well enough, but they really need to be customized to the particular framework component being edited to make them more user friendly.

There has been some work on profiling the performance of STEM and this has resulted in some fine tuning of the internal MapView graphics.

We currently have 92 open bug reports with 16 unassigned.

Open Source Tools and Applications at American Medical Informatics Association

Will Ross, linuxmednews.com

Seven Open Source projects were featured at a workshop on Open Source software at the annual AMIA Symposium in Chicago, Illinois. Despite the Saturday evening time slot, about 60 conference attendees were treated to some inspiring presentations. Senthil Nachimuthu, M.D., organized the two and a half hour workshop. This year's AMIA Symposium on Biomedical and Health Informatics features 14 Workshops, 26 full or half day Tutorials, 96 Scientific Sessions, and over 300 poster presentations. The Symposium runs from November 10 to 14. More here.

Third Annual Government Open Source Conference, October 15-16, 2007, Portland, Oregon

Built for the Public Sector by the Public Sector GOSCON provides senior public sector decision-makers outstanding access to industry leaders as well as agency peers. GOSCON covers a range of interests, from the basics to strategy to projects taken on by their peers. The focus for 2007: Open Standards and Interoperability.

This one and one-half day non-profit conference, designed for public sector IT management and key technology staff, is filled with real world examples, practical information and strategies for anyone considering how Open Source Software might fit into their software acquisition or development strategies.

GOSCON 2007's core program include the tracks:

* Open Source 101 for Management

* Strategy; Standards, Architecture and Organization

* Real World Open Source: Public Agencies' Experience

* Technology

This year's keynotes include:

• Andrea DiMaio, Vice President and Distinguished Analyst, Gartner Research
• Jim Zemlin, Executive Director, Linux Foundation
• Skip McGaughey, Director of Eclipse Ecosystem, Eclipse Foundation

Call For Papers Opens for Apache, Eclipse OS Summit Asia 2007

The Apache Software Foundation (ASF) and the Eclipse Foundation invite submissions to OS Summit Asia 2007, to be held Nov 26 - 30 at the Cyberport, Hong Kong. A ground breaking event, OS Summit Asia is the first joint conference between the Apache and Eclipse Foundations and the first such event in Hong Kong and greater China. OS Summit features a wide range of activities designed to promote the exchange of ideas amongst foundation members, innovators, developers, vendors, and users interested in the future of Open Source technology. Original link here.

If You'd Like To Advocate For FOSS in Healthcare

as Ignacio H. Valdes, MD, MS suggests, you might want to call in on the AHIC Successor Public Technical Assistance Meeting to be held 9:30 a.m. to 12:00 p.m. Eastern on September 5, 2007, to ask detailed questions related to a Notice of Funding Availability (NoFA) to resource an entity designated to design and establish the AHIC successor by Spring 2008 and the role FOSS will play. 

Here's the current vision.

Open Source Workshop at AMIA 2007 in Chicago, Nov, 2007

Eishay Smith writes:

A team lead by Senthil Nachimuthu (MD, University of Utah) will conduct an Open Source Workshop at AMIA 2007 in Chicago (Nov, 2007). Contributed to the workshop paper where Thomas Jones, Jon Teichrow, Paul Biondich, Cal Collins, Will Ross, and myself.

The workshop will include representatives from the open source projects:

Eclipse Open Healthcare Framework

Machine Learning Tools

Mirth

Tolven

OpenEMPI

OpenClinica

OpenMRS

IBM Contributes Epidemiological Modeling Software to Eclipse Open Healthcare Framework

By Digital Infrastructure Features Staff

A tool for projecting the spread of infectious disease becomes freely available for use and research.

IBM has released a tool to an open-source foundation that helps scientists and public health officials predict the spread of disease. Healthcare researchers say that STEM (Spatiotemporal Epidemiological Modeler) could have been helpful, for example, in monitoring the recent case of a man with tuberculosis who flew on airlines, or the spread of SARS several years ago. A tool like STEM could help save lives in such cases.

OHF (Open Healthcare Framework) is a project of Eclipse, a foundation that develops open-source solutions in a variety of fields. OHF is focused in the area of healthcare informatics technology. The goal is to facilitate the integration of systems through open standards and methods. At the same time, OHF announced that version 0.2.0 of STEM was available for download.

Tracking infectious diseases with Eclipse

Ian Skerrett's post.

Sarah Knoop, IBM Almaden Research Center, on OHF XDS

The XDS consumer supports 3 transactions:
- Registry Query (ebXML 2.1, ITI-16)
- Registry Stored Query (ebXML 3.0, ITI-18)
- Retrieve Document (http, ITI-17)

These transactions are implemented as defined by the IHE organization. So the consumer will send ebXML 2.1 messages if you invoke the "query()" methods as defined. The XDS Consumer will send ebXML 3.0 if you invoke the "invokeStoredQuery()" method. XDS Registries, as stated by IHE, are required to handle Stored Queries (ITI-18) and it is optional for them to additionally support the Registry Query (ITI-16). If you are just beginning your implementation and have an ebXML 2.1 registry, the OHF XDS Consumer should work right out of the box using the "query()" method. The OHF XDS Document Source sends ebXML 2.1 messages, so you should be all set.

A HEADS UP as well: This year peer transactions using ebXML 3.0 are coming out in a new supplement in IHE. This supplement is still under development and will be made available for public comment in the coming weeks. After this point in time XDS will have a set of "original" transactions and a new set of "web service" transactions.

Orginal (using ebXML 2.1):
- Registry Query (ITI-16)
- Provide and Register Document Set (ITI - 15)
- Retrieve Document (ITI-17)
- Register Document Set (ITI-14)

Web service (using ebXML 3.0)
- Registry Stored Query (ITI-18, updated again this cycle)
- Provide and Register Document Set-b (ITI-15.b)
- Retrieve Document Set (ITI-XX - new transaction)
- Register Document Set-b (ITI-14.b)

These transactions will have an effect on OHF and XDS Registry implementors. Requirements for Connectathon and compliance will be affected as well.

For more details on the current status of these new transactions, please see the in-progress document.

It is my intent to try and implement the XDS Source and XDS Consumer side of these new transactions for the 2008 North American Connectathon, but I will be doing so after the trial implementation text is available from IHE ... which should be sometime in late summer.

IHE Educational Workshop for Vendors and Implementers - June 11-13, 2007

The annual Integrating the Healthcare Enterprise (IHE) educational workshop, Changing the Way Healthcare Connects, will be held June 11-13, 2007 at the Doubletree Hotel in Oak Brook, IL. The workshop will focus on IHE's role in improving interoperability in healthcare and realizing the vision of a connected health system. It will include sessions for vendors, public health experts, consultants and healthcare providers on participating in and leveraging the IHE initiative.

The opening day, June 11, will provide an overview of IHE and will feature a roundtable of regional health information organizations that are using IHE to share health information effectively. Providers and administrators wishing to learn how to use IHE in their facilities, as well as vendor marketing and product development professionals can attend this special one-day track. June 12-13 will offer technical workshops on the integration capabilities defined by IHE. Vendors planning to participate in the IHE Connectathon in January 2008 and demonstrations at the RSNA 2007, HIMSS 2008 and ACC 2008 annual meetings are strongly urged to attend the workshop.

For registration and further information go here.

LinkedIn OpenHealthCare Group Launched

<ed.note>In order to better network between the various OS efforts touching healthcare I asked LinkedIn to set up a group. If you're a biz dev, booster, coder, contributor, venture-type, the invite is here.</ed.note>

Free and Open Source Software (FOSS) for Healthcare: Progress and Promise - April 24th, 2007

School of Health Information Sciences, UT-Houston
University Center Tower
7000 Fannin, 14th Floor
Tuesday, April 24th
8 am - 3 pm

TO REGISTER: CONTACT CYNTHIA CASTRO
Cynthia.Castro@uth.tmc.edu or 713-500-3901
            
8:00    Registration
9:00    Welcome
Jack Smith, MD, PhD
Dean, School of Health Information Sciences

9:05    "Lowering the Barrier to a Decentralized NHIN Using the Open Healthcare     Framework"
Eishay Smith
Director Open Source
IBM

10:00    "The Microsoft of Medicine vs. The Google of Medicine"
Ignacio Valdes, MD, MS
Chief Technology Officer
Your Doctor Program, L.P.
Founder, Linux Medical News
Recipient:     Inaugural 2006 International Medical Informatics Association
Award for Open Source Software

10:45    "Content Management and the Experience of Plone"
Alan Runyan
President Enfold Systems
Plone and the Plone Foundation Founder

11:15    Lunch served for first fifty seminar registrants (SO CALL TO REGISTER)

12:00-1:00    Luncheon speaker: Schull Institute Scholars Program
Introduction:     William J Schull, PhD
Ashbell Smith Professor Emeritus
President, Schull Institute
"Toward FOSS Health Care Informatics Systems Integration in Latin America"
Jorge Raúl Rodríguez Yañez, MD
FOSS Developments Coordinator, Bioengineering Faculty, National University of Entre
Rios, Paraná, Argentina
Founder and Executive Director, BioLinux Group, Buenos Aires, Argentina
Informatics Coordinator of Hospital General de Aguos
Dr. Velez Sarsfield, Buenos Aires, Argentina
Recipient:  LIS Day 2006 Award, @LIS Society of Information, Europe

1:30-3:00    Roundtable: Approaches for Open Source for Translational Research
Moderator:  Kim Dunn, MD, PhD
Jack Smith, MD, PhD
Dean, School of Health Information Sciences
Director, Biomedical Informatics, CTSA, UT-Houston
Charles Hurmiz
St. Jude's Hospital
Lynn Vogel, Ph.D.
Chief Information Officer
MD Anderson

Git Yer SODA Here

Open Healthcare Framework (OHF) Project SODA, Device Kit, & Service Activator Toolkit

Service-Oriented Device Architecture (SODA) is an initiative to standardize and simplify the integration of devices with enterprise solutions by introducing a services-based programming model. SODA leverages existing and emerging standards from both the embedded-device and IT domains to provide well-defined interfaces for hardware devices to a service-oriented architecture (SOA).

SODA’s goal is to allow developers to interact with sensors and actuators just as business services are used in today’s enterprise SOAs. Reusing and combining SODA services to address changing business priorities has applicability across many industries including healthcare, military, and RFID.

Device Kit and Service Activator Toolkit are core framework components that support the development and runtime environment of SODA services.

Oh Sure, Everyone SAYS they want Open Source Healthcare Solutions...

<ed.note>... but when it comes to ponying up the dough, Eishay notes:</ed.note>

I thought that it’s expected of the applications to be commercial or commercial ready. Doesn't IHE expect the vendor that subscribes to the Connectathon to be serious about taking the tested application to the market as product? Won't it violate the spirit of the Connectathon if I'll hack up some panels that trigger the underlying actors without it look remotely like something a physician will ever consider using? Actually it will be much simpler to run them from the command line :-)

Coming from IBM research we have some serious problems sponsoring this huge code investment, and vendor integration+education. To most of the vendors we serve as a major IHE support, explaining how to do the MESA tests, and how to "think IHE Secured Node" etc. Note that we are implementing seven actors and supporting dozen vendors, we expect the number of vendors using OHF to more then double by next year.

This year IBM supported the open source openEMR application participation fees. We will probably not be able to do it next year. I know of open source applications that wish to go to the '08 Connectathon (openEMR, Mirth, Tolven, MirrorMed, and more are coming). They have lots of motivation that comes with considerable barriers in the shape of travel expenses plus the investment in integration, implementation, and passing the MESA tests. From talks with them I understand that the 8K$ registration fees is something they will not be able to swallow, and I assume that it will prevent them from participating in the event.

I see it as a big miss to IHE since these end user applications have real users in the market. Each of them have a unique characteristic that can display more innovative ways of integrating IHE in the market. For example the Tolven's PDA PHR application with its personal medical devices integration, and Mirth's healthcare messaging integration server.

EclipseCon Healthcare Day March 8 2007

Eishay notes:

Health IT Architecture technologies like Master Patient Index, record locator services and services as defined by HSSP HSSP, OMG, IHE for providers, research and academic proposed architecture, Electronic Health Records for ePrescriptions, eLibratory, eRadiology tooling face meeting of the Eclipse OHF project.

EclipseCon is a conference by developers, for developers, and focuses on the Eclipse. It covers all aspects of the Eclipse Open Source to C, from UML tooling to data tooling, from embedded to the technical leaders come, participate and network to understanding and integration of the Eclipse technology. There the feather, technical demonstrations, tutorials, technical groups, and presentations.

Update: Two short talks by the Eclipse OHF Team:

Generating Web Services from Eclipse Plug-ins

Healthcare Development/Deployment Risk Mitigation Using Eclipse OHF

Melih and Eishay on OHF, IHE Connectathon, NHIN, HIMSS 2007

As you might know, the OHF project had an integral part in two major Healthcare IT events recently, IHE Connectathon and the NHIN demonstration. OHF is looking forward to continuing that success at HIMSS 2007.

IHE Connectathon
===========
http://www.ihe.net/Connectathon/ihena2007.cfm
OHF Components were used by a large portfolio of healthcare PHR, EMR and other applications running on a variety of platforms (J2SE, J2EE, .NET, PHP).
The following vendors used OHF in the systems they tested:
PossibilityForge
CapMed
PracticePartner
Bell Canada
MedCommons
MedQuist
Blueware
Accenture
IBM

All of the vendors who used OHF passed the Connectathon tests. The number of tests the OHF partners passed was significantly higher than other applications of a similar nature (who did not use OHF). An internal information network was established between the vendors, feeding each other with problems, fixes, configurations etc. This network and the successful week resulted in a strong sense of community amongst the OHF partners. It was commented by the testers that it was clear from the level of readiness who used OHF and who didn't.

Nationwide Health Information Network (NHIN)
=========================

The OHF components were used at the IBM NHIN Prototype demonstrated yesterday in Washington. The demonstration was very successful, and four of the participants in the demo used the OHF components including Duke University, CapMed, OpenEMR, and the OHF Viewer.

HIMSS 2007:
========
http://www.himss07.org/exhibition/interop.aspx
We expect to see all of the vendors who had their applications tested in the Connectathon display their applications at HIMSS 2007 IHE Showcase. So if you're at HIMSS, be sure to drop by and see how IHE motors interoperability in the Healthcare IT industry :-)

Eclipse Open Healthcare Framework at IHE Connectathon Week

Registration for testing participants has begun for the IHE North America Connectathon, scheduled for January 15-19, 2007 at the Hyatt Regency Chicago, 151 E Wacker Drive.  Information and links to the online registration system are available here.

IT Infrastructure Supplements for Trial Implementation and Public Comment 
The IHE IT Infrastructure Technical Committee has published the following documents for trial implementation:

    * Cross-enterprise Document Media Interchange (XDM)
    * Cross-enterprise Document Reliable Interchange (XDR)
    * Cross-enterprise Sharing of Scanned Documents (XDS-SD)
    * Registry Stored Query Transaction for Cross-Enterprise Document Sharing Profile

The Committee has aslo published the following supplements and white papers for public comment:

    * Retrieve Form for Data Capture (RFD) -  Comments on this supplement are due by August 31st.
    * PIX/PDQ HL7 V3  Supplement - Comments on this supplement are due by September 15th.
    * White Paper: Cross Community Information Exchange including Federation of XDS Affinity Domains - Comments on this white paper are due by September 30th.
    * White Paper: Cross-Enterprise User Authentication (XUA). 

These documents are available for download. Comments can be submitted to the online discussion forums.

OHF and HL7 JavaSIG project

Grahame Grieve writes:

hi Everyone

OHF is collaborating a little with the HL7 JavaSIG project, which is producing an open source implementation of the HL7 V3 standard.

They have just published a report describing progress for 2006 ( see ).

Eclipse Open Healthcare Framework: Connectathon participants should install your one instance of the bridge

Hi there :-)

After few discussions with IHE it was concluded that each of the OHF Bridge users should install their own instance of the bridge. Actually, its not that bad :-)

I listed the steps of doing that here:

http://wiki.eclipse.org/index.php/Bridge_Install_Steps

It should be very easy if you have the binaries. Since we don't have an official release yet, you have to send me an email asking for the binaries and I'll send them over.

If you see flaws in the description, please let me know or edit the wiki yourself if you think there are clarifications you can add.

So what will be at the Connectathon?

Each of the bridge users will run the bridge on the machine that runs their application. The bridge was tested on both windows and Linux, I expect it should run on a mac the same way (its a Java application).

The bridge can drew the RHIO configuration from a URL. At the connectathon we'll provide a server for configuration so we'll be able to configure RHIOs for all the tests you'll be doing. It will be very useful since based on last year's experience finding the attributes of all the systems participating is a big headache. The same server will also server updates to the bridge in case will need to.

See you at the Connectathon :-)

--eishay smith

A National Summit: Moving Toward Interoperability - Technologies for Accessible, Affordable Healthcare October 18-19, 2006 [ Updated ]

Presentations available online here.

NIST Administration Building, Gaithersburg, MD

Keynote Address:

Michael O. Leavitt (confirmed)
Secretary, U.S. Department of Health and Human Services

Carlos M. Gutierrez (invited)
Secretary, U.S. Department of Commerce

Craig R. Barrett (confirmed)
Chairman of the Board, Intel Corporation

Just Announced...

Keynote Address (Day Two):
Mike Magee, MD, Director, Pfizer Medical Humanities Initiative and Vice President, Science and Medical Advocacy, Pfizer Inc. (confirmed)

This is a unique opportunity where government and industry will come together to chart a path toward a far-reaching vision for connected, home-based health technologies through public-private partnerships.

Five session topics will cover today's interoperability issues, such as:

• Market Drivers and Societal Issues
• Technology Gaps and Barriers Networked, Interoperable Solutions
• Device Standardization and Interoperability of Equipment
• EHR and PHR Standards as a Foundation for Future Digital Healthcare Systems

Register Today!
Register online now. The registration fee is $195 and includes meals, summit materials, and transportation to and from the NIST facilities to the Gaithersburg Holiday Inn.

Hotel and Travel
Reserve a hotel room at the Gaithersburg Holiday Inn. A limited number of rooms are available for the rate of $104 per night. Book online or call (301) 948-8900 to make your reservation . Please refer to the "NIST/Moving Toward Interoperability Workshop" room block. The group booking code is MTI.

Posters and Case Studies
Interact with researchers at universities, companies and government on technologies to support our aging population during our poster networking session.

Questions?
Contact Rebecca Scritchfield
E-mail: rscritchfield@agingtech.org
Tel: (202) 508-9416
Official Event Web site: http://www.itl.nist.gov/Healthcare%20Summit/intro.htm

Who Should Attend
Technology Researchers and Developers
Healthcare and Aging Services Providers
Government Agency Representatives
Healthcare Product Vendors
Company Executives
Standards Development Organizations
Associations
Consumer Organizations

Companies, government, and consumers are developing partnerships to address the challenges of the coming "age wave". Through the application of consumer-directed technologies, opportunities exist to empower individuals to take charge of their own health care and maintain independence.

To achieve this vision, our country must advance the development of new technologies and ensure the interoperability of these devices. To help explore the best way to enable the vision of connected home-based health delivery, Center for Aging Services Technologies, the Department of Commerce's Technology Administration and National Institute of Standards and Technology have come together as partners to host a National Summit to identify issues around the needs and challenges to make interoperability a reality. Recommendations from the Summit will drive needed public and private sector action.

Co-Sponsored by:
Center for Aging Services Technologies (CAST)
U.S. Department of Commerce's National Institute of Standards and Technology (NIST)
U.S. Department of Commerce's Technology Administration (TA)

For more information about this Summit, visit the official website at http://www.itl.nist.gov/Healthcare%20Summit/intro.htm

Eclipse Open Healthcare Framework Bridge PHP Sample Client

To demonstrate how easy it is to access the IHE world through OHF, Eclipse Open Healthcare Framework made a PHP web application that does that. The full source code of the application is located in the OHF CVS at org.eclipse.ohf.bridge.client See the OHF Bridge PHP Sample Client page for instructions of how to install the web application.

It's place in the big picture... ( from the Eclipse Open Healthcare Framework wiki ):

EuroRec 2006 Annual Conference Presentations on Electronic Health Record systems and Certification

here.

This year’s conference focused on the Quality Labelling and Certification of the EHR, the importance of which is recognised by the European Commission in funding the Q-REC project to be managed by the Eurorec Institute. Not only in Europe has this been seen as key to the future but elsewhere in the world. An example of this is in the USA where their Government have funded Certification Commission for Healthcare Information Technology (CCHIT) and Eurorec is liaising with them to make this a global initiative.

The EUROREC Institute (EuroRec) is an independent not-for-profit organisation, promoting in Europe the use of high quality Electronic Health Record systems (EHRs). One of its main missions is to support, as the European authorised certification body, EHRs certification development, testing and assessment by defining functional and other criteria.  EuroRec is organised as a permanent network of National ProRec centres and will provide service to industry (the developers and vendors), healthcare providers (the buyers), policy makers and patients.

Barry Smith, Werner Ceusters, and Rita Temmerman on Interoperable Electronic Health Records Ontology Best Practices

The last two decades have seen considerable efforts directed towards making electronic health records interoperable through improvements in medical ontologies, terminologies and coding systems. Unfortunately, these efforts have been hampered by a number of influential ideas inherited from the work of Eugen Wüster, the father of terminology standardization and the founder of ISO TC 37. We here survey Wüster’s ideas – which see terminology work as being focused on the classification of concepts in people’s minds – and we argue that they serve still as the basis for a series of influential confusions. We argue further that an ontology based unambiguously, not on concepts, but on the classification of entities in reality can, by removing these confusions, make a vital contribution to ensuring the interoperability of coding systems and healthcare records in the future.

Medical Banking Infrastructure Investment

<ed.note>In "A secure investment: Banks, hospitals buy into high-tech defense" Robin Roger, Herald Staff Writer makes some points which run parallel to the article "The Identity Management Arms Race - The Next eHealth Hurdle", by John Casillas, in the September/October 2006, The Medical Banking Report, Vol. 3, No. 5. Normally folks only get access to John's cutting edge insights and summary of current medical banking thought if they are MBP members but since the mission of the MBP is to try to communicate the hybrid domain/worldview which is medical banking I want to make this article available more widely ( with his permission ) at the "more" link.</ed.note>   

Beta 2 preview of both the web services and ohf lightweight portal was just published

Eishay Smith writes:

Please note its still an unstable version. A stable one should be out next week. Notice about the stable release will publish. The reason for the early preview is to give developers a head start and get early comments. We would prefer comments / enhancement requests to be communicated through the bugzilla so we can track them better (i.e. submit bugs to https://bugs.eclipse.org/bugs/).

The new version of the portal is available here:
http://ibmod235.dal-ebis.ihost.com:8080
The old version is still there at the same URL:
http://ibmod235.dal-ebis.ihost.com:8080/ohf/demo/index.php

The new version of the WSDL is located at:
http://ibmod235.dal-ebis.ihost.com:8090/bridge/services/ohf-bridge?wsdl
The new APIs are not backward compatible since we added mandatory session information in each method call. We expect the APIs will not change or at least will be backward compatible at least until the '07 connectathon. The old WSDL is still up there, new url:
http://ibmod235.dal-ebis.ihost.com:8090/legacy_bridge/services/ohf-bridge?wsdl

Eclipse Open Healthcare Framework & OpenEHR at Stuttgart

The Eclipse Open Healthcare Framework (OHF) Project is an open source project whose aim is to build an e-health computing platform (tools, run-times and community) on which developers can more effectively build useful and interoperable applications.

Eclipse is widely known as a tools IDE, or even just a Java development environment. But Eclipse is more than this. Eclipse is a community with a strong open source governance model that develops tools which have strong reuse of the knowledge code for run-time use by developers.

We believe that the openEHR community could leverage the Eclipse platform - the tooling, run-time and governance support, to improve the coherence of the the tools, implementations and uptake of openEHR.

OHF will propose an openEHR component at the European EclipseCon meeting. We have an OHF FTF meeting in Stuttgart on Oct 13th, where the project will be proposed for formal adoption as an OHF component.

I am currently working with Tom Beale to clarify the scope of the proposal, and how it relates to an overall tooling roadmap for openEHR. This notice is an invitation to come to the Stuttgart meeting and have your say, or to work with Tom and I on the proposal in advance.

Grahame Grieve - grahame at kestral.com.au

EclipseCon: http://www.eclipsecon.org/summiteurope2006/

Stuttgart Meeting announcement: http://www.eclipse.org/newsportal/article.php?id=216&group=eclipse.technology.ohf#216

Eclipse OHF: http://www.eclipse.org/ohf

Eclipse OHF newsgroup access: http://www.eclipse.org/newsgroups/register.php

Ignacio H. Valdes, MD, MS, Editor of Linux Medical News, posts about Open Source Healthcare

at the os-wg mailing list ( os-wg@mailman.amia.org - http://mailman.amia.org/mailman/listinfo/os-wg )

eChannel line reports: 'According to a newly released IDC study, open source software has spread far beyond Linux and is gaining enormous momentum. The study, which analyzed IDC surveys from over 5,000 developers in 116 countries, finds that developers worldwide are increasing their use of open source. The study declares that open source software represents the most significant all-encompassing and long-term trend that the software industry has seen since the early 1980s. IDC believes that open source will eventually play a role in the lifecycle of every major software category, and will fundamentally change the value proposition of packaged software for customers...'

http://www.linuxmednews.com/1156343542/index_html

The recent LinuxWorld conference hosted a 'Healthcare Day' with a few recaps:

There is a wiki page of all the presentations at the recent Linux World Healthcare Day presentations: 'On August 15th, 2006 OSDL hosted the first ever Healthcare Day at LinuxWorld Expo. Below is a recap of the event as well as links to the presentations from Medsphere CEO Dr. Kennth Kizer, Joe Alexander - Bull's Director of Strategy and Planning as well as panel discussions moderated by Bernard Golden and Fred Trotter...'

http://www.linuxmednews.com/1155997922/index_html

and more here:

http://www.linuxmednews.com/1156282031/index_html

IBM Brings Electronic Medical Records Closer Through Open Technology [ eclipse open healthcare framework ]

Aug. 9, 2006 By: Enterprise Open Source News Desk

IBM has announced a major step in the drive toward a national electronic medical records system by contributing software technology that supports the exchange of healthcare information to the open source community.

The software, contributed to the Eclipse Foundation's Open Healthcare Framework (OHF) project, provides a mechanism to connect isolated "islands" of information that today reside throughout the healthcare system to any Health Information Exchange (HIE).  Software developers will also be able to build applications that can aggregate and sift through this information to improve healthcare delivery and research while protecting individual privacy.

According to the Center for Information Technology Leadership, systems that enable standardized information exchange are by far the best investment for the nation as a whole, with net savings that likely represent 5 percent of current U.S. healthcare expenditures.  Such capabilities stand to enable more accurate, timely diagnoses that could markedly improve treatments.

OHF, one of the leading efforts to deliver an open source, standards-based platform for healthcare software, has close ties to leading healthcare standards organizations. Any Independent Software Vendor (ISV) will be able to use the tools in OHF to connect their applications to any standards-based infrastructure, including IBM’s HIE.

IBM Research has also established new Healthcare and Life Sciences Innovation Centers spanning its Almaden, Watson, Haifa and Zurich Research Labs.  These centers provide a focal point for collaborative work with healthcare clients and qualified IBM Business Partners in the application of key IBM Research expertise and technologies in this field.

Eclipse OHF PIX and PDQ Plugins Betas Documentation Available

I have posted documentation for the recent beta release of PIX and PDQ plugins on the Eclipse wiki.  If you are interested, the documentation is here.

The primary enhancement of this beta-release is the addition of the Eclipse OHF HL7v2 message verification functionality. HL7v2 message verification relies on a two step process; a definition file and an XML conformance profile. The definition file comes from HL7 while the XML conformance profile is configurable to allow site specific limitations.

HL7v2 message verification is currently an incomplete implementation. Monitor Eclipse Bugzilla for the HL7v2 OHF component to determine when it will be advantageous to enable message verification.

Additional release fix and enhancement notes are in the completed documentation.

I greatly appreciate your feedback. Thanks.

Sondra Renly, MT

Focused on Creating an Advanced and Interoperable Medical Network, HIMSS and Internet2 Announce Collaboration

The two organizations will leverage each other’s expertise to explore the viability of an independent and logically interconnected medical network in the United States

CHICAGO, Ill. and ANN ARBOR, Mich. - August 1, 2006 – The Healthcare Information and Management Systems Society (HIMSS) and Internet2 announced today that the two organizations have created a partnership to explore the development of a secure, reliable and advanced networking solution for the transmission of medical information, messages and images throughout the broad healthcare industry.

The two organizations are exploring a new network designed to offer the health sciences and healthcare sectors a private and secure medium for exchanging health information. A next-generation architecture built to meet federal regulatory requirements, this new network may also have value to offer in the work of the Nationwide Health Information Network (NHIN).

This ground-breaking collaboration is a natural extension for both not-for-profit organizations. Through a membership of 20,000 individuals, 45 chapters, and more than 300 corporations representing millions of employees, the HIMSS mission focuses on the betterment of healthcare through the most effective use of information technology and management systems. Internet2, the U.S. ’s advanced networking consortium led by 208 U.S. university members in partnership with over 100 industry and government members, works to develop and deploy advanced networks, applications and resources.

“HIMSS and our members look forward to this collaboration with Internet2,” said H. Stephen Lieber, HIMSS president/CEO. “The synergies between HIMSS and Internet2 brought our organizations together to consider and evaluate the feasibility of establishing a network that would meet the evolving needs of the biomedical and healthcare delivery community.”

Since 1999, Internet2 has operated an advanced nationwide network that supports leading-edge Internet technology development for the research and academic community. Internet2 recently announced a major upgrade to this network to provide members 10 times the capacity and speed of its current infrastructure. In addition, the Internet2 community has successfully developed important middleware technologies to address critical issues in authentication and authorization in order to enable active privacy management. Through this partnership, HIMSS and the Internet2 community will work closely together to leverage these leading-edge technologies to explore development of brand new capabilities that meet the specific security and privacy needs of the healthcare industry.

“The research and education community has long understood the potential for leveraging advanced Internet technology to enhance the healthcare industry’s ability to serve the public’s needs, to improve the flow of information for research, to streamline care processes and to enable cost savings,” said Douglas Van Houweling, Internet2 president and CEO. “Our partnership with the HIMSS community is a major step forward in realizing this vision. Together we will work to create a new state-of-the-art platform for biomedical research, education and clinical practice on a national scale.”

Through the partnership, four working groups have been established to explore the requirements and capabilities needed to create an advanced medical network during the next year. HIMSS and Internet2 will join each other’s organizations. Members of both organizations will also join each of the four working groups, which include:

Identity Management that will allow the identification and authentication of individuals regardless of their physical location.

Privacy & Security that will focus on the tools and techniques that will assure the privacy and security of the information that travels on the network.

Biomedical (Health Sciences and Healthcare) Education that will focus on meeting the unique needs and accessing the resources required for biomedical education.

Telehealth that will focus on the implications for clinical practice when a reliable advanced network is available.

In addition, members of both organizations will work for the development and implementation of the network with other partnerships and collaborations, including Integrating the Healthcare Enterprise (IHE).

LinuxWorld Healthcare Day Tuesday, August 15, 2006

Room 310 - Healthcare Day Wiki

Join us at the Linux World Conference & Expo first ever Healthcare Day and become part of the force that is re-shaping the healthcare IT landscape.

Learn from industry peers about the issues and driving forces behind the growing use of open solutions throughout healthcare. OSDL has created a compelling program that will provide essential information on how Open Source Software and Open Standards are being developed and deployed by innovators throughout the healthcare industry.

Healthcare Day will:

Enable developers and integrators with experience in developing/porting/integrating applications for the Open Source platform to share, learn, and/or begin the process.

Develop a community of health IT organizations, to collaborate, learn, and collectively promote Open Source solutions and standards.

The agenda includes real world application demos, deployment case studies, interactive discussions and a close up look into the emerging revolution of open solutions and standards for the next generation of healthcare.   

Healthcare Day Agenda

10:00 a.m. to 11:00 a.m.
Keynote Presentation – Open Source and Healthcare
Dr. Kenneth Kizer, CEO, Medsphere

11:00 a.m. to Noon
Linux, Open Source and Open Standards – A Positive Disruption for Healthcare
Joe Alexander, Director, Strategy and Planning, Bull

12:00 p.m. to 1:00 p.m.
Lunch Break

1:00 p.m. to 2:00 p.m.
Opening up Healthcare Markets with Open Source
Bernard Golden, Navica – Moderator
Agfa, HP, Medsphere, Free Open Source Solutions

2:00 p.m. to 3:15 p.m.
Innovation in Healthcare with Open Source – Who is Doing What ?
Fred Trotter, Linuxmednews.com – Moderator
Agfa, Eclipse, IBM, Intel, McKesson, Open Sourcery

3:15 p.m. to 3:45 p.m.
Coffee Break

3:45 p.m. - 4:45 p.m.
Building a Global Healthcare Open Source Community
Joe Alexander, Bull - Moderator
Eclipse, IBM, Medsphere, McKesson, Open Sourcery

SynSeer and IBM integrate MirrorMed and OHF

Posted by Fred Trotter on Wednesday July 26, 2006 @ 04:40 PM from the MirrorMed dept. of Linuxmednews.com

Over the past few weeks SynSeer (the sponsoring company for MirrorMed) has been going back and forth with IBM regarding the new Eclipse OHF project. This work started with the release the OHF bridge and has culminated in the integration of MirrorMed and Eclipse OHF. Thanks to Ivan and everyone at the IBM team for the help getting the code working!!

The Eclipse Open Health Framework ( The IBM Research Report )

The success of open source software in other fields has generated a surge of interest in open source for healthcare. Open source initiatives not only help reduce costs for the patients and healthcare providers but also establish standards that are necessary to prevent vendor lock-in. The National Health Information Network (NHIN) project is aimed at modernizing the US Healthcare Information Infrastructure (HII) by integrating various regional health centers. Such an initiative requires standardization of protocols and data models. Eclipse Open Health Framework (OHF) is the official open source organization for HL7 and one of the leading efforts to deliver an open source, standards-based platform, for healthcare software. In this paper, we present an overview of the OHF project, describe the technologies it will provide in the near future, and discuss possible future directions for this important community.

By: Srivatsava R. Ganta, Eishay Smith, Sarah E. Knoop, Sondra R. Renly, James H. Kaufman

Published in: RJ10382 in 2006

LIMITED DISTRIBUTION NOTICE:
This Research Report is available. This report has been submitted for publication outside of IBM and will probably be copyrighted if accepted for publication. It has been issued as a Research Report for early dissemination of its contents. In view of the transfer of copyright to the outside publisher, its distribution outside of IBM prior to publication should be limited to peer communications and specific requests. After outside publication, requests should be filled only by reprints or legally obtained copies of the article (e.g., payment of royalties). I have read and understand this notice and am a member of the scientific community outside or inside of IBM seeking a single copy only.

Global Health Information Networks Get a Boost

IEEE DS Online Exclusive Content, Greg Goth

...The next step in expanding the interoperable and open source mindset among healthcare developers might not come from patient-facing applications such as VistA. Instead, some healthcare IT experts see it in projects such as the [Global Pandemic Initiative], the new Eclipse Open Healthcare Framework project, and the Open Group’s Universal Data Element Framework. Chris Harding, who heads the Open Group’s UDEF working group on semantic interoperability, describes UDEF as a Dewey decimal-like classification system for data semantics. He thinks it might allow even healthcare organizations with disparate top-level architectures to share metadata: “Because they have a common indexing method,” he says, “they’ll know what each other is talking about.”

UDEF is based on the ISO 11179 standard for metadata registries. Harding says it’s also intended to integrate Semantic Web technology, therefore serving as a sort of bridge between the two. Among the organizations interested in testing the UDEF for its potential in improving interoperability is the US National Cancer Institute.

First Nationwide Health Information Network Forum June 28-29, 2006

Purpose:
The purpose of the Nationwide Health Information Network Forum is to identify and catalogue the list of functional requirements that will frame the development of a Nationwide Health Information Network.

In the design of network systems, functional requirements are brief, verifiable, declarative statements of what a system and its components must do or the actions they must take (i.e., locate, transmit, retrieve, etc). The NHIN functional requirements will define the behaviors of systems, services, and networks that wish to participate in a Nationwide Health Information Network. The statement “the Record Locater shall return pointers that enable retrieval of patient records from data sources and repositories” is an illustration of the type of statement that could be considered a NHIN functional requirement.

While other processes continue to explore the policy determinants for nationwide health information exchange, the development of functional requirements will focus on the critical technical components of architectures to support a Nationwide Health Information Network.

The identification of functional requirements will lead to the foundational specifications of the next phase of Nationwide Health Information Network development. In addition, the functional requirements will provide a framework for the Health Information Technology Standards Panel's efforts to define implementation level guidance in their interoperability specifications, and input for the Certification Commission for Health Information Technology's compliance certification criteria that address the infrastructure or network components through which EHRs interoperate.

Overview:
As a key element of the Administration's health information technology strategy, the development of a Nationwide Health Information Network will provide the foundation for an interoperable, standards-based network for the secure exchange of health care information.

On June 28 and June 29, 2006, a forum to address the functional requirements of a Nationwide Health Information Network will be held. The Nationwide Health Information Network Forum will be open to the public and include participants in key processes supported by the Office for the National Coordinator for Health Information Technology (including the four consortia developing prototype Nationwide Health Information Network architectures, the Health Information Technology Standards Panel, the Certification Commission for Health Information Technology, and the Federal Health Architecture) and key representatives from other public, private, and non-profit health information technology stakeholders.

The Nationwide Health Information Network Forum will be structured as an interactive discussion with facilitated breakout sessions to illuminate the technical components of a Nationwide Health Information Network.

More details here.

Make use of an {open} EHR a Condition of Participation for Medicare

Statement of Kenneth W. Kizer, M.D., M.P.H., President and Chief Executive Officer, Medsphere Systems Corporation, Aliso Viejo, CA

Testimony Before the Subcommittee on Health
of the House Committee on Ways and Means

April 06, 2006

Good afternoon. I am pleased to appear before you today to comment on how Congress might accelerate development of a national health care information infrastructure and speed up adoption of electronic health records and to do so at a substantially lower cost than generally thought to be necessary.

At the outset, I should acknowledge that I am cognizant of the large amount of testimony that this Committee has heard over the past two years about health care information technology and ways to improve the quality and safety of health care. I know that I have contributed testimony on at least two previous occasions (March 15, 2005 and June 17, 2004). Being mindful of this, my background comments are intentionally very brief.

* Make Selection of Open Source Software the Default Mode for Federal Funds

* Leverage the Federal Government’s Existing Investment in Health Care IT 

* Make use of an EHR a Condition of Participation for Medicare

Oh, why won't they listen?

Even though for the past decade reporters have covered the the Medical Banking Vision in articles, ( as recently as a few days ago eg Monya Baker, "Banks Seek to Sort Out Health Bureaucracy with Electronic Remittances", eWeek.com ) apparently the folks who should be reading them aren't.