A generous, virtuous society should settle for nothing less than this.

If the nation allows and funds with taxpayer money black-box, trade-secret, proprietary health IT software it will only ensure ‘government certified alchemy’. The Alchemists where all trying to corner the market on turning lead into gold and kept their techniques secret from one another. The bad side effect was that everyone had to find out for themselves that mercury was poisonous. When the Alchemists abandoned that strategy and began to share techniques, the scientific method and the Renaissance began.

This is the choice that our nation faces, to become a nation of government certified health IT alchemy ushering in a medical digital dark age or a nation that reaffirms that transparency, and openness are the answer. A dark age of proprietary, opaque, rented, expensive cartel or monopoly favoring, innovation stifling, health IT infrastructure at taxpayer expense that will take 20 years to undo. Or will we become a nation with thriving, science-based, efficient, transparent, health information technology that will mark the start of a renaissance of medicine? Clearly, to ensure a generous, virtuous society Free/Open Source licensed health information technology is the only effective choice.

Government can ensure this transparency and level playing field by only funding the purchase of software that is licensed under licenses approved by the Free Software Foundation (best) or the Open Source Initiative (okay). Government can ensure a generous virtuous society with certification that does not penalize the individuals and corporations that choose to use, develop or sell Free/Open Source licensed health information technology.

Thank you,

Ignacio Valdes, MD, MS

1st – break a leg.

2nd – please forgive the terseness; I’m multi-tasking.

3rd – these are my opinions and thoughts, no one else or anything else is responsible for them. I am assuming your audience is not technical, are in fact beauracrats, and want to understand your perspective.

- there is a lot of Jargon. Need to define: GPL, Underground Railroad, Best in Klas.
- explaining the word Hacker and Hacktivist is like me trying to “fix” the use of the word “lady”. Hacker got screwed down in the last century, this is not the time to try and fix it, leave more time for questions. Hacker is a word that scares a lot of people. Does the value of this part of the discussion outweigh the potential benefit?
- when you describe technologies “I love web 2.0 …” and mentioning SQL/OOP; my experience is that this type of talk alienates my non-tech audience and causes some to think I am hiding behind my profession. Others just dismiss me for being out of touch. You can say the same thing wothout the Jargon.
_ when you start talking about “specs” spell it out “requirements specifications.” Do not assume they know SDLC.
_the first paragraph in the clearhealth mirrormed section is totally confusing to me. Do not assume they know that a code base can be shared, do not assume they know what “code base” means.
- when you call out sage and assert their market share would be improved with GPL, you are speculating. Your sage callout may generally be misplaced and this may not be the right time for it.
-you mention the modern hcare article but do not say what was in it. You jump right into attcking the author.
- re/consider pointing and calling people “beauracrat”. You are there to influence beauracrats a.k.a. People who will vote on/define legislation
- by saying the only people worth listening to are U.Railroad card holders you do two things: 1. Minimize your value as a self identified novice 2. Suggest only a handful of people get it, that the next generation is un-teachable, the humans cannot evolve, or add value, and so on
- phrases like “babbling about” are derisive, maybe that’s what you want to express?
- you do a drive-by on Mumps, does it have value in this way? More time for questions? Or explain the Mumps question.

I wish I had the time to be more involved – I certainly have more thoughts. I do not intend to play arm-chair testifier I am wishing you clarity, conciseness, and efficacy!

.alesha

“The Free and Open Source Software community, often referred to as the FOSS (F-O-S-S) community, respects me because I have made substantial code and documentation contributions under FOSS licenses.”

2. disambiguate your reference to an open source license.

“I am the original author of FreeB (http://freeb.org) which is the first billing engine that supports both paper formats and X12 available under the open source General Public License, or GPL.”

3. Insert “open source” occasionally as a full term. Like this:

“I should note that Dr. Ignacio Valdes (of LinuxMedNews) and Will Ross (of Mendocino Informatics) have both maintained similar open source project neutrality and I have relied on their council heavily.”

ok, out of time. best of luck with your testimony.

Just a few suggestions…

- I would put a simple description of FOSS and the GPL towards the
beginning and then throughout, refer to it using the same terminology.
Avoid using technical terms that you have not defined. These people
are not techies and you’ll need to keep it simple.

- AcerMed. You might want to point out that if AcerMed had been open
source, its clients could have continued to use it and find support
for it.

- ClearHealth and MirrorMed. Explain at the beginning that these are
both FOSS GPL applications.

I would put in a strong plug for free open interoperability protocols.
These will do a lot to level the playing field.

On the questions:
- time to market…
I would state that all software adoption depends on the client. FOSS
has the advantage that software changes can be made quickly available
to clients because they don’t depend on a single vendor.

- criteria for 2011
FOSS has an advantage over proprietary systems in that the software
can be produced more quickly, by more vendors.

- later years…
FOSS is more sustainable since it is not dependent on a single vendor
who may go out of business or run into difficulties in producing new
software.

I would also criticize the CCHIT as an expensive gatekeeper who will
limit choice to established proprietary vendors. There should be a
‘self-certification’ process. Ideally, certification should not be on
‘features’ but on ‘functions’ and especially the ability to meet open
interoperability standards.

All the best,
Mark

Mark Spohr, MD