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The next major event we will be blogging will be SINI2008 - the 18th Annual Summer Institute in Nursing Informatics at The University of Maryland school of Nursing (http://www.nursing.umaryland.edu/sini/). Peter and Scott have been presenting at, and blogging, this event for several years, and we will be doing the same again. Technorati Tags: SINI, SINI2008, nursing informatics, nursing, Maryland, Baltimore 
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Leslie Hawthorn, Program Manager for Open Source with Google, talked about ‘Creating, sustaining and growing collaborative communities: lessons learned from Google Summer of Code’. The ‘Summer of Code’ has grown to its current size of around 1200 students, working on 175 projects in nearly 100 countries. She discussed the development of communities of programmers, and of how they needed to not only set goals and mission statements for communities and projects, but also to set ‘non-goals’ (ie, what they were not going to address. However, these should not be set in stone, as communities evolve over time. Much of what she covered seemed fairly obvious, including the needs to acknowledge and reward contributors to projects (with different people valuing different types of ‘reward’ and the need to understand what motivates them), and value of ‘many eyes’ looking at projects to not only find and solve bugs/problems, but also to provide different perspectives. Open source communities are not just about the code, but need to embrace the contributions of, for example, enthusiastic users to other areas such as documentation, marketing, etc. Technorati Tags: Google, open source, collaboration, communities, South Africa
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Molly Cheah, from Malaysia and from OSHCA, spoke about local training for use of free and open source software in healthcare. She began by talking about OSHCA (www.oshca.org), the Open Source Health Care Alliance, which is a non-profit organisation which aims to promote the use of free and open source software. She explained her work with UNU-IIGH (United Nations University - International Institute for Global Health) which focuses on local capacity building and software technologies for development. OSHCA has been working with UNU-IIGH on training in a range of aspects around FOSS, including how to critically analyse and select applications. There is a focus on competence and capacity building among healthcare workers in developing countries and in health informatics. An outline curriculum has been developed, and future activities will include collaboration with other institutions and development of a directory of open source health applications. Technorati Tags: FOSS, open source, free software, United Nations
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The first plenary speaker for Friday is given by Lee Seldon from Swinburne University of Technology in Sarawak on the topic of ‘FOSS, health records, infrastructure and ’standards”. He started from the premise that the purpose of the health record is (or should be) to benefit the patient, rather than simply the Health Ministry/Department. He referenced ISO 18308 in respect of criteria/architecture for EHRs and gave a detailed overview of standards and coding (such as ICD-9 and SNOMED) that deal with health records. He said that the greatest most common denominator for standards in English, with XML being the second most common. At the beginning of his talk, Lee highlighted the one gripe I have had about HISA2008, which is that the AV people cannot cope with anything other than Microsoft and Powerpoint - he had to convert his slides from Open Document Format and so they did not appear as he would have hoped; I also did my presentation in OpenOffice, and had to convert it to powerpoint - which, of course, is easy with OpenOffice. In the latter part of his talk, he moved on to discuss open source health applications, focusing on WorldVistA EHR, IndivoHealth and OpenMRS, and their degree of compliance (overt or otherwise) with standards. Technorati Tags: EHR, standards, health records, open source, FOSS
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It’s a bright and sunny morning here in Durban; the rain has gone and the wind settled somewhat. Last night was the Gala Dinner for the conference - a very well-organised event with some nice ‘branding’ touches, and a good menu - it augers very well for the social events for medinfo2010. The event closes at lunchtime today and has an interesting-looking programme covering open source and telehealth education and training. More to follow. Technorati Tags: open source, South Africa, telehealth
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Dennis Israelski and Eduardo Jezierski from InSTEDD (http://instedd.org/ - a not for profit organisation based in California) introduced some of the software and services trhat are being developed for disease surveillance and distaster/emergency response work. The organisation was founded as result of a 2006 TED prize, and the materials being developed are being made available as free and open source software. They began from the premikse that collaboration in outbreak containment is the critical task. The approach taken is to go from a ‘faint signal’ (initial indication of problems) to collaborative action to detect and respond to global public health threats. Healthcare workers locally can identify events and unusual diseases, changing frequency of disease, etc – these can be reported to local health districts to inform decision-making, so that control measures can be taken as appropriate. Peer-to-peer information sharing and collaboration is supported from the field workers through to those involved in implementing collective actions. Among the early technologies that are being developed are:
These initial products have also lead to collaborative analytics – allows user to take in other information (eg remote sensing data) and add and classify information in such ways that may be able to give early alerts. There is a presentation covering some of the same material at: http://www.slideshare.net/edjez/instedd-where-20-409348 The session provoked a lot of interest and discussion. Technorati Tags: disease, surveillance, geo-mapping, Web 2.0, collaboration
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Bill Perry has provided a report ( >>> ) on his ‘Digital Hornbook’ blog on the Rutgers University 26th Annual International Nursing Computer and Technology Conference, held on June 4-7 at Bally’s Hotel in Las Vegas. Technorati Tags: Rutgers, PageFlakes, nursing, education
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Peter has just finished his keynote talk at HISA2008. Titled ‘IMIA and Africa - towards strategic planning for health informatics’, I talked about IMIA, the development of its strategic plan, and some of the work that is going on to try and turn the plan into reality. As always, I tried to get too much into the time available. The main focus was trying to show how people from Africa could become involved in IMIA activities. The presentations from most of the speakers will be available from the conference website, in due course - www.hisa.co.za Technorati Tags: IMIA, South Africa, strategy
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For the latter part of the morning, our students from Walter Sisulu University in Mthatha, South Africa, are presenting some of their MSc Health Informatics work (www.chirad.org.uk/mthatha.htm); specifically a review/critique they undertook of the UK’s National Programme for IT (NPfIT). The session was introduced by Graham Wright, who explained the background to the development of the MSc course and some of the background to the development of NPfIT. Prof. Jimmy Chandia started the series of presentations, setting the context of NPfIT and the work that the students had done on exploring the implementation of the project. In addition, the students had looked at lessons learned and mistakes, with a view to South Africa trying to avoid repeating them. Menti Masiza explained the background of the original strategy for NPfIT; the vision, she said, was to deliver a 21st century health service through efficient use of IT, to use modern IT to deliver the NHS Plan, to deliver services to the patient and to support staff through effective electronic communications and knowledge management. The original plan saw the appointment of Local Service Providers through national procurements. The approach was a top-down, government driven approach with a centralised plan and big bang type of strategy. Tony Odama talked about the NPfIT infrastructure, starting by summarising the inherited levels of computerisation prior to NPfIT and how it differed between different parts of the health service; these, he described as technological islands. He explained the development of the NHS number, a 10-digit number to provide a unique patient identifier for the NHS, and described the N3 network and that it aimed to provide sufficient bandwidth for transmission of digital images from PACS systems. Dr Pradhan explained the nature of the ICRS (Integrated Care Record Service) and cited Dr Ashwin Hurribunce’s view that ‘integration is not merging’. He covered some of the issues and problems of the multitude of paper records that exist for patients, and why benefits would accrue from the development of electronic patient records (including error reduction, speeding up clinical communications, and assisting in diagnosis and treatment). ICRS is seen as a cornerstone of NPfIT, aiming to provide an integrated clinical information system across the whole care continuum, through a ‘life-long health record service’ that can be shared between different clinicians in different care settings, organisations and tiers of care. Ntsiki Mashiya followed with further detail on the nature of the ICRS and the NCRS, including the Summary Care Record (SCR) and the Personal Demographic Service and its relation with the National Data Spine. The SCR is currently being piloted in parts of the UK, and there are provisions for patients to opt out of its use. Dr Khatry-Chhetry talked about the Electronic Prescribing Service, introduced with a view to providing benefits to patients, as well as reduced administration and fraud. He notes that it is behind schedule, with greater useby GPs and in community settings, but less use in hospitals, and there remain concerns and issues around electronic signatures and patient privacy. Nomawethu Mjekula talked about Choose and Book, the e-booking component of NPfIT. It was originally designed to promote the government’s ‘patient choice’ policy and to remove lengthy waits and improve services. Lulamile Klaas covered the six implementation phases. Dr Yogi Parimalarani talked about the students’ views of the lessons learned from NPfIT. She noted the importance of strong political support by the Prime Minister and continuity of leadership, although there was a drive to fast-track and meet deadlines., and professional anxieties were often not taken seriously and the experience of expertise of health informatics professionals tended to be ignored. Benefits included cost savings in the procurement processes, but there were problems of local capacity development for the future. One of the major problems of NPfIT, she says, was communication, which was handled badly, with lack of transparency. There was also lack of early involvement of users and champions in managing change. Other problems included shortages of skilled IT staff and of trainers to train staff, as well as a mismatch between the training and implementation. Clinicians were not consulted and involved early in the whole project/process. Technorati Tags: CHIRAD, Walter Sisulu University, health informatics, NPfIT, CfH
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It’s Wednesday already, second day of the HISA2008 conference. Last night’s opening cocktail reception was well-attended; plenty of wine and more than enough to eat (which makes a welcome change for such events). Plenty of networking opportunity, and I was pleased yesterday to finally meet Molly Cheah from OSHCA. Today’s first keynote by Graham Wright from the UK and CHIRAD is on the IMIA Knowledge Base project. He spoke first about the ‘$100 for 2010′ appeal (www.chiradfoundation.org/100for2010) to support African students attending medinfo2010. He explained that the project started as a cognitive mapping of health informatics and defining the basis of health informatics as a discipline, through the ‘Education Steps’ project. He explained how the project developed, the processes of planning, and the early work on exploring the laws, theories and concepts that make health informatics what is, and the original use of Bloom’s taxonomy. The original Education Steps meeting at Otley had a mix of clinicians and computer scientists. He went on to explain how the initial output from the Education Steps meetings fed into a project with IMIA on updating the IMIA Scientific Map that had been developed by Nancy Lorenzi. The project with IMIA involved a triangulation of expert opinion and document analysis and literature review. Graham explained the use of a variety of search tools to analyse the collection of health/medical informatics literature, and that different algorithms produced different results. The keywords derived from the various methods of searching the literature for concepts and keywords (including adding index terms from journals) were compiled into a database that was then sent out for expert review by health informaticians around the world. He explained that the current results of the project are based in what the literature, and the views of experts, say health/medical informatics is about today. Technorati Tags: IMIA, knowledge, South Africa, Education Steps, CHIRAD
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