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Switching Hospital Systems to Linux
Posted by
samzenpus
on Wednesday December 12, @10:08PM
from the open-sores dept.
from the open-sores dept.
jcatcw writes "Health care software vendor McKesson Provider Technologies is focusing on ways to cut IT costs for customers, including hospitals and medical offices. The cure is moving many of McKesson's medical software applications to Linux, which can then be used on less expensive commodity hardware instead of expensive mainframes. A deal with Red Hat allows McKesson to offer its software in a top-to-bottom package for mission-critical hospital IT systems."
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Switching Hospital Systems to Linux
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hmm (Score:5, Funny)
Re:hmm (Score:5, Funny)
Tuesday, Wednesday, RAID set's broke
Thursday, let out the magic smoke
but on Friday, I patch bugs
Monday, my xorg conf is toast
Tuesday, Wednesday, CPU roasts
Thursday, it won't even POST
but on Friday, I patch bugs
Re:LINUX IS FUCKING SHIT!!! (Score:4, Insightful)
Java is "fully of weird mysteries" regardless of the platform.
Java app servers are plenty prone to crashing and eating up
all available memory. You don't need to run them on Linux for
that. AIX or Solaris will do equally well.
My guess is that they made changes without fully understanding
them or testing them. They disturbed their the little java
house of cards they had going.
Affordable health care (Score:5, Interesting)
Re:Affordable health care (Score:5, Insightful)
Re:Affordable health care (Score:4, Insightful)
The entire medical biz is a scam to get the poor to finance a few $2,500,000 homes and lots of BMW 7 series cars. Doctors do not deserve to be paid insane rates. Some doctors are sane and charge real rates and tell their clients to avoid the hospital at all costs while helping them with outpaitent surgery in their offices.
IT costs are less than 1/90th the cost of health care.
Re:Affordable health care (Score:5, Interesting)
You would think that after they pay for their equipment, the costs of using it would go down. It just isn't so, Sure there are still costs like maintenance and so on but generally the cost of using it goes up once it is paid off.
Re:Affordable health care (Score:4, Insightful)
"So, what kind of 'special version' of word should a doctor need? do they come with special medical symbols? "
Oh well... I can not do sarcasm as well as a real Briton would do it... sorry.
Re:Affordable health care (Score:4, Interesting)
But thinking about it, I guess you're right, these socialist countries suck. The game console they carted into my room while I was in the hospital was a stinkin' NES - now, come on. How rinky-dink and Soviet can you get? I wanted an N64, damnit!
Re:... and screw the economy (Score:5, Insightful)
Re:... and screw the economy (Score:5, Insightful)
If you ask why, or even worse, try to reduce your consumption, you are directly challenging the personal validation system of the more conformist consumers. If someone measures their self worth on the amount of money they earn, or the expensive toys they have, then you are questioning their status in the social pecking order.
Re:... and screw the economy (Score:5, Insightful)
Re:... and screw the economy (Score:5, Interesting)
You get the picture. In fact, in most of health care, that's just what happens already. They spend as little as possible on IT and reapportion the cost to areas of service that will directly benefit their ability to attract doctors and customers and therefore generate greater revenues.
Those reading this might think I'm kidding, but let me tell you this: I once replaced a token ring network with an ethernet network connecting Pentium IIs and IIIs. In 2005.
-- A former healthcare IT worker.
Lackluster vendor makes incremental, pitiful step (Score:5, Interesting)
I wish our hospital system could dig its way out of it. I don't think running on top of Linux will help much. See if you can get a screenshot of their software on their website - I can't - they don't promote this stuff to the physicians and nurses who use it - it gets sold to the suits. There's a goldmine out their awaiting some entrepreneur who could really take pride in writing good software of this sort, and though I love Linux, I don't really care what it runs on top of.
Re:(laughs so hard milk squirts out his nose) (Score:5, Funny)
Re:(laughs so hard milk squirts out his nose) (Score:5, Informative)
Re:(laughs so hard milk squirts out his nose) (Score:5, Informative)
Just because a product wasn't plug-and-play in 1997 when you last used it, doesn't mean it still sucks a decade later.
The amount of testing/development that takes place in the fedora community all funnels directly into a more stable and usable product(i.e. RHEL). That subscription to RHN ensures those engineers bust their ass to fix whats wrong and get it delivered to you: it also means that if your the IT staff in said hospitable and something doesn't make 100%, you can call someone who it does make 100% to and get an answer/fix instead of diagnosing it for 45 minutes while a doctor needing to do a simple task breathes down your neck and wastes both their time and yours.
Re:Lackluster vendor makes incremental, pitiful st (Score:4, Informative)
Linux at the desk top is so next year.
Re:Lackluster vendor makes incremental, pitiful st (Score:5, Informative)
Re:Lackluster vendor makes incremental, pitiful st (Score:5, Interesting)
Pay attention here, IT freaks. Notice that the user here (possibly your doctor) says nothing about the OS. This is simply abysmal design and implementation. Unix/Linux/Windows/OSX/Oracle/Postgres/MySQL/MSSQL....ALL could end up thusly. Or all could end up not too bad. Design it right, and build it right. Think about what your user is actually trying to accomplish.
I saw some comments upthread about RedHat this and Linux that...Bullshit. The user interface is (most of) the key. If you screw that, the backend matters little.
Yes, if you start from a stable base, it is easier. But no matter what the base is, if you fuck up the actual program and interface the that user, in this case a doctor or nurse, uses....everything else is irrelevant. They will hate it. And still not care what the base OS is.
Re:Lackluster vendor makes incremental, pitiful st (Score:4, Insightful)
Think about what your user is actually trying to accomplish.
But you missed the point in the grandparent posting -- this system is sold to the suits who run the hospital, not the poor sods who actually get to use it. As a result there is really no impetus for the management of the software company to spend anything more than the barest minimum they can get away with to actually develop the software or make sure it runs right.
I've been in this sort of situation (as a programmer) and I can say that it's not pleasant, nor conducive to good software development, usability, reliability etc.
Rich.
Re:Lackluster vendor makes incremental, pitiful st (Score:5, Interesting)
We're in beta testing with actual patients now and my boss is bankrolling us into starting a company to sell the software and other medical-related IT solutions to local doctors (many of whom have horribly inefficient offices and don't fully realize it). I'm hoping we can expand beyond just local doctors, because it is a huge market and the best anyone else seems to be doing (around southern Ontario at least) is holding seminars to talk about how technology could be used to enhance medical practice someday.
Re:Lackluster vendor makes incremental, pitiful st (Score:4, Insightful)
my 2 cents
Re:Lackluster vendor makes incremental, pitiful st (Score:5, Funny)
I remember sitting in on a presentation they once made to one of our directors regarding some new patient records management system they were trying to pitch to us. Not one single screen shot was shown nor were any technical people on hand so that I could ask the difficult questions. In the end, when she asked me my opinion, the conversation went like this:
Me: Remember application X that you used to use at hospital Y?
Her: Uh... yes.
Me: They wrote it.
We didn't buy the software.
Just wanna give a shout out to the PR rep... (Score:5, Insightful)
Two points off for the "less expensive commodity hardware instead of expensive mainframes" - that's a Microsoft marketing phrase from the early 1990's for God's sake - but still a pretty good job all around.
I'd hate to be a patient - first hand experience (Score:1, Interesting)
HIPAA (Score:1)
Pubic Sector (Score:1)
embedded PowerPC Linux gets medical (Score:1, Interesting)
A year or so after the dust had settled following my departure from and the subsequent implosion of LinuxPPC, I got a call from some southeast Wisconsin consulting group. The woman who called admitted she didn't know what she was talking about, but here it was: "Linux development on an embedded PowerPC processor." Apparently one of the people there, whose name I recognized at the time, had said "find Jason Haas! we need to find Jason Haas! He'd be perfect!" I laughed and told the nice woman that I honestly had no clue how to do what she was talking about, but I knew just the person for it... and I gave them Jeff Carr's phone number. She thanked me and we hung up.
Time passes...
A few months later I get a call from jcarr. "Heeeeeeeeeeeeeeeeeey!!!" (this will sound very familiar to anyone who knows jcarr!) It took a few minutes for me to be able to tell what he was saying, as he was rather excited.
Turns out I'd gotten him a job subcontracting for GE Medical Systems. What I like to refer to the military-media-medical industrial complex.
That was 2001 or 2002... and now jcarr's out in the Valley, hooked up with old school Mac developers like Chuck Boich,
and Linux folks too. We'll see about working on The Next Big thing some time soon. (RSN!)
Dont make me laugh (Score:3, Interesting)
OpenVista (Score:5, Informative)
OpenVista is the open source version of the VA's VistA program, deployed at over 1500 sites worldwide. You can also grab it for free from http://sourceforge.net/projects/openvista [sourceforge.net].
Yes, you can get professional training, installation and ongoing support for it:
http://medsphere.org/ [medsphere.org]
Re:OpenVista (Score:4, Informative)
I'm a pretty hardcore advocate of FOSS solutions, and I was excited by the hype around VistA. But after learning about this system in some detail there's no way I could recommend it as a reasonable alternative to the better commercial systems out there despite the savings on software licenses. MUMPS is a platform without much of a future. There are huge gaps in functionality. And the future of VistA outside the VA is far from certain. I'd encourage anyone looking for an EMR/EHR system to educate themselves about VistA a little, but I suspect most of them will reach the same conclusions we did.
Oh..Good (Score:1)
Oh wait..They moved from mainframes
Posting as AC for obvious reasons... (Score:4, Interesting)
We can argue about how much of healthcare costs are sucked up by IT. But whatever percentage you come up with is likely to be not insignificant. And one of the biggest costs of healthcare IT is the amount of money paid to so-called "IT Consultants".
My understanding is that pure healthcare people don't understand much about IT and since they figure IT is the next biggest thing, they are willing to give money hand over fist to people who have decent resumes in this field who present themselves as IT "experts".
They are throwing their money away. It's really awful.
If you don't believe me, look at some of the so-called IT "standards" documents coming out of the healthcare IT community.
Sure, HL7 V3 is a good, robust yet flexible standard definition. But look at some of the abysmal crap that is being built off of it.
I mean, seriously, read some of these "standards" documents coming from non-HL7 sources. Not only are they inconsistent with reality. They have massive internal contradictions, logical inconsistencies and even simple syntax errors. And this is stuff from organizations that have been around for A DECADE.
Believe me, IT consulting has nothing to do with helping the healthcare industry actually make the best use of modern technology and everything to do with lining the pockets of a few contractors who would be thrown out of any other domain for sheer incompetence.
I worked for these guys and can definitely say.... (Score:2, Insightful)
Just make it work (Score:3, Interesting)
In the past Unix (SunOS) was the preferred platform, there are actually many MRI systems running on a 100Mhz Sparc processors today, which still do and excellent job.
We've moved to Windows, it's a common interface for users who can learn it quickly. Windows requires CPU's in the 3Ghz range and higher to be effective. Windows also has major issues with Service Patches and hotfixes in the Medical imaging world, all updates have to be QA'd so there is a delay of months before they get applied. Medical Imaging will probably continue to move away from Windows and it's patches if can make an interface easy for the average user who walks upto a system and start using it.
Recently at Siemens Medical http://www.siemensmedical.com/ [siemensmedical.com] the MRI systems moved from Windows to Linux (Suse) for the image reconstruction computers (Not at the user console). During MRI imaging data is coming in from the scanner at 10MSamples/Sec at 24bit accuracy up to 32 separate channels, that's a significant amount of data to be processed, having a mouse pointer and a GUI interface is just not needed, Linux just more efficient.
Bad idea (Score:3, Insightful)
DB... (Score:2)
Btw, I can run plenty of web front end applications that have a mainframe on the backend. This looks like a case of rewriting crappy applications with more crappy applications. But this time I can make a press release showing I'm tossing out my "5 nines" mainframe for a linux farm (which could, provided the apps are written correctly, provide "5 nines")
In the middle of a hospital system implementation (Score:2, Insightful)
* The database and reporting layers are Oracle 10g.
* The hospital system application system runs on top of the Oracle 10g Business intelligence suite.
* The system is run on 3 servers per hospital site. Two of the servers are configured to use RHEL and one is running Windows Server 2003. Medium term planning (after the system is stabilized) include cutover from the Windows servers to the Linux servers.
* The system utilizes a client on workstations that is browser based. Initial design of this client includes ActiveX controls, which limits the use of the clients to Windows based workstations. Further down the road, testing on MONO based clients are options.
* Major customization and integration has taken place as part of a large project.
All in all, it is quite easy to switch systems to Linux, since Oracle is portable. It would also put a lower load on the servers and bandwidth. Note however that the biggest expenditure is still the Oracle licenses and the Windows licenses pales in comparison, and changeover would also cost money... so, is this not a case of penny pinching?
I'll take medical starts and ends with Alex... (Score:2)
It's Not a Mainframe (Score:5, Interesting)
The original Computerworld article [computerworld.com] cited is confusing, but it refers to UNIX mainframes. The most likely educated guess is they're talking about high-end UNIX servers from Sun, Hewlett-Packard, and/or IBM, not what we would generally think of as true mainframes, notably IBM's System z [wikipedia.org].
Yes, among System z's five popular operating systems z/OS contains a complete and certified UNIX(TM) implementation (called z/OS UNIX System Services). And yes, System z runs 100% GPL open source kernel.org Linux. And yes, OpenSolaris on z will be z's OS #6 before too long, and that's clearly UNIX(TM) too. But I doubt the article is talking about any of these technologies, based on the context of the article. There are not 2,500 U.S. hospital IBM mainframes (the number of McKesson hospital customers cited), for example. Maybe there should be.
Computerworld's editors seem to be on vacation, unfortunately, so their usually good copy editing is suffering, resulting in some gibberish articles. This week they also reported that Steve Jobs and The Woz approached Commodore in 1982 to talk about the latter company selling the Apple II, pointing out that Apple's two founders didn't have enough money to launch the product, worked out of a basement, and the safety and stability of cashing out for a couple hundred Gs was better than the alternative. Unfortunately for Computerworld they got the date wrong: by 1982 Apple was doing just fine, and The Woz was doing Nissan commercials.
Mirth (Score:1, Informative)
mainframe to windows (Score:3, Interesting)
Potential... (Score:2, Interesting)
Some years ago, when I entered the greek army to do my military duty and after boot camp, I ended up in a military hospital. To make the story short, I worked there for a couple months as an office assistant.
The resident Captain Psychiatrist called me to his office one day to request assistance for some Microsoft Access database he was building. I told him I didn't knew anything about it, but I was going to find out. I had time to spare.
I went through the built in help files and solved his problem and that excited him probably thinking he found some computer genius. So, he showed me his project, which was an extremely basic database in Access for his patients and asked me if I could take over. I am not a programmer (having only typed a few lines in C64 Basic and Amiga AMOS) and not the programming type (I even failed math at high school),but I am comfortable with computers and in the greek army people that know how to use a keyboard and click with a mouse are a tiny minority. Plus, I definitely had lots of time to spare!
So I bought a book on the subject, borrowed his Psycho-bible and sat down and learned about MS Access, databases, interface design and psychology while programming this thing. It became a complicated beast with all kind of diagnostic entries and references and pushed Access and myself to the limits. After about a month, Captair Doctor was jumping around with joy as the project seemed to have a good starting point and lots of potential. He told me that there was nothing good in the market, especially the greek one and that we should develop and market it commercially. We also became friends and even had dinner with his family, a very rare thing to happen, considering I was a drafted private and he a professional officer. I had to abandon the project when my time to leave the hospital came but I found out that it was picked up by another, just like me, drafted soldier who took my position in the hospital office.
Now, isn't that more or less the situation with Open Source? Imagine if I didn't have to use a developing base that sucked (both OS and tool), actually was skilled with coding, had more time and a whole community to take the project from me, instead of letting it die in some dusty box...
I declare shenannigans! (Score:2)
Secondly, speaking as someone who has worked many years in hospital IT with a number of software vendors, INCLUDING McKesson, I can tell you that this has done very little to save money for hospitals. While it's true that running RedHat on commodity hardware is going to be less expensive than running AIX on an IBM P-Series, the single biggest expense is still the vendor's software, in this case McKesson. I know, I know, the article says:
Red Hat estimated that health care facilities that have switched have been able to save as much as 60% on IT costs compared with what they were spending before.
I'm pretty sure that they were talking about saving 60% on OS licensing and hardware purchasing costs, not overall savings.
I use McKesson (Score:1)
I contacted about 40 software providers... (Score:3, Informative)
Medical Systems and IT (Score:1)
come up with something that does not suck. and suck bad. what happens, is; most of these apps have ok workflow, and decent usibility from the docters or nurses point of view which is why the get bought. but from an IT perspective these hospital software house are almost all just nightmares. they have poor or non existant architecture, and dont use any modern or even past best practices. these apps, have to be very custimize hell i even have to write my own
-Nex6
Blah Blah Blah (Score:1)
These are big money businesses. Somewhere along the time necrotic momentum sits in and consumer satisfaction takes a back seat.
Don't expect better integration either. That's perhaps the biggest joke amongst these vendors.
Until there's a solid council formed that bend the vendor to adopt best practices and interop, things won't change. How much of an effect this is on Healthcare costs to the consumer, much less an improved continuum of care, I have no idea. There are other factors, such as people, skills and processes that mix into it.
Regardless, nicely spun, but it's still shit in a box.
The relationship between IT and corporations ... (Score:2)
People fail to understand the difference between capital expenses and operational expenses.
Cheaper hardware and software only save capital expense, at the cost of the need for a more sophisticated staff and a reduction in the number of big name expensive software application packages available.
Bigger capital expenses mean bigger budgets, and justify larger compensation packages for senior management. A more sophisticated staff generally means greater responsibility and performance, and that's NOT something that senior management wants anything to do with. Better to kick the problems back to an outside vendor or consultant -- someone who the manager is not directly responsible for the performance of. It's important to leave wiggle room for finger-pointing.
None of this appeals to hospital senior management -- they want the big name spiffy stuff, but don't want to pay for (and worse yet, to manage and be responsible for) a talented staff to keep things running smoothly -- that's the vendor's job.
Impressive names on the software and equipment, and plug & play people -- that's what hospitals (and companies of all stripes, but more-so in hospitals) want.
The real news is that it's not really news. (Score:2)
If they'd decided to switch to Windows as some companies did a few years back they'd be stuck now, with no path back. Open systems
This is no more significant, really, then them switching from HP/UX to Solaris. UNIX is UNIX is UNIX.
The other thing that seems fishy is the use of the term "mainframes"? Mainframes? Really? I suspect they're talking about minicomputers... most of which are just really well engineered micros.
No!!! (Score:5, Funny)
Re:No!!! (Score:5, Insightful)
In mathematical terms:
A = {basic set of programming artifacts}
B = {domain-specific structures and computable knowledge elements}
X = {A U B}
and Y = {A}
Re:No!!! (Score:4, Funny)
public class YourWrong {
public static void main(String args[]) {
System.out.println("Hello Asshole. Yeah, this is 50 lines...");
}
}
That's five lines...
$ wc -l YourWrong.java
5 YourWrong.java
$ javac YourWrong.java
$ java YourWrong
Hello Asshole. Yeah, this is 50 lines...
Re:Just watch (Score:2)
Re:McKesson... (Score:2)
Re:Just watch (Score:5, Funny)
The janitor will come by, type a few random key strokes into the terminal, and boom, no more linux box. *nix computers are just too easy too kill.
Yeah, that's the major flaw of Unix operating systems, and it still hasn't been solved in the 35 years Unix has been around.
If only there was some sort of system under which some special user with special powers could create user accounts deprived of these special powers so that they wouldn't be able to break everything...
You're right - you're so right (Score:2)
Any advanced server you should be able to kill with a few mouse clicks, [wikipedia.org] so that way your janitor or your cat can kill the system. Killing the system through a root console is so 1970's.