Medical Open Source .NET

Resources for MCS and ECE students
OpenPayments, Sunshine, Waste, Fraud and Abuse
An Obituary

   The past year under the Trump administration seems to be more about protecting the revenue streams of the medical industry than improving the lot of the patient. These pages will explore selected issues.

   Beginning November 22, 2016 this site is getting its first major overhaul in 15 years. If you are looking for something specific that you don't see please send me an email request.

   Welcome, this is Not a .COM but rather a Web space for making and sharing tools that help patients work with the doctors and nurses of their choice. The focus here then, is building partnerships, not marketing, and not simply providing information. The problem is the fragmentation of the medical record among the many "owners" of parts of the record who are not the subject of the record. The goal is to have all the relevant data available whenever and wherever patient meets doctor to make a health decision. This goal is the same if that meeting is face-to-face or over the Internet or by cell phone (hopefully stopped at the side of the road.)

   A New Year's resolution! Remember no person or institution cares more about the accuracy of your and your family's medical data than you. We started with a family oriented immunization record 30 years ago at the West Bloomfield, Henry Ford Health System, Pediatric Unit. Next we will be exploring a family oriented and family owned medical record. Not a family portal into some provider's record system, but a family's medical record that providers might use a portal to access. The U.S. military paper record that was carried to the specialist by the patient was a very good system. The digital age needs a system like this. Linus Torvalds's innovative Git version control for the Linux kernel is a nice template for a more modern medical record.

   Open Source software is an important topic here. The Open Source community has "discovered" many things that medicine once knew and perhaps forgot.

   The Open Source software movement and the tradition of medicine have much in common. Individuality and privacy are respected. The best practices and methods are shared openly. Progress is rapid because both good and bad ideas are identified quickly by a larger, interested, informed community working together. Resources are not wasted hiding secrets and defects to protect market share. Both traditions are established. Medicine is the older, but still the apprentice at using the Internet for community communications.

   The business of proprietary software development and the business of medicine also have something in common. Arguably this has been good for some software companies. Also secret methods and screens may have benefited some medical businesses. In turn, this may have benefited some medical consumers. Increasingly however, the medical consumer in the marketplace is not the patient.

   Consider two sorts of medical software. One, software to manage care-givers and the care they render. Two, software for a patient and physician to use together to plan health-care. The first is common, often proprietary and secret. It has a mixed legacy and poor prognosis. The second is rarer and often co-opted as advertising. It is however, more common in other arenas. For example, there are many software tools to help a client and financial advisor plan for retirement. This second, somewhat under-served, area is our focus here.

John M. Miller M.D.

Revised May 2, 2018