18:01:51 <susmit> #startmeeting
18:01:52 <zodbot> Meeting started Tue Jan 19 18:01:51 2010 UTC.  The chair is susmit. Information about MeetBot at http://wiki.debian.org/MeetBot.
18:01:52 <zodbot> Useful Commands: #action #agreed #halp #info #idea #link #topic.
18:02:05 <susmit> #chair cwickert
18:02:05 <zodbot> Current chairs: cwickert susmit
18:02:39 <mgwmgw> I think we can start, or give it a couple more minutes for people to join.
18:03:03 <susmit> luisibanez, shilbert, diamondgr , mgwmgw  I guess we are meeting for the first time.
18:03:05 <susmit> :)
18:03:42 <shilbert> :)
18:03:44 <susmit> I think a short intro of all of us will be a fine point to start.
18:03:55 <susmit> for me
18:04:34 <diamondgr> OK
18:04:56 * cwickert is a Fedora packager and owns a lot of packages. also sponsor, FeSCo member, Ambassador and some more wich I forgot atm :)
18:05:28 <cwickert> shilbert is the author of gnumed, he usually uses SuSE I think
18:05:29 <susmit> I am working on fedora for 4 years now. I do a bit of everything, but I was not a medical student or does not have any domain knowledge :)
18:05:44 <cwickert> is that correct shilbert?
18:05:46 <shilbert> I am working with the GNUmed team
18:06:03 <shilbert> I am physician by day and help out with GNUmed at night :-)
18:06:22 <shilbert> I run openSUSE on my notebook
18:06:26 <cwickert> for those of you who don't know GNUmed
18:06:28 <cwickert> #link http://wiki.gnumed.de/bin/view/Gnumed
18:06:43 <shilbert> started packaging GNUmed for openSUSE and Fedora a while back
18:06:57 <shilbert> packages are crude at best
18:07:03 <cwickert> shilbert: :D
18:07:14 <shilbert> works but I have little experience re packaging
18:07:30 <cwickert> ok, some more introductions please?
18:07:45 <diamondgr> I'm studying veterinary medicine, my last year (at clinics). I use Ubuntu for 2 years now. Recently I met a Greek Fedora Ambassador and I'm turning to Fodora.
18:08:04 <susmit> mgwmgw, a few words please?
18:08:04 <mgwmgw> I am an experienced software developer, most recently priarily Java.  I have dabbled a little in OpenMRS.  My primary systems run Gentoo and OSX.
18:08:14 <susmit> ah..sorry
18:08:44 <mgwmgw> I am currently unemployed and would love to get paid to do something worthwhile.
18:08:51 <cwickert> #link http://openmrs.org/wiki/OpenMRS
18:09:26 <diamondgr> By the way, I don't have programming skils.
18:09:38 <cwickert> me ether, or just a little
18:10:04 <shilbert> well that makes three of us
18:10:07 <susmit> I don't have any packaging skills, so we all complement each other :)
18:10:13 <shilbert> :-)
18:10:35 <mgwmgw> I have a lot of programming skills but don't know much about medicine.
18:10:53 <shilbert> IMHO packaging what is out there already is very important
18:11:16 <susmit> IMHO, finding out the workflow is most important.
18:11:27 <shilbert> away from keyboard for a few minutes ...
18:11:31 * cwickert works as an IT consultant and mainly consluts doctors
18:12:44 <susmit> ok...that's nice. My point is "Do we want to package and integrate all the med softwares out there?" or " we want to do something that will fit nicely into the day jobs of medical consultants"
18:13:03 <susmit> and organizations
18:13:27 <susmit> your opinions?
18:13:45 <susmit> I prefer the second
18:13:54 <diamondgr> I prefer the second too.
18:13:58 <cwickert> I think we should first package as much medical software as we can and doe a Fedora medical Spin
18:14:07 <mgwmgw> In addition to the computer skills I also have a psych degree.  I read that when electronic health records re added to clinics, they are often not well received, so I think I agree about understanding the workflow.  OpenXData/JavaRosa is already doing some integrating.
18:14:26 <cwickert> susmit: the question is: what is the second? what can we do that fits nicely?
18:15:02 <cwickert> I'm open to ideas, I think this is no ether ... or ... thing, we can do both
18:15:17 <susmit> cwickert, we can find the works that requires software and find out and package the best option for that
18:15:32 <diamondgr> Maybe the question is that we want clinics to use the software or private practices?
18:16:01 <mgwmgw> #link http://www.openxdata.org/Main/Projects
18:16:41 <luisibanez> on our side, we develop open source toolkits that are used in medical applications
18:16:49 <luisibanez> for example ITK, VTK, IGSTK and Slicer
18:16:54 <mgwmgw> #link http://www.open-mobile.org/technologies/javarosa-open-rosa-consortium
18:17:10 <cwickert> I don't think we should narrow our focus to a certain target audience. out goal must be to promote linux in medicin whereever possible, no matter if it's small practices of bigger clinics
18:17:21 <cwickert> s/out/our
18:17:26 <luisibanez> www.itk.org is medical image analysis,  www.vtk.org is visualization,   www.igstk.org is image guided surgery,  www.slicer.org is a research & clinical application
18:17:43 <luisibanez> we are mostly a C++ & Open Source development company
18:17:44 <cwickert> #info www.itk.org is medical image analysis,  www.vtk.org is visualization,   www.igstk.org is image guided surgery,  www.slicer.org is a research & clinical application
18:17:48 <susmit> my question is, simply put, what is our goal? Will we consider ourselves successful if we package xxx numbers of softwares? or we consider ourselves successful if we can provide a comprehensive solution to doctors/clinics/hospitals
18:17:51 <susmit> etc?
18:18:23 <diamondgr> cwickert you're right. In my country we have many private practices. They pay for their equipment. Clinics are mostly state clinics, so the goverment pays.
18:18:38 <cwickert> diamondgr: which country?
18:18:44 * cwickert is from Germany btw
18:19:08 <susmit> kital told me about dentists in Germany ;)
18:19:18 <diamondgr> cwickert: I'm from Greece. Recently we had a contract with Microsoft, so all state organizations use MS products.
18:19:39 <mgwmgw> I am sorry about using MS products.  That is too bad.
18:19:47 <mgwmgw> I am from America.
18:19:52 <cwickert> susmit: what did he tell you? they are rich and all drive Porsches? this is true
18:20:00 <susmit> :)
18:20:18 <luisibanez> be aware that many CT and MRI scanners run Linux    :-)
18:20:41 <kital> cwickert: in india all people have excellent teeth
18:20:43 <cwickert> luisibanez: right, but most of the time people are not even aware of the fact that they are using Linux
18:21:02 <cwickert> kital: then indian dentists are likely poor ;)
18:21:22 <susmit> cwickert, nobody wants to study that branch.
18:21:30 <diamondgr> Usually doctors wants a machine that works...Don't care what software it's installed.
18:22:04 <luisibanez> If we are targeting doctors then one of the first things we need is : DICOM viewers & PACS
18:22:10 <cwickert> In Germany the market is dominated by one company which is outbuying all the others. they have a market share of 50-60% I guess
18:22:39 <cwickert> they also bought some Linux companies and closed them down, so people must use their windows flagship product now
18:22:45 <luisibanez> Osirix is probably the most popular OpenSource DICOM viewer but only runs on Macs   :-/
18:23:07 <diamondgr> Can I ask something? Is there someone with marketing skills in our team?
18:23:15 <cwickert> there are some docom viewers for Linux too
18:23:20 <luisibanez> there will also be a need for EMR (Electronic Medical Record) packages
18:23:43 <luisibanez> like http://feed.openmrs.org/?page=1
18:23:52 <mgwmgw> If a medical person has a problem which can partly be solved with Linux, there are three reasons why it might not be: 1. They cannot find the solution.  2. They perceive that the non-linux solution is better in some way and 3. the solution does not exist.  If we could pick a problem and solve any of these 3 reasons, I would call that success.
18:23:53 <diamondgr> Here EMR are needed most I think.
18:24:05 <susmit> my point is a doctor/ a clinic/ a hospital management/ a vet surgeon  / a xray-clinic/ everyone will have their own set of requirements. I don;t want to go for all of them at the same time. Let's take one workflow at a time, complete it and move to the next workflow.
18:24:08 <diamondgr> Here=Greece
18:24:23 <cwickert> susmit: +1
18:25:06 <diamondgr> susmit: +1
18:25:14 <cwickert> as a start I think we should gather a list of applications that we could package. I will try to package as much as we can, so we a "product" we can work with.
18:25:49 <luisibanez> sounds very reasonable
18:26:00 <mgwmgw> The wikipedia article on open source medicine would be a place to start looking, but a lot of that software is no longer being maintained, but that can be fixed too.
18:26:10 <susmit> cwickert, not exactly. Let's find the workflow of a practitioner first. Then we will identify all the softwares needed for it and package the,.
18:26:20 <susmit> them
18:26:29 <shilbert> There are a handful that can be marketed *right now*
18:26:50 <shilbert> The FOSS health community is rather small
18:27:09 <shilbert> a few very vocal people are US based
18:27:20 <shilbert> a few are distributed worldwide
18:27:31 <susmit> shilbert, if we can do this successfully, it has a huge marketing potential. Ii shall work with marketing regarding this.
18:27:38 <shilbert> there is little collaboration between them
18:27:53 <shilbert> What it needs is packages ready to go
18:28:06 <diamondgr> That's why I asked if there's a guy with marketing skills.
18:28:09 <shilbert> Noone I know (consultants) are willing to go the extra mile
18:28:15 <mgwmgw> #link http://en.wikipedia.org/wiki/Open_source_healthcare#Categories
18:28:19 <luisibanez> so, if we follow the clinician workflow, I would assume that all starts with EMR, when the patient arrives to the doctor's office and start providing all her/his personal information and medical history...
18:28:20 <shilbert> they want to install and charge
18:28:23 <shilbert> easy as that
18:28:23 <jim_busser> Do we know to what extent existing EMR candidates would be fit for "any country" as opposed to "hard-coded to fit specific maybe-national systems"
18:28:26 <shilbert> but anyway
18:28:34 <shilbert> most important in my mind
18:28:41 <shilbert> opinion are
18:28:48 <shilbert> VA Vista
18:28:53 <shilbert> OpenMRS
18:28:58 <shilbert> Freemed
18:29:30 <shilbert> one requirement
18:29:46 <shilbert> all practices have is billing
18:29:56 <mgwmgw> #link http://www.mirthcorp.com/products
18:30:08 <diamondgr> Is there a possibility to create a questionaire?
18:30:12 <mgwmgw> You might also want to integrate the EMR with Mirth Connect.
18:30:18 <shilbert> few doctors want to implement EMR for documentation
18:30:27 <shilbert> billing is the key feature
18:30:34 <susmit> The first action item should be : Document the clinician workflow in the wiki and listing related softwares. Any volunteer?
18:30:56 <mgwmgw> If you want a questionnaire, Survey Monkey should suffice.
18:31:04 <mgwmgw> #link http://www.surveymonkey.com/
18:31:17 <shilbert> be aware that there is no single workflow
18:31:38 <shilbert> if you have a look at the GNUmed wiki you will get a lot of info re clinical workflow
18:32:16 <susmit> shilbert, I am not the best person for that :)..can you please take this up?
18:32:20 <shilbert> a list of must have packages for a clinic solution would be a start
18:32:30 <susmit> shilbert, +1
18:33:05 <diamondgr> shilbert +1
18:33:12 <cwickert> +1
18:33:41 <cwickert> #agreed to gather a list of must have packages for a clinic solution
18:33:51 <mgwmgw> Do we want one person to figure out the needs  or do we want to gather requirements from a bunch of people?
18:34:20 <cwickert> I propose shilbert to do that, he seems to know best ;)
18:34:33 <cwickert> of course others are welcome to help him
18:34:39 <susmit> mgwmgw, and it is a wiki...open to edit :)
18:34:45 <diamondgr> Bunch of people. Maybe one person misses something.
18:35:43 <susmit> cwickert, we need a mailing list and a tracker. right?
18:36:09 <cwickert> +1
18:36:24 <susmit> I shall do it.
18:36:38 <diamondgr> mailing list absolutely
18:36:39 <cwickert> I wouldn't say we *need* but it's nice to have
18:36:54 <cwickert> the tracker is most important to me
18:37:10 <susmit> cwickert, I shall take care of both.
18:37:13 <shilbert> what is missing is a distribution targeted at clinics
18:37:36 <shilbert> if you have a small team don't try to go for the big hospitals
18:37:46 <shilbert> there is just no enough manpower
18:38:04 <cwickert> susmit: you want a project on fedorahosted?
18:38:11 <susmit> cwickert, yes
18:38:19 <shilbert> make sure fedora and openSUSE have a medical packages
18:38:38 <shilbert> produces a spin or whatever it is called
18:38:44 <shilbert> and market it
18:38:46 <cwickert> #action susmit to request a project on fedorahosted.org
18:38:52 <shilbert> btw
18:38:58 <shilbert> have a look at debian-med
18:39:13 <shilbert> they are doing the package side for debian
18:39:25 <cwickert> #link http://www.debian.org/devel/debian-med/index.html
18:39:48 <shilbert> still there is no preconfigured distribution that compiles these packages into something workable
18:40:10 <shilbert> I am rolling debian based Live CDs every once in a while
18:40:19 <shilbert> but this is only the beginning
18:40:22 <diamondgr> #link http://linuxforclinics.sourceforge.net/wordpress/
18:40:44 <shilbert> think branding, tools like medical calculator, preconfigured browser
18:40:45 <diamondgr> Ubuntu based distro.
18:40:46 <shilbert> and more
18:40:57 <shilbert> linuxforclinics
18:41:04 <shilbert> is a one man show currently
18:41:12 <shilbert> and starting out
18:41:19 <shilbert> he sure needs help
18:41:22 <susmit> shilbert, once the packages are there, customization should not be a problem.
18:41:36 <shilbert> there is no working solution available now
18:41:57 <susmit> and that's why we are here :) isn't it?
18:42:03 <shilbert> customization is no problem but needs to be *done*
18:42:26 <shilbert> as a start such a distro could start off with GNUmed
18:42:44 <shilbert> but there are no wallpapers, no browser preconfigured and so on
18:42:54 <shilbert> if you pull that off you are one step ahead
18:43:42 <diamondgr> Prefer EMR progs to work also local and not server based.
18:43:52 <susmit> I am not sure how big gnumed is..but only a package can not make a distro..we need at least enough material for a live-cd to roll out.
18:44:05 <diamondgr> Greek private practices have one doctor.
18:44:20 <shilbert> sure you need more packages
18:44:27 <shilbert> but if you have one you have a start
18:44:38 <susmit> right
18:44:44 <shilbert> I am not sure openmrs is suited for small clinics
18:45:09 <shilbert> the biggest one is VA Vista
18:45:14 <shilbert> it is mature
18:45:23 <shilbert> and in use in many US hospitals
18:45:35 <cwickert> shilbert: what license is it?
18:45:39 <shilbert> package that and you have something to sell :)
18:45:54 <shilbert> VA Vista is in the public domain (US government)
18:46:00 <mgwmgw> True, but I hear there has been some conflict about who can contribute to Vista, arguments about control.
18:46:03 <shilbert> it is regarded FOSS
18:46:15 <susmit> cwickert, we can put the rest in rpmfusion ;)
18:46:21 <shilbert> That is true but not the business of the distributions
18:47:10 <shilbert> I would start packaging a software that is already deployed in a number of clinics
18:47:40 <shilbert> I believe it would be hard to convert clinics to linux and some small unknown FOSS EMR
18:48:03 <shilbert> Is there agreement on the scope of this proposed project
18:48:17 <shilbert> coding or packaging or distribution rolling ?
18:49:17 <susmit> coding is not the immediate goal. Packaging a few and distro rolling..Should we target for six months?
18:49:36 <cwickert> I don't thing we can do actually coding, but we can submit patches etc
18:49:50 <susmit> cwickert, right
18:50:06 <cwickert> we start packaging and then make a spin/distribution once we have enough interesting packages
18:50:19 <shilbert> good idea
18:50:46 <shilbert> is there agreement on the base of the distribution ?
18:50:57 <shilbert> it would be a shame to split forces
18:51:01 <susmit> base?
18:51:24 <shilbert> there are debian guys, ubuntu guys, openSUSE guys , fedora guys and gals
18:51:48 <mgwmgw> I understand about packaging what exists to create buzz.  However, if you find something that needs coding, please let me know.
18:51:50 <susmit> oh ok.. I talked to OpenSUSE guys..they are ready to colleborate
18:52:22 <susmit> mgwmgw, sure thing
18:52:33 <shilbert> I would salute anyone who can act as an integrator and establish collaboration
18:52:40 <cwickert> shilbert: well I guess the Fedora medical SIG will use Fedora of course, but we try to contribute to upstream as much as possible. our changes should go upstream, so they come back to all downstream distros
18:53:09 <susmit> cwickert, +1
18:53:16 <shilbert> cwickert, right just asking :-)
18:53:18 <cwickert> and of course we can directly cooperate with other downstream projects at Debian or SuSE on a multilateral base as well
18:53:41 <shilbert> for a start I would look at Freemed and OpenMRS
18:53:52 <shilbert> Freemed can be sold and marketed already
18:54:07 <shilbert> OpenMRS has seen a lot of marketing
18:54:31 <shilbert> those two are a worthwhile goal for 6 months timeframe
18:54:55 <shilbert> GNUmed is targeted at small clinics /doctor's offices
18:55:09 <shilbert> packages are there but need some cleanup I gues
18:56:33 <ncq> what's the status so far ?
18:56:34 <cwickert> shilbert: s/small/big ;)
18:56:39 <ncq> re this discussion
18:57:00 <shilbert> ??
18:57:39 <shilbert> Is there agreement that packaging those apps is a worthwhile start for the next six months ?
18:57:45 <cwickert> +1
18:57:49 <susmit> +1
18:58:05 <shilbert> during that timeframe upstream could be made aware of the effort
18:58:15 <shilbert> project vision will shape up
18:58:59 <cwickert> for a timeframe: we will not make it for Fedora 13, because the feature freeze is in one week. our target fpr a first release should be Fedora 14, which is scheduled for November 2010. I think we can have a great variety of apps by that time
18:59:18 <shilbert> volunteers with little coding/packaging skills could research custumization options
18:59:36 <cwickert> please define "customization"
18:59:50 <cwickert> wallpapers and stuff?
18:59:53 <shilbert> I would be nice to have the browser available with extensions for medical literature
18:59:58 <cwickert> I see
19:00:16 <cwickert> #idea have the browser available with extensions for medical literature
19:00:18 <shilbert> take a look at PC security such as encrypted home directories
19:00:26 <ncq> pre-set defaults for the apps re single-doctor practice, hospital A/E, etc
19:00:48 <shilbert> I would go for single doctor practice first
19:00:49 <ncq> like profiles
19:01:13 <shilbert> hospitals tend to plan for years before implementing anything
19:01:48 <ncq> nah, they tend to buy
19:02:06 <shilbert> right
19:02:06 <ncq> rather than plan :)
19:02:16 <mgwmgw> In America, mental health doctors are more likely to have smaller clinics and single practices because they do not need access to expensive equipment as much as the physical doctors do.  Would starting with that be a useful thought?
19:02:23 <ncq> to buy a plan, to be precise
19:02:25 <shilbert> they buy solutions, not ideas
19:02:36 <shilbert> yes, that is a useful thought
19:03:06 <shilbert> find out what they need (how they want their PC configured) and try to match their requirements
19:03:27 <mgwmgw> Then again, in America, a lot of the mental health work is done by people who are not doctors.
19:03:33 <shilbert> there is a software package called mental clinic I believe
19:04:15 <mgwmgw> Does it match what the users want?
19:04:26 <susmit> I shall take a guess that we are almost end of out time. We will continue to discuss in the mailing list
19:04:36 <mgwmgw> +1
19:04:49 <susmit> I have already filed the ticket and expect to have it by a couple of days
19:04:54 <shilbert> Good idea
19:04:58 <shilbert> Nice discussion
19:05:06 <shilbert> Keep up the good work
19:05:21 <ncq> +1
19:05:48 <susmit> yes, it was a very nice discussion. Thank you all for coming.
19:05:55 <susmit> #endmeeting