Time lawyer up.
Time lawyer up.
"Space is hard" and this is harder, because it's about ourselves.
This has no chance until someone like Pres. Kennedy chooses to do it "because it is hard" to do.
I think this, updating legacy system (something I do), is close to the second problem, which is that no one person or team has a grasp on how it works now, and what ever is put in place will be in the exact the same situation: no person knows it all. The only way I've seen this addressed is that after the Big Problem is cut into the Smaller Problems, the people involved with each Small Problem have to be to only ones who understand it: it must be accepted that there will never ever be a global "this is how it works" person or team.
Then the first problem can be addressed: interoperability. Each Small Problem can then announce (or publish) how they solve their problems in their area of expertise. Then tell all the other vendors that they will interoperate with them in that way. This is not the way this has been stated so far, where the new system will interoperate to all the others, which won't happen for the simple fact that all the other vendors don't want to, its not in their self interest.
The third problem is inherent in our species: we change, so no static model can be used to organize the data about us. The next versions of HIV, Ebola, anti-Vaxers, are all changes that will strain any extensibility, but most especially a government/military/project planning approach that can only deal with statically defined, long term goals. In the 18 years of this project they will always play catchup.
So, yes, centrally defining EMR is going to fail, absolutely (or the Soviets would still be a power...).
My only poor suggestion is to find a way to give each medical specialty, including ones yet thought of, a way to define their own representations of their expertise and publish it so those working in that field can interoperate with each other. Something like a distributed/grid processing system that includes distributed people being involved.
Google searching still requires that you know that you have the results you want when you see it, where a library is organized to begin with, so Library Science has been trying to do this for a centuries and it might be worth studying to understand some of the problems.
Of all the criticism that Sorkin got from the media about The Newsroom, no one seemed to explain why most of the primetime or premier talking heads are white and male.
And it was better, at least in the SF Bay area:
For 40 years, a black man, Dennis Richmond was a noticeable reporter, and for his last 30 or so years on air, an anchor.
Similarly, a black woman, Belva Davis, for over 50 years worked in various news organizations, including 30 years as an anchor.
Aaron Sorkin, The Newsroom, and the greatest country in the world
For all the later melodramatic histrionics that did not work, Aaron Srokin hit this subject in the opening of The Newsroom, where just ignoring the evidence for ratings doesn't do anybody any kind of justice.
Transcript and comments from Sorkin:
"Fine. [to the liberal panelist] Sharon, the NEA is a loser. Yeah, it accounts for a penny out of our paychecks, but he [gesturing to the conservative panelist] gets to hit you with it anytime he wants. It doesn't cost money, it costs votes. It costs airtime and column inches. You know why people don't like liberals? Because they lose. If liberals are so fuckin' smart, how come they lose so GODDAM ALWAYS!
And [to the conservative panelist] with a straight face, you're going to tell students that America's so star spangled awesome that we're the only ones in the world who have freedom? Canada has freedom, Japan has freedom, the UK, France, Italy, Germany, Spain, Australia, Belgium has freedom. Two hundred seven sovereign states in the world, like 180 of them have freedom.
And you, sorority girl, yeah, just in case you accidentally wander into a voting booth one day, there are some things you should know, and one of them is that there is absolutely no evidence to support the statement that we're the greatest country in the world. We're seventh in literacy, twenty seventh in math, twenty second in science, forty ninth in life expectancy, 178th in infant mortality, third in median household income, number four in labor force, and number four in exports. We lead the world in only three categories: number of incarcerated citizens per capita, number of adults who believe angels are real, and defense spending, where we spend more than the next twenty six countries combined, twenty five of whom are allies. None of this is the fault of a 20 year old college student, but you, nonetheless, are without a doubt, a member of the WORST period GENERATION period EVER period, so when you ask what makes us the greatest country in the world, I don't know what the fuck you're talking about?! Yosemite?!!!
We sure used to be. We stood up for what was right! We fought for moral reasons, we passed and struck down laws for moral reasons. We waged wars on poverty, not poor people. We sacrificed, we cared about our neighbors, we put our money where our mouths were, and we never beat our chest. We built great big things, made ungodly technological advances, explored the universe, cured diseases, and cultivated the world's greatest artists and the world's greatest economy. We reached for the stars, and we acted like men. We aspired to intelligence; we didn't belittle it; it didn't make us feel inferior. We didn't identify ourselves by who we voted for in the last election, and we didn't scare so easy. And we were able to be all these things and do all these things because we were informed. By great men, men who were revered. The first step in solving any problem is recognizing there is one, America is not the greatest country in the world anymore."
I think the Newsroom story was written last year, so maybe this new owner wasn't watching?
Late 80s, upgraded to SCSI and 16 MB @ 200ns, run OpenVMS 7.3.
Also, my penis, late 50s, works just fine, does everything I want it to.
Mommy, what happens to your files when you die?