Thursday, April 23, 2009

OSCAR Fundraising Update

From the every tireless Dr. Colleen Kirkham, an update on the current OSCAR Canada Users Society fundraising effort:
The OSCARCanada first ever fundraising campaign was launched in early March and has raised $17,500 to date. Donations have come from BC, Ontario and Quebec. A huge thank you to all those in the OSCAR community that have made a donation so far!

There is a new page on the OCUS website where donors are acknowledged. (Note-if you have made a donation and don’t see your name there, please let me know. You are likely in the group of 20 anonymous donors as I didn’t want to post anyone’s name without explicit permission to do so!)

For those of you who have been meaning to make you donation, you can find the form here. Keep those cheques coming in!

What we will do with the funds raised? David Daley has created a new roadmap page which outlines the top items we are targeting for the October release. You can also see what has been completed on the April release. Some programming we hope to accomplish includes:

  • We have a programmer lined up this spring to revamp billing module and the WCB module

  • Dr. Karen Cunnningham has collated a wish list for changes to the prescription module

  • At the national usergroup meeting we agreed on changes we want to the encounter page

  • We also have plans for a new INR module

  • What to do if you don’t see your most desired programming item at the top of the list?:

  • Start by making sure your item is on the wishlist

  • Be vocal, participate, show up at the meetings, teleconferences etc and make sure you are part of the ongoing discussion

  • Volunteer-the more people we have helping to move this project forward, the more we can get done –there is a job for everyone!

  • Don’t forget to make your donation –we can’t do anything without funds for programming

  • Don’t panic, be patient –those of us that have been using OSCAR for a few years can tell you that most things seem to get done eventually and the speed of development is actually very fast

  • If you really can’t wait –hire a programmer (or your kid) and get started (but don’t forget to talk to Jay Gallagher or David Chan about what you want to build!)

  • The OSCARCanada board of directors will be discussing the ongoing management of the wish list and the setting of priorities and how to do this in the most efficient and fair way. If you have any ideas about this, please pass them onto the board. Your board of directors are listed online and all of them read the list serv!

    Thanks again to Dr. Carole White, our treasurer, who is processing all the donations.

    I will keep the group posted regarding how our fund raising campaign is going.


    Wednesday, April 22, 2009

    OSCAR EMR Roadmap

    OSCAR Roadmap
    (last update, April 15, 2009)

    The OSCAR Roadmap strategy is to target two formal releases each year - in April and October. We've adopted a new numbering strategy consistent with other significant open source projects, specifically following the format Year.Month. The next release will be version 9.04.

    Source code will continue to be available for interim and development releases.

    OSCAR is based on a community based development model. Current contributors to the OSCAR project include:
    - Large institutions (e.g. McMaster, McGill & City of Toronto)
    - Independent companies (e.g. OSCAR support companies)
    - User Groups (e.g. OSCAR Canada Users Society)
    - Independent clinics and individual doctors

    We encourage all users and organizations that are working on significant new features to inform us of what they are doing so that we can support and publicize their efforts.

    Whenever possible, our intention is to be transparent about what features are currently committed (ie funded and scheduled), and which are currently planned (ie prioritized, but funding/scheduling is still being organized).

    Spring Release - April, 2009 - OSCAR v9.04 (committed)

    - OntarioMD CMS Spec v3.0 conformance, including improved data portability, chronic disease management, and diabetes reporting
    - French OSCAR & improved internationalization
    - OSCAR Measurements extensions to enable easier end user customization
    - Improvements to the encounter page (additional CPP input boxes)
    - Customizable CDM flow sheets and new CDM flow sheets for other diseases
    - ICL lab interface
    - support for OntarioMD web portal
    - enhanced support for MyOSCAR, including
    -> create patient myoscar account from the demographic screen
    -> direct pasting of the myoscar message into eChart roll
    - enhanced support for MyDrugRef, including
    -> display/hide MyDrugRef messages while prescribing
    -> show how many untrusted postings

    Fall Release - October, 2009 - OSCAR v9.10 (planned, unless noted otherwise)

    - (committed) Billing subsystem improvements and extensions, including BC specific improvements, multi-jurisdictional support allowing easier regional localizations
    - Prescription subsystem improvements (workflow and functionality)
    - Document handling and workflow routing enhancements, including scans delivered to inbox, improved document tagging
    - Improvements to the allergy module (improved interactions)
    - Reworked INR flow sheet
    - Code maintenance, UI cleanup, improved documentation

    Saturday, April 18, 2009

    Access OSCAR Anywhere

    Walk outside.

    Pull your iPhone out of your pocket.

    Open up Safari and navigate to your OSCAR EMR server.

    Accept your certificates & enter your passwords.

    Enjoy reviewing your latest lab results while sipping a coffee, on your patio, in the summer sun.

    Saturday, April 4, 2009

    OSCAR EMR Security

    "Will my medical records be safe?" This is what is all reduces to. This is what patients are concerned about. This is what practitioners are concerned about.

    Before the deployment of your EMR, you may have your medical records in locked cabinets, within a locked room, within a locked office, and within a locked building. Most, however, have their files on open shelves in a locked office, within a locked building.

    In the world of paper charts, the concept of offsite access and offsite backup is usually a function of the files that you've taken home with you at the end of the day.

    By computerizing your infrastructure, you will clearly gain new functionality (e.g. reviewing lab results from the Bahamas), but how does this affect the security of your medical information?

    Unfortunately, all EMRs are different and thus the security of your medical records are a factor of the EMR you select and the architectural decisions made during its construction.

    The good news for OSCAR users and the patients they care for is that you are in safe hands. You don't have to take our word for it. OSCAR is an open source project and as such, the security model is plainly available for anyone to look at, review, evaluate, and improve.

    When you select an EMR, you should insist on reviewing or performing an independent third party security audit of their system before your entrust your records in their package. It is not acceptable to "just trust them". It is not acceptable to believe that the mechanism used to implement the security of your medical records is "a secret".

    Within the security community, it is a known truism that publicly available, tested, peer-reviewed and improved security mechanisms are significantly more secure than those mechanisms that are based on the cleverness of a hidden algorithm. It is important to realize that no reputable scientist disputes this fact.

    In the security world, it is what you don't know that kills you. For an example, review how Researchers Crack Medeco High-Security Locks With Plastic Keys.

    It is no secret that some consumer operating systems are inherently insecure. OSCAR starts on a secure foundation. OSCAR was designed to run on the open source UNIX operating system. UNIX is a very old operating system. It was first designed in 1969 by a group of very clever folks at Bell Labs. In the 40 year history of UNIX, it has become the industrial operating system of choice due to it's flexibility, efficiency, and robust security.

    OSCAR uses a number of significant open source packages, including the Apache-Tomcat web applications framework, the MySQL, PostgreSQL relational databases, SSL & PGP encryption technologies, and the JAVA programming language. Each of these open source projects were designed with security in mind, have been deployed and tested on hundreds of millions of servers around the world, and have been challenged and enhanced repeatedly over the years.

    OSCAR users don't access the infrastructure directly. OSCAR runs as an unprivileged application within an overall secure environment. OSCAR users access the application, the application accesses the needed infrastructure as required.

    Clearly OSCAR is based on a secure, robust and tested platform, but what about the OSCAR application itself?

    Let's start with the login and take if from there.

    Before you connect to the server, your web browser will encrypt the data stream between you and OSCAR. If you try to access OSCAR via an unencrypted channel, your server can be configured to reject your connection, or redirect you to the encrypted one. OSCAR can be configured to force users to supply secondary passwords to gain access from any computer, or from just those machines not physically connected to your local office network. OSCAR can be configured to allow connections only from specific computers, machines that have been authorized by OSCAR administrators in advance, whether these computers are local or remote.

    Once OSCAR users log in, the security doesn't stop. What you actually see as a user is dependent on what role you've been assigned.

    OSCAR comes pre-configured with specific security roles for a number of typical users:

  • Admin
  • Doctor
  • ER_clerk
  • External
  • Locum
  • Nurse
  • Receptionist
  • Remote_access
  • Vaccine Provider

    And these roles are easily expandable to meet your specific needs.

    The access rights of your users are then configurable at the object level:

    This gives you incredible control over who gets to see and do what, and under which circumstances.

    OSCAR has a legally relevant audit trail. What this means is that everything that anyone does in OSCAR is tracked and timestamped. If a user writes a prescription, it is tracked. If a user views a chart, it is logged.

    If information is accessed and modified, not only is it logged, but the modifications are tracked so that you can view both the "before" & "after" records.

    OSCAR security has been designed throughout the system, and the system was designed with security in mind.

    However the best security in the world is useless if users will turn it off because it gets in the way of ease of use and simplicity of operation. Once again, OSCAR has taken this challenge up.

    OSCAR users typically find that a correct balance has been achieved. Layers of security prevent unauthorized access to the system, but authorized users have full and easy access to the platform, making the day to day use of the system a joy to work with.

    It is nice to know that you can count on an electronic medical record system that has been designed to give you the security that you need today and into the future.
  • Wednesday, April 1, 2009

    McMaster Family Health Team Wins Award

    The Ontario College of Family Physicians recently announced the 2008 Family Practices of the Year. Along with The Centre for Family Medicine Family Health Team, Kitchener, and the Victoria Family Medical Centre, London, McMaster Family Health Team, Hamilton was recognized.

    The McMaster Family Health Team is one of the most advanced family practices in the country and their facility is truly an amazing operation to visit.

    The McMaster Family Health Team provides care to 27,400 patients with two large primary care teams consisting of 28 physicians, 15 nurses, 6 social workers, 2 dieticians, 1 lactation consultant and numerous support staff. They also educate 64 Family Medicine residents at the two teaching sites.

    Congratulations to Dr. David Chan, Dr. David Price, and the rest of the McMaster Family Health Team.