Gee,
Ya talk to these vendors that offer these ASP model services and ask them straight up, do you offer copies of the program so users can run them on their own system and they all say no, I know I asked. This is all part of their shareholders, the CEO's, definitely CFO's grand plan, to keep the users on the Taximeter forever.
And most people who opt for these types of programs do so exactly because they don't feel very confident in their tech skills, so they prefer to let most of these issues be the vendor's problem. Heck that is even how most if not all of these programs get pitched and sold. "Don't worry about networks, servers, backup and the like, don't worry we'll take care of everything"
And so most of these people don't even know to ask the important and intelligent question about how to get their data back, "in a truely usable form". And half the time they get an answer that sounds good but they don't really even understand it and know that it actually doesn't mean very much at all. "Oh it is all HL7 based in an open format. OK so now how are you going to easily convert 4 years of notes and can it cross over to your next program? Not likely. If you're lucky and this is the case 9 out of 10 times, most practices can get the demographics to cross over from one program to the next and not a whole heck of a lot more. That doesn't make me feel very confident about my data and it shouldn't make anybody else.
I agree it sure seems that it shouldn't be a big deal to make programs that can do both, run on the vendors big ASP servers and still have a small office/home like version, but there you have it, they simply won't and don't. They want it that way, to do otherwise would not be in their own self interest, and so they don't.... So people build all this data in their propietary program and so if you are a regular user like myself and the majority of other folks here and at other offices, we don't have your skills, knowledge and confidence that we will ever be able to do anything useful with all those jumbled "0's" and "1's"; and so for the most part we and our data really are trapped, caught and held by the
's (sorry I just really enjoy doing that sometimes).
But G you are most probably correct that these two ideas shouldn't be and need not be mutually exclusive, but without some sort of enforcement and ethical guidance that comes from outside the inner sactum of these greedy enterprise sized software vendors and their bought and paid for hand puppets at CCHIT. Who by the way, half of their own people sit on the CCHIT committee itself, so we can all see where that leads to, right?, Don't ask me, talk to Al, he knows all too much about how in-breed and unholy this alliance really is. He has done more research on this nasty group than anyone I know, he is our champion in this aweful game.
Again, the technology itself is not good or bad, it's our own lack of self control to truely use it for the greater good, all while at the same time, protecting those things that are so important to protect. And although this really bad group of people would like to try and tell you otherwise, those two concepts are also not mutually exculsive either. With good people at the helm, it probably could be done, but that is not what they are after, now is it???
Who will stand up to them and speak for the greater good? Who will break up this unholy alliance of co-opted gov't officials and various medical organizations like AAFP, AAP and the AMA, and most of the state medical societies for sure, and the powerful self interested, well funded from Wall Street corporations? So far I see few except, myself, Al and Roy (where are you?? we need you). That is pretty sad.
Paul
