The four major adopters of VistA – VA (VistA), DoD (CHCS), IHS (RPMS), and the Finnish Musti consortium – each took VistA in a different direction, creating related but distinct “dialects” of VistA. VA VistA and RPMS exchanged ideas and software repeatedly over the years, and RPMS periodically folded back into its code base new versions of the VA VistA packages. These two dialects are therefore the most closely related. The Musti software drifted further away from these two but retained compatibility with the infrastructure of RPMS and VA VistA (while adding additional GUI and web capabilities to improve function).

link to full Wikipedia article

The Musti Consortium “has also been active to transfer the M Technology and applications to new environments like Unix, PCs, PC networks as well as client/server environments.” This would appear to cut costs even further, and being a European implementation, might well be better suited to Ireland.

Given the experience with electronic voting machines, it would appear that the current government (March 2010) can be trusted to choose the worst possilbe option. To avoid disaster by default, a debate on the issue is of the utmost importance.

Electronic health records could cut costs by a third

RONAN McGREEVY

The Irish Times, Tue, Mar 09, 2010

Thousands of man hours could be saved if the State implemented an integrated electronic system of patient records

THE COST of administrating the health service could be cut by a third if integrated electronic patient records were introduced across the system, a medical conference has been told.

Currently there is no integrated system of patient records in the State, a situation which leads to thousands of man hours being spent recovering electronic and paper records.

Speaking at the spring conference of the Irish Society of Rheumatology last week, Dr John Carey said they could see three times as many patients if a proper electronic health information (EHI) system was in place.

Dr Carey cited international evidence which showed that one in five laboratory tests was repeated and one in seven hospitalisations was carried out unnecessarily because patient records were not found in time.

In Galway University Hospital, where he works, there are 20 different sets of health records in individual specialities.

Dr Carey said the integration of the health system into a “single seamless system” was achievable with modern technology and broadband and would pay for itself many times over after the initial investment, although he said he hadn’t costed the initial set-up.

He cited the Veterans Health Administration (VHA) in the United States, which administers the health of four million US veterans, as an example of best practice in this regard.

It has a widely praised system called VistA which is accessible to health professionals with secure passwords.

“I’m in favour of a universal system that everybody from GPs to consultants can use and we can look at what we are all doing.

“It takes time. If it is done well, it has great advantages; if it is done badly, it creates more problems,” according to Dr Carey.

“You should be able to access it from anywhere and see that information is accurate.

“There are huge savings in terms of finances, efficiency, etc,” he said.

US President Barack Obama made an integrated system one of the pledges of his presidential campaign.

Consultant rheumatologist Dr Robert Coughlan told the spring conference that having an integrated system would be good for patients because doctors would have immediate access to the relevant details.

He revealed that an e-clinic to be set up in Roscommon Hospital, which is connected to Merlin Park University Hospital, would enable rheumatology doctors to collect about 90 per cent of the information they need without physically seeing the patient.

It will also save patients long bus and car journeys from all over the west of Ireland to visit the hospital.

“There is no reason why this kind of practice should not be rolled out in all specialities nationwide with the support of private initiatives and the HSE,” Dr Coughlan said.

© 2010 The Irish Times

(published in The Irish Times, Mon, Mar 08, 2010)

In this open letter, 28 leading economists, social scientists and economic analysts tell the Government that it’s policies for dealing with the economic crisis are wrong. And they chart a different course

THE GOVERNMENT’S economic strategy is failing. The Irish recession has been deeper and longer than almost any other in the industrialised world.

Consumer spending has collapsed while at the same time unemployment and emigration have soared. Crucially, investment has plummeted off the chart. Not only have Government policies failed to stem this haemorrhage, they have actively contributed to this collapse.

The Government has pursued deflationary policies, in particular public expenditure cuts. The most damaging are cuts in transfers to low-income groups which, along with general tax increases on low and average pay in 2009, have reduced spending power in the economy at a time when it was most needed.

Equally damaging have been the cuts in public investment at a time when private investment has plummeted. This has laid the foundations for a low-growth, high-debt future where unemployment will remain high and inequality endemic. All the wrong options have been pursued.

Budgetary policies have been short-termist and reactive. Instead of cutting real waste in the public sector by increasing productivity and efficiency, the Government has cut public services and the living standards of those who can least afford it, further reducing domestic demand and, thus, employment.

These policies are weakening the economy’s ability to cope with growing debt levels. Without a strong recovery, tax revenues will fail to rise and future budgets will simply embed that deficit into the economy.

This will depress economic activity even further. This explains why the Government’s own forecasts for the deficit keep rising, not despite, but because of, its own deflationary measures. We are heading into a joyless, jobless recovery.

We require fundamentally different policies, a twin track strategy, which will maximise environmental and sustainable progress and restore employment while addressing the deficit. We urgently need measures to tackle five key areas which require fundamental reforms: our substantial physical infrastructure deficits;

our poor social infrastructure – early childhood education is poorly developed, primary and community healthcare lag behind European norms, housing lists continue to lengthen, while Irish public transport remains inadequate and under-funded; our high levels of relative poverty and income inequality; our under-performing indigenous business sector – which needs appropriate support to contribute to our export base, RD and innovation capacity; and our unsustainable reliance on carbon-heavy resources and activities.

It may seem astonishing that we face such economic and social deficits after 15 years of boom but these are the consequences of pursuing a failed low-tax, low-spend model which sought short-term gains from the speculative activity of a small but powerful golden circle.

Only the modernisation of our economic and social base through a sustained investment programme and a transformation of our corporate governance practices can overcome past mistakes. This will need substantial back-up in the form of retraining and return to education to ensure people – whether managers or employees – have the skills to fully exploit the opportunities that investment in innovative enterprise generates.

Educational investment, in particular, will be key to strengthening our export base. Driving competitiveness and productivity in the medium-term, while increasing employment in the short-term, is a win-win scenario.

We must mobilise all the resources available to accomplish this transformation. We still maintain a relatively low-debt status in the euro zone, buttressed by the vast accumulated borrowings in our exchequer cash balances (over €20 billion).

We can employ the strength of our combined public enterprises – their off-balance sheet borrowing and investment capacity to invest in our infrastructure and create new indigenous enterprises, both public and private.

We can further employ new funding vehicles – enterprise development bonds (eg green bonds), municipal bonds and the new National Solidarity Bonds – which can leverage our current high savings ratio and international investment. All this becomes even more necessary given the potential capacity of Nama to pile up considerable debt; at the same time there is little evidence of credit being freed up for investment purposes.

The resources and labour to finance this modernisation drive are there. We just need the political vision and will to make it happen.

Addressing the deficit needs a long-term vision of what kind of taxation system we want. In the short-term we need to target the least deflationary sources of revenue so as not to weaken our recovery prospects. A comprehensive property tax – encompassing both housing and financial assets – should be introduced starting with high income groups and eventually extended to all incomes. Reform of regressive tax expenditures (ie tax breaks that disproportionately benefit high income groups), shown by Tasc to be in the billions of euro, should be urgently undertaken to increase the income tax take. Extension of environmental taxes and incentives should be accelerated. An additional tax band at the higher level is needed.

In the medium term, we should explore the potential of social insurance and local taxation to broaden the tax base while providing real benefits in return. PRSI can be expanded to incorporate a comprehensive free healthcare system (in particular, primary care) as well as earnings-related pensions. Stronger local taxation powers have the potential to be more accountable while providing investment in services responsive to local needs. On the expenditure side, it is time to make public sector workers partners in the process to increase productivity and efficiencies.

As other countries have shown, employee-driven innovation (in both public and private sectors) has the capacity to reduce costs and increase output – much more so than crude, top-down employment and wage-slashing measures.

We can afford neither wasteful policies nor wasteful practices. But elevating the ethos of public service and personal responsibility will require harnessing the collective resources of employees through an open and honest engagement by all stakeholders – one that is not afraid to find and, then, repair fault.

What is absolutely crucial is that these twin approaches – investing in sustainable growth and full employment while addressing the deficit – complement each other.

This will require a level of fiscal management we have as yet not experienced. But it is do-able. Embedding investment, rather than debt, into the economy while restructuring taxation and expenditure in a progressive and expansionary manner to ensure a job-rich recovery – this, and not the current deflationary strategy, is the road to success.

This article has been co-ordinated by Tasc, which describes itself as an independent think-tank dedicated to combating Ireland’s high level of economic inequality and ensuring public policy has equality at its core.

Open Letter To The Government: The Signatories

PROF TERRENCE McDonough, Department of Economics, NUI Galway.

Prof Ray Kinsella, Smurfit Business School, UCD.

Prof David Jacobson, Dublin City University Business School.

Prof Paul Teague, School of Management and Economics, Queens University Belfast.

Prof Peadar Kirby, Department of Politics and Public Administration, University of Limerick.

Prof Rob Kitchin, National Institute for Regional and Spatial Analysis, NUI Maynooth.

Prof James Wickham, Department of Sociology, Trinity College Dublin (TCD).

Prof Seán Ó Riain, Department of Sociology, NUI Maynooth.

Prof Mark Boyle, Department of Geography, NUI Maynooth.

Dr Jim Stewart, Senior Lecturer in Finance, School of Business, Trinity College Dublin.

Dr Joe Wallace, Kemmy School of Business, University of Limerick.

Dr Michelle OSullivan, Kemmy School of Business, University of Limerick.

Dr Daryl DArt, Dublin City University Business School.

Dr Roland Erne, UCD School of Business.

Dr Proinnsias Breathnach, Department of Geography, NUI Maynooth.

Dr Mary Murphy, Department of Sociology, NUI Maynooth.

Dr Colm ODoherty, Department of Applied Social Studies, Tralee Institute of Technology.

Paul Sweeney, economic adviser, the Irish Congress of Trade Unions.

Sinéad Pentony, head of policy, Tasc.

Dr Nat OConnor, Tasc.

Tom O’Connor, lecturer in Economics, Cork Institute of Technology.

Rory OFarrell, European Trade Union Institute (Brussels).

John Corcoran, lecturer in Economics, Limerick Institute of Technology.

Michael Burke, economic consultant (London).

Peter Connell, TCD.

Patrick Kinsella, DIT.

Tony Moriarty and Michael Taft, Unite trade union.

© 2010 The Irish Times

Some 2.8 million of us, two thirds of the Irish population, are younger than 44 years of age. Our politicians, civil servants, bankers, business men and women, decision makers and media commentators are predominantly over 40. As Prof Ray Kinsella said on these pages last week: “We have screwed up – that’s the truth of it.” My generation of 20 and 30-somethings do not identify with the tired voices that have failed us and endowed us with a future choked with their mistakes: mistakes fuelled by mediocrity and downright incompetence without consequences; mistakes that are homeless, absent of acknowledgment or apology.

I may be wrong, but I think it may well have been the generation of 20 and 30-somethings which predominantly voted for the present and last governments. But the past is past. If the younger generation of voters does not in fact relate to the current politics and political practitioners, what is to be done?

Perhaps radical new policies should be discussed. In the words of Paul Sweeney (again the Irish Times, May 7) We cannot go back to cosy Irish capitalism after this recession

And now Village is talking about a new departure.

Well, this website, alternativeparty.org, has been dropping hints for years, but it’s nice to see the need has entered the zeitgeist, and people are actually saying it out loud.

I’m going to muse about a mythical radical new party and give it some policies. Alternative Party of Ireland, or API, with an url of www.alternativeparty.ie

Note: it isn’t a simple thing to form a political party for national elections. Scroll down the discussion Anyone interested in putting together a ‘political party’??? at face.boards.ie to get the details.

It could be called anything, so long as the party itself is radical in the sense that its members and voters think outside the box. Indeed, it could be a current party for all I care.

The first thing it should do is think big. Voters are tired of small parties who only stand in a few constituencies. What’s the point? Even if several TDs are elected, they will only ever be the rump of either of the conservative parties. API should have at least two candidates in every constituency, even three seaters. It’s the pre-requisite to being taken seriously.

It would have to be done on a shoestring, of course, but that’s where technology comes in, as Elaine Bynre realizes. Okay, here’s a skeleton outline, which can of course be improved on.

Purchase the domain alternativeparty.ie. Make sure you do it with my excellent host, Letshost.ie, as you can have 999 subdomains and MySql databases for the price of one account, ie for less than €100. There are 43 consituencies, so we probably won’t require all 99!
So, for example, http://galway-west.alternativeparty.ie, http://clare.alternativeparty.ie, http://kerry-north.alternativeparty.ie etc.

We’ll use a reliable, democratic and opensource software like Wordpress, which runs this site.

I don’t know about other providers, but O2 offers 250 free webtexts per month. Texting via the web isn’t everyone’s preferred method, but it’s easy to type and 250 is a literally powerful amount of texts, if you have ten volunteers in each constituency texting everyone they and their friends and family know about the alternative party website and its consituency subdomains. If you ask those who are interested to text their friends who might be interested, suddenly its viral. As a new way forward is very much in the zeitgeist, perhaps this is an optimum time to intrigue people about such a party.

Each constituency discusses its own problems on its own website and arrives at solutions. These solutions are fed to the main site. www.alternativeparty.ie, and become the bedrock of national policy.

Okay, so that’s the bones of structure, to be fleshed out by those who are interested.

Where will the candidates come from? My guess is that many will come from community groups. Affiliations with groups like The Irish Senior Citizens’ Parliament might prove fruitful.

And what about policies? Several will be suggested in the next post.

We need to get away from the “fur coat and no knickers” mentality that dominates transport policy. Big, glamorous and monumentally expensive projects like Metro North would be fine if they were coming on top of a decent basic public service. In a time of crisis, scrapping the metro would save at least €5 billion.

And he gets to the nub of it here:

This is a public service that you’re paying for twice, through your taxes and your fares. It is, literally, a connection to your city, your society, your country.
And when it doesn’t function, your society is telling you something. It is reminding you that you don’t really matter, that even in the small, apparently banal things of life, you are a person of no importance.

Public transport, in this respect, is a function, not just of an economy, but of a democracy. A decent service is a form of public respect. A bad one is a form of public disregard.
–Fintan O’Toole Bus cuts plan shows contempt for people

“This is a public service that you’re paying for twice, through your taxes and your fares.”

No one seems to ask the question: why are we paying twice? Why not just once, through taxes?
I’ve tried to tease out this question in Transported for some years now, but O’Tooles article has crystalized a few things for me. For instance, the point about respect has been at the back of my mind for a long time. Now it’s at the front.

Contrast urban Dublin, with a population of half a million, with a city like urban Bogotá in Columbia, with a population of almost 7 million, and where income is one-tenth of what it is in New York.
Here are two videos from Streetfilms which illustrate the point. [Streetfilms is the video arm of the Livable Streets Initiative: producing educational, entertaining, and inspiring films for a sustainable urban environment.]

Bus Rapid Transit: Bogotá

Note: I used the Youtube versions of the videos above as I found the FlowPlayer used on the site to be very slow (a pity, it’s a gpl player).
Note 2. I used the Video Embedder plugin for Wordpress to embed these video files. It makes life a lot simpler, from a cross-browser point of view. If you’ve problems seeing the videos please let me know.

OF THE 357,175 people working in the public sector, only one-tenth are employed in the Civil Service.

Public-sector salaries range from €13,000 to €240,000. (The Irish Times)

Nobel Peace Prize winner Seán MacBride wrote to the Taoiseach in April 1978, expressing concern about the nuclear plant plans and urging an examination of alternative sources of energy such as solar, wind, tidal and wave power.

He pointed to a plan that had been discussed decades earlier, involving the conversion of Clew Bay into a reservoir for the production of electricity. “Seventy years ago such a scheme might well have been uneconomical and regarded as impractical, but would it be so in the circumstances of today?”

The Irish Times also reports on the controversy surrounding the proposed nuclear plant at Carnsore, Co Wexford. The Taoiseach, Jack Lynch, to his credit, foresaw contracting oil supplies by the turn of the century.

Full report at the Irish Times.

Happy 2009, everyone.

There is no better potential driver that pervades all aspects of our economy than a new energy economy. I was just reading an article in the New York Times by Michael Pollen about food and the fact that our entire agricultural system is built on cheap oil. As a consequence, our agriculture sector actually is contributing more greenhouse gases than our transportation sector. And in the mean time, it’s creating monocultures that are vulnerable to national security threats, are now vulnerable to sky-high food prices or crashes in food prices, huge swings in commodity prices, and are partly responsible for the explosion in our healthcare costs because they’re contributing to type 2 diabetes, stroke and heart disease, obesity, all the things that are driving our huge explosion in healthcare costs. That’s just one sector of the economy. You think about the same thing is true on transportation. The same thing is true on how we construct our buildings. The same is true across the board.

for full story: Treehugger Obama Cites Michael Pollan’s sunfood agenda

World Changing

The ReCyclone works by grinding trash into small pieces, thereby reducing landfill space up to 97 percent.

Trash compacted by the ReCyclone can be used to create energy or compost material—organic waste becomes diesel fuel, and plastic becomes oil. The machine can grind up any piece of waste ranging from 20 microns to 12 inches.

For some perspective, the ReCyclone can get more gold out of electronic devices than from a gold mine (one metric ton of circuit boards contains between 80 and 1,500 grams of gold, which is 40 to 800 times the concentration of gold available in gold ore mined in the United States) and 1 kilogram of plastic recycled in the machine can yield 95 percent of 1 liter of diesel.

CleanTechnica

What is there not to like about the new shuttle buses at Tokyo’s Haneda Airport – the hybrid electric buses save energy and have less air pollution. They are more quiet and the ride is smooth as silk. Plus they are free. Hino has supplied one while Mitsubishi Fuso supplied three: these cool vehicles now link Haneda’s first, second and international terminals, covering a distance of about 4.2 kilometers, and in one day, they may each travel up to 300 km.

more with photo at
Free Hybrid Electric Buses at Tokyo’s Haneda Airport

See also my Transported : Draft 1(b) of an argument for Free Public Transport