Matt Kucera 3-3-11

Host Team: Andy Whillans, Stephen Donaldson, Mark Falatovich


Started working with a company doing EHR.
In order for a company to get govt money, they have to meet standards and certifications
CCHIT(Certification Commission for Health Information Technology)
-Requires certain (abstract/nonspecific)standards to be met when developing programs
-They don’t necessarily move forward, or make progress.

Meaningful use

-Nebulous term (lacking definite form or limits)
-Must be used to improve quality of care
-Use it to submit clinical and quality measures

Noteworthy Medical Systems

First Job
- A month or two out of the year was making new features, making it better. The rest was meeting certifications.
-Regulations may have inhibited company’s ability to innovate, make new advances.


Focus was making ipad.iphone apps
-different way to tell stories, books, etc.
-developed app for parents to read to kids when they're away

Company recognized they needed to come up with new idea
-New app meant parent could read to the kid through distance reading.
-Needed to get patent
-Able to keep making new things with people paying them

Eventually got a little burned out doing development as a full time job
-Led to him leaving for a healthcare company

Orion health

Work from home office
Customer support for technical people
-answer questions setting up software.
-can help implement something using the software.
-Training in New Zealand taught him skills, information he needed to know in order to support others.

Rhapsody development environment

GUI used to handle/compile HL7 messages
-Series of filters in a visual environment, flow-chart type picture.

Searches for certain types of HL7 messages, converts them to different types,
-get message from lab then gets moved to other department
-certain labs can’t handle specific types of messages due to their software restrictions.
-message starts at router and goes to another router through multiple filters


Who was more difficult to write for, Healthcare workers or general public?
Doctors are better at breaking software than the general public surprisingly.

Clients mostly looking to get things to work or meet regulations?
Yes, generally already have met regulations, trying to get it to work
Rhapsody have random errors all the time or does it work generally well?
Usually works, not too many issues

HL7 V2 vs. V3

HL7 is just a standards organization
V3 is very complicated
-messages read as XML doc
-A lot of the places which are adopting version 3 have never had version 2, makes it easier to transition
V3 likely won't be picked up in U.S.
-Continuity of care documents(CCD), a small portion of V3, is getting adopted in U.S.
-constraint which makes messages simpler.
-probably the only thing that will get adopted.

V2 is easier to read
V3 is more efficient
-not used because it is too hard for general user to read
- Though easier for a computer to parse
-cost to use V3 is very high
- V3 is already 10 years old!

Government Incentives:

$17 Billion in Government Incentives for new technology to be implemented into the healthcare industry.
-E Perscriptions
- EMRs
— They must improve quality of care.
— Extremely Hard to Measure.


Can v3 do other things better?
Yes, but people are reluctant to change for reasons of ease of use , so it will not be adopted
Is version 3 easier to parse than version 2
Yes, but for human readibility v2 seems to be better.
Is there any reason why the protocol itself should be human readable?
From my perspective yes, but if the systems worked the way they should than it wouldn’t be an issue. From a debugging perspective its better to make it be human readable.
Is this unavoidable for large, complex systems?
Yes, even in New Zealand, they have issues with it, but they have a universal system with lots of problems.

What was more stressful, ipad or healthcare?
Ipad, much more business-oriented