My Health SAFE (Programmer/coder Questions)

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My Health SAFE (Patient & Provider versions)

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I am going to take OpenEMR (https://github.com/openemr/openemr) and make two SAFE applications:

  1. Personally controlled Electronic Health Record (EHR) (currently OpenEMR’s patient portal) They have 3 options, but I’m only interested in two: 1) Native portal; 2) APIs
  2. The practice management app that includes things like schedule, messaging, personal health information, billing, inventory, etc. Basically the bulk of the OpenEMR code.

My goal is for the patients to have complete control of all of their personal health information (PHI) and then grant access privileges to their personal health provider network. The health providers who are creating PHI will have permanent access to data they personally create. The main log-in authentication medium used will be what everyone has, a heart beat (electrophysiological biomarker).

Open EMR is the largest open sourced EMR project (www.open-emr.org) in the English language and appears to be written in php with mySQL. I am going to save all of us time and assume we all know the power Project SAFE will bring to these two apps, and why it is important for individuals to have the caretaker role of their PHI.

I am planning on hiring/partnering with programmers who can take this EMR to the next level, with is the SAFE level:) I am a medical provider who has built and hosted websites, tinkered with computers for years and know just enough to have a vision, but I know this will never be done SAFE without some pro’s. Open EMR is an amazing project that has done nothing but inspire me and I also would not prefer to reinvent the wheel. So the plan is to just build on to what they have already done.

What kind of programmer should I look for? Could you rate language expertise from most important to least? Where should I focus my resources (money, professional-network, energy)?

I’m thinking:

  1. Rust
  2. PHP
  3. MySQL

I welcome any and all advice and comments.

Thank you for your time in reading this.

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This would be a great project to see in action anywhere, but especially on SAFE.

Two things strike me, it’s one thing to build this, and another to get it adopted.

  • on the first, I wouldn’t look for programmers at this stage, but a technical lead from either community who has the interest and skills to learn about the other in order to assess technical options for developing this on SAFE and begin putting a team together. It doesn’t have to be just one person, but I think that’s the first technical task. The skills needed will include understanding of software systems design and implementation, but coding skills alone don’t imply the ability to assess different approaches and put together a plan that can then unfold into building something.

  • on adoption, there will most probably be people in the health project with ideas about this, though they will be very dependent on jurisdiction. This is more your area too I think, so maybe you already have thoughts about this.

Hope that helps a bit :slight_smile:

Because there are no central servers, and your data will be charded and scattered,I suspect you will need to migrate a NoSQL style database… I could be wrong - but that is my understanding…

Yes I would agree I’m much more comfortable with that aspect. As a medical provider I feel I know exactly what we need from computer network technology to do a better job of creating personal health information. The part that has limited us until SAFENetwork was having to trust a human with PHI.

on the first, I wouldn’t look for programmers at this stage, but a
technical lead from either community who has the interest and skills to
learn about the other in order to assess technical options for
developing this on SAFE and begin putting a team together. It doesn’t
have to be just one person, but I think that’s the first technical task.
The skills needed will include understanding of software systems design
and implementation, but coding skills alone don’t imply the ability to
assess different approaches and put together a plan that can then unfold
into building something.

I have emailed the main dev (Dr. Miller) for OpenEMR and following his advice I am going to start posting on their dev forum.

@jreighley I agree with you. At this point I will try to develop with both approaches. Porting mySQL and also with a NoSQL/SAFENetwork. Medical info like MRI/CT scans, ultrasounds, video are huge files and still a major problem for the current centralized approach of dealing with these files. Harnessing the SAFENetwork will make it impossible for centralized providers to compete.

Doing a search of what relates to coverting from mySQL to NoSQL is:



Any other references out there? It seems I need to next better understand the two approaches of storing data.

The work @joshuef and I are doing should help with some options in due course, see:

Putting Web Apps on SAFENetwork by Adapting Existing Frameworks

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I’ve often wished there were an open system like this, but where users can easily track all of their health info, plus submit it in an anonymised form to a back end system that anyone in the world can use to run statistical analysis on a live, constantly updated & dynamic dataset. A researcher (anyone) may find something interesting (e.g. a correlation), then propose questions to their anonymous, live dataset to quickly clarify what’s going on.

Virologists could monitor the spread of illnesses around the world, and people with conditions could collaborate on research themselves rather than just leaving it to professional researchers.

Might it be possible to allow people to share info from this ‘My Health’ system with an analysis module to enable this? This could all be hosted on the Safe network so that nobody can hack the very personal data.

Absolutely, with SAFE Network being the foundation. The tech for all of those features already exist in closed/isolated systems. I know as a medical provider and someone who is a caretaker of PHI, I’ll be much more willing to contribute data for analysis once I know my patient’s identity is protected/safe.

PracticeFusion.com is already doing something similar, which I really like, but they will always be faced with the same problems centralized/closed systems have.

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Practice fusion looks great, particularly their Insights package. Having a free, open, global version of that could be very powerful! Looking forward to some of this becoming reality once the Safe network is up & running :slight_smile:

Continuing my search for the best open source health system I have found another interesting possibility:
Decentralized Hospital Computer Program

The Veterans Health Information Systems and Technology Architecture (VistA) is an enterprise-wide information system built around an Electronic Health Record (EHR), used throughout the United States Department of Veterans Affairs (VA) medical system, known as the Veterans Health Administration (VHA). It consists of nearly 160 integrated software modules for clinical care, financial functions, and infrastructure.]1

It has been in development since the 70’s, rated here in the US as the easiest EHR to use and is based on a

MUMPS (Massachusetts General Hospital Utility Multi-Programming System) or alternatively M, is a general-purpose computer programming language that provides ACID (Atomic, Consistent, Isolated, and Durable) transaction processing. Its most unique and differentiating feature is its “built-in” database, enabling high-level access to disk storage using simple symbolic program variables and subscripted arrays, similar to the variables used by most languages to access main memory. The M database is a key-value database engine optimized for high-throughput transaction processing. As such it is in the class of “schema-less”, “schema-free,” or NoSQL databases. Internally, M stores data in multidimensional hierarchical sparse arrays (also known as key-value nodes, sub-trees, or associative memory). Each array may have up to 32 subscripts, or dimensions. A scalar can be thought of as an array element with zero subscripts. Nodes with varying numbers of subscripts (including one node with no subscripts) can freely co-exist in the same array. Perhaps the most unusual aspect of the M language is the notion that the database is accessed through variables, rather than queries or retrievals. This means that accessing volatile memory and non-volatile storage use the same basic syntax, enabling a function to work on either local (volatile) or global (non-volatile) variables. Practically, this provides for extremely high performance data access.1

The current version open source version of MUMPS is GT.M:

GT.M is a high-throughput key-value database engine optimized for transaction processing. (It is a type also referred to as “schema-less”, “schema-free,” or “NoSQL.”) GT.M is also an application development platform and a compiler for the ISO standard M language, also known as MUMPS.

Would this GT.M database back-end be a better fit with the SAFE network than the more popular MySQL used with OpenEMR?

I have flew far off where I first started with building the first SAFE Health APP(s)

Started a new thread since this find deserves its own thread…it’s a monster and I can not stop working on it. Check it out:

I would love thoughts from people. It is a fascinating system/concept and I think it has the makings to be one of the most influential apps ever produced.