Category Archives: Medsphere

Rebooted: The Medsphere Saga Ends

Reboot (rē-būt) v.

  1. To turn (a computer or operating system) off and then on again
  2. To restart something

Last Thursday, we finalized a mutual settlement agreement with Medsphere. It took five hundred and four days after being drawn into the campaign to reach this conclusion. To us, this war was always about principles, while to others it was “just business“. In the end, all parties had heard and seen and spent enough.


Looking back on my 5 1/2 year experience at Medsphere, the only thing I can say is:


[cntrl][alt][delete]


Looking forward, I certainly wish the new Medsphere CEO Mike Doyle every success in fulfilling our vision to revolutionize the healthcare information technology industry. He is correct in recognizing the vast VistA opportunity that lies before Medsphere. Hopefully he will have the freedom and wisdom to run it as a truly open source company, dedicated to a transparent development process, a transformative business approach, and clear commitment to openness so as to engender trust from the community and the market place. Viva la Revolución, Mike.

As for me, “now by the [recent] pacification, acknowledged to be possessed of [near] absolute freedom and independency; [I am], from this period, to be considered an actor on a most conspicuous theater, which seems to be peculiarly designed by providence for the display of human greatness and felicity”. Having helped to create the open source health information technology category, I now plan to be a part of the next wave of entrepreneurs enabling the crossover into next generation health care.


[1] George Washington’s Farewell Address. Published September 19, 1796 as a valedictory to the years of dedicated public service in the creation of his beloved country.

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Dramatic Irony: Closing the Door with An "Open" Letter

Irony (i·ron·ee) n.

  1. The use of words to express something different from and often opposite to their literal meaning.
  2. Incongruity between what might be expected (say) and what actually occurs (do)

I have read with “interest” Medsphere’s most recent press release and the community’s response to it.

Besides the irony of “the leading provider of open source technology for the healthcare industry” having to explain to its employees what its position is regarding open source (by posting a press release, nonetheless), one must also consider why they are having to explain it in the first place. Perhaps Medsphere’s motivations are the requirement to answer for their “betrayal of the community“, about “losing the faith“, and about their monumental identity crisis. There probably are 50 million other reasons why they are being forced to do so as well.

While I could spend a (few) thousand words describing the situation, let me accomplish the same objective with a single picture:

Source: Publicly available Cross-Complaint, Orange County Superior Court Case #06CC07475

Any “confusion” or “controversy”? I didn’t think so.

The irony runs MUCH deeper, of course, but I am unable to comment further in this forum at this time. Having co-founded the company, developed the founding vision, raised ~$15M in capital, closed ~$25M in customers business, and presented in nearly every forum possible in our industry (HIMSS, TEPR, interviews, etc) regarding the open source healthcare IT model, I believe I can speak with authenticity regarding the historicity of Medsphere’s open source position. Revisionist allegations aside, Medsphere’s open source vision has always been clear.

No need to say anything more, it was a part of everything we ever did.

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The Truth Shall Prevail

“…know the truth, and the truth shall make you free” – John 8:32


The Information Age has created an unprecedented technical ability to rapidly disseminate information. This speed is both powerful and dangerous. Powerful in its reach, dangerous in its ramifications. A good example of this is when misleading information is spread through this medium:

Disinformation (ds-nfr-mshn) n.

1.Deliberately misleading information announced publicly or leaked by a government or especially by an intelligence agency in order to influence public opinion or the government in another nation.
2. The dissemination of such misleading information.

When associated with a malignant intent, I would more appropriately term it dysinformation. Dysinformation is an intentional, targeted effort to create confusion around or away from the truth. Instead of enlightening, it darkens our understanding. Instead of enlarging our minds, it diminishes our knowledge. The campaign to erode the truth can be insidious whispering campaigns or overt propaganda fliers. When purposefully directed at individuals or intentionally designed to malign character, it crosses the line into defamation and slander. When corporations throw their weight behind attacks on individual employees, it is akin to the malicious use of an imbalance of power which is often the root of sexual harassment cases.

Fortunately, the internet provides a potent medium to counteract this traditional power imbalance. The ability of the individual to stand against the corporate machine is dramatically enhanced. It allows an individual to have a forum to shine the light of truth on disinformation injustices – small, large, and every variety in between. This has been seen again and again where individuals or individual causes, can galvanize an entire community around the cause. In fact, the cause can take on a life of its own, far beyond and in ways the original individual or the maligning corporation never imagined. Many a corporation have been brought to their proverbial knees – and individuals unjustly accused redeemed – by this phenomenon. An unsettling acceleration of populist opinion that can actually engender change within corporations of any size – merely by getting the truth into the hands of the people.

The ability of the individual to generate this type of galvanizing response correlates with the “viscerality” (ability of an issue to generate a visceral response) of the issue at hand. A hot topic of late has been the “Outing of Open Source Companies.” Multiple people have commented about the wonders of Open Source to the point that everyone states they are an new Open Source company with an new open source strategy. Maybe even worse than someone transforming their business model to become Open Source is a company who claims to be Open Source (and surf the rising tide) but who demonstrates by their actions they are not. The label most typically applied in other settings to this type of behavior is that of a groupie (doing your best to look, act, and be a star purely by association).

Just as the proverbial “with enough eyes all bugs are shallow” idiom rings true, in an open source world, the truth will eventually prevail. Despite the massive R&D and S&M budgets of large corporations, in Open Source individual contributors can call out the dysinformation in powerful ways. While the fury directed to Micro$oft is often warranted, a real tornado of hate is engendered against infiltration within the Open Source ranks. The community takes especial care to protect their own – outing a groupie for who and what they are, is a function (not a byproduct) of operating in an Open Source world.

The transparency and the meritocracy of Open Source demands this. The individual developer in his underwear in Slovenia, watchdogs users challenging the proprietary tendencies of corporations, and an industry pundits are all empowered to re-engineer the dysinformation (in this case Open Source companies functioning as closed source). Any one individual participating in solo or in concert can counteract the disinformation by leveraging the tools of the new information trade (blogs, posting boards, forums, conference, etc). Power to the (individual) people, indeed.

In the end, the Open Source community could care less about you as an individual, as a corporation, or the worthiness of your cause. The collective conscious of Open Source communities has an insatiable desire for the truth – because – they just want to be free (libre).

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