Clinician Desktop - New Software Paradigm?

I often ask myself the question if it is the time for a new kind of software for healthcare. America and others are investigating if Open Source software is an option for EHR Systems. I think the question should be different.
In the Netherlands hospitals are doubting if they should develop their own software or if they should buy a complete solution like McKesson Horizon, Alert, Epic, iSoft Lorenzo, Microsoft Amalga or Siemens Sorian.
They should not be looking for a complete EHR system in the commercial nor the open source space. They should ask/look for framework software that delivers all the basic functionality that healthcare providers need. They should not be forced in processes that happen to be implemented in the software. The software should support their own processes and way of work. The software should be flexible and help them.
I think you will always be developing your own solutions, so you need more than just a programming language or framework like Java or .Net. You will need a healthcare framework that understands the basis healthcare information concepts like Detailed Clinical Models, Care Pathways, Clinical Research Queries, etc.
It should be a Clinician Desktop.

Yes I Can ... CDA R2!

At the HL7 Work Group Meeting in Orlando, FL January 15, 2009 I did the CDA R2 exam and now I may call myself a "Certified CDA R2 Specialist" (the list)!
It is a confirmation that I know CDA R2. The Monday after the WGM I got a mail telling me I had passed the exam. And 2 weeks later, just as I was told, I received the certificate and the pin. I think HL7 does a good job on this.
Some may think a certificate is not saying much, but I really think the exam tests your knowledge to use the CDA R2 and not just that you can learn well. Furthermore it is not just a test of CDA, but also of the RIM and interpreting the DMIM diagrams.
Just to be sure I was prepared I also followed the excellent CDA Advanced tutorial by Bob Dolin and later the CCD tutorial. In my hospital I created a CDA Implementation Guide for archiving and sending clinical documents. At the moment we are working on a SemanticSOA which uses something similar to the CDA R3 Model as it's Common Information Model. See also this great blog entry about the future roadmap of CDA R3/CCD by Rene Spronk.