Wikipedia:Articles for deletion/PatientOS

The following discussion is an archived debate of the proposed deletion of the article below. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review). No further edits should be made to this page.

The result was delete. Despite attempts to confer notability, the keep !voters have failed to meet the very basic guideline of WP:GNG. Two keep !votes arn't even based on any sort of policy, simply asserting "It's notable" and one of the keep !votes asserts that one source confers notability. Our guidelines are very clear that we require multiple sources. DGG's keep rationale is interesting because it suggests that there should be a lower threshold on Wikipedia where there is lower interest by mainstream media such as in the open source world. I might sometimes agree, but notability guidelines do not support this and certainly do not support forums. On the subject of the Wiki, I'm convinced that if it truly is a Wiki of experts, then WP:RSN might make an exception for it. However, no effort has been done yet to take the source there. I strongly suggest that any WP:DRV do their homework and take that Wiki to WP:RSN first. All other arguments for keep in the varying paragraphs are largely WP:OTHERSTUFFEXISTS. The delete !voters make it very clear that this article does not meet WP:GNG and WP:NSOFT. They nominator also questions the factuality and neutrality of 'this software is used in 5000 hostpitals worldwide' and hints that there may be COI or at least NPOV issues. Although COI and NPOV are not reasons for deletion, they certainly strengthen the argument that this article is not suitable for Wikipedia. If there is ever a recreation, I suggest a new draft that cites controversial statements. v/r - TP 20:19, 3 February 2012 (UTC)

PatientOS

PatientOS (edit | talk | history | protect | delete | links | watch | logs | views) – (View log)

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Non-notable software package. This may be a symptom of the open-source community, but google mentions seem to be blogs and forums. I'd like to see an independent reference that says something definitive like 'This software is used in 5000 hospitals worldwide' or such. Previous version had been deleted by CSD (not nominated nor deleted by me), and article creator de-proded my prod (as is his right) so I am bringing it here for a wider discussion. Syrthiss (talk) 18:55, 25 January 2012 (UTC)

Sythiss, there is no free software suite 'used in 5000 hospitals worldwide'. Does this mean the whole list of software at http://en.wikipedia.org/wiki/List_of_open-source_healthcare_software has to be deleted? Dumol (talk) 19:00, 25 January 2012 (UTC)

Its 'Syrthiss', thanks. Possibly. Certainly if they cannot establish their notability, they should be. You may want to review WP:OTHERCRAP. While it is not an official policy or guideline, the existence of other substandard pages is not the benchmark for your own substandard article to exist. It is usually more an indicator that those other articles should be removed as well. Syrthiss (talk) 19:09, 25 January 2012 (UTC)

Let's weigh PatientOS against other software from that list such as FreeMED and OpenEMR, which have extensive Wikipedia articles. On the medfloss.org and fosshealth.org portals, users have voted PatientOS 31 times and 14 times respectively, while FreeMED and OpenEMR have a total of 6 votes (on medfloss.org) and 0 thumbs (on foss-for-health.org) cumulated. We need to have relevant free software medical software listed in Wikipedia and PacientOS is rather relevant in the field of open-source EMR, although not as popular on the Internet as older software. Dumol (talk)

• Delete - no sign of meeting WP:NSOFT. Editor has been putting forth other wikis and copies of press releases as reliable sources. --Nat Gertler (talk) 19:02, 25 January 2012 (UTC)

NatGertler, are you serious? Do you think the pages dedicated to PacientOS in open-source medical portals are press releases? And the Health Informatics Forum, "A Social Network for Health Informatics Professionals and Students" is a wiki? LATER EDIT: Sorry for the misunderstanding, Nyaya Health uses a Wiki-type software to publish its articles on the Internet, that is true. However, what difference does it make as long as that Wiki is not publicly-editable? Nyaya Health "operates a hospital and mobile medical care services in Achham, a large district in Nepal", so their article on the subject of open-source EMR qualifies as a reliable source. Dumol (talk) 11:04, 1 February 2012 (UTC)

I'm not sure why you would think I'm not serious. The "press release" was this source you had used, which you can see the source for on the website of the company whose services it advertises. We don't know who all in Nyaya has access to the wiki and what sort of verification they may do on it, and they put some heavy disclaimers on it, so it's a somewhat dubious source. --Nat Gertler (talk) 17:20, 1 February 2012 (UTC)

Sorry for the tone in my previous comment but you were saying "copies of press releases" which means more than one. So I thought you were equaling the two listings in medical software portals as press releases. As for that forum entry which I have already removed, I thought you were mistaking that for a wiki, which I have already apologizes for and corrected.

As for the Nyaya disclaimer, this kind of disclaimers is common place in the world of software, no need to overreact. It is clear from it and the site's description that there is no public access to the editing functions of this wiki, which makes it rather irrelevant that it is a wiki and not a static site. Thanks! Dumol (talk) 18:51, 1 February 2012 (UTC)

• Delete Next to zero sign of anything that might show notability. All I can see are self-published sources, forums, blogs and other wikis. As per nom, if no open source healthcare package is notable, then delete the lot! Wikipedia isn't here to help establish or do the marketing leg work for software developers. Equally, I believe that we shouldn't lower our inclusion criteria because it is free. If the software is really that good, coverage should follow. I'm inclined to suggest that if the 45 (total) votes on medfloss and fosshealth represents the opinion of the even just the IT system buying subset of the world's medical community then the subject isnt notable. If the low number of votes is because of the low patronage of these sites, then why are they being presented as evidence of significant coverage? Pit-yacker (talk) 19:46, 25 January 2012 (UTC)

45 votes from users of medical portals is a lot, don't downplay that. Dumol (talk) 20:27, 25 January 2012 (UTC)

I have replaced one of the references (which could be seen as not reliable enough) with an academic reference, which lists PacientOS as being relevant among open-source EMR software over two years ago. PacientOS has seen much improvement since then, but I guess it's better to have a more reliable source, so I used this rather outdated report from the University of Cambridge.

As for the 'Nyaya Health Wiki', what does it matter that they use a wiki-type software 'to provide clinical and public health content to the public'? There is no open-to-all sign-up on their log-in page and the people that publish stuff on that site are professionals. Their English may not be great but it's not their native language.

So I'm calling on classifying this as 'notable' because 'the software is discussed in reliable sources as significant in its particular field' which is open-source electronic medical records. As required in WP:NSOFT. Thanks and sorry for misspellings and ignorance in regards to Wikipedia rules. Dumol (talk) 20:27, 25 January 2012 (UTC)

• Comment Whilst the Cambridge "Technical Reports" are a start, I think it needs to be noted that these do not appear to be "Peer Reviewed" articles. It appears the publication is an internal series published by the authors own institution. The following page notes that it is intended for "the long-term archival of results and descriptions that are not suitable for publication elsewhere, due to their length or nature". The primary author doesn't bother to list it in her list of publications. A google scholar search suggests only one of her real publications even mentions PatientOS at all. It appears to be a passing reference. However, I dont have access to verify this or the other publications. Pit-yacker (talk) 20:57, 25 January 2012 (UTC)

I'm not surprised by the current situation. I myself currently work on an academic paper and an article for a medical informatics journal that will mention PatientOS among others. These documents will not be published on the Internet and are not going to be indexed by Google. The fact that PatientOS is a relative new-entry in the field of open-source EMR and the product of a single individual focused on his company doesn't help either. I just thought that PacientOS is missing from http://en.wikipedia.org/wiki/List_of_open-source_healthcare_software and that it should help others if I include it there and add a starting point for a dedicated article. That list of open-source healtcare software is pretty extensive and includes software that is less notable than PacientOS. Dumol (talk) 21:34, 25 January 2012 (UTC)

I might suggest that if you have access to journal subscriptions, academic databases such as INSPEC, etc then you could do a search to find articles on the subject. Sources don't necessarily have to be publically available on the (free to access) Internet (and many of the most highly regarded journals arent free). They dont even have to be on the Internet at all - there have been occassions where I have had to go to a library to get information for an article - some books I have used are only available in a small number of libraries in the world. The references just have to be presented in a way such that someone reading this article would know where to go to verify the sources (i.e. Publication name, date, pages, author, etc).

If its the case that these sources don't exist yet, then I think its important to remember that Wikipedia isn't a crystal ball and that a good proportion of research doesnt result in any notable application. However, if the page is deleted, there are options which may be available such as WP:Userfication. This might allow you to work on the article until such time as it is suitable for article space.Pit-yacker (talk) 21:50, 25 January 2012 (UTC)

I'm not sure what do you mean by "a good proportion of research doesn't result in any notable application". PatientOS is a notable application by any standards, it is used in clinics and hospitals, there are third-party companies which offer commercial support for it, it is present at conferences etc. I have invested a bit of time in trying to do it some justice and include it in the relevant list of open-source EMR products on Wikipedia but it wasn't my intention to put more than a stub for PatientOS. I've just added two more academic references at PatientOS but this feels like overkill for a stub article. Dumol (talk) 01:00, 26 January 2012 (UTC)

• Keep - So this stub article now references two academic papers, one book on the subject of Electronic Medical Records and an article written by a professional on an independent site. Is this notable enough? As required by WP:NSOFT 'the software is discussed in reliable sources as significant in its particular field' which is open-source EMR/HIS. Dumol (talk) 01:00, 26 January 2012 (UTC)

The references are:

1. a mention in a single sentence that this is one of three packages that the authors used to test a system
2. a wiki entry that does have several lines on it, including noting that few if any folks are developing it
3. a University of Cambridge "technical report" that does have about a page of material on it, and notes that the product is not yet finished, and the date for finishing not yet published
4. The book Successfully Choosing Your EMR: 15 Crucial Decisions has three mentions in the text, and one in a grid comparing features of various software packages. Page 8 merely mentions it as an example of a package in its category ("Open source EMRs, such as PatientOS, which a one of the various incantations of the Veterans Health Information Systems and Technology Architecture (VistA), are an alternative to be considered" - yes, it says "which a one"), page 162 mentions it once as part of a four-item list of products that meet certain criteria, then notes that none of the group are not legacy vendors and most would not be familiar to hospital IT folks. Page 362 is a single-sentence mention of PatientOS as one of two results that come up if you ask a certain system for certain criteria.

Item 1, while it serves fine as a reference for a specific fact, clearly does not denote notability. Item 2 is a wiki, albeit one editable by a private group; it is unclear to me what, if any, significance this carries; it is not yet clear to me if 3 is merely a formal but internal document; the mentions in 4 would certainly be too brief to establish notability on its own. --Nat Gertler (talk) 14:50, 26 January 2012 (UTC)

I would prefer if we debate this openly without distorting facts, I'll get to this in the following points:

1. Item 1 proves that PatientOS matches HL7 requirements. How many EMR/HIS open-source solutions are able to claim that? This does help with establishing notability in the field of open-source EMR/HIS.
2. Regarding Item 2, you are transcribing 'only has a few developers at most working on it' as 'noting that few if any folks are developing it'. Let's get this straight, PatientOS is actively developed and maintained and it had at least one active developer at any time in its history, it never was abandoned. The point with item 2 is that PatientOS is acknowledged as an 'EMR Option' by an independent group of professionals. Stop distorting this fact by saying it is a wiki, what difference does it make as long as it is only editable by its editors?
3. Item 3 is a technical document that has an ISSN number of 1476-2986. Therefore it is not an internal document, as you say. The report is called 'Report on existing open-source electronic medical records' so the inclusion of PatientOS proves it is notable enough to be reviewed in this report. More so, it concludes that of the 12 solutions reviewed, only 3 were deemed 'appropriate for usage in a hospital intensive care' and PatientOS was among them already, two years ago! It mentions PatientOS was not finished at the moment and it is right, the current version at the time was 0.99. The current version is now 1.3, the software was marked as feature-complete by its developer at version 1.0, so yet another of your points are deemed irrelevant.
4. Item 4 is a book on the subject of EMR that pits PatientOS against 30 other commercial alternatives. It uses about 42 different criteria for evaluating those solutions and the result is pretty good for PatientOS which AFAIK is the only open-source product in that list. Remarkably, only 4 of those 31 solutions are close to meeting MSP EHR Selector requirements and PatientOS is one of them. And MSP EHR Selector is not 'a certain criteria', it is a benchmark of around 700 criteria for assessing EMR solutions... So we have here, luckily available on the Internet, a book written by a couple of independent experts on the subject of EMR that proves PatientOS is notable by itself in competition with commercial alternatives. This proves PatientOS is a prominent option among the open-source EMR solutions, because they are typically behind in features compared to their commercial counterparts. QED!

The only thing you would be able to establish is that PatientOS is not a hot topic on the Internet. But why would it be? EMR/HIS is not something that many people are interested in, it is a specific medical informatics topic. I would rather argue in regards to PatientOS notability in the field of open-source EMR/HIS with someone knowledgeable or at least well-intended and not waste time in fighting half-truths and distortions. So, thank you Nat Gertler for your time and effort! Dumol (talk) 18:53, 26 January 2012 (UTC)

• Keep - Looks like this software is downloaded about 1200 times per month according to Sourceforge. That's actually very significant for an open source EMR package; this is equal to the GNU_Health project, which is an official GNU package. Does that have any impact on its notability? Bradygmiller (talk) 11:25, 26 January 2012 (UTC)

Note: This debate has been included in the list of Software-related deletion discussions. • Gene93k (talk) 14:47, 26 January 2012 (UTC)

• Delete - The discussion here is not about the merits of PatientOS. It could be the best system out there, or it could be a complete turd. It doesn't matter. What matters is if it meets Wikipedia's inclusion guidelines which is usually referred to as "notability". This would be established by significant coverage in independent reliable sources. I am in agreement with Nat Gertler's assessment of the current sourcing. I'll add that my own searches for better sourcing have not turned up any significant coverage. -- Whpq (talk) 17:53, 30 January 2012 (UTC)
  • Please do not equal notability in a certain field with notability on the Internet. What we should establish is if PatientOS is a notable open-source EMR/HIS software. As per WP:NSOFT I think the already gathered info strongly shows that PatientOS is notable in its field. In Wikipedia, there is already a plethora of software suites listed in the dedicated page for open-source healthcare software. Granted, not all are that notable but if there's a place for open-source EMR/HIS in Wikipedia, then surely PatientOS should be included. — Preceding unsigned comment added by Dumol (talk • contribs) 22:09, 30 January 2012 (UTC)
    • Per what I said previously and User:Whpq's comments. No one is talking about notability on the Internet. We are talking about notability in general. If there is significant coverage in reliable and independent sources anywhere (be it print, subscription based academic journals or on the general Internet) then the subject is notable. At that point Wikipedia should not lower its inclusion criteria for some subjects using reason such as "its free and Wikipedia must record all things that are free", "there aren't many sources on the Internet as its a specialist application", "there aren't many reliable sources because it is free" or "something similar is notable, therefore this must be", if only because it isn't necessary - something that is notable and/or "really that good" should attract coverage somewhere.Pit-yacker (talk) 22:38, 30 January 2012 (UTC)
      • Sorry, but how did we get back to "no significant coverage in reliable and independent sources anywhere"? Can you contest what I have written in reply to Nat Gertler's argument in 4 points? Are those sources not reliable? Are they not independent? Is that coverage not significant enough? The Cambridge reports covers 12 open-source EMR/HIS and PatientOS was in the top three, two years ago. The book from 2010 covers about 40 EMR/HIS solutions and PatientOS seem to be the only open-source solution tested. More so, it comes out on top again when tested in a benchmark of 700 criteria. What coverage are you actually asking for? Dumol (talk) 12:34, 31 January 2012 (UTC)
    • Reply I will point out that WP:NSOFT is an essay and not an official guideline or policy. I'll also go into a mini-rant on the use of the word "notability" on Wikipedia. It is perhaps an unfortunate choice of word to use as it taken in a pejorative sense when subjects are declared "non-notable". I deliberately used the term "inclusion guidelines" in my rationale for deletion. We are judging whether it a subject meets inclusion criteria in this discussion. The applicable guideline is WP:GNG, the general notability guideline in the absence of any other topic specific guidelines (and as I pointed out, WP:NSOFT is not an official guideline). I'll accept an argument that PatientOS has recognized merit in its field, but that needs to backed up with significant coverage in independent reliable sources. None of the sources offered so far represents such significant coverage in independent reliable sources. -- Whpq (talk) 22:43, 30 January 2012 (UTC)
• Delete per the general notability guideline for lack of significant coverage in reliable sources. The single paragraph in the cambridge report and passing mentions do not satisfy this. If this is an important piece of software, someone will eventually write about it, in detail, in a trade publication or book. – Pnm (talk) 03:31, 31 January 2012 (UTC)
  • I have actually written about this piece of software in detail in an academic paper last year but it probably will never be available on the Internet and it doesn't have an ISBN. Comparing PatientOS with the other open-source solutions listed in Wikipedia I find the current situation pretty sad. Some are much more notable per your rules (eg. FreeMED and OpenEMR) because of their long history but they are rather inferior to PatientOS in features. More so, other less-featured solutions from that list won't pass "inclusion guidelines" if submitted today, but there probably isn't enough manpower to actually make sure Wikipedia lives to its rules. So the whole picture of open-source EMR/HIS in Wikipedia gets distorted as a result of this 'deletionist' attitude that only applies to new entries. Dumol (talk) 12:34, 31 January 2012 (UTC)
    • Was it an academic paper in a peer reviewed journal? That would help to establish notability. I do agree with you that sometimes the coverage of things in Wikipedia isn't 'fair'. I know of several biographical articles on people that were created by their PR agents, and whose only notability seems to be the ability to meet our guidelines for notability. I am kind of at a loss on how to respond vis a vis the 'whole picture of open-source EMR/HIS in Wikipedia gets distorted'. A lot of things get distorted on crowdsourced projects (ie The Troubles, Israel / Palestine, Abortion) because people are editing for their own ends instead of trying to build a neutral account of the facts. What it comes down to is either you can work to make your project's the article's notability reflected in reliable sources to the current standards, or work to strengthen the guidelines for inclusion in this area, or WP:FORK and start your own crowdsourced list of open source healthcare software (which seems somewhat to have already been done on some of the sites cited in the article). Syrthiss (talk) 14:29, 31 January 2012 (UTC)
      • Thank you Syrthiss for your answer. Clarification needed: PatientOS is not my project. It just happened that I recently wrote my masters thesis on the subject of free software in the field of medical informatics with a focus on EMR software. However, my thesis received a bit of appreciation and as a consequence I was recently invited to write an article in a medical informatics journal on the subject of free software. I seriously consider to dedicate my article to PatientOS, this way the much-needed notability of my stub article on PatientOS will be self-fulfilled, it seems... :) Dumol (talk) —Preceding undated comment added 16:16, 31 January 2012 (UTC).
        • Sorry, fixed. Syrthiss (talk) 16:18, 31 January 2012 (UTC)
    • I think your masters thesis could be used as an external link if it were made available online (it would be better to suggest the link on the talk page than to add it yourself) but per WP:RS a masters thesis can't be used as a source unless it can be shown to have had significant scholarly influence. It's not the first time I've seen this come up at Afd, and I regret that there isn't a good place to take informational content on open-source software which Wikipedia dismisses as non-notable or original research. I'd be interested in helping to coordinate collaboration between Wikipedia and such a project. However, expanding Wikipedia's inclusion guidelines to include such content would jeopardize WP:V and WP:NOR. These policies are essential for what Wikipedia is: an online encyclopedia. Rather than an exposition of all human knowledge, it's an exposition of human knowledge already published in reliable sources. When the article you're writing is published it would likely establish notability. Until then, why not ask to have the article moved out of main space to your user space (we call it userfy). – Pnm (talk) 18:56, 31 January 2012 (UTC)
      • Well, the whole text of this stub article is referenced from already published reliable sources. More so, those sources show that PatientOS is currently one of the best open-source EMR/HIS software suites. If there is a place in Wikipedia for info on open-source EMR, PatientOS should be listed and I think it deserves its own article. These assertions of mine do not require much knowledge in the field of EMR, just a bit of logic and some diligence in following up the references already included. However, if there is no place for open-source EMR solutions in Wikipedia, why don't you delete the list of open-source healthcare software and remove all the linked Wikipedia articles, there are already tens of them? Not that I would advice you so, I am not a deletionist. Dumol (talk) 23:03, 31 January 2012 (UTC)
    • The wiki 2 does not qualify as a reliable source and should not be used to cite any facts in the article. The Romanian university article 1 – appears to be part of a book published by InTech. WP:SCHOLARSHIP asks that material be vetted by the scholarly community. InTech has an Editorial Board, but it's not clear that this is enough to qualify. The other two sources seem fine. (I noticed the article also plagiarizes its sources – three of these sentences are direct quotes.) – Pnm (talk) 02:48, 1 February 2012 (UTC)
      • Thank you for your constructive criticism. I have re-edited the article trying to remove all traces of plagiarism. In regards to the wiki not qualifying as a reliable source, please see my reply to user A412 below. Thank you! Dumol (talk) 11:18, 1 February 2012 (UTC)
• Keep. Three of these sources do not fulfill our sourcing criteria:

1. Passing mention.
2. Wiki, not a WP:RS
4. Another passing mention (The fact that it is open-source, although interesting, does not confer special privileges onto it.

But the third one does, as per the WP:GNG. "Significant coverage is more than a trivial mention but it need not be the main topic of the source material." The mention is clearly not trivial (that would be a passing mention, while this is really a case study). A412 (Talk * C) 02:27, 1 February 2012 (UTC)

1. The first passing mention assesses PatienOS as meeting HL7 certification. That is not something many open-source EMR software can claim.
2. The Wiki is not a publicly editable one, what difference does it make that a group of professionals from Nepal uses a Wiki-type publishing system as long as its only editable by themselves? Nyaya Health operates a hospital and mobile medical care services in Achham, a large district in Nepal. That is a reliable, independent source. I know their English blows, mine is not great either, but they are professionals, please do not downplay their notes on PatientOS just because they use a Wiki-type publishing system.
3. The mentions in the book on choosing an EMR solution acknowledge that PatientOS was tested against 40 different criteria, that it fairs well compared to its commercial counterparts and that when tested against the MSP EHR Selector (which consists of 700 criteria) it is one of only four to be almost feature complete when all 46 specialties are asserted. This amounts to much more than just a passing mention Dumol (talk) 10:57, 1 February 2012 (UTC)

Significant coverage should generally be in multiple sources. This is especially necessary here because the single paragraph is on the borderline, barely significant coverage. – Pnm (talk) 02:54, 1 February 2012 (UTC)

Please see my above arguments. Thank you! Dumol (talk) 10:57, 1 February 2012 (UTC)

Let me explain why these do not meet sourcing criteria for you, Dumol:

1. Even if PatientOS is the most amazing, unique software in the world, Wikipedia relies on inclusion guidelines: WP:V, WP:RS, and WP:N. This is simply a passing mention, which does not count per WP:GNG.
2. Because it is a wiki, we don't know who wrote the content. While it may be in fact true, this would not fall under WP:RS.
3. Again, being open-source confers no special notability on PatientOS. A412 (Talk * C) 15:18, 1 February 2012 (UTC)

Reply Thank you for responding! However, I find it amusing to hear "because it is a wiki, we don't know who wrote the content". We use Wikipedia, I suppose we all know what a wiki is and how it functions when it's edited by private editors only... Weren't it better if it were a static page on nyayahealth.org? The editors say on the front page of the wiki: "We use this page to collaborate, upload files, and organize among our team members, and to provide clinical and public health content to the public. We hope that by publishing our operations in an open-access format, we can contribute to the growing community of practitioners working to improve global health delivery." And who is Nyaya Health? "Nyaya Health operates a hospital and mobile medical care services in Achham, a large district in Nepal" from http://www.nyayahealth.org . So, why is this not a reliable independent source on EMR software?

I think you got me wrong in regards to the book. The book is on the subject of choosing an EMR and it was written by a couple of independent professionals. So it is reliable and independent, AFAICT. Those professionals tested PatientOS against tens of criteria, please see page 386. This is not just a passing mention, they took the time to test PatientOS and they got tens of results, listed in the table on page 386. Besides mentioning that PatientOS is open-source, they have also tested PatientOS against the MSP EHR Selector, which is a benchmark of 700 criteria. Granted they didn't mention all those criteria in the book for every product because this is a well-known standard in this field. But qualifying this as 'just a mention' is like saying: Oh, look, in this book on baroque composers it says Bach is at least as great as Haendel ever was. But it only mentions Bach three times, so why bother? Haendel is still celebrated by anyone, while Bach is an almost unknown composer. (Please realize, Bach really was an almost forgotten composer for almost a century, he probably wouldn't have qualified as notable by your standards back in those days...). Dumol (talk) 16:06, 1 February 2012 (UTC)

Nyayahealth.org is a health organization, not a publisher. It would be considered a primary source. It could be used as a reliable source on itself – for example, to cite a statement saying which EMR it uses. Notability is about coverage, not attention or importance. It doesn't matter how much time the authors spent looking at it, it depends what they actually wrote about it. And according to that book PatientOS wasn't even finished at the time it was written. It reads like they were evaluating the specification for the software, predicting what it would become, and saying that it was off to a good start. – Pnm (talk) 16:51, 1 February 2012 (UTC)

Reply. In the very same page the Nyaya Health editors say Nyaya has currently customized a version of PatientOS for testing at its site. Moreso, at http://www.globalgiving.org/pfil/2286/projdoc.pdf they say Our clinical forms are downloadable from http://nyayahealth.pbwiki.com/Clinical_Records. We have customized the open-source PatientOS software (http://www.patientos.org/) for the electronic medical record that we are starting to use at both at the Sanfe Bagar Clinic and at the Bayalpata hospital. So, happy now? :)

And I think you are confusing the book on choosing an EMR with the Cambridge tech report that found PatientOS 0.99 not quite complete despite being one of the only three appropriate for usage in a hospital care and the only one to meet the 6-point clinical vision of the EVIdence group out of 12 open-source EMR tested two years ago. That amounts to much more that just a good start. In the mean time, PatientOS has continued its development and has reached version 1.30. Dumol (talk) 12:38, 2 February 2012 (UTC)

• Delete. This meager coverage does not convince me--if this could even be called coverage. Drmies (talk) 05:34, 1 February 2012 (UTC)

Please see my above arguments in reply to A412. Thank you! Dumol (talk) 10:57, 1 February 2012 (UTC)

I did. Drmies (talk) 17:07, 1 February 2012 (UTC)

• Keep The coverage is sufficient for the subject. In this field, blogs and forums can be an exception to our usual rules on sourcing. We have to go with the way the RW covers the material. DGG ( talk ) 06:44, 1 February 2012 (UTC)

  Shall we do the same for other topics which are only occasionally covered in our usual RS's but are amply discussed on primary source or user-contributed-content sites, personal web pages, blogs, and Twitter, like Internet memes, viral videos, high school sports, or local restaurants? Shall we throw away WP:V and WP:N and just say, "if you think the topic is important, the material is on the Internet, and you think the material is trustworthy, the material can go in Wikipedia?" – Pnm (talk) 17:04, 1 February 2012 (UTC)

to a certain extent, yes I think the nature of the sources, but not the basic requirement for sourcing, can be modified according to topic. I think that's the case for some computer software, and for small political and religious groups, and for creative people in some countries . As most of you know, I do not extend it to topics of local interest, and have never supported articles on any but the most famous local restaurants or high school personalities. Internet memes is a specially difficult topic to judge--so much of it is nonsense, but I'm inclined to be flexible here also. On the other hand, I'd be more inclined to be stricter on topics where there is over-aggressive press coverage, like society figures, and those in many sports and some types of musical endeavors. The criteria should match the customary sources, not a Procrustean rule that seems almost designed to give the present weirdly disproportionate topic coverage. DGG ( talk ) 06:05, 2 February 2012 (UTC)

Comment:As previously discussed WP:NSOFT is a guideline. Personally, I don't like this idea that we should lower the inclusion criteria for some subjects with rationale such as "open source/free software doesnt attract coverage in mainstream sources". It sets a dangerous precedent for other subjects. I'm also inclined to suggest it isn't true, especially when you consider that some free software has whole books devoted to it. ~In my opinion the rationale is an excuse to justify keeping articles on non-notable subjects. Pit-yacker (talk) 20:40, 1 February 2012 (UTC)

• Delete Lack of coverage in reliable sources, fails our inclusion guidelines, if others think they should be changes, this is not the place to do that. Mtking ^(edits) 08:34, 1 February 2012 (UTC)

Please see my above arguments in reply to A412. Sorry for all the spamming, I'm a beginner when it comes to debating in Wikipedia's talk pages. Thank you! Dumol (talk) 10:57, 1 February 2012 (UTC)

To all Wikipedians who might happen to come across... I am not familiar with all the intricacies of Wikipedia and I am getting tired of this. It also seems none of you is into open-source healthcare software or EMR in general and this makes it even more frustrating for me. So at least help me solve this cognitive dissonance, please.

My reason for adding this stub article was that if there is a place in Wikipedia for open-source EMR, there should be a place for PatientOS. And there are plenty of software suites listed at http://en.wikipedia.org/wiki/List_of_open_source_healthcare_software, EMR being the largest section there. Maybe you are right and there is no place for PatientOS in Wikipedia and it is not notable enough by your standards. But why keep all the tens of articles on open-source healthcare software mentioned in the aforementioned list then? I think most of them wouldn't pass your draconian notability rules if submitted today...

If someone looks at the EMR section of open-source healthcare software as it looks today he/she gets a distorted picture on open-source EMR because one of the best options is missing, namely PatientOS. What I have already referenced in the stub article proves this and if you find a reliable recent study on open-source EMR that shows PatientOS is not one of the best I promise to buy you beer and have it delivered by your door. So why keep all that cruft and reject one of the best options in open-source EMR when Wikipedia's coverage on open-source EMR is so extensive? Thank you! — Preceding unsigned comment added by Dumol (talk • contribs) 19:13, 1 February 2012 (UTC)

It is not our goal to be a recommendation engine, to chronicle what is most wonderful. There are probably plenty of unknown musicians who are better than (insert the name of your least favorite teen pop sensation here) who do not have articles when (inserted name) does, What we're wresting here is a question of notability (in its strange Wikipedian sense of notedness), not of quality. This is actually a fairly poor venue for recommending products, there are certainly many better - and it sounds like you are working to publicize the product in a more appropriate venue, which is good. Are there other packages covered here which do not deserve such coverage? Probably. If anyone tells you that Wikipedia is perfect, giggle. --Nat Gertler (talk) 22:20, 1 February 2012 (UTC)

I'm not daring to hope Wikipedia will ever be perfect. It's just that it is beyond unfair to have so many obscure packages included in the aforementioned list of open-source healthcare software and not have PatientOS, which is one of the best products in this field, as acknowledged in (what I think are) reliable sources. Disclaimer: I am not involved in any way with PatientOS or its creator, I just happened to know a bit about free software in the field of EMR, having wrote a master thesis on this very subject, which also touches PatientOS among other five software suites. Dumol (talk) 09:59, 2 February 2012 (UTC)

Also, I find it unfit to compare software suites the way you compare pop musicians. The recognition of pop musicians is very subjective, so I understand the need for extensive coverage. But we have a few reliable sources that assess PatientOS as one of the best in the field of open-source EMR by evaluating it using some pretty significant standards in the field: HL7, the 6-point clinical vision of the EVIdence group and the MSP EHR Selector. PatientOS also comes on top when benchmarked against other 11 open-source EMR (in the Cambridge tech report) or 40 other EMR (in the book on successfully choosing an EMR). That is something that fits the first criteria in WP:NSOFT: The software is discussed in reliable sources as significant in its particular field. I think the book on choosing an EMR, the Cambridge technical report and the notes in the Nyaya wiki do qualify as reliable sources and all three of them show (directly or indirectly) that PatientOS is one of the best free software EMR suites currently available. Is that not significant enough in the field of open-source EMR? Dumol (talk) 12:51, 2 February 2012 (UTC)

I agree it seems pretty unfair considering a lot of the other applications out there. From another person heavily involved in open source EMR's, my initial impression is that any EMR that garners 1200+ downloads a month on sourceforge is important, but after reading others input, now agree this isn't equal to being "notable" by wikipedia standards. The things that do strike me as odd about this open source EMR project are barely any forum or mailing list activity, the lacking of a current public code repository and the apparent tight binding of the software with a "independent" company. If this article does stay, then would like to see these type of things discussed.Bradygmiller (talk) 12:30, 2 February 2012 (UTC)

You are right on spot. PatientOS is open-source and free-software in a way more akin to Android, being developed almost exclusively by a company, with public releases from time to time. This doesn't disqualify it as FLOSS, the code is available from SourceForge and it is licensed under the terms of GPL version 3. But the way PatientOS is developed, not much noise is generated on the Internet. As for notability, as far as I understand WP:NSOFT, PatientOS would qualify, please see the comment I have just inserted above yours. Thank you! Dumol (talk) 12:51, 2 February 2012 (UTC)

After consulting WP:V, WP:RS and WP:N in addition to WP:NSOFT, I am resuming here, to the best of my understanding of these guides, the status of the four references from the PatientOS article:

1. A study on RFID Technology in eHealth that only has a passing mention of PatientOS which acknowledges that it is compatible with the HL7 standard and therefore it was used in a series of tests besides two other EMR solutions. This source, although reliable, doesn't have significant coverage of PatientOS, indeed. But it hints PatientOS is not just any open-source EMR suite, given its HL7 compliance.

2. Nyaya Health's notes on EMR options. This amounts to a passing note saying Nyaya has currently customized a version of PatientOS for testing at its site and a list of bullet points that summarizes the characteristics of PatientOS, this section representing a significant proportion of their notes on EMR options. Although this site uses a wiki-type software, it cannot be edited externally so it is not an open wiki as per WP:SPS, contrary to what someone started to insinuate above. The wiki is being used by Nyaya Health to collaborate, upload files, and organize among our team members, and to provide clinical and public health content to the public[1]. What is Nyaya? Nyaya Health operates a hospital and mobile medical care services in Achham, a large district in Nepal[2]. As published in a more recent document, Nyaya Health is now using this EMR suite and customized the open-source PatientOS software (http://www.patientos.org/) for the electronic medical record that we are starting to use at both at the Sanfe Bagar Clinic and at the Bayalpata hospital[3]. Although not explicit in their notes, it is evident that they have only considered open-source options. This seems to be a reliable source, with significant coverage of the subject of open-source EMR which suggests PatientOS is one of the best in its particular field. As per WP:NSOFT: it is not unreasonable to allow relatively informal sources for free and open source software, if significance can be shown.

3. The Report on existing open-source electronic medical records] from the University of Cambridge Computer Laboratory. This 12 page tech report on 12 open-source EMR suites dedicates about a page to PatientOS and concludes that it is one of the only three appropriate for usage in a hospital care and the only one to meet the 6-point clinical vision of the EVIdence group. This source has an ISSN number of 1476-2986 and it is not an internal document, as the same someone has suggested above. The source is reliable, the coverage is significant and the conclusions show that PatientOS was prominent in the field of open-source EMR two years ago, although the three authors note that PatientOS is not yet finished. In February 2010, the publication date of their report, the current version of PatientOS was indeed 0.99. The first mature version of PatientOS (1.2) was launched a year later, in February 2011. The current version is 1.3, launched in August 2011.

4. Successfully choosing your EMR a book by Gash, Arthyr and Gash, Betty published by Wiley-Blackwell with an ISBN number of 978-1-4443-3214-8. This book assesses PatientOS and 40 other commercial EMR using 42 criteria, the matrix with the results is published at page 384 and following. The results indicate that PatientOS holds its own against commercial alternatives. More so, when tested against the MSP EHR Selector, PatientOS is found to be one of only four (out of a total of 41 EMR options) that come close to meeting MSP EHR Selector™ requirements when 46 specialties are asserted. As required by WP:SPS, the source is reliable, a couple of independent experts in the field of healthcare software writing on the subject of EMR in a book published by the respectable Wiley-Blackwell publishing house, which specializes on medical subjects among others. The coverage is pretty consistent given all the tests against which PatientOS was asserted. As required per WP:NSOFT, the results indicate that PatientOS is significant in the field of EMR even when pitted against 40 commercial alternatives.

I hope you reconsider your options now that I have better explained the reasons for adding the PatientOS article, this time hopefully using the complete and rather elaborate set of Wikipedia inclusion guidelines. I thank all who have challenged this article in good faith and give special thanks to all who have directed me to the inclusion guidelines. I'm not happy about wasting 10 times more time learning the intricacies of these guides than it took to actually add and improve the article on PatientOS. But I don't easily quit a cause if I believe in it. And if there is place for open-source EMR in Wikipedia, there should be an entry for PatientOS too, I do believe that.

Disclaimer: I'm not affiliated in any way with PatientOS or the company behind it. It just happens that I have recently wrote my masters thesis on the subject of free software EMR and I have also examined PatientOS among five other free software EMR options so I'm pretty confident in regards to its current significance in the field of open-source EMR. — Preceding unsigned comment added by Dumol (talk • contribs) 19:22, 2 February 2012 (UTC)

Comment My point about the Cambridge Report is chiefly that it does not appear to be peer reviewed - as one might expect such an academic article to have been. I will repeat the quote from the home page of said series which says "the long-term archival of results and descriptions that are not suitable for publication elsewhere, due to their length or nature". The fact that the article isnt long (The reports usually seem to consist of a several hundred page articles "based" on a student's PhD thesis) suggests here it wasnt published elsewhere for other reasons (because it wasn't suitable for a peer reviewed publication???). That leaves me with a problem as it tends to suggest that the research community might have had a problem with the research. I will also repeat my note that the author doesn't mention it in her publications list. So I'm left assuming she doesnt regard either/or the paper or the series as a serious publication. I might suggest that by "internal document" I actually meant one that has zero or no following outside current members of said Lab and alumni. That aside, I wouldn't object to its use as a reference, IF there was more coverage in other equally strong or stronger sources. The problem is, as is, it is the strongest source by some distance.

As I said yesterday, I have problems with some of the rationale put forward in WP:NSOFT and AfD for other Open Source software. In my opinion the rationale that inclusion criteria should be lowered to "reflect lack of coverage of the sector", is somewhat false. Numerous free and open source projects and applications have numerous books written about them. It leaves me thinking that the rationale is an excuse to keep articles on non-notable subjects.Pit-yacker (talk) 20:49, 2 February 2012 (UTC)

Reply It seems your previous comment on this topic escaped my attention. I was actually referring to Nat Gertler who said that the Cambridge report is merely a formal but internal document. You have said that it appears the publication is an internal series, which at least leaves room for doubt. Well, one thing is for certain, it is not an internal document. The rest is just speculation, we don't know why it wasn't published in a journal and peered reviewed and why one of the three authors does not list this report in her publications list.

As for open-source EMR being a non-notable subject for Wikipedia, I am not willing to debate this. FTR, I am strongly leaning to being an inclusionist. But as long as there is a list of open-source EMR in Wikipedia, I believe there is a case for mentioning PatientOS. — Preceding unsigned comment added by Dumol (talk • contribs) 21:13, 2 February 2012 (UTC)

The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review). No further edits should be made to this page.