Tag Archives: Publication

Use of Open Source Software in Health Care Delivery – Results of a Qualitative Field Study

The article about my previous research has finally been published in the IMIA Yearbook 2013. It is meant to provide a practitioner’s perspective on the use of medical free/libre and open source software (FLOSS) in clinical routine. In this context I examined and presented the opinions and experiences of chief information officers (CIO) working at larger hospitals. The abstract reads like this:

Objectives: To assess and analyze the attitude of health IT executives towards the utilization of specialized medical Open Source software (OSS) in Germany’s and other European countries’ health care delivery.

Methods: After an initial literature review a field study was carried out based on semi-structured expert interviews. Eight German and 11 other European health IT executives were surveyed. The results were qualitatively analyzed using the grounded theory approach. Identified concepts were reviewed using SWOT analysis.

Results: In total, 13 strengths, 11 weaknesses, 3 opportunities, and 8 threats of the utilization of OSS in a clinical setting could be identified. Additionally, closely related aspects like general software procurement criteria, the overall attitude of health IT executives, users, and management towards OSS and its current and future use could as well be assessed.

Conclusions: Medical OSS is rarely used in health care delivery. In order to capitalize the unique advantages of OSS in a clinical setting, complex requirements need to be addressed. Short-comings of OSS describe an attractive breeding ground for new commercial offerings and services that need yet to be seen.

Schmuhl, H., Heinze, O., & Bergh, B. (2013). Use of Open Source Software in Health Care Delivery – Results of a Qualitative Field Study. Contribution of the EFMI LIFOSS Working Group. Yearbook of medical informatics, 8(1), 107–13.

The full text article available via: Apfelkraut.org | PubMed | Schattauer

I am looking forward to your feedback!

Towards Open Collaborative Health Informatics – The Role of Free/Libre Open Source Principles

A general overview article about free/libre and open source software in the context of health care to which I strongly contributed as co-author has recently been published in the IMIA Yearbook 2011. The abstract reads like this:

Objectives: To analyze the contribution of Free/Libre Open Source Software in health care (FLOSS-HC) and to give perspectives for future developments.

Methods: The paper summarizes FLOSS-related trends in health care as anticipated by members of the IMIA Open Source Working Group. Data were obtained through literature review and personal experience and observations of the authors in the last two decades. A status quo is given by a frequency analysis of the database of Medfloss.org, one of the world’s largest platforms dedicated to FLOSS-HC. The authors discuss current problems in the field of health care and finally give a prospective roadmap, a projection of the potential influences of FLOSS in health care.

Results: FLOSS-HC already exists for more than 2 decades. Several projects have shown that FLOSS may produce highly competitive alternatives to proprietary solutions that are at least equivalent in usability and have a better total cost of ownership ratio. The Medfloss.org database currently lists 221 projects of diverse application types.

Conclusions: FLOSS principles hold a great potential for addressing several of the most critical problems in health care IT. The authors argue that an ecosystem perspective is relevant and that FLOSS principles are best suited to create health IT systems that are able to evolve over time as medical knowledge, technologies, insights, workflows etc. continuously change. All these factors that inherently influence the development of health IT systems are changing at an ever growing pace. Traditional models of software engineering are not able to follow these changes and provide up-to-date systems for an acceptable cost/value ratio. To allow FLOSS to positively influence Health IT in the future a “FLOSS-friendly” environment has to be provided. Policy makers should resolve uncertainties in the legal framework that disfavor FLOSS. Certification procedures should be specified in a way that they do not raise additional barriers for FLOSS.

Karopka, T., Schmuhl, H., Marcelo, A., Molin, J. D., & Wright, G. (2011). Towards Open Collaborative Health Informatics – The Role of Free/Libre Open Source Principles. Contribution of the IMIA Open Source Health Informatics Working Group. Yearbook of medical informatics, 6(1), 63–72.

The full text article available via: Apfelkraut.org | PubMed | Schattauer

I am looking forward to your feedback!

Barriers to FOSS Adoption in Quebec and elsewhere?


G. Paré et al. published in Februar 2009 an insightful article about the “Barriers to Open Source Software Adoption in Quebec’s Health Care Organizations” (PDF) in the Journal of Medical Systems. Their abstract reads like this:

“We conducted in-depth interviews with 15 CIOs to identify the principal impediments to adoption of open source software in the Quebec health sector. We found that key factors for not adopting an open source solution were closely linked to the orientations of ministry level policy makers and a seeming lack of information on the part of operational level IT managers concerning commercially oriented open source providers. We use the case of recent changes in the structure of Quebec’s health care organizations and a change in the commercial policies of a key vendor to illustrate our conclusions regarding barriers to adoption of open source products.”

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Open Source im Gesundheitswesen


Dieser Blog-Eintrag ist auch in leicht gekürzter Form in der aktuellen Ausgabe 06/2008 des Fachmagazins für Gesundheitstelematik, Telemedizin und Health-IT E-HEALTH-COM erschienen (PDF Version des Artikels).

Open Source Initiative Logo Die Entwicklung der letzten Jahre zeigt, dass sich Open Source Programme einer immer größeren Beliebtheit erfreuen, und das in den unterschiedlichsten Anwendungsgebieten. Ein bekanntes Beispiel ist das LiMux Projekt der Stadt München, in dessen Rahmen insgesamt 14.000 Arbeitsplatzrechner der Stadtverwaltung mit freier Software ausgestattet werden sollen. Mit Stand Juli 2008 war auf 1.200 Arbeitsplätzen das quelloffene Betriebssystem Linux installiert und auf ca. 8.000 Rechner wurde die kommerzielle Microsoft Office Suite durch deren Open Source Pedant OpenOffice.org ersetzt. Die Open Source Programme Firefox (Web Browser) und Thunderbird (eMail-Client) werden bereits auf allen Arbeitsplätzen eingesetzt. Insgesamt zeigt dies, dass Open Source Software (OSS) unterdessen nicht mehr nur für rein unterstützende Aufgaben im Hintergrund herangezogen wird, wie beispielsweise der Apache Web Server oder Scripting Sprachen wie Perl, Python oder Ruby. Vielmehr hält OSS Einzug auch bei klassischen Desktop-Anwendungen, die bislang durch proprietärer Software kommerzieller Hersteller dominiert wurden.

Im Gesundheitswesen sieht es ähnlich aus, wobei der Markt in diesem Bereich nach wie vor stark von proprietären Anwendungen beherrscht wird und die Nutzer dort der Open Source Bewegung eher kritisch gegenüber stehen. Dieser Artikel soll eine Übersicht über die Vor- und Nachteile von Open Source Anwendungen im Medizinumfeld geben, Initiativen aufzeigen, die sich speziell in und für diesen Bereich gebildet haben. Abschließend werden zwei OSS Projekte vorgestellt, die bereits in vielen Gesundheitseinrichtungen zum Einsatz kommen.

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