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.
As you might know Medfloss.org (formerly medfoss.apfelkraut.org) tries to provide a comprehensive and structured overview of Free/Libre and Open Source Software (FLOSS) projects for the health care domain.
After the initial launch 6 months ago it recently welcomed the 200th project in its repository: the GPL-licensed iDART software – iDART is the abbreviation of „Intelligent Dispensing of Antiretroviral Treatment“ and according to its authors addresses many of the challenges faced by public ART dispensing pharmacies in developing countries.
Starting with originally just 120 projects, the medfloss.org database currently holds:
My cordial thanks goes to all the contributors that already made and hopefully will continue to make use of the open content concept by revising/extending existing information or adding new content!
For more information about the site and its objectives please refer to the mission statement or these slides. Beside amendments to the actual content I also highly appreciate any general feedback about the site, offered functionality and shortcomings of it.
Are you a practice, clinic or any other health care institution that is using medical open source software in daily routine? And wasn’t it quite hard for you to find the right software, to get it up and running and to finally customize it to your needs without having any experienced users or reference sites at hand?
Even a high number of downloads or a strong ‚activity percentile‘ of an open source software project doesn’t tell you anything about the suitability for your purposes and in general about the stability and efficiency that are required for successful clinical practice.
But what if you could see on a per-project basis at which site it is already deployed and even whom you could contact and ask for advice and personal experiences?
Medfloss.org (formerly medfoss.apfelkraut.org) should provide a comprehensive and structured overview of Free/Libre and Open Source Software (FLOSS) projects for the health care domain. Moreover it should offer a platform to foster the exchange of ideas, knowledge and experiences about these projects.
For details about the offered features and services please refer to the Mission Statement.
Once upon a time SourceForge.net used to be the biggest and most popular platform for Free Open Source Software (FOSS) in the world. Just in the field of medical FOSS they hosted more than 900 projects and in total more than 230,000 projects. People from all around the world could search for projects of interest, collaboratively develop them via the platform, seek for support or just download the source code or precompiled binaries.
It appears really strange to me that they still show phrases like „Find and develop Open Source software“ or „SourceForge is your location to download and develop free Open Source software.“ on their front page. I am not yet sure if they should add the note „… in case you are from a ‚good‘ country“ or better remove the term „Open“.
At least it is clear that it is not Open Source anymore what they are doing as they are infringing two of the most crucial principles of the Open Source Definition which read like this:
„5. No Discrimination Against Persons or Groups: The license must not discriminate against any person or group of persons.“
„6. No Discrimination Against Fields of Endeavor: The license must not restrict anyone from making use of the program in a specific field of endeavor. For example, it may not restrict the program from being used in a business, or from being used for genetic research.“
SourceForge seems not to be familiar with these and is blocking users to comply with the US law … and hell yes, the US is the country whose Secretary of State recently gave a widely honored speech about Internet Freedom.
Happily there are dozens of other real FOSS portals/platforms where you can now move to and host your FOSS project while preserving the original idea of Open Source.
Just another post about this region, but from a bit different perspective … and this one is meant especially for those who are still thinking that Open Source software in the area of health care is a useless toy for computer fetishists and far from being deployed in a productive clinical environment.
Since the beginning of 2003 the Bosten-based Partners in Health (PIH) rolled out a web-based EMR to primarily track HIV patient within Haiti. Meanwhile the system was replaced by the FOSS EMR software OpenMRS and is deployed in 9-10 PIH hospitals spread over Haiti (and by the way more than 20 countries worldwide). Luckily these hospitals are networked via satellite links, so still online after all other systems went down after the earthquake. Only an instance of the system which was used in a now destroyed hospital of the Médicins Sans Frontières directly in Port-au-Prince seems not to be at service anymore.
According to Hamish Fraser, director of informatics and telemedicine for PIH, OpenMRS served before the current crisis more than 14,000 patient records and is now used to „… generate reports for the government and funders and make lab data available to the physicians and medication lists for the pharmacists. We also built a drug supply management tool to track all the medications in our main warehouse and our 10 hospitals.“ as Fraser said in an interview with the Healthcare IT News.
Surely FOSS will not play a keyrole in the relief efforts, but still provide considerable means to support medical care for the Haitian people. Also take a look at Fred Trotters article „OpenMRS shines in Haiti“ who originally pointed me to this.