Report: Open Source Will Invigorate Health IT

The California Health Care Foundation's findings show that the previous attempts to use open-source software for health applications failed because the technology wasn't ready and because many health care providers weren't ready.

Open-source software will bring down the costs of health information technology and help networks of doctors exchange information. At least thats the conclusion of a new report, here in PDF form, released by the California Health Care Foundation.

Previous attempts to use open-source software for health applications failed partly because the technology was not ready but mainly because health care providers were not ready to adopt the technology, said the report, which was written by analysts at Forrester Research.

Further, companies like RedHat, JBoss and MySQL now demonstrate that companies based on open-source technologies are viable.

The report said that industry must rethink its current practices and "look at ways to add value to commonly used software rather than producing competing, though functionally equivalent applications."

With open standards in place and an effective open-source community established, collaboration could fill the gaps in EMR (electronic medical records) technology and network infrastructure.

"Where those standards exist, open source is a good candidate for implementing them at low cost because there will be less motivation for proprietary vendors to invest in competing products," said the report.

And such efforts will be self-perpetuating because tools developed by one community can be used, and improved, by another.

"Access to source code will allow each region to adapt the software to its specific requirements without having to develop an entire software suite from scratch."

However, many health care providers will lack the resources and skills to implement and improve open-source code, so such innovations may well be restricted to larger, richer groups of clinicians.

"Theres a big pressure for health IT to become less expensive," said Blackford Middleton, chairman of Center for IT Leadership at Partners HealthCare System.

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Such pressures fuel interest in open source, he said, but a more fruitful way of getting doctors to use clinical information would be commoditizing health IT software, so that installing clinical information systems dont require such intense interactions with vendors.

"One day we will have the kinds of applications that doctors and patients can buy off the shelf," he said. "Were just not there yet."

A handful of open-source EMR systems exist, but industry and some health care providers protest that such systems are hard to use.

Middleton praised VISTA, an open-source system developed by the Veterans Administration, but said it wasnt set up to deal with most outpatient settings.

Trying to move it into a physicians office with only a few providers, he said, "is like trying to put an aircraft carrier in your garage."

However, health IT czar David Brailer said that EMR vendors built on open-source software were participating in a commercial certification system under development by CCHIT (Certification Committee for Healthcare Information Technology), a nonprofit industry group.

Brailer said he was both surprised and pleased that such companies had responded to an open invitation from CCHIT.

Still, the vast majority of EMR software is proprietary.

The Forrester report predicts that open source will become the dominant model in creating software and improving quality.

While commercial vendors will persist, the availability of open source will force them to play nice.

"Commercial offerings will have no choice but to follow this model of compatible information systems and data exchange," the report concludes.

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