Natural progression
- 3 August 2006
Neil Cowles
CEO, Tolven Health
The shortcomings of IT solutions in the healthcare industry are well documented and understood, but the means to resolve them remain elusive. Open source, however, may allow users to enjoy the same variety of solutions as such other industries as banking and finance, telecommunications and manufacturing.
The advent of open source will prove to be a watershed event for healthcare. It will provide truly extensible and affordable solutions for the marketplace. Open source solutions will offer unprecedented flexibility and affordability, enabling institutions to more effectively address the complex challenges associated with data interoperability.
The most glaring deficiencies in existing healthcare IT solutions is the ability of existing systems to share patient data outside of a given organisational unit.
This can put lives at risk, add significantly to the expense and inefficiency of healthcare and produce frustrations for patients, service providers such as laboratories and pharmacies and governmental agencies responsible for monitoring disease and health status of populations.
As consumers and providers prepare for IT to play a more important role in care delivery, the demand for better quality and more affordable healthcare solutions is becoming extremely pressing. Open source is synonymous with affordability and quality. It also meets market requirements: open source solutions are designed and built in full view of the community that will eventually adopt it.
Security
Healthcare leaders have started to recognise the positive contributions of open source in other industries. This has led to increasing declarations of open source standards for healthcare systems (particularly by governments across the globe), which in turn has fostered a limited number of successful open source solutions in healthcare in the United States, Canada and Europe.
One characteristic of open source that has contributed to its success is that the code is held in the public domain. This means it is exposed to extreme scrutiny, precluding the tendency of traditional application providers to hide or ignore problems. Instead, problems are identified and fixed, and the resulting solutions achieve a uniform level of quality.
In healthcare, security and confidentiality is of paramount importance. The ability for an adopter of an open source solution to understand and look at the way security and confidentially has been implemented at the lowest level provides a level of comfort far beyond that of a supplier ticking the “yes” box in the sales document.
Major healthcare IT initiatives are virtually unaffordable to all but the most well funded organisations, if onefollows the tradition models of procuring software licenses from existing vendors. Add to this dilemma that even when procuring solutions from the largest of the existing software vendors, there appears to be no guarantee of the company’s long-term stability.
Widening marketplace
The growing number of open source companies focused on addressing quality, cost and stability is forcing existing software vendors to awaken to the challenge to their historical dominance in the industry.
Thirty years ago healthcare software companies not only developed their business and clinical applications, but also heavily invested in the development and maintenance of major components of their technical infrastructure.
Companies such as McKesson and Shared Medical Systems (SMS), to name but two, spent millions of dollars on the development and management of their own database technologies (derivatives of Mumps), delivery systems and software development tools.
Subsequently, the operating system, development tools and database marketplaces were been commoditised by commercial vendors in the technology marketplace (e.g., Oracle, Microsoft, Sun, IBM). These technology vendors themselves are now coming under threat from open source solutions (e.g., MySQL, ProgresSQL, J-BOSS and Eclipse).
As these solutions are changing the dynamics in the core technology marketplace, desktop suites such as Open Office are starting to make inroads too. Open source platforms and applications will introduce similar change to the healthcare IT environment.
Affordability and empowerment
As an industry, healthcare has singularly failed to demonstrate affordability and innovation in IT. Hundreds of millions of users around the world are scratching their heads in disbelief as the systems they are inflicted with today add limited or no value to their daily activities.
The collaborative nature of open source software development harnesses worldwide knowledge and experience, and turns it into an engine for developing usable, affordable healthcare applications in a very short period of time. Given that open source is all about collaboration, the movement is a uniquely empowering and bridging initiative in its own right.
While not heralding the end of commercial software vendors, a recent report by Forrester concluded that conditions are ripe for open source solutions to take root in healthcare, and that it will likely become the standard for capturing, sharing and managing patient information to support quality care. Forrester also noted that healthcare businesses have the opportunity to take the lead and drive the shift to this new information technology model.
In the coming months we will see interoperable healthcare platforms, interface engines, clinical trials applications and even clinical applications launched in the healthcare marketplace based on open source development. It will not be long before the healthcare industry can finally realize the long-sought advantages of information technology solutions; it is the advent of open source technology that is making this long awaited evolution occur.
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