OHN 2013 Readers Choice: 'Open Source' Health IT Systems

As we head towards the end of the year, the global 'open source' software movement continues to grow and strengthen, especially in the field of healthcare. Based on the number of hits by readers of Open Health News (OHN) on links to our brief profiles of 'open source' Health IT systems, the following are their top choices of interest over the past year:

• VistA System  – major variants include:   o VA VistA & OSEHRA   o vxVistA   o OpenVistA   o WorldVistA   o OHUM VistA   o Hakeem VistA • OpenEMR • Resource & Patient Management System (RPMS)

• District Health Information System (DHIS2) • 'Blue Button' • 3D Slicer • ClearHealth • Clear Canvas • Hospital OS • OpenMRS • KitWare Systems • OSCAR • CHCS & AHLTA

* See links to other 'open source'  and 'public domain' health IT systems in the OHN Resources Section, e.g. Epi Info, GIMIAS, iHRIS, NEDSS, OpenEMPI, PHIN, Ushahidi, ...

Which is your favorite 'open source' Health IT software solution? Do you have another notable 'open source' Health IT system you would like to recommend to our readers?

Readers Choice: Most viewed 'Open Source' eHealth software

The global 'open source' software movement continues to grow and strengthen, especially in the field of healthcare. Based on the number of hits by readers of Open Health News (OHN) on links to 'open source' eHealth systems, the following are their top choices of interest: 

VistA  – Grabbing the top spot, major variants of this comprehensive 'open source' EHR system for hospitals & clinics include: VA VistA vxVistA OpenVistA WorldVistA RPMS 'Blue Button'

OpenEMR  ClearHealth   HEAL   CottageMed caBIG  HCUP BIRN Tools   Aurion Project

The next layer of top choices for 'open' eHealth systems contending for our readers interest include:

Apelon DTS Bika Lab Systems CAISIS CARE2X CHIT Epi Info

NEDSS/PHIN OpenCDMS OpenClinica Sahana Tolven Health Record 3D Slicer

* See links to more 'open source' health IT systems in the OHN Software Resources section, like OSCAR, RODS, Ushahidi, ClearCanvas, HuGENet, iPATH, HealthMap, iHRIS...

Which is your favorite 'open source' eHealth software solution? Do you have another 'open source' eHealth system you would like to recommend to our readers?

Open Source Mega-Companies & the 'Open Health' Marketplace?!

Senior executives and investors, pay attention. Hundreds of major open source companies have been established and are now succeeding in the 'Open Source' & 'Open Health' marketplace.  Think Red Hat, Clear Health, KitWare, MedSphere, Black Duck, Mirth, Alfresco, Canonical, Open Dental, Indivica, and many more. See Open Health News (OHN) Resource Section.  

Open source software has had a revolutionary impact on the software industry. With the success and ubiquity of open source projects, most enterprise and commercial software development teams now mix open source with internal code to shorten software development schedules and save on the development costs.  See BlackDuck Open Source ROI

The latest reports from Gartner, Forrester, Cenatic, and many other news and industry research organizations all point to the continuing growth of the open source marketplace. In fact, Red Hat recently became the first open source software company to generate more than $1 billion in annual revenue, a watershed moment for the global open source business community.  See COSI Open Health Studies & Reports.

Open source software has obtained a significant share of several markets, such as web servers, server operating systems, desktop operating systems, web browsers, databases, e-mail and other IT infrastructure solutions. A major driving force behind the adoption and growth of open source solutions in the U.S. has been the emergence and growth of open source software product and service providers with a profitable, sustainable economic model.  See Cenatic Report on International Use of Open Source Software – 2010

It would seem the time is right to start building more 'mega' companies in this space like Red Hat. Companies in the Open Source, and especially the Open Health space, are ripe for the picking with growth as far as the eye can see. Certainly Oracle has been busy picking up open source properties. What do you think is going to happen?

A recent survey by Gartner, Inc. found that more than half of organizations surveyed have adopted open-source software (OSS) solutions as part of their IT strategy. Nearly one-third of respondents cited benefits of flexibility, increased innovation, shorter development times and faster procurement processes as reasons for adopting OSS solutions.  See Gartner Report

Looking forward to your comments and a 'heads up' about any movement in this arena.

What is the Role Of the 'Open Source' Movement in Healthcare?

Every so often, we need to go back and remind ourselves why the open source movement is so important. We need to revisit and ask questions about the role of the open source movement in improving healthcare. How does the non-profit open source movement relate to companies operating in the for profit marketplace?

The intent of this particular blog is to raise these questions again and set the stage for further discussion of this issue. While I am a strong advocate of the 'Open Health' movement, I am not so fanatical that I lose site of the need for a robust industry composed of numerous 'for profit' companies competing for new customers and increased market share.

So what is the real role of the 'open source' movement and software development process in healthcare? Here are some ideas that immediately come to mind:

·         To enhance collaborative 'open' Research and Development (R&D) efforts by -  

o   Including more subject matter experts (SME) in the brainstorming and functional requirements definition process

o   Facilitating more open discussions and exploration of alternatives

o   Increased sharing of technology, information, and knowledge

o   Helping to foster increased creativity and innovation

o   Allowing for concurrent yet different agendas and differing methodologies and approaches

o   Helping to  establish 'open' industry standards to facilitate development of high quality, interoperable solutions.

·         The end results of the 'open source' Software Development process include –

o   Lowering development costs for all participating organizations

o   Providing ready access to 'open' source code and materials needed to produce health IT products

o   Providing a low cost alternative for those healthcare provider organizations that can't afford more costly commercial products

o   Facilitating continued collaboration on the creation of innovative system innovative enhancements

o   Increasing the speed of the design, development, and distribution processes, thereby reducing time to bring a product to market

o   Helping to create new business models for the 21^st century

·         The 'Open Source' software development process and movement is not about –

o   Competing against companies for paying customers

o   Increasing commercial market share

o   Competing for contracts to install new systems

o   Competing for contracts to provide ongoing support & services

What else is the 'Open Source' movement and software development process about? Just as important, what is it not about? Please share your thoughts with us.

'Open' Health Solutions for Church Healing Ministries

Many large church denominations operate or support hospitals and clinics in your community and around the world. One of the keys to providing high quality health care in these hospitals and clinics is the ability of clinicians to access health information on patients when and where it is most needed.

Along that line, the following are links to selected web sites offering innovative free and 'open' health information technologies (IT), tools, and solutions for use by religious organizations and individuals involved in health care and healing ministries.

• Christian Care Ministry - Equipping Christians to achieve biblical health.
• Consumer Health Information - Providing health care consumers with links to a wide range of free and open source health information & software tools.
• Directory of Charitable Religious Health Care Organizations - Links to major religious health care organizations around the world.
• Healing Ministries & Open Health IT Systems - Detailed blog about the use of free open source Health IT systems for Christian health ministries.
• Mobile Health Apps - Links to many free or low cost health & wellness apps for consumers and clinicians.
• Personal Health Record (PHR) Systems - Free and open source PHR systems available for use by patients in the U.S. and around the world.
• Public Health Information Systems - Links to open source software, tools, and public health information sources.

Take the time to visit the COSI 'Open' Health and COSI 'Open' Religious Technology web sites.  Also, check out this related blog on Healing Ministries & 'Open' Health IT Systems.

Do you know of other free and open source solutions for religious organizations and their followers that you would like to recommend? Share them with us.

Genomic Information, EHR Systems, & Open Source

Introduction

Next generation electronic medical record (EMR) will contain genomic information modules and provide predictive care capabilities supporting the continued movement towards more personalized medicine. Much of the work on genomic information systems being done involves extensive collaboration between public and private sector organizations with a heavy emphasis on standards and 'open source' solutions.

According to the journal, Nature Reviews Genetics (NRG), researchers from the McLaughlin-Rotman Centre for Global Health (MRC) in Toronto claim Mexico, India, Thailand and South Africa are blazing the way for other countries around the world. They report that those four countries are actively establishing domestic capacity in genomics and personalized medicine - efforts that will ultimately improve national health, slash medical costs through better resource allocation, and bolster their economies. See www.hoise.com/vmw/08/articles/vmw/LV-VM-10-08-10.html

Selected Genomic Information Projects & Related Activities

The following is a selection of major projects and activities related to genomic information systems and biorepositories that you might want to take the time to explore further. Many of these are either public domain or 'open source' solutions.

• Armed Forces Repository of Specimen Samples for the Identification of Remains (AFRSSIR) –  http://www.afmes.mil/index.cfm?pageid=afdil.afrssir.overview
• Disease InfoSearch & Genetic Alliance -  http://www.geneticalliance.org
• DOE Genomics Gateway -  http://www.doegenomes.org
• GeneCards Project -  http://www.genecards.org/index.shtml
• GeneTests -  http://www.geneclinics.org
• Genetics Home Reference -  http://ghr.nlm.nih.gov/ghr/template/Home.vm
• Genetics & Rare Diseases (GARD) –  http://rarediseases.info.nih.gov/ 
• Human Genome Organization (HUGO) –  http://www.hugo-international.org
• HuGENet & Public Health Genomics -  http://www.cdc.gov/genomics/hugenet/default.htm
• Genetics & Rare Diseases (GARD) –  http://rarediseases.info.nih.gov/ 
• International HapMap Project -  http://snp.cshl.org
• National Human Genome Research Institute (NHGRI) - http://www.genome.gov
• NCBI Human Genome Project & Resources – http://www.ncbi.nlm.nih.gov/genome/guide/human/ 
• PCPGM GeneInsight Suite -  http://pcpgm.partners.org/it-solutions/geneinsight
• VA Genomic Information System for Integrative Science (GenISIS) - http://research.maveric.org/genisis.html

* Also see Alphabetic Listing of Other Genetic Analysis Software - http://linkage.rockefeller.edu/soft/list.html

Major Issues

Integrated longitudinal health records that include personal, clinical, and genomic information will provide unprecedented access to details about an individual in a manner that was previously inconceivable. Privacy and security are absolutely crucial when it comes to genomic information. To protect individuals and their genomic information will require everything from new legislation, policies, operating guideline, better access controls, data encryption, system audit tools, informed consent, release of information procedures, training, and more.

Findings & Conclusions

• Over the next decade, one of the goals for R&D staffs working in genomics will be to transform knowledge about the human genome into improvements in clinical practice and patient care.
• Numerous Federal agencies and private clinical research enterprises engaged in developing genomic information systems over the past decade are embracing collaborative ventures and 'open source' solutions.
• Health care organizations need to be more proactive in collaborating with on the construction of the unified clinical and genomic health information systems of the future.
• It is anticipated that genomic information will start to become a standard component of a person's electronic medical record (EMR) in the coming decade.

If you are involved with the development and testing of EMR systems that contain genomic information, please let us know about it. Tell us how its going.