Insist on Open Source
A National Dialog ON HEALTH INFORMATION TECHNOLOGY AND PRIVACY
What is the idea?
Those deciding on health IT solutions should insist on Free and Open Source (FOSS) software.
When people use proprietary Health Information systems, there is always one party, the developers of the proprietary system, that has a dramatically skewed proportion of the control of the health information.
People will suggest many wonderful ideas on this board: PHR's, transparency, consumerism, Health 2.0, interoperability etc etc. But if those good ideas are implemented in proprietary systems, then the true "owners" of the health information are the vendors. They are the only ones who can change what the software needs to do.
This is important because we have no idea what a Health IT applications should be doing in two years.
Arguably (just check my comments) the best EHR in the world is VA VistA. It is the best because it was developed with the following way:
- Openly, everyone could see the code
- Collaboratively, different people did different parts focusing on solving local needs.
- Distributed, there was no central body who created the "specs" for VistA
That is essentially the open source development model.
Freedom is not incidental to the quality of VistA. It is the foundation of VA VistA. Without the local control and the centralized coordination that are the hallmarks of the FOSS development model, we will never realize the potential for software to improve healthcare
Why is it important?
Proprietary licenses are only good for the vendor: not the patient, not the provider, not the hospital, not the clinic.They put the vendor in control of patient data. One could argue all day about who should "own" patient data, but it should not be the software vendor.
All of the good ideas that are proposed here will be tainted by the licensing unless those who are interested in the greater good take a strong stand against those who wish to guarantee thier own profitablity.