Features Editor
Over the last week I have been busy building a new laptop. I needed a machine that could handle writing articles and surfing the web, but I also needed to have something with the power to play the latest video games and edit video. I bought the hardware and built my new PC from the ground up, but when it came time to load the software that would power my PC, I had but one caveat – I refuse to pay for anything I can’t own, like DRM-protected software.
A few hours later, I had a nice computer running Ubuntu, a Windows emulator, OpenOffice, and Kdenlive. The net cost was less than $10, and I’d be willing to bet it’s more functional than the Windows 10 machine you’ll find at Best Buy. Further, if I need to make any substantial changes, I’m free to do so. That’s the beauty of open-source alternatives.
I’m left with but one question – why can’t healthcare be this easy? Why can’t the EHR software that our hospitals use be open source and freely allow customization that would combat the interoperability issue and undoubtedly lower costs?
A quick Google search for “open source EHR” reveals that there are a few options out there, though I hadn’t heard of them. Many seem not to meet the standards set down by Meaningful Use, which may be indicative that they’re of less-than-meaningful quality. Or, it may be an indication that those incentive dollars are only going to be spent on vendor products that have the funding to get the MU certification.
There is also something called the OpenEMR Project, and if you go to their website, you’ll find them seeking dollars for Meaningful Use certification right on their homepage. Judge for yourself what it means when community-based projects and labors of love can’t enter the marketplace in a real way.
Granted, the market is opening up. There are more options than ever for those looking for an EHR system. Some vendor products are more open than others; some are designed to communicate while others function as a vault for data. To a degree, a demand for choice on the part of health systems is changing the industry. However, every other technology field from entertainment to finance benefits from open-source software and the talents of creative individuals with a desire to solve problems and freely share information. Open-source options are good for competition.
Bitcoin is now an accepted legal currency in Japan, and as we speak it’s being used to buy products all over the world – including from major retailers, such as Amazon, thanks to companion apps developed by people who saw a problem and decided to solve it.
On another front, Linux now has more variations I can count, and it’s still being improved upon every day. It’s also used as the foundation for the Android operating system, powering a myriad of easy-to-customize smartphones and tablets that are sold by every major player in the consumer tech space, from Samsung to Acer.
I understand that EHRs are big, complicated systems, but I sometimes wonder if their complexity is a result of intellectual property protection and a need to suck up dollars, as opposed to a genuine desire to make the system more functional. I’m not claiming profits are an evil motivation on their face. However, when coupled with regulatory efforts that put barriers of entry into the market and subsidize only those wealthy enough to exceed those barriers, the end result is going to be uniformity and collusion, which is exactly what we’ve seen in the EHR space. Things are getting better, but at a snail’s pace when compared with other tech sectors.
I know a community-based or open EHR carries with it a fringe stigma and some concerns, especially in the area of protecting patient privacy. But, the beauty of open-source innovations is that anyone can take them, use them, and expand upon them to their liking. Such open software could be used as a foundation for a multitude of products and future improvements that solve the concerns associated with a less-expensive alternative, and possibly solve the interoperability issue in the process.
When people come together, the things they create can be amazing. And tech proves that time and time again in other industries. I don’t see why healthcare has to be any different. Honestly, even if this is a pipe dream – I don’t know what we’d have to lose.
