Open Source Expected To Improve Innovation

Aug. 1, 2009

The greatest perceived challenge is the integration of the various open source and proprietary software components.

Open source technology delivers free access with unrestricted use and flexibility, thereby accelerating innovation, characterized by collaboration, sharing of intellectual property and a commitment to standards. For healthcare providers and organizations that face reduced reimbursements, rising costs and ever-increasing compliance requirements, this “free” technology is a welcome option.

The greatest perceived challenge is the integration of the various open source and proprietary software components.

Open source technology delivers free access with unrestricted use and flexibility, thereby accelerating innovation, characterized by collaboration, sharing of intellectual property and a commitment to standards. For healthcare providers and organizations that face reduced reimbursements, rising costs and ever-increasing compliance requirements, this “free” technology is a welcome option.

According to an IDC study on open source, the cost savings achieved through open source software adoption is the number one reason for users’ selection and deployment of the technology. The study also noted that the greatest challenge was the integration of the various open source and proprietary software components. Nevertheless, even if healthcare organizations need to outsource the software integration and support, the total costs would typically be less than those costs related to proprietary software.

Arguably more important than the benefit of cost reduction is vendor independence. Relying on open source technology enables organizations to resolve any code issues themselves or draw from innumerable sources for assistance, including the open source community.

From a vendor perspective, open source technology provides the opportunity to supply lower-cost solutions with almost unlimited customization. By leveraging open code-sharing initiatives, developers can select proven, established code to realize clients’ objectives. Furthermore, this organic, community code-sharing model, which uses accepted standards such as HL7, ensures that weaker code is quickly replaced by more-robust solutions.

Vendor resources can be directed to more-profitable business aspects, such as service contracts, installation, data security, training and documentation. Also, vendors are not limited to supplying only open source solutions. The reality is that most open source-friendly healthcare organizations will have a heterogeneous environment, comprised of both proprietary, closed-source applications and open source programs.

As open source reaches critical mass within healthcare, an even greater milestone will be reached – broadly accepted standards for codes, such as how information is structured, defined and exchanged. This common foundation will speed the realization of interoperability between all systems within a healthcare enterprise.

As the number of developers examining code increases, the quantity of improvements achieved also rises – and these advancements are obtained more readily.

Healthcare payers have an equally strong need for interoperability supplied by open source solutions. Whether the healthcare IT application is claims processing, billing administration or customer-service management, each solution should function seamlessly with the existing heterogeneous environment to maximize efficiencies, control costs and ensure better health outcomes. The ability to customize interfaces and integrate disparate healthcare IT systems enables payers to directly access necessary healthcare data to optimize health plan designs, resulting in such additional benefits as successful patient (or member) interventions and measurable improvements in workforce productivity.

In the 1999-2001 timeframe, there were several notable open source failures and the technology failed to gain traction among healthcare IT decision-makers. Since that time, many factors have changed, including the technology’s evolution into a stable platform and the growth of an active open source community of developers.

The healthcare industry overall has also embraced the culture of collaboration in other areas, as regions and states deploy health information exchanges, the definition of which echoes the mission of open source: transparent information sharing, interoperability between technologies, minimal cost and maximum results. Additionally, the open source community could be seen as a mirror of the evidence-based medicine community that honors the process of peer review and seamless data exchange to promote improved outcomes.

Executives are embracing open source technology into their previously proprietary-dominated ecosystems. In the IDC survey, almost 60 percent of respondents said their company increased spending on open source in 2007 as a relative percentage of IT spending. To support that investment, respondents anticipated that spending on quality assurance, testing and certification of open source solutions would grow 150 percent from 2007 to 2008.

The largest open source success story within healthcare to date is the U.S. Department of Veterans Affairs’ development and deployment of VistA, a platform that powers various clinical and medical-delivery systems at hundreds of healthcare facilities of all sizes across the United States. One of the biggest perceived negatives cited by open source naysayers is the expanded security risks. As the number of developers examining code increases, however, the quantity of improvements achieved also rises – and these advancements are obtained more readily.

This strategy has even been used in a similar manner by Microsoft, which challenged some of the world’s most acknowledged computer experts to hack into Vista during its development period. With a large, active open source community focused on optimizing code, the results should supersede that which would be obtained by the limited resources of any given vendors’ IT development team.

Low-cost, high-value, open source technology levels the healthcare playing field, offering all stakeholders an equal opportunity to access leading-edge solutions that deliver secure access to patient data and enhance the efficiency of healthcare delivery. With President Obama’s declared support for open source technology, greater adoption is anticipated as the country drives toward ubiquitous electronic health records in the next five years. As such, the industry will keep close tabs on the administration’s and Congress’ reaction to the recently published recommendations by HIMSS that suggest using CCHIT certifications as a prerequisite for obtaining federal funding and incentives, which could slow the expansion of open source within healthcare.

Bruce Ralston is the chief technology officer of Eldorado, an MphasiS company, Phoenix.

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