Why are Open Source & OpenEMR Good for Healthcare

“What are the advantages of open source software for health care?

Open source solutions have a number of advantages for a health care enterprise. The collaborative sharing of ideas and concepts practiced by users of open source software can create ‘communities’ of developers, partners, testers and users who interact with each other to further improve the software. This can speed up the development process,
bringing in skills that a single software vendor would not be able to provide.”

What is the size and quality of the OpenEMR’s supporting community?

“If the open source product is maintained on SourceForge, for example, one can assess the degree of community involvement from the activity posted on the product’s SourceForge project site. The various forums for community participation should have many more participants than just the code committers. The forums should be sounding boards for high level clinical functionality comments as well as low level chatter about relatively arcane technical nuances. If a product fails to engage
the community, the SourceForge forums will show little in the way of ongoing conversations; this can be a sign that the code is not being examined and may indicate that a valuable community oversight activity is failing to take place.”

Here is a log of OpenEMR downloads/month in the last year or so (averaging 4000):

https://sourceforge.net/projects/openemr/files/stats/timeline?dates=2010-01-01 to 2011-02-20

And the Forum Posts:

https://sourceforge.net/project/stats/detail.php?group_id=60081&ugn=openemr&type=forum

So clearly there are 400 posts per month, to me this indicates a fairly large and vigorous development and user community.

Quality and reliability of open source software.

“Bugs are vigorously discussed and fixed in the open, lending an unusual degree of transparency to the development process. This degree of community engagement takes time, and may give the appearance that open source development is more time consuming than traditional code development. The trade-off of the open source process is a higher degree of software quality. Detecting bugs before the software is placed into superior to proprietary software.”

Security concerns. (Security does not equal Secrecy)

“Since there is an admirable emphasis on protecting patient privacy in regards to health care information, managers need to be assured that an open source product implementation provides the level of security that is expected by consumers and clinicians. There is an unfortunate tendency to conflate security with secrecy. When such confusion reigns, then it is easy to carelessly assume that open source code must not provide the same degree of security as proprietary code.”

How can one profit from free software?

“Open Source Business Model of a license, how do organizations “make money” from open source products?

Since most companies that develop proprietary health care IT of which license fees are one, it should come as no surprise that commercial organizations can garner revenue from providing support services and custom code extensions with open source products. The sales/marketing cycle for an open source company may bear little resemblance to the cycle of those activities for a proprietary software company.  In many cases, the customers come to the commercial open source support organization after they have downloaded and “tried out” the open source code.”

Conclusion of the HIMSS (as it applies to open source software for an HIE)

“…if the team follows through on all of the recommendations outlined above, an open source approach to an HIE project offers no increased risk and also offers some novel factors for risk mitigation.”

Excerpted from: “Evaluating Open Source Software for Health Information Exchange”, HIMSS Healthcare Information Exchange, Open Source Task Force White Paper, June 2008

© 2008 Healthcare Information and Management Systems Society (HIMSS)