Stimulating Innovation with Open Source Software
2012 is a big year for Open Source. Skunkworks One at EHI Live 2011 was an ambitious experiment which succeeded at one level and failed at another. The showcasing of the range and quality of open source software to the general healthcare user and procurement community worked very well. But at the time I felt that it hadn't yet achieved its core objective :” to put clinicians directly in touch with software developers, to reinvigorate a new awareness and dialogue around IT to share awareness of fresh challenges, and stimulate new ideas and new solutions” (link to earlier Skunkworks One paper:http:/
The rather grandly titled “The power of information: putting all of us in control of the health and care information we need” strategy paper was published in May to a largely indifferent audience. Ironic, given the huge shift in responsibility from central to local purchasing.
Data on the other hand is different. The main government story of the year worthy of the allocated publicity was the Open Data White Paper publication and the launch of the Open Data Platform Hackweek http:/
To many this policy might appear a bit left-field, but if you think of data as being the main resource used by all the search engines, social networks and the big data business applications then it is the most strategic infrastructural decision that any government has taken about government since the 70's decision to privatise public services. And one that US health policy makers are trying to emulate. Open data is the e-coal that was missing for Blair's information age. This policy will truly revolutionise UK healthcare informatics and healthcare delivery. But healthcare data is produced by software according to minefield of semi proprietary standards like LOINC, SNOMED and HL7, so it is vitally important to get the NHS's contribution to Open Data aligned with these global interests, without passing on huge unforeseen costs and commercial barriers to innovation at the developer level. Maybe the good old open source NHS Data Dictionary as good a place to start as any, but with HL7 recently announcing a free open standards policy, surely these other standards organisations will be the next to follow suit.
The first bloom
In January, Moorfields NHS Trust - the winners of the 2011 eHealthOpenSource and IHE-UK best open source business case competition category - went live with an open source opthamology EPR sytem called “OpenEyes”. The first release contains core administrative functions and the next release containing core clinical modules is scheduled for August. What a great start to the Open Source calendar year.
Then in February, the Cabinet Office , building on the publication of their open source toolkit, launched a consultation into Open Standards, which attracted great interest from the proprietary software and standards community. I was involved a couple of the workshops, including one that has to be cancelled due to a perception of unfair facilitation (link to article abandoning first workshop). The Cabinet Office team successfully closed the consultation and announced a transition into a new action-oriented phase, which promised less talk and guidelines and more hack day events to inform users and vendors.
On the healthcare Open Standards front, there is good news from Radiology, where IHE open profiles for document exchange and workflow have appeared in tenders for PACS and RIS systems up and down the country, thanks mainly to the efforts of smart, active clinicians who are have not been content with standing still with ageing PACS architectures.
“There is a whiff of revolution in the air!”
. . . was the response from one experienced consultant, after listening to the reactions of the people who attended the first NHSHackday in May this year. The hackday event is the creation of Carl Reynolds and Wai Keong of Open Healthcare UK - two more very smart, active clinicians who believe that software really, really matters to their profession. Quote: “NHS Hack Day (software development day) is committed to producing high quality software that improves health. That's why we support openness and invite you to share code with us on github.” The first event had senior NHS clinician sponsorship unleashed enormous development energy and significant publicity for the people and open source platforms involved. It was a privilege to lead one of the projects here (Bleep/Bleep!) and to encourage the use of hackdays across government procurement (link to EHI Hack the programme paper).
There has been a rush of hackday events and workshop meetings happening across healthcare IT, including a clinical research hackday, sponsored by JISC, NIHR and one of the beacon projects in this space - Leicester University's Brisskit project, which serves its research partners with an integrated set of open source clinical research applications via an Eduserve cloud infrastructure. A flurry of other hackdays including hack4health, ODP hackweek, digitalhealthhack.
Open Source Software is the medium for collaborative innovation
Now the above summary of events is an accurate summary, designed to highlight what I see as a siesmic shift in the way that users relate to software. It won't happen overnight, and will take time to work out stable solutions and ways of working. However, it represents the start of an irreversible change in the healthcare IT market towards a new equilibrium in which Open Source software is used by everyone as platforms for collaborative innovation. The aim of Skunkworks is NOT to declare all proprietary software bad – far from it. The public ownership properties of Open Source serves to neutralise the guarded behaviours, fears and suspicions which so often stifle collaboration between proprietary software vendors. An Open Source Skunkworks is absolutely essential in places where innovation has died through a lack of collaboration. Collaboration can restart with the right Open Source package and in turn develop into an Open API , which can then serve as the vital bridge to support a vibrant multivendor software market such as that supported by the IHE worldwide ecosystem of 400 healthcare IT suppliers.
So what is The Skunkworks up to this year?
Clinicians are already using open source software as a platform for engaging with developers, but not just at the Skunkworks website or stand. They are meeting up in hackday events all around the country using several types of web and social media as planning tools.
The Skunkworks Two website will be launching soon for readers to identify areas where innovation has failed to address their healthcare challenges and for the developer community to propose solutions. The dialogue will shared with the folks in other open source communities through the EHI twitter feeds. Ideas could be promoted to hackevents such as NHShackday for solutions to be actually developed.
The Skunkworks stand at EHI Live on 6/7 November 2012 will be a showcase for open source software and solutions, but will also provide an opportunity for also provide an opportunity for developers to offer advice regarding the use of open source and open API standards. There will also be space for presentations and talks from various open source groups, including the shortlisted ehealthopensource.org competition entrants and winners.
So whether you are a clinician or a geek, a manager or consultant, I recommend that you sign up to the EHI Skunkworks group now to get linked in to this game changing action.