There is a lot going on in open-source healthcare software -- enough, in fact, to provide fodder for 5 1/2 hours of presentations at the 2005 TEPR healthcare information technology show that opened Monday in Salt Lake City.
For example, there is an open-source regional health information organization, or RHIO, under development in Medocino County, Calif.
A medical researcher from Harbor-UCLA Medical Center has developed a Web-based tool to create forms linked to an open-source database. Originally designed as a research and quality improvement tool, the software has since attracted an international following and has been used to design a hospital patient registration system and several full-blown electronic medical records systems.
A technology vendor from Phoenix has developed patient software for scheduling, billing and electronic medical records systems, all using the open-source approach.
A Hawaiian collaboration between the U.S. Army and the Department of Veterans Affairs has produced an open-source version of the VA's electronic medical records system that can be offered via the Internet to multiple small medical clinics.
Under open source, the basic programming code of the software is made publicly available for modification so that users can become co-developers with the expectation -- but not always the requirement -- that any improvements will be shared with other users.
Will Ross, project manager for the Mendocino RHIO, said three hospitals, six clinics, an Indian Health Service care site and the county health department are part of the consortium in a county with limited broadband access and some of the lowest healthcare metrics in the state. The software for the project, which will interface electronic medical records from various off-the-shelf vendors such as Cerner Corp., Meditech and NextGen Healthcare Information Systems, was developed on contract for the coalition, but was based on open-source software developed at Los Alamos National Laboratory.
It will be rolled out at the first five clinics in August, Ross said, but the software is free and already downloadable at openhre.org.
Andrew Ho, M.D., assistant clinical professor of psychiatry at the University of California, Los Angeles, developed his software using an easily modifiable platform to do clinical research, with a primary use to create a form to track follow-up care for emergency-room psychiatric patients. The most common applications are in quality improvement programs, but one user created a 19-question decision-support tool to recommend the best medication for depressed patients. Three clinics in Los Angeles have used it to develop an electronic medical records system. The software, released to the public in 2000, has been downloaded more than 1,000 times.
"The first group that contacted us was in Russia," Ho said. "Sri Lanka was another site that uses our software to track inventory and register patients."
Ho's group, Open Infrastructure for Outcomes, hosts a growing library of forms developed by others at txoutcome.org.
"They can share, but they don't have to," he said. "It takes about five minutes to learn our system. Everybody can contribute to it. I think the line between customers and developers is quite blurry with open-source and we need to keep that. Collaboration is very important."
To lower the cost of IT systems to small group offices and rural and public healthcare installations, the Pacific Telehealth & Technology Hui in Honolulu has launched an open-source version of the VA's Vista system. By using an application service provider, or ASP, model, the software can be distributed over the Internet to multiple care sites from a single computer server and data storage location. The system is up and running at an HIV clinic in Hawaii and is expected to be online at a geriatric outpatient clinic soon, said Reese Omizo, M.D., clinical telehealth coordinator at the Hui, the Hawaiian word for partnership. Documentation for the system should be completed by June 30 and made public.