Category Archives: Politics

Use of Open Source Software in Health Care Delivery – Results of a Qualitative Field Study

The article about my previous research has finally been published in the IMIA Yearbook 2013. It is meant to provide a practitioner’s perspective on the use of medical free/libre and open source software (FLOSS) in clinical routine. In this context I examined and presented the opinions and experiences of chief information officers (CIO) working at larger hospitals. The abstract reads like this:

Objectives: To assess and analyze the attitude of health IT executives towards the utilization of specialized medical Open Source software (OSS) in Germany’s and other European countries’ health care delivery.

Methods: After an initial literature review a field study was carried out based on semi-structured expert interviews. Eight German and 11 other European health IT executives were surveyed. The results were qualitatively analyzed using the grounded theory approach. Identified concepts were reviewed using SWOT analysis.

Results: In total, 13 strengths, 11 weaknesses, 3 opportunities, and 8 threats of the utilization of OSS in a clinical setting could be identified. Additionally, closely related aspects like general software procurement criteria, the overall attitude of health IT executives, users, and management towards OSS and its current and future use could as well be assessed.

Conclusions: Medical OSS is rarely used in health care delivery. In order to capitalize the unique advantages of OSS in a clinical setting, complex requirements need to be addressed. Short-comings of OSS describe an attractive breeding ground for new commercial offerings and services that need yet to be seen.

Schmuhl, H., Heinze, O., & Bergh, B. (2013). Use of Open Source Software in Health Care Delivery – Results of a Qualitative Field Study. Contribution of the EFMI LIFOSS Working Group. Yearbook of medical informatics, 8(1), 107–13.

The full text article available via: Apfelkraut.org | PubMed | Schattauer

I am looking forward to your feedback!

Zu unserer Sicherheit

Es fehlen einem erst mal die Worte, nachdem man das ZDF Interview (YouTube, Tran­skript) von Bierdimpfl CSU-Politiker und “Innenminister” Hans-Peter Friedrich vom 12.07.2013 gesehen hat. Ihm scheint auch nicht ganz wohl bei der Sache zu sein. Trotzdem sollen an dieser Stelle – zu unserer Sicherheit – ein paar Informationen im Kontext des “Überwachungsskandals” zusammengetragen werden und wie wir uns selbst schützen können:

PRISM Logo
PRISM Logo, welches stark an ein Schallplattencover erinnern. Man könnte es auch “The Dark Side of the Earth” nennen.

Auch wenn das Überwachungsprogramm PRISM in aller Munde ist, ist es nur eines von vielen. Da wären noch Tempora, Fairview, Stormbrew, Blarney, Oakstar, … Eine kommentierte ausführliche Übersicht gibt es bei Netzpolitik.org. Heise Online hat ebenfalls eine Zusammenfassung.

Nach einem Bericht der Monterey Herald hat die U.S. Army in ihrem Netzwerk, also für sämtliche Mitarbeiter weltweit, den Zugriff auf die Webseiten des Guardians blockiert, nachdem dort die ersten Berichte zu PRISM veröffentlicht wurden. “Netzwerk-Hygiene” nennt sich das. (via Heise Online)

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Towards Open Collaborative Health Informatics – The Role of Free/Libre Open Source Principles

A general overview article about free/libre and open source software in the context of health care to which I strongly contributed as co-author has recently been published in the IMIA Yearbook 2011. The abstract reads like this:

Objectives: To analyze the contribution of Free/Libre Open Source Software in health care (FLOSS-HC) and to give perspectives for future developments.

Methods: The paper summarizes FLOSS-related trends in health care as anticipated by members of the IMIA Open Source Working Group. Data were obtained through literature review and personal experience and observations of the authors in the last two decades. A status quo is given by a frequency analysis of the database of Medfloss.org, one of the world’s largest platforms dedicated to FLOSS-HC. The authors discuss current problems in the field of health care and finally give a prospective roadmap, a projection of the potential influences of FLOSS in health care.

Results: FLOSS-HC already exists for more than 2 decades. Several projects have shown that FLOSS may produce highly competitive alternatives to proprietary solutions that are at least equivalent in usability and have a better total cost of ownership ratio. The Medfloss.org database currently lists 221 projects of diverse application types.

Conclusions: FLOSS principles hold a great potential for addressing several of the most critical problems in health care IT. The authors argue that an ecosystem perspective is relevant and that FLOSS principles are best suited to create health IT systems that are able to evolve over time as medical knowledge, technologies, insights, workflows etc. continuously change. All these factors that inherently influence the development of health IT systems are changing at an ever growing pace. Traditional models of software engineering are not able to follow these changes and provide up-to-date systems for an acceptable cost/value ratio. To allow FLOSS to positively influence Health IT in the future a “FLOSS-friendly” environment has to be provided. Policy makers should resolve uncertainties in the legal framework that disfavor FLOSS. Certification procedures should be specified in a way that they do not raise additional barriers for FLOSS.

Karopka, T., Schmuhl, H., Marcelo, A., Molin, J. D., & Wright, G. (2011). Towards Open Collaborative Health Informatics – The Role of Free/Libre Open Source Principles. Contribution of the IMIA Open Source Health Informatics Working Group. Yearbook of medical informatics, 6(1), 63–72.

The full text article available via: Apfelkraut.org | PubMed | Schattauer

I am looking forward to your feedback!

World Wide Investment Fund For Nature and More

Sind Sie für eine konstruktive Zusammenarbeit mit Monsanto und anderen Freunden der Gentechnik? Verstehen Sie unter nachhaltiger Landwirtschaft den monokulturellen Anbau von nachwachsenden Rohstoffen? Sehen Sie es als beachtlichen Erfolg, wenn dabei 0,5 % des ursprünglichen Urwaldes durch unser Engagement erhalten werden konnte und als ausschließlicher Lebensraum für alle vertriebenen Arten dient? Möchten Sie dafür spenden, dass wir mit Ihren Geldern unerschlossene Gebiete kartographieren, um sie dann nachhaltig durch die Palmölindustrie brandroden bewirtschaften zu lassen? Sind Sie für die professionelle Jagd auf Wilderer durch von Ihnen finanzierte Söldner? Dann schieben Sie jetzt Ihre Ablassabgabe rüber, so wie dies auch schon Ölkonzerne und andere, nicht ganz so ökologisch und nachhaltig ausgerichtete Großkonzerne erfolgreich gemacht haben … in manchmal, vielleicht nicht ganz so transparenten Vorgängen.

So oder so ähnlich müssten eigentlich der Werbetext für eine der größten Naturschutzorganisationen der Welt lauten, schenkt man der WDR Sendung “Der Pakt mit dem Panda: Was uns der WWF verschweigt” (ARD Seite | Mediathek) von Wilfried Huismann Glauben. Selbstverständlich stimmt das alles nicht und der WWF klärt sofort auf. Bereits die Vorankündigung wurden durch den knurrenden Panda leicht zurechtgestutzt (siehe ARD Seite).

Eine textuelle Zusammenfassung der Sendung gibt es bei der sueddeutsche.de, auch die taz.de hat mitgeschaut.

Was wohl Chi Chi dazu sagen würde?

The untold story of planned obsolescence

Did you know that the lifetime of light bulbs once used to last for more than 2500 hours and was reduced – on purpose – to just 1000 hours? Did you know that nylon stockings once used to be that stable that you could even use them as tow rope for cars and its quality was reduced just to make sure that you will soon need a new one? Did you know that you might have a tiny little chip inside your printer that was just placed there so that your device will “break” after a predefined number of printed pages thereby assuring that you buy a new one? Did you know that Apple originally did not intend to offer any battery exchange service for their iPods/iPhones/iPads just to enable you to continuously contribute to the growth of this corporation?

This strategy was maybe first thought through already in the 19th century and later on for example motivated by Bernhard London in 1932 in his paper “Ending the Depression Through Planned Obsolescence”. The intentional design and manufacturing of products with a limited lifespan to assure repeated purchases is denoted as “planned/programmed obsolescence” and we are all or at least most of us upright and thoroughly participating in this doubtful endeavor. Or did you not recently think about buying a new mobile phone / computer / car / clothes / … because your old one unexpectedly died or just because of this very cool new feature that you oh so badly need?

The Light Bulb Conspiracy
"The Light Bulb Conspiracy" by Cosima Dannoritzer

A really well done documentary that provides a comprehensive overview about and a detailed insight into this topic recently aired on Arte and other European television networks. It is entitled “The Light Bulb Conspiracy – The untold story of planned obsolescence” (aka “Pyramids of Waste”, DE: “Kaufen für die Müllhalde”, FR: “Prêt à jeter”, ES: “Comprar, tirar, comprar”) and is a French/Spanish production directed by Cosima Dannoritzer. Recordings of the movie have been uploaded to various video portals, for example currently available on YouTube in EN/International with Norwegian subtitles, DE, FR and ES. Just the official TV and Internet broadcasts were viewed by over 2,500,000 people.

If you like to follow up on some of the documentary’s content, here are the links: The light bulb at the Livermore-Pleasanton Fire Department can be watched here via web cam. Wikipedia has some more information on the Phoebus cartel in EN and DE. The referenced clip about the tremendous waste of ink by inkjet printers can be found at Atomic Shrimp: “The Dirty Little Secret Of Inkjet Printers”. The software to reset the page counter of various Epson printers can be found here: SSC Service Utility for Epson Stylus Printers. The people that made “iPod’s Dirty Secret” are the Neistat Brothers. The tough guy from Ghana that collects evidences at the dumping grounds to identify the orignators of electric waste is Mike Anane and he also contributed to the report “Poisoning the poor – Electronic waste in Ghana” issued by Greenpeace.

That planned obsolescence may be needed or even is substantial to appease the ever-growing hunger to achieve continuous and distinct economic growth that is natural to nations with advanced economies aka developed (?) countries is one part. The past and present is comprised of numerous advocates and supporters with well-engineered argumentations in favor of this business strategy. But even the ultimate argument gets immediately and indisputably absurd and unreasonable when it comes to the thereby produced waste – the other part of planned obsolescence. “The Light Bulb Conspiracy” quite clearly showed where this leads to and especially where all the resulting waste is dumped.

Let’s keep that in mind while impatiently waiting for the release of the next generation of the iPhone …


Trailer “The Light Bulb Conspiracy”

[written and directed by Cosima Dannoritzer]