Medical FLOSS repository at www.medfloss.org

After the initial launch 6 months ago it recently welcomed the 200th project in its repository: the GPL-licensed iDART software – iDART is the abbreviation of “Intelligent Dispensing of Antiretroviral Treatment” and according to its authors addresses many of the challenges faced by public ART dispensing pharmacies in developing countries.

Starting with originally just 120 projects, the medfloss.org database currently holds:

• 206 medical FLOSS projects that can be browsed by application type, enterprise function, standard and additional categories.
• 63 companies and other institutions that are offering professional service for specific FLOSS projects
• 83 references to scientific publications about the utilization of FLOSS in health care
• detailed overview of past and future FLOSS events like the Med-e-Tel 2010 FLOSS-HC track or OSCON Health IT track 2010

… and much more useful information.

My cordial thanks goes to all the contributors that already made and hopefully will continue to make use of the open content concept by revising/extending existing information or adding new content!

For more information about the site and its objectives please refer to the mission statement or these slides. Beside amendments to the actual content I also highly appreciate any general feedback about the site, offered functionality and shortcomings of it.

Corpus Delicti - Eine Schallnovelle

Gestern gab es dann ordentlich was auf die Ohren und Augen. Neben der perfekten Symbiose von verlesenen Worten und dargebotener Musik, wurde das Stück auch sehr passend visuell untermalt, in Form von Animationen und teils grellen Lichteffekten. Die eigens für das Stück komponierten Lieder ver-klang-bildlichen die Handlung in eindrucksvoller und teils sphärischer Art und Weise, lassen aber vor allen Dingen Zeit, um das Gesagte gedanklich weiterverarbeiten zu können. Während der literarischen Passagen wurde Juli Zeh auch schauspielerisch durch die Bandmitglieder unterstützt, so zum Beispiel Christian Neuburger unter anderem in der Rolle des Moritz Holl. Gemeinsam wirkten sie wie eine eingespielte Schauspieltruppe und nicht wie ein loser Zusammenschluss einer Autorin und einer Band für ein Theaterprojekt. Auch deshalb ist das Theater der geeignetste Ort für dieses ‘Extra’-Genre … nur manchmal hat man sich, noch besser passend zur Musik, eine unbestuhlte Konzerthalle herbei gewünscht.

Wer sich selbst überzeugen will – ein kleiner Ausschnitt aus dem Studio:

Eine rundum gelungene Veranstaltung, die ohne Einschränkungen weiterempfohlen werden kann. Die nächste Möglichkeit scheint sich vorerst in Bernau am Samstag, 29. Mai 2010, um 20.00 Uhr zu ergeben oder eben aus der Dose: Corpus Delicti – Eine Schallnovelle, erschienen 09/2009 bei Strange Ways Records. Mehr zur ursprünglich klanglosen, rein papier-basierten Novelle Corpus Delicti: Ein Prozess von Juli Zeh findet man zum Beispiel bei de.wikipedia.org.

Ich will mehr solcher Schallnovellen !!

Weitere Informationen:

• Volkstheater München
• Slut (Homepage | MySpace)
• Juli Zeh

Even a high number of downloads or a strong ‘activity percentile’ of an open source software project doesn’t tell you anything about the suitability for your purposes and in general about the stability and efficiency that are required for successful clinical practice.

But what if you could see on a per-project basis at which site it is already deployed and even whom you could contact and ask for advice and personal experiences?

This is where medfloss.org (formerly medfoss.apfelkraut.org) wants to help out. Medfloss.org is mainly an open content platform in which everyone is invited to participate. Beside a comprehensive and structured listing of free/libre and open source software (FLOSS) projects for health care, it now offers also the possibility to submit reference sites that are using a specific project in a productive environment.

So if you are already a medical FLOSS veteran and are open to share your experiences, please take a look at the subsequent steps. You could thereby make life much easier for the ones who want to follow your example.

• You can add your institution as reference site and just provide your site name and homepage. Thereby potential users can leave a comment at your entry and ask for help.
  While creating your entry you can immediately hook it up with the project(s) you are using. Probably the project(s) should be already in the database, otherwise you are welcome to add them.
• If you are open for people seeking assistance to contact you directly, feel free to add also your contact details. Your email address is protected by SpamSpan against spam bots, but please be aware of that your contact information will be visible to every visitor at medfloss.org.
• How to add your site:
  
  

  Medical FLOSS Portal at www.medfloss.org

  • First make sure that the project(s) you are using is/are already listed at medfloss.org. The easiest way to do so would be to use the search functionality that you can find on top of the left navigation pane. If it is not yet in the database, please add it by using the link ‘Submit project’.
  • Second just go to the ‘Bazaar’ (http://www.medfloss.org/node/285) and add your institution as reference site. The referring link ‘Add reference site’ is given in the second part of ‘HAVES – professional service providers & reference sites’.
  • Alternatively you could just send me your site information via the contact form and I will add it asap to medfloss.org.

Please help spread the word and feel free to forward this message.

Medical FLOSS Portal at www.medfloss.org

For details about the offered features and services please refer to the Mission Statement.

Update (2010/03/06): Links have been updated as site was moved from medfoss.apfelkraut.org to www.medfloss.org.

Trackbacks: The H Open Source – “FOSS for health care”, heise.de – “Open Source für die Medizin”, healthcaremarketing.eu – “Open Source-Initiative ‘Medfoss.apfelkraut.org’ gestartet”.

OpenMRS - an Open Source EMR system

Since the beginning of 2003 the Bosten-based Partners in Health (PIH) rolled out a web-based EMR to primarily track HIV patient within Haiti. Meanwhile the system was replaced by the FOSS EMR software OpenMRS and is deployed in 9-10 PIH hospitals spread over Haiti (and by the way more than 20 countries worldwide). Luckily these hospitals are networked via satellite links, so still online after all other systems went down after the earthquake. Only an instance of the system which was used in a now destroyed hospital of the Médicins Sans Frontières directly in Port-au-Prince seems not to be at service anymore.

According to Hamish Fraser, director of informatics and telemedicine for PIH, OpenMRS served before the current crisis more than 14,000 patient records and is now used to “… generate reports for the government and funders and make lab data available to the physicians and medication lists for the pharmacists. We also built a drug supply management tool to track all the medications in our main warehouse and our 10 hospitals.” as Fraser said in an interview with the Healthcare IT News.

Surely FOSS will not play a keyrole in the relief efforts, but still provide considerable means to support medical care for the Haitian people. Also take a look at Fred Trotters article “OpenMRS shines in Haiti” who originally pointed me to this.

PIH welcomes any donations to support their efforts in Haiti.

As freemedsw.apfelkraut.org is now online for more than two years (2nd anniversary 2010/01/12), it is again time for a ranking of the most popular Open Source projects for the health care sector.

Meanwhile more than 130 active projects are listed in 21 categories and I still (!) appreciate your help in case you find a broken link, incorrect information or you just have improvement suggestions. Please send me a message or leave a comment. You can submit change requests or new projects via a form which is available here.

Congratulations to the ClearHealth Inc. and its contributors for the popularity of their project ClearHealth!

The numbers are based on the statistics of WordPress.com, measured in the time between the 2009/01/21 and the 2010/01/21. In the last year (2009) freemedsw.apfelkraut.org was viewed 8,765 times. The ranking just lists the first 5 most popular projects:

Recently added categories are Dentistry, Homeopathy and (Medical) Linux Distributions.

Take a closer look at especially the last one, as they are an easy, fast and convenient way to get many of the listed projects up and running without having to build and reconfigure them from scratch. Debian-Med is meanwhile a veteran in this field, offering many health care related applications as Debian packages, which are by the way also compatible to the popular Ubuntu distributions. OpenSUSE-Medical is quite new and still looking for interested developers to support their packaging effort, while the group around Fedora Medical just found together and will soon start is also seeking for contributors.

Concluding my special respect goes to the GNUmed EMR project and the Hil’Brothers behind it. They seem always to be the fastest, especially when it comes to packaging and so GNUmed is the first project ever that is available through all three listed medical Linux distributions.

Now tagging is used for indexing the projects while the categories have been thrown overboard. Regarding medical FOSS the project admins seem not to really make use of this feature. Tags similar to hospital information system, PACS, EMR or patient management have never been used or I was just too dumb to find some health care related ones. Only two projects are tagged with “Medical“, the tag “Medical Science” is associated with 146 projects. One and a half year ago the category “Medical Science Apps” contained 139 projects there.

In contrast at SourceForge.net – that by the way still has the category feature – the Medical Science Apps have grown in the same time from 640 to 907 projects. Beside the much more active community, SourceForge.net is also a pure open source software development platform whereas freshmeat.net is just an software indexing platform where you will also find non-open and commercial software.

So better stick to SourceForge.net when looking for medical FOSS projects, although tagging is a really useful feature … if it would be utilized. Anyway, I just learned that both platforms belong to the same company. @SourceForge Inc.: So why not combine both of your platforms? Looks like they contain already quite similar content …

The ones who doesn’t like digging through hundreds of projects can also take a look at my listing of free open source software for the health care sector that is available at freemedsw.apfelkraut.org. I appreciate as always your comments and additions to it.

Phillip Longman recently wrote an interesting article for the Washington Monthly about Obama’s Stimulus Bill and its impact to the implementation of FOSS in the American health care system.

Titled “Code Red – How software companies could screw up Obama’s health care reform” he gives introductorily a short overview about the drawbacks of the current health care system and the idea behind Obama’s Stimulous Bill aka American Recovery and Reinvestment Act (ARRA).

He subsequently provides detailed insights about Electronic Medical Record (EMR) implementations across the U.S. in which the adoption of FOSS has considerably increased the quality of care and reduced costs in contrast to proprietary EMR solutions.

His actual point is that the bill and the thereby provided money (about $ 20 billion) is about to be restricted only to proprietary EMR software companies in case their lobbying succeeds.

This is on one hand due to the not so clear definition of the term “meaningful use of certified software” in the ARRA (see pages 467-96). The commercial vendors are now trying to persuade the regulators so that the “meaningful use” of software is proven by a certification process. The responsible institution for that could be – and in their eyes should be – the Certification Commission for Healthcare Information Technology (CCHIT) that is according to the author “… largely funded and staffed by the very industry whose products it is supposed to certify”. The about page of the CCHIT states it like this: “…with capital contributions and in-kind staff support from a collaboration of three health IT associations: the American Health Information Management Association (AHIMA), the Health Information and Management Systems Society (HIMSS), and The National Alliance for Health Information Technology (Alliance).”

On the other hand – even if the vendors will not succeed with their strategy – they will have much better means of marketing and sales to get their slice of the cake. P. Longman doubts that this will contribute to the process of improving the quality of care and making the health care system more effective – the original idea of the Stimulus Bill.

Concluding he suggest “… to take the stimulus money off the table …” until the details are clearly defined and the potentials of Open Source health IT have been analyzed by a federal interagency study that should be available until in 2010.

The article has quite some length, still it is absolutely worth reading … as beside the political debate it clearly constitutes the advantages of FOSS in health care.

[found via Crossover Healthcare]

For more information about the in the article mentioned “VistA” EMR software see:

• Hardhats.org (VistA user community)
• WorldVistA

A comprehensive listing of medical FOSS projects is available at freemedsw.apfelkraut.org.

G. Paré et al. published in Februar 2009 an insightful article about the “Barriers to Open Source Software Adoption in Quebec’s Health Care Organizations” (PDF) in the Journal of Medical Systems. Their abstract reads like this:

“We conducted in-depth interviews with 15 CIOs to identify the principal impediments to adoption of open source software in the Quebec health sector. We found that key factors for not adopting an open source solution were closely linked to the orientations of ministry level policy makers and a seeming lack of information on the part of operational level IT managers concerning commercially oriented open source providers. We use the case of recent changes in the structure of Quebec’s health care organizations and a change in the commercial policies of a key vendor to illustrate our conclusions regarding barriers to adoption of open source products.”

Although the study was carried out just for a small region in Canada, I think the results can also be seen in a much wider context. The identified barriers are preventing the adoption of FOSS in health care in many parts of the world (especially in industrialized countries). Subsequent is a table listing these. The third column represents the percentage of respondents that cited the given barrier. In total there have been 15 respondents, all of them have been CIOs at health care organizations in the area of Quebec:

For details about these barriers and how the study was carried out please refer to the original article. Would be interesting to have a similar study for regions here in Europe …

[photo taken from commons.wikimedia.org]

Vielleicht sollte man korrekterweise noch erwähnen, dass dieses Bild nicht ganz vollständig ist, da die ersten Karten wie von der Kasse gewünscht vernichtet bzw. wieder zurück geschickt wurden.

Und da soll mal noch jemand behaupten, den öffentlichen Krankenkassen gehe es schlecht … wenigstens bekommt man für seinen Versicherungsbeitrag etwas Handfestes.

Vielleicht kann die mittlerweile größte Krankenkasse Deutschlands mal eine Vorreiterrolle einnehmen bzw. dieser gerecht werden und an ihre Versicherten wiederbeschreibbaren Karten ausgeben? Möglicherweise könnte damit etwas mehr vom Versicherungsbeitrag seinem eigentlichen Verwendungszweck zu Gute kommen?