Sobald es um IT-Sicherheit bzw. genauer gesagt, den Schutz der Privatsphäre bei der Nutzung von Informations- und Kommunikationstechnologie geht, hat der Laie kaum eine Chance den Rat der Experten zu folgen. Die zu Grunde liegende Technik ist an sich schon recht komplex. Bei der Aufklärung bedienen sich Experten am liebsten Ihrem Fachjargon, während den unbedarften Nutzern beim Zuhören nur die Ohren flattern. Sobald diese dann noch jäh aus Ihrer heilen Welt gerissen werden, durch Whistleblower die von einer omnipräsenten Überwachung durch repressive Regime, Geheimdienste und andere kriminelle Organisationen berichten … mag man am Ende nur hoffen, dass alles nicht so schlimm ist und man selbst ja eh nichts zu verbergen hat … und man macht weiter wie bisher.
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.
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.
As you might know Medfloss.org (formerly medfoss.apfelkraut.org) tries to provide a comprehensive and structured overview of Free/Libre and Open Source Software (FLOSS) projects for the health care domain.
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:
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.
Are you a practice, clinic or any other health care institution that is using medical open source software in daily routine? And wasn’t it quite hard for you to find the right software, to get it up and running and to finally customize it to your needs without having any experienced users or reference sites at hand?
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?