Tag Archives: Public Health System

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!

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!

The Stimulus Bill and Its Impact on FOSS

WSM: Code Red

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.

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Gar nicht so dumm … Versicherungsfirmen und die Tabakindustrie

Laut des Artikels “Insurance-Industry Investments in Tobacco” (PDF) von J. W. Boyd et al. der kürzlich im New England Journal of Medicine erschienen ist, haben Versicherungsunternehmen mit Stand März 2009 über 4,4 Milliarden US Dollar in Anteile an Tabakfirmen investiert.

Es handelt sich dabei um private Versicherungsfirmen (Prudential, Prudential Financial, MassMutual, New York Life, Northwestern Mutual, Standard Life, Sun Life) aus den Vereinigten Staaten von Amerika und dem Vereinigten Königreich. Interessant wird die ganze Sachen erst, wenn man weiß, was diese Firmen für Versicherungen anbieten … wenn es nicht bereits der Name verrät: Lebens-, Kranken- und Pflegeversicherungen.

Gar nicht so dumm … so kann man wenigstens auch von seinen Rauchern provitieren, sofern diese eh nicht schon höhere Beiträge zahlen müssen. Gefährlich wird es nur – wie der Autor anmerkt – wenn das Gesundheitssystem weiter privatisiert werden soll oder gar genau diese Versicherungsunternehmen an der Neugestaltung des Gesundheitswesens beteiligt sind. Bei solchen Konstellationen mag man es dann doch stark bezweifeln, dass die Gesundheit und das Wohlergehen des Einzelnen noch im Vordergrund stehen.

Da lob ich mir doch meine Krankenkasse, denn abgesehen von den Unmengen an Versicherungskarten würde ich für eine Raucherentwöhnungskur Punkte in mein Bonusheft bekommen.

Vielleicht gibt es in Zukunft auch Punkte für jede geleerte Schachtel?

[found via Alles Schall und Rauch]