November 2008

The length and diversity of Wikipedia's list of open source healthcare software may come as a surprise to many readers.

This issue of the OSBR provides an excellent introduction to the complexities and interoperability issues associated with healthcare software and the role open source plays in helping to resolve these issues. This month's authors also provide insight into an open source projects that follows open standards, lessons learned from providing a reference implementation, the benefits of a healthcare ecosystem, and the value of open source projects working closely with standards organizations.

As always, the authors and other readers appreciate your comments and references to additonal resources. You can send these to the Editor or leave them on the OSBR website or blog.

Dru Lavigne



The shift towards electronic health records now seems inevitable, driven by a combination of economic and demographic forces. This creates a demand for upgraded information technology (IT) infrastructure while simultaneously opening the door to new business opportunities for products that utilize that infrastructure. Whether this will result in a virtuous cycle that generates both improved public health and economic benefits remains to be seen. A key determinant will be interoperability between systems. Today, interoperability still represents a barrier to increased adoption and effective use of IT systems in healthcare--resulting in increased costs, medical error, poor care and even death.

While many of the articles in this issue of the OSBR focus on specific open source implementations, together they present an argument that interoperability in health care systems cannot simply rely on open standards but requires a widely available open source platform. The emergence of constructive partnerships between standards experts and open source implementers has the potential to accelerate the adoption of electronic health records and create an ecosystem of cooperating private and public sector players.

Brian Barry, CEO of Bedarra Research Labs and CTO of Open Health Tools (OHT), covers OHT's planned development of a common platform. In his article, he applies his experience with the founding of Eclipse to the problems of interoperable healthcare.

Mark Yendt, Duane Bender and Brian Minaji of Mohawk College describe their reference implementation of the Canada Health Infoway pan-Canadian Electronic Health Record Solution. They see the need to involve a range of partners from both the private and public sector to achieve success for the project.

Jacob Brauer of WebReach describes the Mirth Project, an open source healthcare interface engine and interface repository created and professionally supported by WebReach. Mirth attacks the interoperability issue directly through providing an interconnecting middleware for health information systems.

Skip McGaughey, Executive Director of OHT, and Ken Rubin, a senior healthcare architect, describe the requirement for a more out-reaching community which encompasses end users, operational users, and developers.

Jon Siegel and Richard Mark Soley explore the relationship between open source and open standards by examining the results of their interviews of developers of open source tools based on open standards.

Throughout these papers we see mention of the essential role played by healthcare data standards. These are clearly necessary for the development of any interoperable electronic health record solution.

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