Ignacio, I cannot provide you with any numbers, but have a few comments as to why open source systems are not widely deployed:
1) Physicians, and probably many institutions, don't really understand the concept of open source code, and the potential advantages, which include cost savings, protection against obsolescence, and the ability to meaningfully influence the architecture of the EHR system, among others ( I have made a few inroads with organizations such as the American Medical Association, the American Public Health Association, and the American Bar Association). 2) The word ?open? suggests to many that there is no security (where in fact, and as you point out in your draft, systems may be more secure (also see HIMSS White Paper, June 2008)). 3) Proprietary systems are heavily marketed. No one is marketing open source EHR to a comparable degree (you make this point, but perhaps it could be elaborated upon). HR 6898, introduced 9/15/08 (Stark, D-CA, and Camp, R-MI) and referred to the House Committees on Energy and Commerce, Ways and Means, and Science and Technology, includes making available open source (VistA or comparable) EHR at a ?nominal? cost, and provides for a consortium to govern the development and updating of such a system. Its recent White Paper on open source EHR notwithstanding, HIMSS now opposes these provisions. There was similar (and successful) opposition to a plan by David Brailler, when he was the ONCHIT, to promote open source EHR three or four years ago. The impetus behind both of these opposition fronts is protection of the proprietary interests of EHR software vendors, couched in terms of the protection of innovation (but, as you seem to say, traditional copyright protection isn't the exclusive path to innovation, e.g. Encarta sold for $500+ a few years ago, and is now available on eBay for around $25 if anybody is stupid enough to buy it instead of using Wikipedia). Cheers, Bruce --- Ignacio Valdes <ivaldes at hal-pc.org> wrote: > The un-official, Draft 7 of the upcoming American > Medical Informatics > Association Open Source Working Group white paper to > be voted on > November 9th can be found > http://ignaciovaldes.com/amia. It will be > voted on for ratification on November 9th-11th or > so. Action is needed > on your part to answer the question: If open source > is so great why is > no one using it? There is no aggregate data that I > can find to counter > this opinion. If you know of a Free/Open Source > EHR/EMR deployment and > could please send three pieces of information on > each deployment that > you have by Wednesday November 5th: General > Location, software version > and most importantly NUMBER OF PATIENTS IN SYSTEM. > This paper could > have national impact with this data. Please respond > by email to > ivaldes at hal-pc.org if you are able to obtain this > data. > > -- IV > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > Bruce L. Wilder, MD MPH JD Interprofessional Systems, Ltd. 436 Seventh Avenue, Suite 1050 Pittsburgh, PA 15219-1826 Tel 412 683-6015 (Toll Free 1-866-594-6015) Fax 412 683-6430 Changing health care for the 21st century
