There is another, simpler reason: open systems rather than open source code is a far higher priority for clinical and secondary use users.
- thomas beale Bruce Wilder wrote: > 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 > _______________________________________________ > openEHR-technical mailing list > openEHR-technical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-technical > > > -- *Thomas Beale Chief Technology Officer, Ocean Informatics <http://www.oceaninformatics.com/>* Chair Architectural Review Board, /open/EHR Foundation <http://www.openehr.org/> Honorary Research Fellow, University College London <http://www.chime.ucl.ac.uk/> * *
