http://content.nejm.org/cgi/content/full/360/15/1477
How is progress on certification, or access to certification of existing and future FLOSS EHRs? The tendency of government and of closed source providers is toward a model which certifies a whole "system". In the UK where this has applied for more than a decade the ssytem in place is often not identical to the version which was bent into certifiable shape - they are definitely very similar, but unreliable components necessary for certification are reasonably enough left inoperative or not added to the fielded versions. In the UK, most operational systems in general practice (approx = "primary care") embed, link to, call upon or coexist with additional software, which I doubt has been tested as a complete assembly. Nor should it have been in my view. Officially, after 1999, recognition of this was growing, but a change of approach has left discussions of this internal, or away from anywhere I listen. I doubt it has changed greatly. The Open Source philosophy as well as good engineering practice would be that components should be movable and installable, and in this context certifiable, rather than a complete system needing to be changed and recertified as a whole. Political efforts by marketeers for closed source suppliers may prefer to compete for customers, and may present a different and wrong view of how things should be for safety and reliability as part of this. FLOSS needs to be represented on this, to governments, and the philosophy and engineering merits not lost. -- Adrian Midgley
