Is open source the key to successful national e-health?

Open source provides flexibility and agility but questions have been raised over the likelihood of implementation

The Federal Government and healthcare industry bodies should abandon proprietary software and embrace open source software if Australia is to have a successful national e-health platform, argues e-health academic, Professor Jon Patrick.

Professor Patrick, who heads up the health information technology research laboratory at the University of Sydney, said the existing proprietary software used in the health industry lacked the flexibility and cost-effectiveness to meet the demands of emergency department clinical situations.

“One of the problems we are seeing is that [health] authorities get locked into contracts and software which they can’t change when their needs change, yet the health sector is highly dynamic,” Professor Patrick said.

“If we try and define information systems needs in some static way, we are absolutely destined to produce systems that are not effective in the ongoing nature of their work. Unless your information system can change very quickly, it will fall from use and will contribute to lack of productivity.”

Patrick said that current proprietary systems either intrinsically lacked the sorts of functionality required by the health industry or required users to pay large sums of money to add functionality.

“Medical staff will keep inventing new things they want to do and new ways of doing things, so you need software which is agile and the way it performs and behaves can be changed,” he said. “You will only get that with a very agile software development methodology and, at the moment, the most agile we have is open source.”

Another important consideration is the ability for the healthcare sector to avoid vendor lock-in and be able to have the freedom of choice over who and how its software is serviced.

“Only open source allows you to have the free market operation of the service side of software production,” he said. “In an open source environment, having software changed is exactly the need which is served the best.”

Patrick argues control and oversight is an issue that pertains more to proprietary software rather than one that potentially prohibits the uptake of open source software in the healthcare sector.

“At the moment hospitals have no control over their software - they get what’s installed. So the control situation would improve in that they would have control over what is installed and what they can achieve,” he said. “Oversight is always a software issue for organisations but it [depends on] the types of policies and practices in place. Open source is agnostic about those sorts of things and has the flexibility to provide a wider range of choices about what you want and who makes those changes. That’s a good thing if we believe in a competitive society.”

Patrick criticised the New South Wales Government’s rollout of its $80 million FirstNet Emergency Department program, saying the influx of US-developed software in emergency departments is costly and hinders the capacity for hospitals to achieve greater productivity.

“Australian software engineers are amongst the best in the world," he said. "We should be using that talent and building an Australian medical software industry."

Professor Patrick's comments come on the back of recommendations for an e-health policy from the National Health and Hospitals Reform Commission (NHHRC).

The report recommends that by 2012 the Federal Government must ensure that the national e-health policy framework incorporates open technical standards which provide for interoperability, compliance, confidentiality and security.

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