Open Source and Health Care

Here is a small paper I wrote after talk to my uncle (a doctor) about using open source in health care. Please let me know what you think. I have made a PDF available if you wish to pass around.

History has shown us that there have always been huge contrasts between the very wealthy and the very poor. This difference has been measured in wealth, job type, and living conditions. One factor that is often overlooked is that of health. One’s health can be seen, measured and have a cost associated to it. What if there was ways to help reduce the cost that is required to keep someone healthy while increasing the efficiency of their care?

Open source solutions have revolutionized the way we communicate, interact and socialize. We should continue in the same vein by allowing community driven software to help guide how we take care of each other. Imagine programmers, nurses and doctors combining efforts to provide freely available products that would impact and save lives.  Let’s look at a few examples of how open source solutions have impacted the world.

[1] In 1985 Professor Andy Tanenbaum wrote a UNIX like operating system call MINIX. MINIX came with a popular computer science operating system textbook.  Finnish student Linus Torvalds was inspired by this operating system and created improvement to the OS. Andy Tanenbaum rejected the improvements, so Linus created his own kernel and released the source code to the world. Linus later adopted the GNU license for his source code in 1991 and thus Linux as we know it was born. Linux has become one of the leading operating systems for servers and desktops around the world. Linux is used in web servers, telecommunication networks, and even in cell phones. It has been used to reduce the barrier and cost of innovations in technology and the web. It suggested that 60% of servers in the world run a UNIX type operating system and most of them are Linux.

[2] Seven years before Linux was released a computer engineer by the name of Richard Stallman made an announcement that still has a profound impact today; [3]“Free Unix!” Richard was most noted for at the time for writing EMACs (a text editor) and software compilers. When he said “Free” he meant free as in freedom. Thus started the GNU project. The GNU project was started to create a Unix like operating system. Since the start there have been other software projects that have come on the GNU banner, they have these 4 basic [4] freedoms:

  1. Freedom to run the program, for any purpose.
  2. Freedom to copy and give away copies to friends and co-workers.
  3. Freedom to modify the code as you see fit, by having full access to all of the source code.
  4. Freedom to redistribute the modified code to help the community as a whole.

These are just some examples of how open source has been able to change how things are done. What if the same thing was done for healthcare? Imagine how much money could be saved if it did not have to be spent on software solutions. Healthcare companies spend billions on record keeping and imaging in the United States alone every year. What I propose is that there is a foundation set up to fund projects that would deliver these solutions with no cost to healthcare providers.

The new solutions will have to meet the demands of a new era of data collection and computer interaction.

The first project that should come from this foundation should be a patient record keeping and imaging system. This system would be completely paperless; a digital system with digital imaging and multi-touch technology would be used instead. Records would no longer be kept in folders but in a database and charts would be multi-touch screens. You would be able to view patient information in real time. With this type of technology available patient care becomes a collaborative effort. You can ask for a consult with a tap of a button and discuss issues with specialists instantly and securely. The best part of this solution is that the software is free and open. The only cost would be for the hardware to run it.

Not only does this model allow for the reduction of cost for software but also will allow anyone to fully customize the software. This will also let other companies who are use to dealing with open source technologies to help partner with healthcare companies that may need assistance with installation and maintenance.

Now there are currently open source projects that are currently working on these issues. With that being said it needs to be researched which of these projects could be brought under the foundation, if any. We also need to remember the foundation is being setup to help guide projects to meet the demands of the next generation of health care by using next generation technologies, which some of these pre-existing projects or sorely lacking.

One of the biggest issues for the new foundation will be funding. I believe there is grant money that is already available for establishment. Then the foundation should seek donations from private and public groups. Any healthcare provider that uses the software should contribute a donation; a small percentage from each patient transaction should go back to the foundation. These are only suggestions. I am sure there are other ways of raising money; it will need to be researched further.

Another issue will be that of governance of the foundation. Governance should take on a similar structure to [4] Mozilla or the [5] Free Software Foundation. This should be a non-profit organization, which should have three purposes: fund raising, technical consultation and administration/hosting of projects.

This is only a few reasons why this approach to health care solutions is a great benefit. As this topic is researched and discussed, more reasons will become apparent. I thank you for your time in reading this and hope you spread the word. If you have any comments or questions please send them to james@freedomnet.co.nz.

A special thanks to Erin Ryan (4u2wear2@gmail.com) for helping with the editing of this document. Also thanks to those that provided input for this document.

References:

  1. Wikipedia.org, Linux, http://en.wikipedia.org/wiki/Linux#History
  2. Free Software Foundation, Overview of the GNU System, http://www.gnu.org/gnu/gnu-history.html
  3. Richard Stallman, Sept. 27, 1983, http://www.gnu.org/gnu/initial-announcement.html
  4. http://www.gnu.org/philosophy/free-sw.html
  5. http://mozilla.org
  6. http://fsf.org

Download: HealthCare draft


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