Summary
Objectives
To analyze the contribution of Free/Libre Open Source Software in health care (FLOSS-HC)
and to give perspectives for future developments.
Methods
The paper summarizes FLOSS-related trends in health care as anticipated by members
of the IMIA Open Source Working Group. Data were obtained through literature review
and personal experience and observations of the authors in the last two decades. A
status quo is given by a frequency analysis of the database of Medfloss.org, one of
the world’s largest platforms dedicated to FLOSS-HC. The authors discuss current problems
in the field of health care and finally give a prospective roadmap, a projection of
the potential influences of FLOSS in health care.
Results
FLOSS-HC already exists for more than 2 decades. Several projects have shown that
FLOSS may produce highly competitive alternatives to proprietary solutions that are
at least equivalent in usability and have a better total cost of ownership ratio.
The Medfloss.org database currently lists 221 projects of diverse application types.
Conclusions
FLOSS principles hold a great potential for addressing several of the most critical
problems in health care IT. The authors argue that an ecosystem perspective is relevant
and that FLOSS principles are best suited to create health IT systems that are able
to evolve over time as medical knowledge, technologies, insights, workflows etc. continuously
change. All these factors that inherently influence the development of health IT systems
are changing at an ever growing pace. Traditional models of software engineering are
not able to follow these changes and provide up-to-date systems for an acceptable
cost/value ratio. To allow FLOSS to positively influence Health IT in the future a
"FLOSS-friendly" environment has to be provided. Policy makers should resolve uncertainties
in the legal framework that disfavor FLOSS. Certification procedures should be specified
in a way that they do not raise additional barriers for FLOSS.
Keywords
Open source software - health information systems - health informatics policies