What Problems Can Open Source “Solutions” Actually Solve?

A reader request at Alexandria (another blog at which I post) got me digging into the open source side of Electronic Health/Medical Records.  I was fascinated by a discussion of how a person can ascertain the stability of open source software as it shed light on both (a) the viability of open source software for the future of health record systems and (b) the ways in which we determine the reliability of a product, in general.

John, of the EMR and HIPAA blog, proffers that

The most important point to consider with an open source EMR is the health of the community surrounding the open source EMR. If the community is strong, then you’ll see some amazing things happen. If the community is weak, then the open source EMR will still be around in a few years, but no improvements to the software will be made. The way technology progresses means that your software must improve or it will be outdated in a couple years time.

To be sure, there are multiple rating systems for open source software, but none yet has the power to shape the market in any way comparable to the more traditional bastion of authority; namely, the government.  Most people are not comfortable taking the time to research the community that surrounds a software or the ratings it receives from open source rating systems.

Unsurprisingly, the liveliest discussions in the EHR/EMR currently revolve around the Department of Health and Human Services (HHS) interim final rule on EHR’s.  The prospective flow of stimulus money is a strong motivator to attend to HHS’ precise definition of

standards, implementation specifications, and certification criteria [intended] to enhance the interoperability, functionality, utility, and security of health information technology and to support its meaningful use.

Of course, distributed networks of software developers cannot compete with the financial heft and generalized credibility of the federal government.  The short- to mid-term viability of open source software in the health information field will, accordingly, be influenced by the final “certification” and “meaningful use” rules determined by HHS.1 The longer-term viability of open-source software solutions to large-scale social policy issues may depend on the increased acceptance of improved mechanisms for consumers to quickly evaluate the durability of these intriguing technologies.

1Interestingly, a number of federal agencies did recently collaborate to develop open-source software (called CONNECT) “that lets federal agencies securely link their existing systems to the NHIN [National Health Information Network].”

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