• Open Source News Comments Off

    An award winning electronic patient record system could help convince the NHS of the value of licence fee free software.

    Doctors need to be able to access patient data in the same way as air traffic controllers monitor aeroplanes, believes Bill Aylward, a consultant ophthalmic surgeon at Moorfields Eye Hospital foundation trust.

    “The role of the air traffic controller is quite similar to a doctor, in that they both have to make frequent decisions in limited time, that have an impact on people’s lives,” he explains. “The difference is that the air traffic control has all the information required on the screen in front of them, or at the touch of a microphone.”

    Disparate electronic systems, imaging devices, emails and paper notes mean that this rarely possible in hospital trusts. But Aylward believes open source software – where the lines of programming instructions (source code) are freely available to view, and licence fees are not paid – could hold the answer.

    As part of a team of eight staff at Moorfields, Aylward has been working on OpenEyes, a collaborative, open source electronic patient record (EPR) project for opthalmology. As a collaborative framework able to integrate with different applications, it will allow NHS staff to work more efficiently and prevent the need to access multiple systems, each of which has to be logged in and out of separately.

    “You would sit down on one machine, with one log in, and there would be everything you wanted to know about the patient in front of you,” says Aylward. “That’s our vision, and it will make real improvements to patient care.

    “One of the key aims of OpenEyes is to give the doctor that air-traffic controller screen, so that all the data they need is right there in front of them,” he adds. Currently Moorfields has 18 separate silos of information, and some other trusts are rumoured to have many hundreds of different clinical systems, hindering the process of diagnosis and treatment.

    To explain OpenEyes, Aylward uses the analogy of an iPhone, which can run apps (software) from both its maker Apple and from approved third-party providers for a range of functions. “In other words, you’re providing an infrastructure that comes with all the basics you would expect, like security, writing correspondence, prescribing, which are generic to the whole of medicine, but will accept apps that do specific things within that infrastructure.”

    OpenEyes has been piloted in the paediatric accident and emergency department at Moorfields since last November and recently won the best business case at the Smart Healthcare Live Open Source Awards. It will be implemented widely at the hospital and a satellite site from this November to improve the surgery booking process, both for patients and staff. “It’s working well, it’s got good user acceptance and we’ve learnt a lot in terms of the design and the function of the system which is now going into the first release in November,” says Aylward. He hopes that Moorfields will have fully adopted the system and subsequently be paperless by the end of 2013.

    He added that the system has the potential to save several million pounds over three years as a result of improved efficiencies and the reduced amount spent on storage, fire protection and transportation of paper notes. The exact savings will depend on the phasing out of paper notes and their associated costs.

    Opening up to open source

    With financial rewards so high, the slow speed with which the NHS is adopting open source is surprising, believes Aylward. He thinks that a cultural stigma prevents healthcare adopting open source, unlike the Cabinet Office, which has made a point of reviewing contracts to see if they can use open source alternatives.

    “The NHS is culturally different. It’s used to paying out for contracts and getting something back in return, even if what it gets isn’t very good,” he says. “If you have diminished expectations then you don’t mind what comes along, even if it’s not very good. So it’s trying to shake people out of that and there are signs that it is changing.”

    The recent emergence of OpenEyes is especially pertinent in light of the ongoing problems of the National Programme for IT’s care records service, which has faced repeated severe criticism from MPs and the National Audit Office. “NHS IT is in a very parlous state,” says Aylward, who spent eight years as medical director at Moorfields prior to his current role. “It’s fragmented, it’s not fit for purpose and it’s not maximising its potential. Particularly at this point in time, when we’ve got lots of changes like producing outcomes data, checking patient records and the problems of paper notes, audit, research and revalidation, all of this is difficult.”

    Reflecting on the failures of the National Programme and the future of NHS IT, Aylward said: “I think the commercial model is not one that is suitable to deliver it in my view, or at least it’s had its chance and failed. If you throw £11bn at a problem and commercial companies give it their best shot and fail, that’s telling you something.”

    OpenEyes has additional benefits in that it can run on the internet as well as a trust’s intranet, meaning professionals currently excluded from secure health service networks, such as opticians, can be involved more closely in a patient’s care pathway. The organisers are looking for partners to help produce apps which will run on their framework and have already had lots of interest in the project.

    Aylward acknowledges that Moorfields is unusual in being able to develop a system like OpenEyes, something that other trusts might not be able to do. But because the software is available in source code form and therefore has no licence costs, trusts without internal expertise can consider using OpenEyes, although even without licence fees they may have to pay a commercial company to install the framework and support system updates.

    “In return, all we’d be interested in would be their feedback because the more users we have, the more feedback we get and the better product it’s going to be.” says Aylward. “Our final ambition is to make this not only work but make it the best possible software that can work.”

  • Open Source News Comments Off

    Close to half of all computer users around the world tend to get their software illegally, and business decision-makers are no exception.
    That’s one finding from a recent survey commissioned by the Business Software Alliance (BSA) lobby group, which reported the results in a blog post last week.

    “An especially troubling finding in the surveys is that business decision-makers exhibit similar attitudes and say they would engage in similar illegal behaviors to other computer users,” the report reads. “This finding is significant because software piracy in enterprise settings accounts for a disproportionate share of the overall software piracy problem in terms of commercial value.”

    Back in May, the BSA reported the results of its 2010 Global Software Piracy study, which asserted that the commercial value of PC software theft had leapt 14 percent worldwide last year to $59 billion. Now, as a follow-up, the group just recently hired Ipsos Public Affairs to survey some 15,000 PC users in 32 countries for a better understanding of the attitudes and behaviors behind this phenomenon.

    Among its findings were that a full 47 percent of computer users globally acquire their software illegally most or all of the time, including 34 percent in the United States, 30 percent in the U.K. and 27 percent in Canada, the group reports.

    Such figures were higher in developing countries, reaching 86 percent of PC users in China, 81 percent in Nigeria and 76 percent in Vietnam.

    Particularly notable is that business users are apparently no different. Piracy rates among business decision-makers in those same three developing nations, for example, were 85 percent, 82 percent and 79 percent, respectively.

    Companies with fewer than 500 employees were found to be more likely to get their software illegally, particularly in developed markets, the BSA notes.

    “Similar to all computer users, business decisionmaker pirates believe that legal software is better than pirated software because it is more reliable and secure,” the report notes. “But, like other computer users, they exhibit a general lack of awareness about which ways of acquiring software are legal and which are not.”

    It’s no secret that I think software patents are a scourge that needs to be gotten rid of, and I’m by no means alone in that opinion. In this era of lawsuits and revenue models based heavily on patent licensing fees (I’m looking at you, Apple, Microsoft and Oracle), the harm they’re doing to innovation is right before our very eyes all the time.

    Regardless of your opinion on patents, however, the fact remains that there’s simply no need to get proprietary software illegally and risk legal action. On MoneyTalksNews, Brandon Ballenger highlights a few specific alternatives, but in fact there’s a whole wide world of open source software available to you, generally for free.

    Even besides the Linux operating system–which is available in flavors for every taste and purpose–there are great alternatives for just about every proprietary package you may be used to. Not only are they typically free, but they also offer numerous benefits for businesses, including flexibility, customizability, interoperability and freedom from restrictive licenses and vendor lock-in.

    It’s easy to keep repeating past mistakes out of sheer habit–‘Microsoft Trained Brain Syndrome’ is one perfect illustration–but once you start looking around, it’s just as easy to break free.