Open Source software in medical informatics—why, how and what
Section snippets
History of Open Source
‘Open Source’ is a 20–40 year old approach to licensing and distributing software that has recently burst into public view [1]. In the traditional software distribution model, users pay for a software license with strict restrictions and no access to the source code. With the Open Source model, users do not necessarily have to pay, the license has fewer restrictions and the software includes the source code which they can examine, modify and incorporate into their own system.
Economic principles
Brief history
The Open Source story has been well told by those who led and lived the movement in: ‘OpenSources—Voices from the Open Source Revolution’ [3] and who view the Open Source movement as a return to the original sharing ethos of programmers at universities and research labs in the 1960s and early 1970s. Two of the voices are of special note. Richard Stallman, the author of the famous Emacs editor was the first, and still the most single-minded, voice of the revolution. He describes the early 1980s
What is Open Source anyway
In 1997 Eric Raymond and Bruce Perens invented the term ‘Open Source’ for what had until then only been known as ‘free software’. The new term was a strategic choice to win a larger share of the commercial industry over to the idea of Open Source [9]. The central argument to Open Source is that when everyone can see the source code the software gets more scrutiny and more corrective feedback than a single development team can provide; so it leads to better software. As Linus Torvalds put it:
Licensing arrangements
Stallman and others emphasize that Open Source does not equate to public domain which implies no copyright or license limitations and allows others to copyright, and impose their own restrictions on the material. A copyright and license agreement is necessary to keep the software open. On the other hand, the Open Source movement has no quarrel with the commercial sale of open-source software or support services for such software. Indeed, large companies have emerged to distribute, improve and
What is the role of open-source software in medical informatics
John Ousterhout developed Tcl as a scripting language because he was worried that large monolithic and proprietary software systems would leave no niche where computer science academics could contribute software to a real world computer system. Tcl is an Open Source scripting language that can glue together independent programming modules so that academics (and others) could build and test, small inventive modules within larger operational systems. Medical informatics is subject to exactly the
Many more base standards for database systems—data modeling, communication, security
A number of new medical informatics Open Source projects have been launched in recent years, some of which are derived from experience with medical record systems and include a medical record database. Table 2 lists the ones we are most familiar with. It does not pretend to be comprehensive.
Open Source Clinical Applications & Resources (OSCAR) [36] is a family practice office management and medical record system developed and used at McMaster University. We feel some kinship with this effort
What would help accelerate an Open Source movement in health care
Most helpful would be a policy that encouraged/required that all software developed with federal funding be released under an Open Source license. (Let the investigator choose between the restrictive and lenient Open Source license). Public funding agencies should also require the use of widely deployed health informatics standards, described above, in all funded development, as the National Library of Medicine has done in a recent RFP [44]. Funding agencies should also encourage the use of
Acknowledgements
Supported in part by the National Library of Medicine (contract N01-LM-9-3517), the Indiana Genomics Initiative (INGEN) of Indiana University, which is supported in part by Lilly Endowment Inc., and by Grant Number H75/CCH520501-01 from the Centers for Disease Control and Prevention and by Grant No. U01 CA91343 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and
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