Can open source save your life?

How many people have died because doctors made mistakes based on incomplete medical records
Written by Dana Blankenhorn, Inactive
Hospitals are the toughest nut to crack in the IT business.


The systems they need are complex. They must be highly-networked, and they have to deal with tons of regulations.

A hospital of 75-200 beds will pay as much as $18-20 million for a new IT system. Many do without, or use old systems bought over time. Wonder why you have to fill out a paper form each time you see a new doctor, and why every doctor's front-office is filled with file folders? That's why.

For nearly 25 years the Veterans Administration has been fighting this paperwork battle. And it's been winning with a home-grown system called VistA. A few years ago Scott Shreeve, a former ER doctor, decided to build an open source business around it under the name Medsphere, with his brother Steve. (Kenneth Kizer, a former VA official, is CEO.) Medsphere's version is based on a Sourceforge project called OpenVista, built on a Linux stack.

"The source code is in the public domain, available under the Freedom of Information Act (FOIA), Shreeve explained. "It's not an open source license, it's public domain - that's a major distinction. It's the freest thing possible.

"The VA has thrown code over the fence, but there has not been a community to catch it and expand it in a traditional open source manner. A lot of the things you are used to in open source aren't there. There's no super-strong development community, just a lot of users."

So that's what Medsphere is working with. They figure they can sell 85% of hospitals a system for $7 million, against commercial providers like Cerner, McKesson, and Meditech.

OpenVista is built around an electronic health record, which covers everything from labs and radiology to clinical information. Shreeve's goal is to build a National Health Care Information Infrastructure, based on open standards.

The first thing to be standardized, of course, has to be the license. Right now Medsphere is writing custom licenses for each client. Shreeve hopes to build a version of the Apache license, or a BSD-type license, by next year, working with the VistA Software Alliance.

I think of this in terms of hassle, filling out paperwork each time I see a new doctor. Shreeve thinks of having spent 7 years in an ER, starting from scratch with each patient because he had no data on them. How many people have died because doctors made mistakes based on incomplete medical records, he asked?

Too many.

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