Why open source is health reform

(Picture from Chilmark Research.)

In the current system, there is no reason to limit costs. The doctor who diagnoses an illness directs treatment. The more treatment, the more money is made by the hospital and its supply chain.

Payment is similarly disconnected from service. Insurers have tried, for years, to fight these cost rises on behalf of their customers, and failed.

Open source starts by connecting data. As Matt Mattox of Axial observed last week (talking with Jason Hibbets of Red Hat), it drives systems toward an open architecture.

The current Administration's support for open source and open architectures is aimed at breaking apart data silos, collecting the data that can in turn drive change.

The fear of the Administration's opponents is that government will control the data. But another important aspect of open source health care is that it can give patients access to their own data.

That's the aim of Indivo, a new open source project from, among others the Harvard Medical School, the same people who are driving the Administration's health reform proposals.

As Fred Trotter explains, it's a Personal Health Record (PHR) platform engine. It's both a way to make a PHR, and link PHRs together. It's a way to break the silos being created in that market, much as the NHIN "Health Internet" is designed to break silos in the larger Electronic Health Record (EHR) market.

We should already have enough data to drive reform. We know what works. Wellness services work. Doing what is cost-effective first works. Every other industrial nation has used these tools to transform incentives and provide ample care at a fraction of the cost Americans pay.

But by making political arguments against science, those who benefit from current business models have succeeded, for now, in preventing reform.

So thousands of people will die needlessly this month, and next month, and the next, because they did not get needed care. And half those with diabetes will be reluctant to get treatment, for fear of losing their jobs and thus access to care.

My point is that these arguments may hold against the rivulets of data we now have available. By automating care under open source standards we can unleash a Google-sized torrent onto the research community, proving the case once and for all. By providing data to patients, we also empower them to demand change, and to seek services before they're sick.

That's why open source is health reform. Unlock a high enough flood of data and mere arguments will be blown away. Show people their own data, explain what it means, and people will demand the services needed in order to live and not just get well.