%0 Journal Article %J Technology Innovation Management Review %D 2013 %T The Evolving Role of Open Source Software in Medicine and Health Services %A David Ingram %A Sevket Seref Arikan %K electronic health care record %K information retrieval %K open source framework %K openEHR Foundation %K persistence %K standards based %X The past five decades have witnessed immense coevolution of methods and tools of information technology, and their practical and experimental application within the medical and healthcare domain. Healthcare itself continues to evolve in response to change in healthcare needs, progress in the scientific foundations of treatments, and in professional and managerial organization of affordable and effective services, in which patients and their families and carers increasingly participate. Taken together, these trends impose highly complex underlying challenges for the design, development, and sustainability of the quality of supporting information services and software infrastructure that are needed. The challenges are multidisciplinary and multiprofessional in scope, and they require deeper study and learning to inform policy and promote public awareness of the problems health services have faced in this area for many years. The repeating pattern of failure to live up to expectations of policy-driven national health IT initiatives has proved very costly and remains frustrating and unproductive for all involved. In this article, we highlight the barriers to progress and discuss the dangers of pursuing a standardization framework devoid of empirical testing and iterative development. We give the example of the openEHR Foundation, which was established at University College London (UCL) in London, England, with members in 80 countries. The Foundation is a not-for-profit company providing open specifications and working for generic standards for electronic records, informed directly by a wide range of implementation experience. We also introduce the Opereffa open source framework, which was developed at UCL based on these specifications and which has been downloaded in some 70 countries. We argue that such an approach is now essential to support good discipline, innovation, and governance at the heart of medicine and health services, in line with the new mandate for health commissioning in the United Kingdom's National Health Service (NHS), which emphasizes patient participation, innovation, transparency, and accountability. %B Technology Innovation Management Review %I Talent First Network %C Ottawa %V 3 %P 32-39 %8 01/2013 %G eng %U http://timreview.ca/article/648 %N 1 %1 University College London David Ingram has held posts in industry, the National Health Service, and university medical schools. After undergraduate physics at Oxford and several years in the medical engineering industry, he studied computer science and completed doctoral research on the mathematical modelling of biological systems at University College London. He was appointed to the first UK Chair in Medical Informatics in 1989 and participated, as partner and reviewer, of numerous EU and UK Research Council Health Informatics programmes and projects from 1985-2011, including coordinating the EU GEHR Project, which laid the foundations for a standard health record architecture and the openEHR Foundation and community, internationally. In 2011, he established Charing Systems as a spinout company of UCL, to provide services to developers and users of clinical systems, to support their integration within open-source platforms, utilizing the specifications and methods pioneered and made freely available under open license by the Foundation. He is an elected Honorary Member of the Royal College of Physicians, in recognition of his services to medical science. %2 University College London Seref Arikan has worked in the software industry for 15 years and in the medical informatics domain for 10 years. He is strongly focused on research and development tasks and has wide experience of information technologies and architectures for projects ranging from workflow based systems to national e-health repositories. He has been studying at UCL, pursuing research for a PhD under the supervision of Professor David Ingram, since 2008 and is currently working at Ocean Informatics UK. His research interests are in innovative, high-performance architectures to enable and support computable machine intelligence in healthcare, supported by open source tools and frameworks. He has already released much of this work as open source – the Opereffa framework described here being the most significant item. The clinical context of his PhD programme is the ophthalmology record at Moorfields Eye Hospital in London, where he works alongside Dr Bill Aylward, leader of the openEyes initiative for an open source electronic patient record for eye care. %R http://doi.org/10.22215/timreview/648