A new report being released by the Center for Strategic & International Studies, a strategic think tank headed by former Sen. Sam Nunn, shows that outside the Department of Defense open source is mainly being stymied.
The annual report, authored by former foreign service officer James Andrew Lewis (left), found 354 major government projects worldwide involving open source, then classified them by type and status. Of nine U.S. Government projects, four are within the Defense Department. Of those five listed as domestic, two were listed as either failed or proposed. Both failures involve health IT.
The failed project is the The Health e-Information Technology Act of 2008 which, in September of 2008, called for the creation of a Federal Open Source Heath IT System as a low-cost approach to sharing electronic health records (EHRs). That bill died with the Bush Administration and a second proposal, Sen. John D. Rockefeller IV's proposal for the adoption of a nationwide, open source program for sharing electronic health records, is still waiting debate.
This should not be a surprise. A government report card on open source issued in January gave the DoD the highest grade of any agency.
Before the 2008 election open source was a fairly non-controversial topic in Washington, the report shows, because it was kept within the bureaucracy and government employees used it to focus on cost savings. A 2003 call to set up rules for using open source in the Defense Department was approved. So was a July 2004 call from the Office of Management and Budget to consider the total cost of ownership in technology procurements.
When politicians get involved, however, proprietary money talks. The report notes that the 2009 stimulus called for a report on the availability of open source health IT systems, by October 2010. At the end of that only the Veterans Administration announced it would re-commit to open source in redesigning its VistA system.
This is not to say there aren't some great open source happenings in health. The NHIN Direct project has been based heavily on open source and industry standards. The standards will become a “Health Internet” that allows transfers of health data, securely, within the existing Internet.
In terms of creating Electronic Health Records, however, open source has mainly been stymied.
Open source health IT blogger Fred Trotter (right) blames people like Glen Tullman, the CEO of Allscripts and a major Obama contributor who have been giving lip service to the idea of open source while building proprietary systems and getting the government to pay for them. So far only one open source Electronic Health Record, that of ClearHealth, has been certified under the meaningful use standards, making its users eligible for sweet, sweet stimulus cash.
The conclusion of politics getting in the way of open source becomes even more inescapable when looking at the roughly 28 state projects listed in the CSIS report. About one-third of those projects have either failed or expired, always due to political objections. Either the legislation to study or use open source died, or (as in the case of Massachusetts and ODF) it was sabotaged after passage. The cost of this is being borne now, by taxpayers around the country, in the form of canceled health and education programs whose cost can no longer be borne.
What's the bottom line here? Bureaucrats need to be committed to open source as a specification if they're to make headway. They have to isolate their efforts from politicians and keep the focus on saving money internally.
Proprietary companies will keep fighting open source, both within government and through the agency of politics. Government advocates of open source need to realize that what they're proposing will remain controversial and political, even if their adversaries don't admit it.
EMR is about aggregation of patient encounter data at the point of care in order to provide a complete, accurate, and timely view of patient information.
EMR is about aggregation of patient encounter data at the point of care in order to provide a complete, accurate, and timely view of patient information.
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