Introduction

There are many reasons why you, as a Health organisation, should consider adopting Open Source Software.

• The source code is available and it uses Open Document Standards. This means it is much easier for you or your supplier to modify and extend it and to integrate it with other health systems – the big issue for health systems.

• It can give you more reliable systems that cost less: you spend less on software, less on hardware and less on maintenance.

• The systems will have less environmental impact because you can recycle old PCs and run on thin client systems which use less energy.

For a longer read see Open Source Software: a primer for health care leaders www.chcf.org/documents/ihealth/OpenSourcePrimer.pdf

There are already many OS health care projects delivering working applications. To see directories go to www.openhealth.com/en/healthlinks.html and www.oshca.org/healthdir .

Leaving aside health specific applications, all the main office applications are available in Open Source versions and they run on Windows or Linux (that's the free alternative to Windows) – email, browsing, word processing, spread sheets, presentation and data base and they can all produce files in international standard formats or in Microsoft Formats (which you will still need for external communications). And in addition you can produce PDF format documents for free. See www.openoffice.org and www.Mozilla.org to find and download the software.

There may be many applications that you use that only run on Windows but you will usually find there are many Open Source equivalents for things like Customer Relationship Management, Website development, accounting, desktop publishing, artwork, content management, document management and Virtual Learning Environment. See www.sourceforge.org, choose a category; usually you will find hundreds of potential applications. To find the most popular sort by “activity”e.g this should show SugarCRM is one of the most popular CRM packages. Note these will usually also run on Linux so you will have the option to switch operating systems later.

The problem, as always with change, is deciding when to give Open Source a try or switch to it because it will take some effort and will cause some disruption. The answer is to do it when you are making changes for other reasons. So you should consider switching some or all of your systems to Open Source Software if

• you are rebuilding your website

• you are rebuilding your network to client server

• you are about to throw away some old PCs

• you are out to tender for new systems – ask for quotes to include OSS components – they should be cheaper as your supplier will be getting them for free.

• You are planning to integrate your systems with other patient care systems, especially if they are using Open Source and Open Standards

• you are planning a move to Vista – it requires more memory and power so more expensive PC and more impact on the environment. Its also different so you will have to retrain your techies and your users.

• you have run out of IT budget

• you want to avoid lock-in – that is finding there is a high cost to switching supplier and software products in the future.

A good introduction to trying out Open source software, written by a medic, is Free Software for Busy People by Mohammad Al-Ubaydli June 2005, Idiopathic Publishing ISBN 0-9544157-3-6 which can be downloaded for free or purchased at www.freedomsoftware.info/content/section/1/45/

Other organisations helping you adopt Open Source.

• OSHCA www.oshca.org the OS Health Care Alliance is a non-profit organisation that provides the collaborative platform and forum to promote and facilitate Free/Open Source Software in Health Care. OSHCA's membership comprises a community of people, civil societies and professional bodies in health care and informatics industries that promotes the Free/Open Source Software Concepts in Health Care. OSHCA helps policy makers, commercial enterprises, and users take advantage of the benefits of Free/Open Source Software. There is a useful directory of health applications at www.oshca.org/healthdir

• openEHR , www.openehr.org, main aims are to promote and publish the formal specification of requirements for representing and communicating electronic health record information, and to maintain open source "reference" implementations, available under licence, to enhance the pool of available tools to support clinical systems. They also have a directory at www.openhealth.com/en/healthlinks.html

Case studies

Beaumont Hospital in Dublin, Ireland describes the implementation of these systems, the difficulties encountered, and also the benefits in terms of astonishing cost savings of €13m over 5 years. see www.netproject.com/docs/Beaumont.pdf

Based on the above the Office of Government Commerce has made recommendations that public procurement of software should consider open source solutions, citing, amongst other case studies, the experience of a Dublin-based hospital that made significant savings in transferring all its software to open source. The report says that public sector bodies should "examine carefully the technical and business case for implementation for Open Source software and the role which OSS could play in current and future projects" as well as "review their current infrastructure and applications... well in advance of any planned procurement or renewal... and consider what steps may be necessary to prevent future 'lock in'".see http://www.e-health-insider.com/news/item.cfm?ID=909

The Royal College of General Practitioners (RCGP) has chosen Trustix™ and IBM to supply a Linux based e-mail server solution to support the delivery of bulk e-mail to over 6000 GP’s across the United Kingdom. The solution, supplied by Cambridge-based reseller ee-scape, will also allow the RCGP to provide new services in the future, including the web enabling of some of the College’s Quality initiatives.www.trustix.com/pdf/html/royal_college_case_study.html and www.informatics.nhs.uk/cgi-bin/item.cgi?id=292