A recent report written by Forrester Research for the California Healthcare Foundation positions open source software as a kind of IT savior for the healthcare industry.  The report suggests that open source software will substantially lower healthcare IT costs.  The report goes on to conclude:

"While not heralding the end of commercial software vendors, conditions are ripe for open source solutions to take root in health care.  It (open source software) will likely become the standard for capturing, sharing, and managing patient information to support quality care.  Health care businesses have the opportunity to take the lead and drive the shift to this new model".

But wait!  Aren't we missing the point here?  It's not about open source vs. proprietary commercial software.  It's about open standards vs. proprietary standards.  Yes, we must adopt open standards so healthcare information can be shared securely between all of the players in the healthcare ecosystem; hospitals, clinics, clinicians, pharmacies, labs, imaging centers, payors, patients, etc.  But open source software doesn't get us there!  It's highly unlikely that the entire healthcare world will move to a singular system built on open source software, and the report fully acknowledges this.  That being the case, how would open source solve the interoperability issue?  It wouldn't.  Furthermore, there's plenty of evidence out there that open source doesn't necessarily equate to lower cost. There are still licensing fees, service fees, and implementation fees.  Even staunch advocates of the VA's open source Vista electronic medical record system say that it can't be easily (or inexpensively) adapted to meet the needs of the private sector.  What's more; who's going to provide updates and security patches for open source?  Who will invest billions of dollars to innovate?  It seems to me that commercial competition is far more likely to provide lower prices for healthcare IT in the long run.  Just look at what's happened to prices for consumer electronics and so many other things in our competitive, free market global economy.

As the demand for healthcare IT solutions increases, and more and more clinicians and healthcare organizations enter the marketplace, competition among vendors will increase and commodity pricing will begin to prevail.  The imperative for interoperability will force ISV's and developers of healthcare IT solutions to conform to open standards (most likely around web services architecture and xml).  In the end, both open source and commercial software will coexist, and both will conform to the standards of interoperability that will enable the fluid exchange of vital healthcare information between and among disparate systems.

What do you think?  Let us know.

See also; "Standards: The Winding Road toward Connectivity" as reported in Most-Wired On Line Magazine 

Bill Crounse, MD    Healthcare Industry Director    Microsoft Healthcare & LIfe Sciences