Benefits of Open Source Software DR PHIL KOCZAN

About me. GP in Waltham Forest for 20 years Long standing interest in Health Informatics Chief Clinical Information Officer (CCIO) for UCLP and NELFT Member of the Health Informatics Group of Royal College of GPs This is a personal view of the topic

Issues Explored What do we mean by “open source” Total cost of ownership System Safety Innovation Integration and Interoperability Areas of potential use Ways forward

Definition “Open Source” allow software to be freely used, modified, and shared. Several different licence types. NHS England working with suppliers to agree Open Source solutions. Range of solutions from small apps to EPR and Portal solutions

Cost of ownership Software is free. BUT consider:- ◦Support and services that may be required ◦Deployment ◦Development ◦Data migration ◦Integration

System Safety Concerns raised about the safety of open source solutions. “Thousand eyes” – early detection of vulnerabilities and fixed developed quickly Solutions have not previously been deployed at scale within the NHS, not unique to open source solutions. Community Interest Companies (CICs) will be developed around solutions to provide governance of the code

Innovation There is a long history of innovation in NHS IT solutions ◦Initial GP systems developed by GPs to solve their management and data recording problems. ◦HANDI ◦NHS Hack Days Many trusts have in house databases which were developed to tackle local issues, often with clinician input These are currently often stand alone and do not integrated with other systems Open source systems should provide greater opportunities around innovation

Integration and Interoperability Need to move away from “one size fits all” and organisational silos Open Source Software – part of the solution, but not the whole solution, potential to be disruptive Focus on Open Standards – will allow greater interoperability Increasing openness of systems. ◦Open APIs are being developed and becoming mandated (Recent GPSoC)

Potential Uses Apps that integrate with the host system supporting development of a paperless NHS ◦Mobile solutions for tablet devices ◦Support specific clinical specialties ◦Support for improved clinical safety and efficiency Trust administrative and clinical systems including clinical portals Patient facing services Provide a platform for developing, testing and training

Developing, Testing and Training Training clinicians to electronic records during consultations ◦Use in medical schools Develop user interfaces with clinicians ◦Improve data capture ◦Right device for right process ◦Improve patient safety – right information, right place, right time Define pathways Rapid prototyping

Way forwards NELFT is developing a business plan to explore the options of Open Source solutions following successful tech fund bid Looking at procurement and governance options with NHS England Open Source Team Tech fund 2 is likely to further support the open source developments

Conclusions We are on a journey and need to work together to understand what can be achieved to support delivery of care across both health and social care. Interoperability is essential for success Need evolution and rapid development to enable the technology to support the internal processes Technology is no longer the barrier. We need to work with the clinical, managerial and technical teams to make best use of the technology. Technology ProcessesPeople

Open source software is one option for implementing EPRs and could help show what is possible. It should also encourage other suppliers to open up their systems supporting greater interoperability, promote sharing of data to support clinicians and improve delivery of care to our patients