By Cindy Atoji

June 3, 2008 | The open source collaborative site, Open Health Tools (OHT), continues to add tools for health interoperability, recently adding an academic outreach project that includes a research component, as well as code from the United Kingdom’s National Health Service (NHS) to implement HL7 messaging. Formed two years ago, OHT has gathered support from major health care organizations in the U.K., U.S., Canada, and Australia; top vendors such as IBM, Oracle, and Inpriva; and also standards powerhouse HL7 and the International Health Terminology Standards Development Organisation.

According to Skip McGaughy, OHT’s executive director, this open source framework for EHRs should enable companies to cut costs of developing applications and reduce time-to-market. The site and offerings are based on the popular Eclipse open source platform. McGaughy, who was one of the founders of Eclipse, hopes to duplicate the success of this community, by creating a “ubiquitous technology” for health care infrastructure to build upon. He spoke with Digital HealthCare & Productivity about the progress and developments at OHT:

DHP: What technology is Open Health Tools developing?

McGaughy: We are developing and assembling free software and tools for interoperable EHRs, including a software platform and secure applications. It involves such things as messages and document interchanges; static model designers; simulators, adaptors, data transformers; as well as device access. We’re looking at data exchange so rural and urban physicians can share and utilize their systems, including the large amount of legacy systems. The Charter Projects will cover the lifecycle of EHRs, including development of standards and architectures, and documentation and training. This framework is available under a commercially-friendly open source license so organizations can build applications without any payment required for the software.

DHP: The Open Health Tools software repository is now publicly accessible. What are some projects that are slated to be released?

McGaughy: The first project is already there and it has to do with HL7 tooling. Canada Health Infoway is supporting the implementation of standards by conformance testing; an Oregon project is trying to improve the effectiveness and efficiency of Medicaid and exchange of EHRs. And there are five other Charter Projects that have been approved.

DHP: What is your relationship with Eclipse?

McGaughy: I helped to start Eclipse, and we’re like a satellite of Eclipse. We’re going to be using Eclipse technology but our governance is under the direction and control of the health and computer industry. We use the same development and intellectual property process, the same paradigms and many of the same people. The Eclipse code has been downloaded and used by millions of programmers, so it’s thoroughly tested and debugged. Programs using the Eclipse framework, through the use of plug-ins, are compatible.

DHP: What kinds of organizations are joining Open Health Tools?

McGaughy: From the vendor side, Inpriva is leading the security effort; the Germany company, Innopract, is heading up the distribution effort. There are companies in Australia which are leading some of the efforts on imaging or record format and layout. IBM is contributing technology that enables devices to connect to a network; Oracle is providing technology and leadership to help with the academic outreach program. We’re utilizing the CollabNet development environment so multiple developers from all over the world can share the same repository. It’s truly a global effort.

DHP: How will Open Health Tools work technically with HIMSS own interoperability council?

McGaughy: We see HIMSS as a standards setting and they’ll do the specifying as to what standards are important to implement, and we write the code.

DHP: How does open source approach particularly lend itself to health care?

McGaughy: Health care is complex and really needs high quality code. What’s also equally important is the commercialization of the open source. Just in the U.S., there’s over $50 billion dollars spent on software that never reaches the end user. So there’s a big investment. What open source does is open it up so the source meets the requirement and there’s an open dialogue. The more complex a system, the more dynamic that system’s needs are and more varied, and that’s when open source has the distinct advantage. It’s componantized, it’s modular, and it’s done in the open, so everyone understands what the requirements are, and there’s a dialogue about the requirements.

In order to build applications that interoperate, the best way is to have a set of common code that people can reuse over and over again. We refer to that as a framework that enables lots of code to plug and play within that environment. So we’re going to provide that common framework so that companies and organizations can use and reuse that and extend it into their own environment. They can bundle, pack, brand, and service and support it however they want.

The security stuff is absolutely essential, as well as the tooling and messaging, and the analytics, legacy adaptors, and data transformation. At the end of the day, what’s really important is reducing costs but also saving lives and improving care. And what is unique is the number of really good software developers who are joining this effort. So instead of just moving little bits on the screen, they can now save lives.

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