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About Open Source

The basic idea behind open source is simple: when programmers can read, redistribute, and modify the source code for a piece of software, the software evolves. People improve it, adapt it, fix it, without the constraint of copyrights and patents. Compared to the slow pace of conventional software development, development of open source software can happen at an astonishing speed!

This rapid, collaborative, evolutionary process produces better software than the traditional closed model, in which only a very few programmers can see the source and everybody else must rely on a ‘black box’ of code. Benefits of open source software include increased security, ability to guard against viruses, and adaptability to grow the software with the organization. Open source software is more than cost-free -- it offers freedom. The open source approach promotes rapid software innovation, adaptation, reliability and quality through open peer-reviewed “evidence based” evolution of source code. There is evidence of a growing open source community in health care and it is receiving proactive support in the European Union and other countries.

We’ve ensured that OSCAR meets the open source definition established by the Open Source Initiative. Open source software is freely distributed and may be used for any purpose. The source code can be viewed, customized, developed, and redistributed, as long as contributions allow further modifications and their distribution with the same software license. Based on a philosophy of academic development and information sharing, open source products like OSCAR are not intended for profit by the developer. A mechanism to support international collaboration is necessary to fully realize the significant patient system and research benefits offered by OSCAR. Our low-cost open source approach is intended to enlist a critical mass of health care users and developers to use and continually enhance the OSCAR system.

An excellent overview is provided by Ken Kizer, the former CEO of the Veteran’s Administration (VA) in the USA. The VA is widely regarded as one of the most successful IT implementations in the world and has been open source throughout its development.

“For the past twenty years open source software has been building momentum in the technical cultures that built the Internet and the World Wide Web. Open source has now established its viability in the commercial sector, and a major shift toward open source software is underway throughout the world.”

 “A critical milestone in the history of open source was the creation of the Linux operating system in the 1990s. Linux demonstrated that open source development methodologies could deliver commercially viable technology to the market.”

“In open source, the basic software is viewed as a commodity and its development is collaborative and shared by the community of users."

"Because contributions to enhancing the code come from many sources in an environment of collaboration, innovation is more rapid."

"Open source is much more consistent with a true free market approach than proprietary products that entail the infamous 'vendor lock'.”

About vendor lock -in

Access to your data can be compromised if there is a contract dispute with the data management company or the vendor, or if your vendor goes bankrupt. Once you go with a product, that vendor essentially has a monopoly.

Migrating between EMRs is usually not possible or encouraged by vendors. Although there are efforts to create EMR to EMR standards, none yet exist. Once you have invested data in a proprietary system you are stuck. The vendor can name their price for additional features because no-one else can write for the product. New features are usually slow to arrive because the vendor has to wait until there is a significant demand for that feature before investing money into developing it. The vendor has little interest in creating customized features for one user because it is more difficult to maintain support.

Conforming to standards alone will not protect against vendor lock - it is only the product being open-source that does this.

Common myths about Open Source: 

Do I need to be a “techie” to use open source

No. Just as with any proprietary EMR you can pay for technical support. In open source, there are often a range of companies who are available to provide support. If you are a “techie” and do not wish to pay for support, that is also an option.

Will it be more work for me if I go with open source?

From the perspective of the customer/user, the amount of work involved in using open-source is no different from proprietary products if you choose to pay for support.

Are security concerns any different with open source software?

Experts believe that open source is actually more secure than closed source software.

For a discussion of these questions see:

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