Why health care is coming to the Open Source convention

This year for the first time, O’Reilly’s Open Source convention
contains a track on health care IT. The call for
just went up, soliciting proposals on nine broad
areas of technology including health data exchange, mobile devices,
and patient-centered care.

One correspondent asked a bit timidly whether it would be all right to
submit a proposal if her company didn’t use open source software.
Definitely! The Open Source convention has always been about a wide
range of computing practices that promote openness in various ways.
Open source software is a key part of the picture but not the whole
picture. Open data, standards, and collaborative knowledge sharing are
also key parts of the revolution in today’s health care.

This new track is as much a response to urgings from friends and
colleagues as it is an O’Reilly initiative. We could use help
spreading the word, because the deadline for proposals is tight. In
this blog I’ll explain why we created the track and why OSCon is a
promising venue for trends that will move and shake health care in
positive ways.

The obvious draw is that there’s a huge opportunity for open source
software and open data initiatives to make a difference in how
electronic medical records are stored and shared. Last year’s Federal
stimulus bill (the American Recovery and Reinvestment Act) included
$20 billion dollars in payments to hospitals, doctors, and medical
practices if they demonstrate “meaningful use” of electronic health

Apart from the opportunity to make a difference, this huge infusion of
money means that there’s financial opportunity in Health IT. IT specialists
and programmers across the country who have lost their employment or
are just seeking new challenges will naturally be wondering what
health care IT is and how they can get into it. A health care track at
OSCon is, to start with, a natural way to serve our core audience.

But we want the track to be much more.

Health care IT is burgeoning, but the standards and technologies
aren’t yet up to the challenge:

  • The government is paying doctors to adopt electronic records, but they
    have the devil of a time sending those records to other doctors–quite
    a problem if your primary care doctor makes a referral to a specialist
    or if you feel chest pains and go to an ER while visiting a strange

  • A wonderful range of specialized mobile devices, as well as popular
    applications for cell phones, let doctors enter data right at the
    patient’s bed side or while walking down the hall. Even voice-to-text
    translation is available. But once in the system, these notes are hard
    to parse and process.

  • Patients are learning to take charge of their own health data, and
    lots of health care providers, not to mention Google and Microsoft,
    offer them access to such data. But getting data in and out is hard.
    Google and Microsoft provide APIs, but both the calls and the formats
    are incompatible. Most systems don’t have APIs. Security standards and
    best practices are also lacking.

  • Evidence-based medicine is the white knight of current proponents for
    reducing errors and costs. But because of the incompatibilities
    already mentioned, systems can’t share data in secure and
    easy-to-program ways.


So the U.S.–and the rest of the world, including areas with
heretofore inadequate health care–is currently on the cusp of an
unimaginably large revolution in health care IT, but it's tripping
over basic roadblocks in data exchange.

The flip side of each challenge, of course, is an opportunity. Open
standards and open APIs will attract a broad range of IT talent and
help lead to more flexible technologies that stand up better as the
environment evolves. O’Reilly as a company, and our Open Source
convention in particular, have been involved with many of the
innovations made by open source developers, and we are excited to
bring more of this community and this experience into health care IT.

O’Reilly was one of the early promoters of the term “open source” (and
the recognized leaders in documentation for free software long before)
as well as the originators of the term Web 2.0 and organizers of
conferences on transparency in government and “government as a
platform,” or Government 2.0. People trying to use APIs and open
source software to create open platforms flock to OSCon. It’s a major
industry venue for announcements and a place where people talk
together to come up with new technical ideas.

We believe that advances in APIs, giving data to patients, open source
software, and interactive mobile devices will free health care IT. We
don’t know precisely which technologies will win out or how the whole
thing will fit together–so we want to use OSCon to help figure that

Help us make OSCon a platform for developing platforms. Submit
proposals, tell your friends, and make your travel plans for Portland
in July.

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  • Tim O'Reilly

    Andy –

    Thanks for helping organize this program. In my time in Washington, I’ve ended up getting really excited about the opportunities for open source and open data best practices to revolutionize healthcare.

    There are already some very successful open source projects in this area, like HHS Connect (they had several thousand people at their last conference) where the government is demonstrating that they understand the power of open source and open standards to catalyze a market. The new NHIN Direct project is trying to take an even simpler approach that is applicable for small medical practices as well as behemoths like the VA, DOD, and Kaiser, which are the primary target of Connect.

    I’d love to see the open source community responding to the opportunity – and that starts with learning about it.

  • Pieter Kubben

    I don’t expect to be present there, but I support the initiative. After completing three iPhone apps, I am updating my HTML knowledge now with your Head First series. Then, from my background as a neurosurgeon i.t. I intend to continue development in open standards as well.

    Pieter Kubben

  • Jim McNeely

    Actually, there is a standard protocol that a lot of healthcare systems use to exchange data, called HL7. Most systems in North America use HL7 2, which is pretty outdated and delimits segments and fields with pipes and carets and such. HL7 3 is an XML format. Most systems don’t use v.3 and it is really hard to turn the ship around because it is an interchange between systems and it all settles around the lowest common denominator. It seems certain that any kind of initiative that doesn’t use HL7 is going to face difficulties because that is what everyone in the industry is used to.

  • Andy Oram

    Thanks for raising this issue, Jim, which illustrates the tug between
    old and new. It’s exactly the sort of thing we should discuss on this
    site, and at the conference. To what extent will whole new
    trends–especially patient-centered care–create a new playing field
    where better standards can take hold?

    As an example of the tug between old and new, MITRE has created a new
    XML-based format and protocol called hData that tries to use modern
    communication techniques such as REST. MITRE submitted hData to HL7
    for standardization. I’m not saying hData is the answer, just that we
    have look at new possibilities while acknowledging what has already
    been done, as MITRE has.

  • Joseph Dal Molin


    It’s terrific to see open source in healthcare on the “Radar” at O’Reilly! What is really exciting is the opportunity this creates for engaging the creativity and energy of the broader open source community in helping tackle the challenges in creating effective health IT ecosystems.

    One of the important, game changing side effects of open source is that it reverses the “dumbing down” of health IT departments that has been going on for decades through the acquisition of expensive, proprietary, mostly turn key software. Adoption of open source will not only create new jobs… it will significantly accelerate user driven innovation, something which has only happened in a few places like the US VA.

  • OpenEHR

    Don’t forget folks that there is an ongoing initiative that has all the right tags for this thread: at http://www.openehr.org

  • Bob Calder

    VistA for the healthcare industry.
    Open sourced child of Mumps.

  • Brenda Moisey

    It is high time that the MENTAL HEALTH care system was overhauled to help to erase the stigma so that more people will fet help and accept help without fear of being fired, or laid off, or shunned.
    The first term that must be changed is MENTALLY ILL. Inless it is irrevocable even with medication, then one should be termed mentally well.
    Mental illness is a disease just like any other. With medications, you are mentally well, and there is also the term that could be fashioned around distinguishing brain injury due to psychological problems, psychological brain disease, anything but mentally ill for those who are able to function normally with their proper medication.

    Mental health professionals also must start stressing the benefits that vigorous exercise at least 3 tuimes per week is required to ensure that your medications work at their fullest. Also diet is by far the most important. Processed foodds have an effect on people with bipolar disorder and the diet must be healthy, whole and sensibble. If you put processed food into your body or fake food it must have some affect on the brain. Whatever your body absorbs, so does your brain. It is an organ. like a liver it can renew itself, but it can take time.

    Psychiatrists also have to start to realize how to explain matters to those whom suffer from PTSD. In the most severe cases, one wakes up everyday and if you do not take the time to choose how you are going to feel that day, you are in for satormy weather I am afraid. When you don’t know what to feel because you are experiencing so many emotions at once that you don’t know what to do and it makes you angry because you feel like you have forgotten how to be human and compassionate and all of the good and positive matters about your life. The frustration that comes out of the short term memory problem when you have severe PTSD is also another stresser for you to handle. The troops coming home should have this explained to them so they do not feel like suich freaks. I know . I have severe PTSD from a military incident a few years ago, and my mind is slowly healing, but some days, it does not work at all. You become so overwhelmed by the choices involved that you become very frustrated and have little patience.

    Just some thoughts. The stigma must be erased . We are in a mental health care crisis in North America. Therer must ber a common denominator as to why and I am sure it iss improper diet, lack of sleep, and lack of exercise which of course releases endorphines and sersatonin. Happy chemicals found in any healthy brain.

    Just some thoughts

  • Lepeke

    How do you think open source health cae I.T can help in the fight against AIDS in the rural areas like south Africa.

  • Joseph Dal Molin

    In reply to Lepke:

    OpenMRS which is based at Regenstrief has been focused on HIV/AIDS for quite some time. The community is very active in Africa and are doing a great job.

  • Fred Trotter

    Thank you.

  • Justin C. Houk

    Hello Andy,

    It’s really great to see OSCON and O’Reilly supporting such an important topic in my own back yard. We have a vital and creative open source community in Portland and I’m sure many will be interested in contributing.