The success of our health care track at the O’Reilly Open Source convention last year (which I covered in a series of blogs) called for a follow-up. This year we offer another impressive line-up. In fact, we had to turn away several interesting presenters, some of whom I am following up with for separate interviews or work projects. This year we’re looking more at what you — patients, clinicians, and researchers — can do with the data you collect, while we continue our coverage of critical IT parts of the health care system.
The health care sessions are tucked away in a little-trafficked area of the Oregon Convention Center. To get to the room, you have to come down to the ground level and walk all the around, away from the registration area, to the part of the building facing the Boulevard. I’m writing this blog to encourage more OSCON attendees to take the steps there.
Open source and health care go together like alkyls and hydroxyls. Open source software offers greater standards compliance, which helps institutions exchange critical data, and gives the extremely diverse field of health providers the flexibility they need to offer the kinds of interfaces and services they want.
And open source software is starting to take its rightful place in the health care field. The people that the federal government put in charge of driving improvements in health care — the Office of the National Coordinator in the Department of Health and Human Services — know the benefits of open source well, and have instigated many such projects. OSCON highlights some of the best-known, as well as some valuable ones that most people have never heard of.
Alison Muckle and, Jason Goldwater will report on the state of open source software in health care. Under contract from the ONC, these researchers studied several systems and found they could provide the features needed by health care providers at a low cost.
The CONNECT Gateway was an existing government project that the ONC decided to make open source. It cut through the proprietary mess in health information exchanges that has been holding doctors back from sharing information on patients for years. Instead of individual translations from one proprietary record system to another (leading to N2 translation procedures among N systems), CONNECT provided a standard protocol that vendors are adopting.
Drawing on the expertise in open source communities demonstrated by Brian Behlendorf (of Apache fame) and David Riley, the ONC built a robust community around CONNECT, including both commercial entities and individuals who care about health care. Behlendorf and Riley spun out the non-profit Alembic Foundation to coordinate further community efforts, and Riley is coming to the health care track to describe where the project is going.
Although CONNECT is going to turn more and more in health information exchanges, it is SOAP-based and heavyweight for casual exchanges among small medical practices. The rural one-physician practice needs to exchange data as much as the hospitals that use CONNECT, and needs to meet the same requirements for privacy. The Direct project provides secure email and other simple channels between facilities that trust each other.
As Bhandari’s and Emami’s talk shows, implementation is a big part of the job of making standards and open source software work. Three representatives of open source projects will discuss their collaboration on an open source health project.
Among the lesser-known beneficiaries of ONC funding is the popHealth project, run by MITRE. The vision behind this project is improving the quality of health care, which requires collecting data from each health care provider. When providers know they’re being measured for quality, they do more of the right things like encouraging patients to come in for follow-up care. And when we know where we did well and not so well, we can apply resources to raise up the laggards.
So the health care reform in the stimulus bill, in calling for “meaningful use” of provider data, gives the providers incentives to send a range of data to the government, such as how many smokers and diabetics they treat. popHealth hooks into electronic health records and makes it easy to generate reports on standard measures of quality. It also provides simple Web interfaces where providers can check their data, and this encourages them to track quality themselves. Programmer Andrew Gregorowicz will speak about popHealth at OSCON. (I interviewed Gregorowicz about his presentation.)
Another intriguing presentation can be expected by David Uhlman, who covers not only the use of open source for meeting meaningful use requirements, but how providers can use open source tools to manage the data.
Personal health records let patients keep track of their health information, but as the recent demise of Google Health shows, it’s hard to make a system that ordinary people find useful. Institutions can use the open source Indivo system to give clients access to PHRs. Its API and uses will be described in a talk by chief architect Daniel Haas. (I interviewed Haas about his presentation.)
Another key link in the chain of patient data is the increasing number of devices that measure blood pressure, glucose levels, and other vital signs. Shahid Shah explains why high-quality treatment depends on connecting these devices to health records, and the role of open source in doing so. (I interviewed Shah about his presentation.)
Several sessions in other tracks are also related to health care:
DIY Clinical Trials (Or: How to Guinea Pig Your Way to Scientific Truth and Better Health) — the intriguing idea that people engaged in a clinical trial for a treatment can communicate with each other about their experiences. I interviewed Greg Biggers about this talk.
Open Source Preventive Medicine: Citizen Science Genomics — ways to explore the data revealed by your genetic data, and those of others.
Garage Biology And DIYbio: Because We Can, Because We Have To — about a fascinating incubator for new biological projects, such as in synthetic biology. I interviewed Eri Gentry about this talk.
There’s so much happening this year at OSCON that I wish I were multi-threaded. (But, actually, threads are on the way out this year — didya hear? Asynchronous callbacks are in.) I hope some of you can make time, by cloning yourselves if necessary, and join us at some of the talks in this blog.