Chairs
Thomas Karopka
IT Science Center Rügen gGmbH
EFMI LIFOSS WG co-chair
Germany

Ricardo Joao Cruz Correia
Universidade do Porto
Portugal


Scope and topics
eHealth is thought to be a lead market in European Health care. It has been acknowledged on a national as well as on an international level that information and communication technologies (ICT) have a great potential in tackling specific challenges within the healthcare sector. Recent research has suggested that the health ICT industry has the potential to be the third largest industry in the health sector with a global turnover of € 50 – 60 billion, of which Europe represents one third. However, this potential growth might not occur if the existing barriers to the market are not removed. These barriers are for instance lack of knowledge and skills of health professionals in respect to ICT, market fragmentation and lack of financial support. Open source for healthcare is different from other areas. The classical open source area is in operating systems and all kinds of tools. The community consists of enthusiastic programmers that have fun working on interesting projects and creating high quality software for the community often working on these projects in their free time. In the case of highly specialized tools, the end users are either programmers or very ambitious computer users. The open source products for a “mass market” mostly have some kind of professional support either from a foundation (e.g. Apache Software Foundation) or from a company (e.g. JBoss, Red Hat, MySQL). The situation in the healthcare market is different. The programmers are not working in their free time. The majority is working in academy or in small companies. Open source in health care is still very rare. Most of the applications are from research and academia but not from the healthcare industry. One possible reason is the different situation in healthcare. The end users are health professionals that have limited time for learning how to use the software. The requirements in respect to quality, security and standards are very demanding. Hospitals or GP practices will never use an open source system if they are not guaranteed to get high quality, timely support and a life cycle of the software that is long enough to justify the investment. The problems are often too complex to be solved by small teams. Most problems need a planed coordinated action that is often out of scope for single persons to start a complete project. In open source projects, developers are not working in the same institution as the final user. Often it is necessary to adapt the software to the specific needs of the institution, integrate it into the local workflow or implement interfaces to other systems like hospital information systems. Small software teams that are based in these institutions could thus flourish the open source idea.

Recently bigger companies are investing in open source. Examples are Ocean Informatics with the openEHR project, the newly build Open eHealth Foundation (founded by InterComponentWare AG, AGFA Healthcare and Sun Microsystems), or the Open Healthcare Framework project (Eclipse). Open source in healthcare needs these professionally planed and coordinated projects to develop a well structured basis to gain the critical mass of software needed to produce a sustainable core of software, provide professional support as well as implementing open standards.

The workshop will like to stimulate discussion about the possible role of open source to overcome these barriers. Participants are asked to provide original research papers about open source software in healthcare. Position papers are also highly welcome. The workshop is designed to stimulate discussion and to continue in forming an open source community in healthcare. Thomas Karopka is currently co-chair of the EFMI LIFOSS working group. The EFMI LIFOSS WG was founded in 2006 and membership is open to everyone who agrees to the WG's objectives, tries to actively participate and references to the WG whenever applicable. More information can be found on the EFMI LIFOSS WG website. The workshop is conceptualized as a follow up of the EFMI special topic conference EFMI STC 2008 "Open source in European healthcare". The positive impulses gained at the EFMI STC in London will be the basis for the organizing team to plan the workshop.

Possible topics include but are not limited to:
- open source software
- tools in all areas of healthcare
- for eLearning and education in the medical domain
- for knowledge bases and knowledge dissemination
- out of the Medicine 2.0 realm

Position papers may discuss the following problems:
- What are the major challenges for open source in health care?
- Proposals to overcome the identified barriers
- What are the specific requirements for open source software to be accepted by health professionals and institutions?
- What has to be done to push open source in the health care arena?
- What has to be done to make open source software attractive for institutions?


Invited Speakers
Dr. David Chan is an Associate Professor with the Department of Family Medicine at McMaster University. He worked as a software engineer prior to entering the field of medicine. He has devoted the past 20+ years in developing Free/Open Source Software solutions to enhance patient care. He has developed a set of web-based applications collectively known as OSCAR (Open Source Clinical Applications and Resources). These include an OntarioMD Certified Electronic Medical Record, a patient controlled personal health record called MyOSCAR, a social networking site called MyDrugRef.org for pharmacists and physicians to exchange drug related knowledge, and an Open Content Clinical Resource Database. He is currently conducting a number of research projects to demonstrate the use of Personal Health Record to improve health outcomes.
Abstract:
The Information Technology group at the Department of Family Medicine, McMaster University developed OSCAR in 2001. It is a fully functional Electronic Medical Record (EMR) that is currently supporting all the academic teaching units within the department and many other large and small clinics across Canada. OSCAR has been certified by OntarioMD under the Physician IT Program. Its ongoing development is being supported by a large group of developers from Brazil, Australia, USA and Canada. MyOSCAR is a Personally Controlled Health Record, an adaptation of the MIT/Harvard Indivo project (http://indivohealth.org). Information can flow freely between OSCAR and MyOSCAR thus allowing patients to participate in managing his/her own health care.

Benjamin Baumann is a Co-Founder and the Director of Business Development at Akaza Research, the originators of OpenClinica. Since the launch OpenClinica in late 2005, Mr. Baumann has helped it rapidly grow to become the world's most popular open source clinical research software. Mr. Baumann is a career entrepreneur and brings a history of successful entrepreneurial ventures to Akaza Research. Previous to his role at Akaza, Mr. Baumann ran a consulting company that provided technology consulting and implementation services to leading life sciences institutions such as the National Science Foundation, the National Institutes of Health, and several leading academic medical centers. Mr. Baumann holds a degree in economics from Harvard University.
Title:
OpenClinica: open source platform for clinical research
Abstract:
OpenClinica is the world's leading open source software for clinical trials. It enables electronic data capture (EDC) and clinical data management for diverse types of clinical research. The system is based on leading independent standards and a modern, flexible technology infrastructure.
OpenClinica is currently in production use at approximately 200 organizations comprising small to large biopharma companies, contract research organizations, academic health centers, government organizations, and NGOs. The OpenClinica community consists of over 5,000 individual members spanning 76 countries.
The open source development model behind OpenClinica involves several layers of participation. Ultimately, however, each distribution of the product is put through a rigorous quality system to ensure that the software can be reliably used within strict regulatory environments. This talk will address the following topics: (i) introduction to the OpenClinica product and community, (ii) overview of regulatory concerns associated with using open source software in regulatory environments, and (iii) specific points of integration between OpenClinica and other types of health IT systems.

Ståle Walderhaug is a researcher at SINTEF ICT in Trondheim, Norway. He is currently doing a PhD at the University of Tromø (Norway), in the field of Model-Driven Development of interoperable health information systems. Ståle Walderhaug is the technical manager of MPOWER, and the responsible for system architecture and approach. Ståle Walderhaug holds a masters degree in telecommunication from the Norwegian University of Technology and Science in Trondheim. He started working for SINTEF ICT in 2000, and has since then been involved in a number of Europan Research projects, including Telemedicare, LinkCare, Modelware and MPOWER. Ståle Walderhaug was the Norwegian representative in the NATO Expert Panel for Telemedicine from 2003-2005. His main fields of research are model-driven development, healthcare interoperability and healthcare information standards.
Title:
MPOWER – an Open Source Service Platform for Independent Living
Abstract:
Starting in Ocober 2006, the EU-IST project /MPOWER/ has designed, implemented and evaluated a set of services that support the smart house technologies in a homecare setting (http://www.mpower-project.eu). The services were identified from an extensive investigation in the homecare domain involving 140 stakeholders from four European countries. Following the guidelines for service specification in SOA4H7 methodology and Erl, 30 services in 5 logical categories were designed.// The services were designed in UML with domain specific extensions UML Profiles. From UML, WSDL definitions were generated and used as input for web service generation in Netbeans. This process, defined as a toolchain is being added to the open source project FREE MPOWER hosted by Sourceforge (http://sourceforge.net/projects/free-mpower) Most of the services are based on international standards such as HL7v3 messaging. Core services such as /medication/ and /calendar/ services have been submitted to the Healthcare Service Specification Project (HSSP) for evaluation. The objective is to establish a HSSP subgroup for /independent living./ Services providing medical sensor data follows ISO/IEEE 11073 standard, whereas domotic sensor services uses a new information model that has been proposed to ISO/IEEE for standardisation. The MPOWER services are being used in two types of homecare applications (information centric and sensor centric) that have been and are being evaluated in Norway, Poland, Croatia and Austria. The FREE MPOWER project on Sourceforge provides the overall architecture, the services designs and service source code. By sharing the service definitions and implementations, we encourage other organizations and EU projects to benefit from our experience and efforts to standardize core services in smart homecare. The MPOWER project finishes in July 2009.

Alexander Ihls is Head of Global Standards Office of the eHealth specialist InterComponentWare (ICW). In this function, he is coordinating ICW's activities in various standardization organizations in the area of eHealth, e.g. HL7, IHE, Continua Health Alliance, and the European eFA initiative. Ihls joined ICW in 2006 after working for iSOFT Germany, where he was responsible for Business Consulting. At ICW, he was head of research and development for the ICW hospital connectivity and RHIO/CHC solution, as well as the ICW Care and Disease Manager, a Tool for the efficient management of DMP programs at health insurance companies and medical call centers. Ihls has more than 15 years working experience in the eHealth sector that he gained in leading positions at iSOFT Germany and MEDOS as well as head of IT of a major hospital. Alexander Ihls studied political sciences at the University of Marburg, Germany. He is member of Gesellschaft für Informatik (Association of information sciences), HL7 User Group Germany and the initiative "Integrating Healthcare Enterprise" (IHE) Germany, where he was founding member of the board. Ihls is President and chief business development officer (CBDO) of the Open eHealth Foundation. In this function, he is directing the foundation's orientation and is responsible for the acquisition of new partners and members.
Abstract:
The Open eHealth Foundation was founded by Agfa Healthcare, Sun Microsystems and ICW to build up a complete Framework and the infrastructure to provide components under an Open Source license. These components will enable companies and non-profit users to implement standardized interoperability (e,g, using HL7 by implementing IHE actors with the components of the Open eHealth Foundation) in their solutions in a quick and easy way. The idea behind this initiative is to force the use of international standards to enable semantic integration and federation of existing and future applications. This session will give an overview about the status of the Foundation and the roadmap till 2009.


Workshop Program Committee
Tim Cook, Health Informatics Research & Consulting Services, Brazil
Etienne Saliez, Consultant, Belgium
Herman Tolentino, Centers for Disease Control and Prevention, U.S.A.
Fred Trotter, SynSeer, U.S.A.
Jan Vejvalka, Faculty Hospital Motol, Czech Republic