OpenClinical: Open Source?

John Fox

University of Oxford (Engineering Science)UCL (Oncology, Royal Free Hospital) www.cossac.org

www.OpenClinical.org

• Goal: To promote awareness and use of decision support, clinical workflow and other knowledge management technologies for improving quality and safety of patient care and clinical research.

• A resource and portal for technologists, clinicians, healthcare providers and suppliers

• Currently about 200,000 visitors a year (80% growth in 2010)

wwwOpenClinical.net

• Experimental project to explore how to develop content for high quality clinical decision support and workflow services at the point of care

• Goal is to build a community of users, researchers and content providers who are willing to contribute to the development of a repository of open content, including applications and application components

OpenClinical.net test sitepro tem: modx.openclinical.net

Content development lifecycle

• Prototype development model for open source content repository on www.OpenClinical.net

• Currently limited to PROforma decision and process modelling language

• Intended to eventually multiple representations (e.g. GLIF, ASBRU, GELLO, OWL ...)

Load from, save to repository

Download tools www.cossac.org/tallis

Web publishing (“publets”)

Integrate and Deploy

Key questions for open content

• Quality and Safety– Quality lifecycles, safety culture, who is liable?

• Reusability and interoperability – Open technical standards, who is developing them?

• Functioning community (Sheizaf Rafaelli)– What will sustain the open source ethic?

• Facilitating infrastructure (Bob Greenes)– Three organisations; too little? too much?

• Sustainable business models– How do the proprietary/open source worlds coexist?

Sustainable business models (1)

• Traditional standalone apps? • Issues of integration and localisation• Likes fragmentation; hates

interoperability

• Pay per patient (analogous to pay per view)

• Who would/should actually pay? • No-one pays for Adjuvant! Online

Sustainable business models (2)

• Standard medical publishing model• Commercially viable on a publishing model?

(Clinical Evidence)• Discussion on www.berkerynoyes.com/

pages/innovations_in_evidence_based_medicine.aspx

• Open Source with value-adding services? (c.f. Linux model)• Attractive model but how can we achieve

critical mass of a content development community?

Towards an open content lifecycle?

Ioannis ChronakisVivek PatkarRichard ThomsonMatt SouthAli Rahmanzadeh