Chapter 13. Open Source Systems

Open source software is not currently found in many healthcare settings in the United States, although the infrastructures of healthcare systems in several other countries run on it, and one of the most celebrated EHRs in the United States—the Department of Veterans Affairs’ VistA—is open source. The role of open source is expanding quickly, and providers are soon going to find themselves using open source software for many everyday functions—perhaps without realizing it, because it might be buried inside proprietary offerings.

The meaning of open source software, also often called free software, is often misunderstood. These systems distribute all the resources needed to continue developing and using them to the public. If the original developer should vanish, or insist on taking the software on a path that some of the users dislike, any user can hire programmers to continue development. The key characteristic of open source systems is not that they are cost-free. Although their source code is available without charge, practical deployment often requires considerable investment, and most users choose to contract with businesses that charge for deployment or maintenance. The key characteristic of open source is that it responds to the needs of the users instead of the vendors, and successful open source systems develop communities that control its future.

Why do we devote a whole chapter to open source, given that it is currently barely a ...

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