Open Source in Healthcare IT Takes a Baby Step

There is plenty of enthusiasm surrounding the idea of open source solutions in healthcare, but getting policies in place hasn't been easy. Open source advocate Fred Trotter was prepared to do battle when he met recently with representatives of the Certification Commission for Healthcare Information Technology (CCHIT), but got a pleasant surprise instead. "[Several] issues were brought up in the meeting," he writes, "and CCHIT is listening to everyone."

Trotter went to the meeting loaded for bear. "The FOSS community, to the degree that such a thing is possible, had authorized me to go nuclear on the issue before the meeting," he writes. "I had been given assurance that the community has been so frustrated with dealing with CCHIT that if they did not work with us that if I started an alternative certification program that I would be backed up with the dollars and brains from the community needed to make an alternative certification go."

The advisability of such aggressive negotiating methods notwithstanding, CCHIT representatives were open to hearing Trotter explain the "profound practical and cultural implications of the ‘rules’ of the [sic] FOSS." As the meeting wore on, Trotter says he became aware that if the complexities of FOSS were hard enough for him to understand, then relative outsiders to the community would require much more time.

Nevertheless, several important issues came to light, including how to determine who is truly responsible for a codebase without resorting to educated guesses. ZDNet's Dana Blankenhorn explains, "Before it certifies software CCHIT wants to know who “owns” it and thus takes responsibility. The problem is that open source companies like ClearHealth don’t have full control of their code. Projects can be forked, then re-certified for one-tenth the cost. Or not certified."

Clearly, ironing out all the issues surrounding healthcare IT certification will take a while, but it's encouraging to know that CCHIT is open to working with the FOSS community. A recording of Trotter's presentation is available from CCHIT's Web site, or people can contact Trotter directly for the ogg version.