Open Steps – open source and health informatics thinktank report now available

The report of the Open Steps thinktank meeting of February 2004, held at the Marwell Hotel, Winchester, UK is now available via the website of the Open Source Health Informatics Working Group of the International Medical Informatics Association (IMIA OSWG), at

We welcome input from all in the health and health informatics communities interested in free, libre and open source software, including GNU/Linux.
There is a Wiki available at courtesy of Dr Adrian Midgley, or responses can be sent by email to

Dr Peter J. Murray
Project Leader, Open Steps
Co-chair, IMIA OSWG �
Chair, IMIA-NI Open Source Nursing Informatics Working Group �

The main purpose of the Marwell Open Steps meeting was

– to identify key issues, opportunities, obstacles, areas of work and research that may be needed, and other relevant aspects, around the potential for using open source software, solutions and approaches within health care, and in particular within health informatics, in the UK and Europe.

Three quarters of participants described their ‘ideal vision for the future use of software in healthcare’ as containing at least a significant percentage of Free/Libre/Open Source Software (FLOSS), with nearly one third wanting to see it ‘entirely open source’.

The emergence of a situation wherein FLOSS could interface with proprietary software within the healthcare domain was seen to be achievable and desirable, and also likely if the right drivers were put in place and barriers addressed. Participants felt that the strongest drivers were:

� adoption and use of the right standards;
� the development of a FLOSS ‘killer application’;
� a political mandate towards the use of FLOSS; and
� producing positive case studies comparing financial benefits of FLOSS budget reductions.

The Marwell event was the first in a series of meetings planned by the IMIA OSWG and held in conjunction with the British Computer Society Health Informatics Committee and other groups. Most participants were from the UK, although others were from The Netherlands, Czech Republic, Belgium and North America.

Participants rated the most important issues why people do and might use FLOSS within the health domain as quality, stability and robustness of software and data, as well as long-term availability of important health data through not being locked up in proprietary systems that do not allow interoperability and data migration. They felt that the two most important areas for FLOSS activity by IMIA OSWG and other FLOSS groups were ‘political’ activity and work on raising awareness among healthcare workers and the wider public.

‘The aim of the Marwell meeting was to identify the issues, not necessarily answer them’ said Dr Peter Murray, the Open Steps project leader. ‘We hope to see wide discussion within the health informatics and open source communities. We know there will be other issues that some will see as more important � we welcome constructive dialogue and hope that many groups will work together to build on what is a small first step.’

The Marwell Open Steps meeting was organised and supported by the following organisations:
�IMIA Open Source Working Group (IMIA OSWG �
�British Computer Society Health Informatics Committee (BCS HIC �
�IMIA Special Interest Group on Nursing Informatics, Open Source Nursing Informatics Working Group (IMIA-NI OSNI �
�Open Source Health Care Alliance (OSHCA �
�Peak Performance (

For further information:

– see the website for the report in html, pdf and versions –
– direct link at

– email

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