2009 Linux Medical News Freedom Award Recipients

It was a difficult choice this year among many worthy people and projects but the panel of judges has spoken. The recipients of the 2009 Linux Medical News Freedom Award presented at the American Medical Informatics Association (amia.org) Fall Conference are the open source, US Government NHIN Connect project and Kevin Toppenberg, MD for his invaluable work and use of Veterans Affairs VistA in the private sector.

The National Health Information Network (NHIN) Connect project holds the real possibility of finally uniting multiple disparate Electronic Health Record systems. Its open source nature is key to its adoption in a landscape characterized by difference rather than uniformity. It is already in apparent successful real world use. Chalk one up for the US Federal Government they seem to have gotten this one right.

Kevin Toppenberg, MD truly exemplifies the spirit of Free and Open Source software. He is a practicing physician and trained software engineer who has installed and used the Veterans Affairs VistA system in his private practice for many years. In doing so he has introduced crucial innovations to its use in the private sector. He is a pioneer who has made the path easier for those who have followed him. His acceptance letter is as follows:

Dear Sirs,

I am pleased and honored to be chosen as a recipient of the 2009 Linux Medical News Freedom Award. Thank you for this recognition!

I am a family physician operating a private practice in Greeneville, TN. When I needed an electronic medical record (EMR), I searched for an open source solution, and found VistA, an extensive code base created and released by the Department of Veterans Affairs (the “VA”). Since then, it has only made sense for our office to improve the software and release these changes back to the community. We are pleased that others have found our extensions to be helpful. Overall, it has been an exciting journey.

I am relatively new to the world of open source software, largely starting with my work in VistA. And I have been ever more impressed with the power of cooperation, as evidenced by successful open source projects. It has been my dream that the community of sharing programmers could create an effective medical record system as easy to install and use as Linux itself. And recently I have have been heartened as individuals in the VistA community, and I’m sure other communities as well, have been stepping up to the plate to bring such dreams to fruition.

But this is no time for resting on our past success. We are truly at a critical moment in time as the medical profession rushes to computerize and qualify for government funds. There is a land-rush as proprietary companies jockey to corner a rapidly-developing market. A recent Harvard Public Heath newsletter points out that less than 10% of hospitals have implemented even basic electronic medical records (1). And my understanding is that <25% of office-based physicians have EMR’s. Surely this will change rapidly. Barriers we all face for adoption have included cost, ease of use, and problems with integration. And while an open source solution will keep costs low, that may not be enough. There is an urgent need for the medical open source community to unite and meet these needs before it is too late. My concern is that physicians may become locked into closed systems after heavy financial investment, and our window of opportunity will have closed.

Although individual developers, such as myself, can accomplish some good on their own, we must integrate as never before if we want to be chosen over proprietary closed-source systems. Thus I call on members of the medical open source community to come together and embrace an ongoing spirit of cooperation, so that we may create something truly amazing for worldwide good.

I thank you again for this award of recognition. And I thank Linux Medical News for being a forum of hope.


Kevin Toppenberg, MD
Family Physicians of Greeneville, PC
Greeneville, TN

1) http://www.hsph.harvard.edu/now/10302009/impact-of-electronic-medical-records.html

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