OpenLIS: The Development of a Clinical Laboratory Information System Using the Op

DESCRIPTION (provided by applicant): Current initiatives in the United States to digitize the nation's medical records are dauntingly ambitious. Achieving seamless electronic health records will require that many existing record systems as well as their feeder sources of information be reevaluated and likely reengineered. This is particularly apparent in the domain of clinical laboratory software where the typical lab runs a pastiche of proprietary computer systems that are expensive, difficult to maintain and virtually impossible to customize and integrate. One solution to overcome this barrier is to provide an open source alternative to proprietary lab information systems based on open data standards. A successful open source project in this area could provide an enterprise-quality product that is more flexible, better performing and more widely accessible than its proprietary alternatives1. The project, called OpenLIS would involve the input of a community of users and developers within the laboratory information systems space. The software would be distributed under a free, open source license, with opportunities for commercial-level support. Since OpenLIS will be freely downloadable and carry no software license fees, the barrier-to-entry for laboratories to adopt the technology will be extremely low. This will encourage people to download the software and evaluate it which, in turn, will drive adoption. With adoption, there will emerge a business opportunity to provide professional support services to those adopters who need them. Such support may include hosting, training, systems integration and other services. This software model and business strategy have proven successful in many other software categories (examples include: RedHat (operating systems), MySQL (databases), SugarCRM (customer relationship management software) and OpenClinica (clinical trials software)). The collaborators on this project include Molecular Pathology Laboratory Network, Inc., a mid-sized clinical laboratory, and Akaza Research, LLC, a leading open source software company and creators of OpenClinica. Together this collective expertise and experience will make OpenLIS well-positioned for success. 1 In many other software categories open source project have proven to deliver more flexible, higher performing technology that is more widely accessible than proprietary software. The Linux operating system, Apache web server, Firefox web browser, MySQL database are just some examples of such successes. PUBLIC HEALTH RELEVANCE: Today, much of the best software in the world is free. It's free not only in the sense of having no license cost, but also free in that can be downloaded from the internet and its inner workings examined and improved by anybody in the world who finds the opportunity compelling enough to do so. One of the early projects to use this transformative paradigm was Linux, the open source operating system. Started in 1991, it was released for free on the internet and soon attracted tens of thousands of users and developers who contributed code and bug fixes back to the project (Weber, 2004). Linux is famous for its superior performance and reliability, and now threatens its closed source, proprietary rivals on every front from personal computers and enterprise servers to embedded systems and hand-held devices. This open source, community-driven approach to software is also making inroads in the healthcare industry. Racked by costs nearing 16% of the gross national product, the health-care industry in the United States is looking to open source as a means of cutting costs without sacrificing quality. Indeed, Senator Rockefeller of West Virginia has introduced legislation that promotes open source as a way to facilitate the universal adoption of electronic medical record keeping, citing as proof of principle the success of VistA, the open source medical records system originally developed by the U.S. Department of Veterans Affairs (VA). We propose a similarly bold effort but in the area of clinical laboratory information systems (LIS) which is a critical component to enabling a fully electronic health records system and an area currently devoid of viable open source options. Closed source, commercial LIS available today are expensive, difficult to customize and largely fail to support cutting-edge developments such as personally controlled healthcare records and genomics- based testing (Battelle, 2007; Mootrey, 2004; Cowan, 2002). We propose to challenge this situation by initiating 'OpenLIS', a project that will embrace the open source model to create a modern LIS that is more easily adopted and integrated than current options. While the software will be given away for free, a business opportunity will emerge as users adopt OpenLIS and require varying degrees of professional assistance. Commercial- level support offered to adopters may include hosting, training, validation as well as other services. Professional open source business models have been proven successful in numerous industries, including healthcare. For example, Medsphere Systems Corporation (Carlsbad, CA) thrives as a provider of professional support for an open source electronic medical records system. We have the expertise and experience to do the same with OpenLIS.