I've been studying many open source medical programs, and it seems to me there are many niche applications but little common infrastructure. I believe that in order for any open source projects to become widely adopted by mainstream physicians, there needs to be a certain level of interoperability between them (not at the applications level via standardized interfaces, but at the knowledge level). I feel there are certain pieces to the puzzle that would provide a substantial boost to the open source movement if they became freely available as international standards, or even de facto standards. For example:
1. Pharmacopoeia with drug dosage, interactions, warnings, clinical pharmacology, etc. 2. Clinical Concept Knowledge Base modeled using Galen, GEHR archetypes, "fils guides", etc. with linkages to standard terminologies and code-sets (i.e. SNOMED, ICD, CPT, READ, etc.) 3. Clinical Guideline Knowledge Base for workflow modeled using GLIF, PROforma, PRODIGY, EON, etc. Perhaps it is the responsibility of governments to fund the development of such open infrastructures? I am especially shocked that no government has forced drug companies to contribute to an international repository of information on their drugs. In the US the FDA has produced a catalog of all approved drugs but as far as I know it provides no clinically relevant information. Perhaps I have a narrow view of what is really going on with regard to open source medical informatics infrastructure. Your thoughts on this matter are greatly appreciated. ============ Matias Klein HealthNetworks.com
