OpenSource NHS System?

slylittlefox · 9 Sep 2009 at 00:30

I've just been discharged from hospital and whilst in there wondered why the OpenSource community hasn't turned their hand to this yet?

Yes, it's an unbelievably huge project with a scary amount of scope, but the benefits it could bring to third world countries etc would be amazing.

It could be put together in components, so a team of devs could work on the GP front-end, another team on the X-Ray integration and handling system, another team on a back end for the pharmaceutical control system etc.

Each one of them would be an extremely interesting project to work on IMO. And again, the benefits would be astounding.

Ross1234 · 9 Sep 2009 at 00:40

The government wouldnt buy an open source software for the NHS they need something with paid support and someone to blame if it goes wrong.

slylittlefox · 9 Sep 2009 at 00:45

Exactly, developers could then make money supporting the system etc.

Bare in mind that I meant NHS as if in any national health service, particuarly emerging countries who are looking to modernise.

Governments wouldn't have to spend billions developing the base system, and developers would be in work for a long time

And there's also the fact that developers would (hopefully!) relish at the chance of working on a project that could literally save lives!

theheyes · 9 Sep 2009 at 01:18

I'm not saying it's a bad idea, but a more immediate problem for developing countries is infrastructure. In some parts of Africa the electronic back-end of their emerging healthcare system is based on mobile phones and text messaging.

Linux/OSS will have a part to play when the infrastructure begins to catch up, but I'm sure Microsoft won't be far behind and willing to throw the rule book out the window (no pun intended) in terms of the pricing.

slylittlefox · 9 Sep 2009 at 01:27

True

The codeine has brought out the idealist in me I guess!

/gets back in his box

leezer3 · 9 Sep 2009 at 01:41

Ross1234 said:
The government wouldnt buy an open source software for the NHS they need something with paid support and someone to blame if it goes wrong.

You mean that they can agree to pay triple the actual cost for, then run another five times overbudget, and still not work correctly

None of the government's major IT procurement projects have worked properly and on budget for a long time now.

-Leezer-

aln · 9 Sep 2009 at 02:12

Ross1234 said:
The government wouldnt buy an open source software for the NHS they need something with paid support and someone to blame if it goes wrong.

You mean like these guys?

http://www.redhat.com/

I'd believe that surely open source is the best idea for government infrastructure. Not having the source of a large system that you rely on means you can basically be held to randsom later down the line when you wish to make additional changes. (i realise it doesn't need to be oss tho)

Jobs could be created to support such a system, both for the average IT support worker, and on the software stack. It would be better, imo, than relying on foreign companys to do the work.

Releasing the source of such a system, which is basically giving it away for free, would mean that other countrys/organisations may also be inclined to use it, this could potentailly creates more jobs once again, as obviously we would have a pool of workers familiar with the systems.

The argument that any money saved would be offset by the fact that staff would have to be retrained is valid, however if this was once again UK workers doing the training, then I don't exactly see that as a huge negative.

I'm sure there would be savings to be made long term.

Unfortunately I'm sure our MPs are too busy finding clever ways to claim expenses, and looking after their own interests to ever consider such an endeavour.

Manlove is my forte · 9 Sep 2009 at 17:53

The NHS Specs its own software and tenders the contracts to the lowest bidder.

In spite of what you might think Open-Source tends to cost more in the long run.

Off The Shelf packages or Vendor Supplied software comes with vendor supplied support.

Also what DB would you be running this on? Oracle & DB2 are the only RDBSs powerful enough to run the NHS backends. They surely are not open source, so you will still have to pay.

PhilGQ · 9 Sep 2009 at 18:34

Manlove is my forte said:
The NHS Specs its own software and tenders the contracts to the lowest bidder.

In spite of what you might think Open-Source tends to cost more in the long run.

Off The Shelf packages or Vendor Supplied software comes with vendor supplied support.

Also what DB would you be running this on? Oracle & DB2 are the only RDBSs powerful enough to run the NHS backends. They surely are not open source, so you will still have to pay.

They could use the Base from OpenOffice, thats scalable, feature packed and amazingly fast.

dangerstat · 9 Sep 2009 at 20:21

Have you ever met a techy working for the NHS, they're useless. God help us if they give them anything more technical than a pencil. Bunch of absolue <best no post this word or I'll get banned>

Manlove is my forte · 10 Sep 2009 at 00:09

PhilGQ said:
They could use the Base from OpenOffice, thats scalable, feature packed and amazingly fast.

funny I cant remember ever hearing of it as an alternative to an Oracle, DB2, Sybase or even SQL Server. Their Wiki even compares it to Access (which is more or less a glorified spreadsheet)

On topic.

I heard on the Radio a while back that in spite of the majority of the Government IT Projects being over priced, over budget, late and short of full functionality. Once Rolled out they work out to be saving the tax payer money. This is something not often mentioned in British Press (because good news does not sell).

The NHS needs a full overhaul and part of this is to make IT central to their operations. In any other industry a business run as badly as the NHS would fail.
Part of the issue is Queue Management. Nothing seems to happen in the background. You queue at the A&E Reception, You Wait your turn for Triage, The assess you, you wait based upon severity (which is right) for a cubical then for treatment, each phase of the treatment happens 1 set at a time. You see the Dr, you queue for an Xray you return to your cubical, the Dr looks at your Xray, you get another visit from the Dr, you go to the Plaster Clinic, you queue to get plastered, you return to the cubicle, you wait for the Dr, you get discharged.

If I was in charge, During busy periods I'd have more than one nurse on Triage and more than one Receptionist, you'd get booked in and in 5 min you'd be assessed. No Longer.
Based upon assessment of injury type you'd be streamed in the right directions, Breaks & Sprains straight to the Xray department, Cuts to Surgery (for lack of a better term), Head injuries to the Nurology dept, etc.

You'd get your tests done first.

I don't see why all tests need to be reviewed by an onsite Dr. Surely you can have a "Call Center" in Sheffield full of Qualified Drs who spend all day reviewing Xrays, CAT scans and the like for the whole country and filling out prognoses. These can then be stored electronically and picked up locally for treatment based upon the prognosis. That way the onsite staff are able to dedicate their time to dealing with fixing patients and not time diagnosing their aliaments.

Once Tested and Diagnosed you go to a treatment cubical and are fixed.

But as I said the management and culture of the NHS needs to change.

manic111 · 10 Sep 2009 at 00:30

The French government run Ubuntu...

aln · 10 Sep 2009 at 00:35

Manlove is my forte said:
funny I cant remember ever hearing of it as an alternative to an Oracle, DB2, Sybase or even SQL Server. Their Wiki even compares it to Access (which is more or less a glorified spreadsheet)

I believe the point would lie more with choosing open source when it is a viable alternative, and possibly contributing to 'nearly there' projects, as opposed to replacing vital infrastructure with software which does not currently exist.

I would be interested in the specifics of your argument that wide spread adoption of OSS would be more expensive long term, and closed source.

The rest of your post made for interesting reading.

Manlove is my forte · 10 Sep 2009 at 10:51

aln said:
I believe the point would lie more with choosing open source when it is a viable alternative, and possibly contributing to 'nearly there' projects, as opposed to replacing vital infrastructure with software which does not currently exist.

I would be interested in the specifics of your argument that wide spread adoption of OSS would be more expensive long term, and closed source.

The rest of your post made for interesting reading.

Training is the real cost. If you had OO instead of MS Office you would find that you would need to retrain most of the "Non-Computer Litterate" staff, you would also need to train every member of staff that comes into the company.

The second issue is support contracts, with Office you are dealing with MS. If Office develops an issue, you can raise a case with MS and they will help you resolve it and IIRC it comes as part of the license fee.
However with Open Source you either have to post on a Forum and wait for the community to come back to you with a fix, and are reliant on good faith that some one will know how to fix the issue, is available to assist with fixing the issue and will not cause another issue by fixing the first issue all in timely order.
You then need to put that fix into a User Acceptance Test environment and will have to run some strenuous and meticulous tests to ensure that the "Fix" does not cause a greater harm, before rolling it out to the general user base. Due to the Software being a niche product the people providing the inhouse IT support will no doubt be highly paid.
Hopefully there is an automated solution for this, as it would be a very costly exercise to have each PC patched individually.

Alternatively you could subscribe to a 3rd Party Open Office Support team, who will support all your OO products and work to help you resolve your issues. However this will cost your company money and you will likely have similar issues and costs associated with just relying on the Open Source community. (at least using a 3rd Pary support company you would hope the roll out of the patch was automated)

I'm not saying Open Source is all bad, but you need to have a vendor, which is running a profitable business backing the product to ensure that the product is sustainable through out its lifetime.

Just look at SUN they moved to the Opens Source Model and in-spite of having (IMO) the best products on the market. They could not sustain their business and are soon to be owned by Oracle a closed source company.

Edit: Open Source != Free. IIRC Redhat Charges a min of $350 Per Installation of Redhat Enterprice and $70 per desktop (per year) as a license/support fee. look at their price lists
https://www.redhat.com/wapps/store/catalog.html;jsessionid=1AoY43Bl+EVpDORswCM8uQ**.3762dd37

Qu3 · 10 Sep 2009 at 12:57

At the moment I believe most software packages are commissioned by each trust not for the NHS as a whole. So at the moment an NHS trust up north may have a totally different system for doing X than one in the south..

Manlove is my forte · 10 Sep 2009 at 13:21

Qu3 said:
At the moment I believe most software packages are commissioned by each trust not for the NHS as a whole. So at the moment an NHS trust up north may have a totally different system for doing X than one in the south..

There is that issue, as well the issue that the NHS does not know if it wants a centralized or Decentralized organization (From what I understand they keep changing their mind, and some things are designed one way and then used the other).

As I said above, the Whole NHS needs a complete overhall

#Chri5# · 10 Sep 2009 at 13:42

Also, I expect MS can/will throw the price list out the window when it comes to being part of a major deal ie an NHS project.

Witness them offering Office 2007 Enterprise to anyone with a .nhs e-mail address for some £20.

Dj_Jestar · 10 Sep 2009 at 14:03

All government contracts must adhere to strict legislation, including that all projects are using PRINCE2 guidelines. Something that just won't happen with OpenSource.

Qu3 · 10 Sep 2009 at 15:23

Manlove is my forte said:
There is that issue, as well the issue that the NHS does not know if it wants a centralized or Decentralized organization (From what I understand they keep changing their mind, and some things are designed one way and then used the other).

As I said above, the Whole NHS needs a complete overhall

Can't see it happening anytime soon though!

Manlove is my forte · 10 Sep 2009 at 16:44

Qu3 said:
Can't see it happening anytime soon though!

Me neither.