DR PHIL KOCZAN

GP in Waltham Forest for 20 years
Long standing interest in Health Informatics
Chief Clinical Information Officer (CCIO) for UCLP and NELFT
Member of the Health Informatics Group of Royal College of GPs
This is a personal view of the topic

What do we mean by “open source”
Total cost of ownership
System Safety
Innovation
Integration and Interoperability
Areas of potential use
Ways forward

“Open Source” allow software to be freely used, modified, and shared.
Several different licence types.
NHS England working with suppliers to agree Open Source solutions.
Range of solutions from small apps to EPR and Portal solutions

Software is free.
BUT consider:-
◦ Support and services that may be required
◦ Deployment
◦ Development
◦ Data migration
◦ Integration

Concerns raised about the safety of open source solutions.
“Thousand eyes” – early detection of vulnerabilities and fixed developed quickly
Solutions have not previously been deployed at scale within the NHS, not unique to open source solutions.
Community Interest Companies (CICs) will be developed around solutions to provide governance of the code

There is a long history of innovation in NHS IT solutions
◦ Initial GP systems developed by GPs to solve their management and data recording problems.
◦ HANDI
◦ NHS Hack Days
Many trusts have in house databases which were developed to tackle local issues, often with clinician input
These are currently often stand alone and do not integrated with other systems
Open source systems should provide greater opportunities around innovation

Need to move away from “one size fits all” and organisational silos
Open Source Software – part of the solution, but not the whole solution, potential to be disruptive
Focus on Open Standards – will allow greater interoperability
Increasing openness of systems.
◦ Open APIs are being developed and becoming mandated (Recent GPSoC)

Apps that integrate with the host system supporting development of a paperless NHS
◦ Mobile solutions for tablet devices
◦ Support specific clinical specialties
◦ Support for improved clinical safety and efficiency
Trust administrative and clinical systems including clinical portals
Patient facing services
Provide a platform for developing, testing and training

Training clinicians to electronic records during consultations
◦ Use in medical schools
Develop user interfaces with clinicians
◦ Improve data capture
◦ Right device for right process
◦ Improve patient safety – right information, right place, right time
Define pathways
Rapid prototyping

NELFT is developing a business plan to explore the options of Open Source solutions following successful tech fund bid
Looking at procurement and governance options with NHS England Open Source Team
Tech fund 2 is likely to further support the open source developments

We are on a journey and need to work together to understand what can be achieved to support delivery of care across both health and social care.
Interoperability is essential for success
Need evolution and rapid development to enable the technology to support the internal processes
Technology is no longer the barrier. We need to work with the clinical, managerial and technical teams to make best use of the technology.
People
Technology
Processes

Open source software is one option for implementing
EPRs and could help show what is possible.
It should also encourage other suppliers to open up their systems supporting greater interoperability, promote sharing of data to support clinicians and improve delivery of care to our patients