Open souce software is code which is publicly available for reading. It is usually associated with free software licenses (such as the various GPL, Apache, BSD and other licenses). "Free" in this context does not necessarily mean without charge (although many open source systems are available without a charge for the licence); instead it denotes freedom on the part of the user to use the software with far fewer restrictions than is typically the case with a traditional commercial license.
Open source systems and their derivatives are everywhere: they were the basis of both MacOS and Android; Linux based servers power the internet; your home router probably runs Linux, so too your TV set-top box, and many other peripherals.
Open source systems are characterised by the following:
- Vibrant communities of developers and users.
- Low cost (but not necessarily free of charge).
- Unrestrictive licensing (or much less restrictive than traditional closed source systems).
- High levels of compliance with public standards.
- Long lifetimes: with communities of developers and users, it is far harder to bury a product, and force users to invest in a new one.
- Much wider peer review of code: this has a track record - especially in the case of large projects - of delivering high quality code, and rapid fixes when required.
Traditionally hospitals have been heavy users of proprietary closed source systems; this is especially so in the clinical sphere where proprietary medecines are widely promoted and used, and device manufacturers patent their inventions: and in such a context it is easy to assume that proprietary, closed source solutions are always better.
What can open source solutions offer a hospital ?
Second: they are freely available: IT staff are able to set them up and use them almost instantly, without the need to establish a budget, seek approval, place a purchase order and deal with a supplier: this is tremendously empowering, and boosts productivity by orders of magnitude.
Third: by adhering to public standards, institutions will find the integration of other systems not only possible (where they had previously often been impossible) but also much easier and cheaper to accomplish; in parallel they are sending a strong signal to traditional suppliers that closed, proprietary protocols, vendor lock-in and abusive licensing restrictions are now recognised for what they are, and are no longer acceptable.
Many open source systems are focused on IT infrastructure. These tools are mature, well supported and documented, and widely available; they include operating systems, network services, file and print, encryption, firewall filtering.
At the application level, there are email systems, network inventory, help desk, disk imaging, instant messaging, remote desktop support, backup, telephone systems and much else.
And finally in the clinical arena there are a growing number of applications, particularly in Radiology.