ONC at OSCON 2012: What Could the Future Bring?

Damon Davis | August 22, 2012

The open source software (OSS) community is full of creative software coders developing amazing computer applications collaboratively. Recently I witnessed the power of their collaborative innovation first hand at the Open Source Convention (OSCON) in Portland, OR. This was the conference’s 12th year…but my first experience.

About the Open Source Convention (OSCON)

OSCON was broken into multiple tracks focused on the technical aspects of coding languages, software development strategies, “Geek Lifestyle,” and health care.  The health care track covered topics like open source tools for tracking your own health, open source electronic health records (EHR) and their coexistence with commercial EHRs, and how open source health applications are being utilized globally.

I found it interesting that the attendance seemed highest in those sessions focused on the quantified self and devices, OSS code, and applications that allow an individual to track their own personal data, analyze it, and make life changes that will lead to better individual health outcomes. Some of the health care track attendees clearly had an eye toward consumer-focused health applications and how they could contribute to the growing consumer eHealth movement.

Here are some quick observations from a few OSCON sessions:

Consumer eHealth

BodyTrack: Open Source Tools for Health Empowerment through Self-Tracking: 

Anne Wright, a former NASA scientist, strongly believes (as a result of personal medical experience) that “self tracking” and self exploration allow you to challenge the information you’re given or getting (from your doctor or other sources) and try new courses of action.”  The open source tool, Fluxtream Exit Disclaimer, allows an individual to aggregate and visualize self-tracking data from a variety of sources. Fluxtream has connectors for data that have an API or that can be parsed so that an individual can mashup their own data. (Think wireless weight scale, dietary tracker, exercise monitor, and sleep habits mashup.)

Hacking Yourself: Hard Core Behavior Change

Fred Trotter is challenging our lack of motivation to exercise by making us pay for it. His site RunOrElse.com Exit Disclaimer, tries to elicit positive behavior change by making you pay cash for your poor motivation—you commit to a weekly running goal online, but if you don’t meet that goal, your PayPal account is charged to a charity of your choosing.  When asked why a charity of your choosing, and not a payment to a “penalty” charity, Trotter says we can, “treat will power like a muscle.You can build it up, or wear it out.If people run for the homework, you run the chance of a moral hazard. When the extrinsic motivator goes away, the desired behavior goes away. If the running app goes down, people may not run because the penalty is withdrawn.”

Experience Sampling Experience

I’ve sometimes wondered if my afternoon cookie craving is the result of boredom, a desire to get out of the office, or a sugar craving? With the open source code of PACO (Personal Analytics Companion), I could quickly set up my own experiment on an Android device to find out the answer (available on IOS some day). PACO’s creator Bob Evans says, “Awareness is the key to change—showing your own habitual data as a result of a personal experiment can subconsciously change your behavior.” PACO started out inside Google, but is now being used by Quantified Self-ers, med schools, psychology departments, and businesses.

Electronic Health Records

Building Safety-critical Medical Device Platforms and Meaningful Use EHR Gateways Data

Shahid Shah has years of experience in health IT implementation and recognizes the value of data’s potential to help solve some hard health care problems and “change how medical science is done.” He points out that increasing data liquidity and open-source solutions can help solve health care problems in categories like cost per patient per procedure, drug efficacy across patient populations, and visibility into a patient’s entire medical record to avoid medical errors. “Data could change the way that we ask questions…changing the medical science paradigm to identify data, generate questions, mine the data, then answer the questions” (instead of identifying the problem, asking the question, collecting data, then answering the question).  He predicts the open-source revolution in health care will be in integration across the entire health care environment—device management, patient self- management, remote surveillance, alarm notification, and report generation.  Finally, he posits that patients managing their own data are going to drive even more innovation because patients are demanding their data.


Free the Code: The Case for the U.S. Federal Government to Open Source Software as a Default Position

Deb Bryant, a long-time advocate for use of OSS in government, made the case that maximizing the public benefit of federal investments and federal efforts toward openness and transparency should include OSS.  Specifically, publicly funded software (that which is developed by a government employee or a contractor and for which the government maintains intellectual property rights) should be released as open source.  She pointed out that historically many local and federal government agencies have attempted to embrace OSS, but “lack of education about what open source really is has led to its condemnation as an opportunity.”  Bryant said that many governments around the world have allowed code developed by the government to be open-source, highlighting U.S. federal government open-source projects like VISTA, CONNECT, and the Federal Health Architecture that have been released as open source.  She even pointed out that some governments were using open-source systems (Linux) and didn’t even realize they had embraced OSS.   Finally, the case was made that open source as a default position supports the federal Shared Services Strategy (or “Shared First”), which sets forth guidance to increase return-on-investment, eliminate waste and duplication, and improve the effectiveness of IT solutions in both intra- and inter-agency information technology.

OSEHRA—Building an Open Source EHR for All (Open Source Health Record Agent)

The Open Source Electronic Health Record Agent (OSEHRA) supports open collaboration between a community of stakeholders for the building of an open-source EHR  and advancing health IT.  The contributors to OSEHRA’s code base use the best practices in opens source software development to produce EHRs, making the code freely available.  The community of contributors simply asks that those who build on the code contribute their additional functionality back, which builds and expands the code base for other users.

In summary, it seems that those involved in the development of open source software believe it has the potential to be a driving force in advances in personal health and wellness, the technological transformation of the health care system, and government innovations small and large.  It is incumbent on those of us in the federal government to continue to strive for greater openness, transparency, and collaboration.

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