open source

is the

only way

for medicine

@marcus_baw


Locum General Hacktitioner, North West UK

Director, @openGPSoC & BawMedical

eHealth, Dermatology, Prison, Hospice

Medical Director, @NeovaHealth

Previous Life #1: Emergency Physician

Previous Life #2: Anaesthetist

open source

IS

the

only way

for medicine

with thanks to Cory Doctorow and Carl Reynolds

"standing on the shoulders of giants"

medicine

medical IT has become an intrinsic part of medicine

line between the medicine and the technology increasingly indistinct

so medical IT should be treated the same way as Medicine

openly published, peer reviewed, verifiable, audited

hardness

medical IT one of the biggest challenges in medicine
monolithic approaches have failed (spectacularly) to meet this huge difficult challenge
'iterative' development seems to work well for large difficult things
(see The Internet as an example of this)

open source does iterative better than anything else

brain-scarcity

re-Solving a solved problem is a waste of time, money, and brains


Eric S Raymond on Hackers http://www.catb.org/esr/faqs/hacker-howto.html

No problem should ever have to be solved twice.
Creative brains are a valuable, limited resource. They shouldn't be wasted on re-inventing the wheel when there are so many fascinating new problems waiting out there.
To behave like a hacker, you have to believe that the thinking time of other hackers is precious — so much so that it's almost a moral duty for you to share information, solve problems and then give the solutions away just so other hackers can solve new problems instead of having to perpetually re-address old ones.

quality

if nobody can examine the code, how do we know this medical device is:

safe?

secure?

adequately tested?

We Don't: "The Alchemist Says It Works"

improvements

if you want to improve something and have the skills, with OSS you can
if you want to improve something and don't have the skills, with OSS you can hire someone to do it
if you improve something, it can be shared with the community
and in return you get to share community developments too
clinicians not directly employed in software are more likely to contribute to an open source project than a closed source product

the NHS and OSS

NHS has an intrinsically Sharing philosophy

we share the risk of illness and derive protection from this

we share medical knowledge (eg journals, conferences)

we share organisational knowledge (eg networks)

NHS staff readily comprehend the idea and benefits of OSS

M$!

Microsoft ports .NET to Linux and Macintosh and open-sources the entire stack

http://news.microsoft.com/2014/11/12/microsoft-takes-net-open-source-and-cross-platform-adds-new-development-capabilities-with-visual-studio-2015-net-2015-and-visual-studio-online/

straw-man economic arguments

"open source is free, so it's anti-commercial"

"you can't make money with open source"

"open source is for hackers and weirdos"

take homes

open source is 'the age of reason' brought to computing

there is no other scientific way to do medical computing

it is a commercial opportunity

the NHS is particularly fertile ground

(artist's impression)
This presentation was built in the open source framework reveal.js