Abstract
Open source HIT efforts in government face significant barriers to their widespread adoption and use. In addition to the inherent growth challenges of open-source software efforts, OSS healthcare projects face barriers that are specific to the HIT marketplace, deriving in part from the penetration, fragmentation and staying power of the existing closed-source HIT players. We reviewed a number of HIT efforts and open source efforts outside the HIT space. The reviews indicate that certain strategies that span technical, legal and business considerations might help to improve the prospects for OSS growth in HIT. We highlight specific suggestions for future government OSS adoption, recognizing the heavy reliance on the commercial HIT sector. Certain strategic elements appear to be necessary for successful technical evolution of a project, including: nurturing a productive distributed development community, avoiding code-base divergence, and targeting early market share growth. When selecting the optimal choice of open source license, the decision can depend on a number of factors, including: the project's phased growth strategy, its position in the marketplace, the potential for brand-building, and the size of the project's active development community. In order to mitigate the threats posed to commercial players by the opening up of standards, OSS efforts can choose to present themselves as an organic component of a future business landscape, one in which the existing commercial parties can occupy new and profitable niches that are grounded on solid and sustainable business models. |
