Open Source
In the strictest sense, software that has been designated as open source has its source code freely available, allowing anyone interested to modify the code for their own purposes. Such products are of a growing interest in health care informatics. Attempts to reduce costs, increase control over revision cycles, and customize applications to address local needs are all fueling interest in open source software.
Open source is a blanket term often used to refer to free, libre, and open source software (FLOSS), but the term does not imply that the code is always free, a common misconception. Organizations utilizing open source code still incur significant support costs for large health care information technology implementations. Outside of the Veteran's Administration's VistA system, there are no proven large-scale health care IT systems with which to model success or gauge risk of failure. All of these factors have had an impact of the rate of adoption of open source solutions, which to this point, has been somewhat slow.
Despite the risk, there are multiple benefits to using open source software. Organizations unhappy with the service of an open source vendor would have the flexibility of terminating their contract and moving to another vendor, an option that would be nearly impossible in a proprietary environment. Another benefit of open source software is the presence of a large body of volunteers who work to support and enhance the functionality of these types of programs. This type of grass-roots involvement shortens the revision cycles and encourages innovation. Nurses working in informatics should consider open source solutions alongside commercial applications when recommending new products.