Contents

Introduction

The Marwell Open Steps meeting was the first in a planned series of three meetings during 2004. The main purpose of the meeting was

to identify key issues, opportunities, obstacles, areas of work and research that may be needed, and other relevant aspects, around the potential for using open source software, solutions and approaches within health care, and in particular within health informatics, in the UK and Europe.

The Marwell Open Steps meeting was modelled on the Radical Steps series of thinktank meetings organised by the British Computer Society Health Informatics Committee (BCS HIC – www.bcshic.org). Through the involvement of a variety of groups involved in Free/Libre/Open Source Software (FLOSS) [footnote 1] advocacy and activity, it can be seen in the context of BCS HIC's current work towards engaging the health informatics community and in exploring the views of that community. However, as the Open Steps meeting had a specific focus, and differed in other respects, a slightly different name was selected.

The focus of this meeting was primarily the UK and its National Health Service (NHS), and so much of this report focuses on the UK and NHS contexts. However, the meeting attracted participants from putside the UK, and discussions included wider European as well as global aspects of the issues explored. Future events will aim to explore the issues in these wider contexts.

The meeting began with the development and exploration of a number of possible scenarios for the status of FLOSS within the NHS in particular, and health services more generally. One of the more probable and desirable scenarios was further examined to determine drivers and barriers towards the adoption and use of FLOSS in healthcare. Reasons why participants, and people more generally, do and might use FLOSS were explored, and the meeting concluded with determination of what were seen as the most important, and possibly effective, ways in which work could be taken forward, assuming there was a desire to see at least some introduction and use of FLOSS within healthcare. In addition, the principles underlying the objectives of the IMIA OSWG were validated (appendix 8).

The outputs of the Marwell meeting will be used as the basis for a further exploration of the issues in an open forum at HC2004, in March 2004, (to explore the UK-specific context). The results from both meetings will then be used to inform an international discussion, to be held as part of the activities of the IMIA OSWG at medinfo2004 in San Francisco, USA in September 2004.

The following sections of this report summarise the main issues that arose from the discussions held, but for those interested in then detail, this is provided in the appendices. The report begins with a summary of the characteristics of the meeting participants and their attitudes towards FLOSS, before taking each of the steps of the meeting in turn and summarising the main points of the discussions and conclusions.

This report cannot include all of the diversity of opinion expressed in the Marwell meeting as the issues were explored, and as we sought some form of consensus on the major items. There may be some reading this report who will feel that there are issues (including drivers or barriers to FLOSS use in the health domain) that are missing; however, it must be reiterated that the major issues as agreed by the majority of participants are what are contained here. The appendices contain some further detail of some aspects of the meeting. The web version of this report also contains more of the raw data and graphics captured from the discussions and interactive digital voting.

Some participants may feel that aspects of the discussions that they felt important have been omitted or underplayed; this is sometimes deliberate, as the focus of the meeting and report are the UK context and the majority opinion. However, we believe that the voices of others should be heard; the web version of this report will provide that opportunity and will allow participants and others to add comments on issues they feel are important and not fully addressed in the report, and/or issues that they feel the meeting might have missed or not explored sufficiently. In particular, there may be drivers or barriers to FLOSS use that some see as more important than did the meeting participants; we welcome input and further discussion on these and other issues so as to inform future reports and meetings.

While members of several organisations contributed to the planning of the Marwell Open Steps meeting and participated in the discussions, the outputs of the meeting as described in this report and other outputs should not necessarily be taken to be official policy of the organisations concerned. Each organisation will consider the outputs of the meeting and the implications for their future directions. We see this meeting and this report as being the beginning of a process, although a report of this form must, of necessity, capture a moment in time; things have already moved on in some of the areas being discussed.

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Executive Summary >>>

Appendices>>>

Status of this report >>>

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Copyright (c) 2004 IMIA Open Source Working Group and British Computer Society Health Informatics Committee

Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, 
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no Back-Cover  Texts.  A copy of the license is included in the section entitled "GNU Free Documentation License".