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Where should we putting the effort in the next few years?

From these reasons, the discussions moved to how the reasons can be best exploited to further ways in which to develop the implementation of FLOSS within the healthcare community. The participants explored 5 areas into which effort might be put by FLOSS groups. These were:

• 'political' activity; including working within existing health informatics and other organisations and persuading them to support and commit to FLOSS approaches, rather than setting up new organisations; working in local health communities; making available documents and speaking on the benefits of FLOSS; further Open Steps type meetings, possibly at European level and including more industry players;

• money issues; including a need for well-written business cases for FLOSS, and for publication and dissemination of material on economics and total cost of ownership issues around FLOSS and proprietary software;

• availability; as above, the importance of health data being available across time and all kinds of boundaries between systems;

• standards; including interoperability issues; and

• philosophy; including promoting the philosophies and benefits of FLOSS software and approaches.

Participants voted 'political' activity (56%) and availability issues (30%) as being the most important areas on which activity should be focused (see appendix 7).

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