University of Oxford, United Kingdom.
University of Otago, New Zealand.
Yearb Med Inform. 2022 Aug;31(1):67-73. doi: 10.1055/s-0042-1742508. Epub 2022 Jun 2.
To assess the impact of open-source projects on making healthcare systems more resilient, accessible and equitable.
In response to the International Medical Informatics Association (IMIA) call for working group contributions for the IMIA Yearbook, the Open Source Working Group (OSWG) conducted a rapid review of current open source digital health projects to illustrate how they can contribute to making healthcare systems more resilient, accessible and equitable. We sought case studies from the OSWG membership to illustrate these three concepts and how open source software (OSS) addresses these concepts in the real world. These case studies are discussed against the background of literature identified through the rapid review.
To illustrate the concept of resilience, we present case studies from the adoption of District Health Information Software version 2 (DHIS2) for managing the Covid pandemic in Rwanda, and the adoption of the OpenEHR open Health IT standard. To illustrate accessibility, we show how open source design systems for user interface design have been used by governments to ensure accessibility of digital health services for patients and healthy individuals, and by the OpenMRS community to standardise their user interface design. Finally, to illustrate the concept of equity, we describe the OpenWHO framework and two open source digital health projects, GNU Health and openIMIS, that both aim to reduce health inequities through the use of open source digital health software.
This review has demonstrated that open source software addresses many of the challenges involved in making healthcare more accessible, equitable and resilient in high and low income settings.
评估开源项目对提高医疗系统弹性、可及性和公平性的影响。
为响应国际医学信息协会（IMIA）为 IMIA 年鉴征集工作组贡献的号召，开源工作组（OSWG）对当前的开源数字健康项目进行了快速审查，以说明它们如何有助于提高医疗系统的弹性、可及性和公平性。我们从 OSWG 成员中寻找案例研究来举例说明这三个概念，以及开源软件（OSS）如何在现实世界中解决这些概念。这些案例研究是在快速审查中确定的文献背景下讨论的。
为了说明弹性的概念，我们展示了卢旺达采用地区卫生信息软件 2 版（DHIS2）管理新冠疫情和采用 OpenEHR 开放医疗 IT 标准的案例研究。为了说明可及性，我们展示了政府如何使用开源用户界面设计系统来确保数字医疗服务对患者和健康人群的可及性，以及 OpenMRS 社区如何标准化其用户界面设计。最后，为了说明公平性的概念，我们描述了 OpenWHO 框架和两个开源数字健康项目，GNU Health 和 openIMIS，它们都旨在通过使用开源数字健康软件来减少健康不平等。
本综述表明，开源软件在提高高收入和低收入环境中的医疗可及性、公平性和弹性方面解决了许多挑战。
