Subject: Re: open source medical software
From: Donnal Walter <>
Date: Fri, 28 Jan 2005 06:33:57 -0800 (PST)

--- "Stephen C. North" <> wrote:

> What alternative to "tight FDA oversight" is being proposed?
> Just the well-meaning intentions of programmers who like to
> ship code early and often?

The alternative is for the users, who are licensed practitioners,
to take responsibility for the accuracy and safety of the software.
That may not be possible in the open-source setting.

For perspective, the now somewhat out-dated predecessor to one of
the applications we are working on has been in use for over eight
years. In over 3000 days, the system has only been "down" one day.
We have computed over 49,000 TPN orders with this program without a
single known error due to the program. To the contrary, this
program has reduced the number of call backs from pharmacy from
dozens a week to a mere trickle. (Call backs were to correct human
miscalculations or oversights.) This was a custom-built program,
and as licensed practitioners we took responsibility for its
safety. If we use its replacement only in our institution, that is
what will will do with it now.

> Can we get a list of hospitals that favor this policy for
> medical software, in order to avoid risking one's life there?

Sarcasm aside, this is a real question. There clearly are medical
institutions using open source software today, but they are still
few and far between. At this point, I would say that the future of
open source software in medicine is still up in the air, a few
notable successes notwithstanding.

Donnal Walter
Arkansas Children's Hospital