Ont. researchers tout cheap eHealth alternative

Free software is secure, creators say
Last Updated: Friday, October 9, 2009 | 8:15 PM ET


Researchers at Hamilton’s McMaster University say they have devised an electronic medical records system that can be implemented by physicians across Ontario for two per cent of the money the provincial government has spent on eHealth Ontario.

The web-based program, dubbed OSCAR, organizes medical records and can be set up on any computer system with a browser. It was first created in 2001, and has attracted more users each year.

Around 600 doctors across the country — including 450 family physicians in Ontario — currently use the software.

The software is open-source, which means users are allowed access to its basic code. Users are free to add to or modify the software without fear of legal repercussions, as long they abide by the conditions of the General Public Licence, which stipulates that the program must remain open and sharable.

Because it’s open-source, OSCAR is free. The costs to set it up come in the form of servers, hardware and support staff.

“In Ontario, there are approximately 8,000 family physicians that are not using electronic medical record systems. All these physicians could have OSCAR implemented within the next 24 months, and the cost would be less than $20 million,” Dr. David Price, chair of family medicine at McMaster’s medical school, said in a release.

While the software would be able to cover all the family physicians in Ontario, it is not as comprehensive in scope as eHealth, which is charged with linking all healthcare facilities, including hospitals and clinics, not just family doctors.

$1B spent already

Yet it can still help in digitizing Ontario’s medical records, said Dr. David Chan, who developed the software.

He said Ontario’s approach to building a health-record system is wrong. The province spent some $1 billion commissioning eHealth Ontario to produce an electronic medical database.

But in a report released Wednesday, Ontario Auditor General Jim McCarter said the province had wasted that investment and eHealth had little to show for its work.

We really don’t need to spend that kind of money. I think the government’s paranoia about building … a secure network is hugely expensive,” Chan said Friday.

People often get concerned about the security risks of open-source software, but Chan said it has passed stringent provincial security tests. It is no more vulnerable to hackers than more expensive proprietary software, he said.

“I think evidence has shown that open-source software has been more robust and free from viruses … than the more common software that we’re familiar with,” he said.

No interest from eHealth

Another key factor in keeping costs low, said a smiling Chan, is that “we don’t have very high-priced executives and consultants.”

McCarter said in his report the government was “lacking in strategic direction and relying too heavily on external consultations.” At one point, the auditor general noted, the eHealth program branch had “fewer than 30 full-time employees but was engaging more than 300 consultants.”

No one from eHealth Ontario has expressed any interest, Chan said.

“A common thing that I hear [about] people who are making decisions about information technology — [they] seem to have an impression that open-source software is not mature enough to market, which I would [call] an incorrect statement,” he said.

Health ministry officials wouldn’t comment for this story.

NDP health critic France Gelinas said the government missed an opportunity.

“EHealth was so concentrated on the use of consultants that they never even looked at the good work that was being done right here in Ontario,” she said.

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