Open Source Digital Health Software for Resilient, Accessible and Equitable Healthcare Systems.

OBJECTIVE: To assess the impact of open-source projects on making healthcare systems more resilient, accessible and equitable. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Using Open Source, Open Data, and Civic Technology to Address the COVID-19 Pandemic and Infodemic.

OBJECTIVES: The emerging COVID-19 pandemic has caused one of the world's worst health disasters compounded by social confusion with misinformation, the so-called "Infodemic". In this paper, we discuss how open technology approaches - including data sharing, visualization, and tooling - can address the COVID-19 pandemic and infodemic. METHODS: In response to the call for participation in the 2020 International Medical Informatics Association (IMIA) Yearbook theme issue on Medical Informatics and the Pandemic, the IMIA Open Source Working Group surveyed recent works related to the use of Free/Libre/Open Source Software (FLOSS) for this pandemic. RESULTS: FLOSS health care projects including GNU Health, OpenMRS, DHIS2, and others, have responded from the early phase of this pandemic. Data related to COVID-19 have been published from health organizations all over the world. Civic Technology, and the collaborative work of FLOSS and open data groups were considered to support collective intelligence on approaches to managing the pandemic. CONCLUSION: FLOSS and open data have been effectively used to contribute to managing the COVID-19 pandemic, and open approaches to collaboration can improve trust in data.

WHO digital health packages for disseminating data standards and data use practices.

OBJECTIVE: The aim of the study is to analyse an initiative from the World Health Organisation (WHO) to facilitate the dissemination of global standards and guidelines through digital health packages, which can strengthen the capacity of countries to monitor the SDGs. Digital health packages include data standards, guidance on data analysis, specifications for analytical dashboards for a specific health area, including a configuration of these standards for a widely used software platform. METHODS: This is a multi-year case study, in which the authors have actively participated in the various aspects of development, implementation and evaluation of the digital health packages initiative. RESULTS: We discuss the key innovations of the digital health package approach: First, the development process, which is based on flexible standards and an integrated approach across health programmes. Second, how the digital health packages combine several related types of standards into one package, including configurations for a widely used software platform supported by strong global and regional technical teams. OUTCOME: This study shows a novel approach to dissemination of standards, through a digital platform. Currently, 40 countries have adopted one or more of the digital health packages in their national health information system.