VISION OF OPEN HEALTH TOOLS

1. VISION OF OPEN HEALTH TOOLS Vision: To enable a ubiquitous ecosystem where members of the Health and IT professions can collaborate to build open, standards-based interoperable systems that enable patients and their care providers to have access to vital and reliable medical information at the time and place it is needed.

2. WHAT IS OPEN HEALTH TOOLS? A community of National, Regional & Local Health Services Providerswho recognize that a common interoperable platform and exemplary tools for medical records is essential to meet the needs of patients, physicians, providers, payers as well as policy makers. A community of health professionals who collaborate in providing the requirements for technology and interoperable information systems to improve the quality, safety and efficiency of human health. A community of Open Standards Organizationswho collaborate in providing specifications for health interoperability. A community of Open Source Developersfocused on developing a Health Information Platform of frameworks, exemplary tools and reference applications A community of vendorswho utilize the Open Health Technology to create wealth, increase profit and market share, while providing expertise and assets to the community. A community of academic and researcherswho bring their experiences, research, ideas and wisdom to provide innovation and evaluation of health information interoperability.

3. Membership National, Regional & Local Health Services Providers UK National Cancer Institute AU

4. Membership Open Standards Organizations IHTSDO Vendor Members

5. MembershipUniversities & Research • Australian e-Health Research Centre (AEHRC) • Linkoping University • Mohawk College • Oregon State University

6. GOALS OF OPEN HEALTH TOOLS (Technology) Design and Develop Open Health Technology:Specifically we will create and enable an open source community of software developers to design and develop open standards based technology that meets interoperability requirements of early adopters. • Utilize an Open Source Paradigm to form a community and develop the technology which enforces an open and transparent communication and coordination software development process • Combine open standards programs, open source development, multiple cooperating vendors and major health consumers into successful software technology deliverables. • Combine a series of councils to integrate the technical/IT and clinical communities. Create Clinical (physician and health professional), Architecture, Planning, and Requirement Councils to assure the software technology is designed, tested and meets the needs of the targeted end users. • Create and maintain a technology harvesting program to identify, outreach and absorb aligned health industry software and provide the hosting environment to make publicly available under multiple licenses.

7. OPEN HEALTH TOOLS STRATEGY Collaboration - Bring together the major players into a single organization that includes national healthcare agencies, healthcare providers, practitioners, product/service companies, standards bodies, patients and clinicians Design & Development - Enable healthcare information interoperability by developing a common software tool platform based on open standards for creating software as well as a range of exemplary tools and several reference / exemplary applications Deployment - Create, nurture and enable suppliers to participate in an ecosystem that allows them to profit from open standards and open source software.

8. GOALS OF OPEN HEALTH TOOLS (Ecosystem) Enable a Healthy Ecosystem to Deliver Open Health Technology : Specifically we will support profit based organizations to create, enable and nurture a community of individuals, vendors, commercial and public organizations to deliver the Open Health Technology. • Grow the membership at a sustainable pace with broad participation from diverse communities including public institutions, vendors, users, academia, and developers. • Build self defining, self actualizing teams that share economies of scale and community collaboration to achieve their collective common self interests. • Create, enable and nurture a third party Open Health Certification program so that the Open Health Technology is a trusted source for interoperable health tools.

9. THE APPROACH TO STANDARDS Adopt recognized industry standards and best practices. Maintain close working relationships with identified SDOs. Provide feedback to SDOs via early adopter program and communities to foster creation of useful, usable healthcare standards that address real healthcare requirements. Strategy: SDOs: • HL7: CCD, Semantics, Documents, Services • OMG: technical specifications of services • IHE: pragmatic community for adoption • IHTSDO (SNOMED): Semantics, terminology definitions for healthcare • ASTM: CCR / CCD specifications • ISO/CEN/HL7: EHR requirements and specifications OHT is NOT a Standards organization. OHT implements standards in the development of software.

10. Measuring Open-Source Maturity • Functionality • Usability • Quality • Security • Performance • Scalability • Support • Documentation • Adoption • Community • Process and Governance

11. Open Source Software is Becoming Ubiquitous • By 2012, at least 80% of all commercial software solutions will include elements of open source.

12. Open Source Software is Becoming Ubiquitous • By 2010, at least 75% of all SOA initiatives will make extensive use of open source software.

13. Tools Architecture Artifact Repository Services Content Definition Requirements Application Development UI Compliance and Testing Messaging Terminology Eclipse Platform

14. Interoperability OHT Platform Other Tools Other Application Rules Reusable components Your Tool Standard open interfaces Your Application Guidelines Their Tool Compliant Standards

15. Personal Health Record Electronic Health Record Laboratory Pharmacy Public Health Viewer/ Portal Hospital / Clinic Radiology / Imaging Health Service Bus Services View of OHT Platform and Standard Reference Applications DATA ACCESS APPLICATIONS SERVICE DELIVERY Public Health Provider Pharmacist Radiologist Physician/Nurse Lab Clinician Patient POINT OF SERVICE APPLICATIONS l • Extensibility Technologies • OSGi • Web Services • Analysis Services • Reporting • Analytics • Data Warehouse • Patient Information Services • Record Location & Management • Entity Identification • Distributed Data Access (CRUD) • Indexing • Replication • Workflow & Business Rules Terminology Service • Infrastructure Services • Security & Privacy • Provider/Patient Registries • Communications • Medical device integration • Public Health Services • Outbreak Management • Detection & Notification • Visualization • Interoperability Services • Data Interchange • Legacy System Adapters • Simulator Service Library Common Services OHT Platform

16. Heath Service Bus Health Record Bank Public Health Database Laboratory Viewer/ Portal Legacy EMR Health Service Bus Patient Information Services Infrastructure Services Interoperability Services Analysis Services Data View of OHT Platform Secure Communications OHT Platform Extensibility Technologies Analysis Patient Information Terminology Service • Interoperability Infrastructure • Public Health Service Library Common Services Terminology Service Secure Communications

17. Technical Architecture Service Provider Service Provider Healthcare Services Bus Semantics Repository Services Directory

18. Health Data Tools Academic & Outreach Conformance HL7 Tools & Messaging Architecture Research User Interface Security Open Source Projects Modeling Tools Clinical Content Tools Legacy Integration Terminology Health Content Device Integration Supply Chain Management OHT Platform

19. Foundations Individuals Vendors Government Projects Open Source Ecosystem Friends of eHealth Charitable Non Profit Open Health Tools Board of Stewards BUSINESS / CONTRIBUTION MODEL Contributes People & Money Contributes Money Allocates MoneyPump priming Matching Funds for Projects Membership Dues, Contributions, Marketing Membership Technical Contributions OHT Professional Services Members are not obligated for financial contribution or dues.

20. Commercial Products & Services Common Healthcare Infrastructure Common IT Infrastructure Multi Platform Multi Vendor Vendor Neutral Business Model Profit Based Distribute Deploy Brand Sell Price Package Promote Fee support Fee services High margin products & services Open Source Free Community Developed Commercial Friendly Lic Formal Development Process Design Develop Test Free Support Free Code

21. Universities Research Organizations Deployment • End User • Education • Training • Service & Support • Implementation Services • Requirement Gathering • Testing & Conformance • Integrated Data Test Centers • Simulation Environment • Self Certification Programs • Developer & Development • Harvesting Programs • Jump Start • Standards Training • Tutorials, Samples, Examples • Training & Workshops • Knowledge Transfer Centers Academic & Research Device Integration Community Outreach Franchise Programs

22. MEMBERSHIP QUALIFICATIONS Participate in the health industry. The following are examples: Governmental institutions and standards bodies; Producers and consumers National, regional, state and local health service providers Vendors and non profit organizations Payers and public health organizations Industry domain experts Make a significant contribution to the success of Open Health Tools. The following are contribution examples: Source code, designs and specifications Intellectual property Resources and expertise Express public support for Open Health Tools Sign the Open Health Tools Membership Agreement and Logo Agreement Public and private organizations and individuals who:

23. MEMBERSHIP RESPONSIBILITIES Each member organization appoints one person to serve as a Steward (ie voting member of Board of Directors) Steward represents your organization in establishing the Open Health Tools policies, behavior, plans, priorities, technology plans and directions. Steward should be a senior executive who can allocate resources and represent their respective organization. Time commitment is one day per quarter for board meetings. Each board member can appoint a delegate and an employee to be a member of the executive committee, which meets periodically and is responsible for operations. Specific Board Member Responsibilities: • There are no financial obligations for membership • All contributions are voluntary and based upon self interest. Beyond the initial contribution there are no obligations to contribute. • No member can bind the Open Health Tools or other members. • All technology is provided on an “as is basis”, without warranties or conditions, no liability Sign Same Governance Agreements • Membership Agreement & Bylaws & Application • Intellectual Property Policy • Terms of Use • Logo Agreement

24. Open Health Tools Governance Principles All members have single vote All members sign same agreements: Membership Application and bylaws IP Policy Web Site Terms of Reference Logo Agreement Committer and Contributor guidelines and agreements Low barriers to entry with all members meeting same criteria Members are all equal • No confidential information • Well established open software development processes and guidelines which are published and open to all. • All deliberations of Board and Councils are open. (Only personnel matters are private.) • All projects are open and transparent Open transparent environment Commercially friendly license to build vibrant eco-system Contribution Model • Those who contribute decide • No obligations to contribute • Merit based contributions as selected by peers

25. OPEN HEALTH TOOLS COMMUNITIES Open Health Tools Open Source Community Open Health Tools Eco-system Private Public Commercial Applications Code & Data Non-Eclipse Open Source Community Eclipse Open Source Community Eclipse Eco-system The Open Health Tools Open Source The community builds common services, frameworks, exemplary tools and example applications. For example: Record Locator Services & Hl7 Messaging Terminology Services & Identity Management The Open Health Tools Eco-system The community takes the Open Health Tools Technology and builds, packages, and sells the technology as products, applications, tools, for profit and use.

26. OHT’s APPROACH TO OPEN SOURCE? Delivers quality software on schedule, within budget, by small collaborative teams. Enables vendors to optimize their self interest while collaborating and competing. Enable vendors to incur lower costs and to gain market advantages by leveraging an extensive base of high quality free source code, proven skills, and resources. Enables a large virtual community of developers to grow with the software, resulting in: improved quality due to open rigorous peer review with many developers, extensive tuning and improvement of the software, rapid porting of code to new hardware and platforms, rapid response to changing requirements and conditions, detailed understanding of how the system works due to the open, transparent nature of process. Enables multi vendor, multi platform and multi language solutions. Advantages of Open Health Open Source Technology

27. Open Source Is DEFINED by the License? • Open source is licensed software in which the source code is made available to users so that they are freed to modify it for their own purposes and (within certain restrictions) redistribute original and derived works as they see fit. • The "open source" software model describes a set of characteristics and properties for developing, delivering, and supporting software.

28. The Open-Source Definition • Free Redistribution • Source Code • Derived Works • Integrity of the Author's Source Code • No Discrimination Against Persons or Groups • No Discrimination Against Fields of Endeavor • Distribution of License • License Must Not Be Specific to a Product • License Must Not Restrict Other Software • License Must Be Technology-Neutral (www.opensource.org)

29. OHT Open Source Technical Projects Technical Projects & Leadership Roles Committed Academic Outreach Oracle Analysis & Reporting Open Canadian .EHR Mohawk, Canada Infoway Clinical Content Tools NHS Common User Interface NHS Conformance Tools Canada Infoway Device Interoperability latform Project OHT Data Modeling MexJ Privacy Access Security Inpriva Health Legacy Interoperability Open HL 7 Tools Project NHS IHE IBM Modeling Tools for Healthcare IBM VHA Supply Chain Tooling for Healthcare ITG Publishing IBM Terminology Tools Project, IHTSDO, NHS NeHTA

30. OPEN HEALTH ECOSYSTEM PROJECTS Enable niche market creation: • Enable rich after markets e.g. Education, Services , • Enable multiple total product solutions, • Provide links and aggregation services for Members & their products. Enable Member collaboration and networking: • Enable tools to self identify and self organize, • Enable language specific target markets (French Japanese, Korean, German, Mandarin) Enable Member lead mindshare and PR activities: • Analysts briefings, • Press and mindshare activities, • Collaborative advertising, • Joint reference accounts, • Joint collateral and content creations and distributions Enable academic and research full participation