Open Source Business Models OSEHRA Corporate Members Session Chair: Michael Webb, Information Systems Engineer, The MITRE Corporation
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Open Source Business ModelsOSEHRA Corporate Members
Session Chair: Michael Webb, Information Systems Engineer,
The MITRE Corporation
Software as a Service:iCare
Jim Riley, Co-founder & CEO
Direct:DSS, Inc.
Hugh Creedon, Director vxVistA Operations
Medsphere Systems CorporationEdmund Billings, M.D., CMO & Executive VP
Integrator:Longview International Technology Solutions
Dr. Hon Pak, CMO
Jim Riley, CEOSeptember, 2014
Open Source Business ModelsPanel Discussion
• VistA-based enterprise cloud EHR
• Founded in 2012
• Veteran owned small business
• Team has successful track record (Learn.com, Oracle)
– U.S Departments of State, Commerce, Defense
– Supported high visibility initiatives (White House oversight)
About iCare
5
• Software as a Service allows customers to utilize sophisticated, secure and scalable applications without the need to purchase, operate and maintain an IT infrastructure.
• Similar to electricity; pay for only what you use.
• Simple subscription model pricing, per user per month.
• In our case, modernized VistA without hardware and software.
• Access your EHR just as you would your Facebook or bank account.
What is Software as a Service, a.k.a Cloud Computing?
6
Not all “Clouds” are the same
7
All true Cloud platforms share three characteristics:
• HTML GUI
• Multi-tenant DB
• Single Code Base
Beware False Clouds
8
• Lower total cost of ownership • No hardware• No software• Faster implementation• Lower upfront costs• Never pay for upgrades• Secure data center, redundancy • Easier integrations
• Alleviate staff and skill shortages
• Allows collaboration• Only one version of the product• Unlimited scalability and
storage • Open system • Always on, always available • Mobile access • Built for flexibility
Benefits of cloud computing
9
The iCare Vision = VistA + Cloud + Big Data
Web GUI & Open API’s
Hadoop Multi-Tenant Database
10
Unique to iCare
• 100% Web enabled
• CPRS replacement
• Any browser or device
• Form & workflow builder
• Social built-in
• Multi-tenant Big Data built-in
11
iCare Modernizes VistA
12
Dashboard Reporting on any VistA Data Elements
13
Coversheet – Multi-Patient View
14
Multi-Facility Scheduling
15
Inpatient & Outpatient Medical Billing & Reporting
16
Admission, Discharge & Transfer
17
ICD-9, ICD-10, SNOWMED CT, CCC ready
18
Form Builder – Assessments, Templates, Care Plans
19
CareLine – Social for efficient handover
20
• Web based
• Mobile Ready
• Big data built in
iCare = VistA Reimagined
21
Visit our booth for a demo
22
The DSS vxVistA Hybrid Model:Combining OS and Proprietary Technologies
Presented by: Hugh Creedon, Director of vxVistA Operations
About Document Storage Systems, Inc. (DSS)
« DSS is a leading health information technology (HIT) software development and systems integration company
« DSS has provided technical and service integration expertise with the Veterans Health Information Systems and Technology Architecture (VistA) for more than 20 years
« DSS released the vxVistA Open Source EHR to meet the needs of hospitals, clinics, long-term care facilities and physician practices—the source code was submitted to OSEHRA
« DSS empowers health systems and hospitals to enhance patient care by adopting and/or enhancing VistA-based EHR solutions that enable interoperability, improve healthcare quality, and reduce cost
« This presentation will focus on the hybrid open source approach successfully developed for the vxVistA EHR
Necessity is the Mother of Hybrid Innovation
« vxVistA is founded on
« Robust, proven EHR technology
« Transparency
« Flexibility
« Partnerships with Community & Commercial Software Development Groups
« Those principles are the building blocks that must come together to achieve the goal of reduced cost of ownership without loss of quality
DSS Hybrid Business ModelExtend the Platform
DSS Hybrid Business Model: Open Source Foundation + Extensibility of the Platform
« DSS Developed Integration with other Open Source and/or Proprietary applications
« DSS developed Add-on applications/interfaces that enhance the unique workflows and functional needs of individual healthcare organizations
« Offer broadest range of choices for clients when it comes to EHR capabilities
vxVistA Service Model
« Services are key for the business model to succeed:
« Training
« Support
« Implementation
« Custom Development
« Project Management
Lesson Learned: Clear Branding & a Consistent Message
« Absolute transparency—clearly identify what is and what is not Open Source
« For vxVistA, the rule of thumb has been if the module is an adaptation of/derived from a VA-developed module, it is released to Open Source
« Rule of Thumb for DSS: Interfaces/integration, customizations, and extensions are proprietary unless it is something that is deemed to serve a needed utility in Open Source for the greater good
Lesson Learned: Tackle the Tough Problems
« Focus on differentiation—build Proprietary Extensions that add value, meet a unique niche need, or improve on inherited functionality
« Add foundational changes to Open Source that support modernization; offer add-ons that add “wow” factor
« Meet regulatory requirements and bolster the CORE system whenever possible; offer localizations and custom interfaces where appropriate
Lesson Learned: Licenses can be Limiting
« vxVistA is licensed under Apache 2.0
« Changed from Eclipse Public License (EPL)
« Opens the door for Collaboration, Innovation, & Unique Partnerships
« Open Source is all around—BUT…
« Check Components Carefully BEFORE Release
« Don’t rely on developers to understand complex legal license questions
vxVistA Open Source StrategyKeep Your Options Open
« Compatible with OSEHRA OS Philosophy to leverage both OS Community Projects AND traditional COTS systems
« Leverage VA FOIA/OSEHRA Patch Updates
« Participate in Community Development Projects within OSEHRA and other Open Source HIT Organizations
« Sponsor Development and Education efforts within the VistA Community
« Partnerships with over 35 Leading HIT Systems Vendors to bring innovation and best-of-breed extensions to clients when an OS tool does not exist
« Freely choose extensions that balance needs, budget, and agency goals
vxVistA ̶ Hybrid without the Hype
« An Open Source Foundation
« When OS Solutions don’t meet all the needs, a hybrid solution can offer the best of both worlds
« For more information:
« www.ThevxHub.org
« www.DSSInc.com
Open Source Business Model OSEHRA 2014
A Systems Integrator Perspective
Hon Pak, MDChief Medical OfficerSep 2014
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 36
• One of the Fastest Growing Companies delivering IT services in the federal sector─ Incorporated in 2005─ Service Disabled Business – CIO-SP3, T4─ Headquartered in Reston, VA
• Our Clients include─ DoD/DHA─ AF (AMC)─ VA/VHA─ DHS
• Business areas: Health Solutions and National Security Solutions
Company Overview
• CMMI Institute Appraised - Capability Maturity Model Integration (CMMI) for Development v1.3 Maturity Level 3
• ISO 9001:2008 - Certified Quality Management System (QMS)
• ISO 20000-1:2011 - Certified Information Technology Service Management (ITSM) System
• ISO 27001:2005 - Certified Information Security Management System (ISMS)
• Fastest Growing 500, Inc. Magazine- Second Year in a row• Featured on 60 Minutes• 58th on the Hire Power Awards List for 2012• Finalist – SECAF 2012 Government Contractor of the Year
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 37
Company Certifications
Company Recognition
Core Competencies/ Solution Practices
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 38
We provide a full-spectrum of IT program support, from software engineering and systems integration, information assurance and infrastructure management to program management and administrative support
• Infrastructure• Software Development• Open Source Solutions
• Enterprise Mobile Solutions• Analytics and Decision
Support• Cyber• Telehealth
Core Practices
Question to be Addressed
• What is the business case for open source EHR software relative to proprietary software?
• Which segment(s) of the market is your product(s) best suited for?
• What are the trends / issues that are driving (further) engagement with private industry and community partners
Potential Business Models for SI’s• There are several different types of business models for
making profit using open-source software (OSS) or fundingthe creation. ─ Selling professional services
The financial return of costs on open-source software can also come from selling services, such as training, technical support, or consulting rather than the software itself.
Open-source companies using this business model successfully are for instance RedHat and IBM; a more specialized example is that of Revolution Analytics.
─ Selling software as a service Selling subscriptions for online accounts and server access to customers is a way of
making profit based on open-source software. ─ Advertising-supported software
In order to commercialize FOSS, many companies (including Google, Mozilla, and Ubuntu) have moved towards an economic model of advertising-supported software.
As another example is SourceForge, an open-source project service provider, has the revenue model of advertising banner sales on their website. In 2006, Sourceforge Increported quarterly takings of USD$6.5 million and $23 million in 2009.
September 8, 2014
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 40
Potential Business Models for SI’s
• Selling of optional proprietary extensions─ Some companies sell proprietary but optional extensions,
modules, plugins or add-ons to an open-source software product. This can be a "license conform" approach with many open-source licenses if done technically sufficiently carefully. Examples include
─ the IBM proprietary Linux software, where IBM contributes to the Linux open source ecosystem, but it builds and delivers (to IBM’s paying customers) database software, middleware and other software that runs on top of the open-source core.
─ Other examples of proprietary products built on top of open source software include Red Hat Enterprise Linux and Cloudera's Apache Hadoop-based software.
•
September 8, 2014
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 41
LongView’s Business Model• IDIQ (Task Order) Vehicles: Task Oriented by
Government─ T4─ CIOSP3─ Other Federal Procurement for IT services
• As a Systems Integrator, we focus on proposing/delivering solutions for a specific request (RFP)
Propose Use of Open Source Software, Modify Open Source Software, Integrate with existing Open Source Software
Tools (Open Source and COTS) as part of the our internal work (Jira-Collaboration environment)
LongView’s Transformation
• Solutions Practices─ Cyber, Analytics, Software Development,
Mobile, Program Mgmt, Infrastructure, HIE─ Strategic focus to develop new business lines,
products and services
September 8, 2014
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 43
Open Source Tools Used Across our Projects by LongView• AgularJS
• Ant
• Backbone JS
• Beanstalk
• Eclipse
• Firefox
• GIMP
• Git
• Github
• Gradle
• Grunt
• Istanbul
• iTerm
• Jasmine js
• Java
•
• Notepad++• Python• RequireJS• Robomongo• Ruby• Selenium• SourceTree• Tomcat• Twitter Bootstrap• VirtualBox• Xcode• Chromium• Firefox Nightly• Ubuntu 12.04 LTS• jQuery-mobile• JS libraries Backbone• Karma• MarionetteJS• Mavin
Sublime Text• KeyPassX• iTerm2• Synergy• Backbone.js• Marionette.js• Bootstrap• Ruby• Selenium WebDriver• Android SDK• Phonegap• Chrome Postman• Apache Tomcat• MongoDB• MySQL• MySqlWorkBench• Netbeans• NodeJS
Open Source Tools by Projects
Mobile Apps• Apache - Web Server• Medical Domain Web Services
(MDWS)• MongoDB - database• MongoSMS – messaging
services• Nginx – HTTP proxy server• Zabbix – network monitoring tool• Node.js - front end development• AngularJS - HTML5 development• PhoneGap
DMLSS • JBoss – Application development
middlewarePJITIC / eKP
• Drupal – content management platform
ES/SOA- node.js - front end development- Jenkins, Gradle - integration
development environment- Ruby on Rails framework - web
development- Git – software source control- Apache Lucene – software
search tool- MongoDB - database- Hazelcast – data management- Apache Commons – reusable
Java components- Spring Web Services – web
service - Google Guava – set of common
libraries for Java- RabbitMQ – Messaging broker
service- slf4j - logging
Which segment(s) of the market is your product(s) best suited for?• Federal
─ VA─ DoD─ IHS
• Technology Sector─ Mobile─ Medical Device/ Internet of Things─ Analytics─ Cloud/Infrastructure─ IA (Open Source IA assessment)─ Health Information Exchange
What are the trends / issues that are driving (further) engagement with private industry and community partners• Mobility• Cloud• Internet of Things/ Medical Devices• Big Data• Cyber• Other Initiatives
─ Personalized Medicine (P4)Systems BiologyGenomics
─ Open Data─ Patient engagement
Summary
• As a systems integrator, we: ─ Leverage open source tools to reduce cost
and improve efficiency─ Propose, design and implement open source
tools/modules as appropriateMongo DB (patient data)
─ Work with VistA to enhance, modify and integrate.EDIS (Enhancing UI to provide a mobile view)
─ Working to develop a proprietary platform with open source modules and sell it as a service for data exchange
September 8, 2014
Copyright © 2012 LongView International Technology Solutions, Inc. All Rights Reserved 48
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