Currently submitted to: JMIR Preprints
Date Submitted: Feb 28, 2020
Open Peer Review Period: Feb 28, 2020 - Feb 12, 2021
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Benefits and Challenges of Open-Source Health informatics Systems: A Systematic Search of Projects and Literature Review
ABSTRACT
Background:
Health Informatics Systems (HIS) draw more attention as their benefits are further explored and becoming more evident. The improvement of patient care and the quality of health services are examples of such advantages. Nevertheless, proprietary systems are not always viable due to their high costs.
Objective:
We investigated the benefits and challenges of Open-Source Health informatics Systems (OHIS) adoption discussed in the literature, and we also mapped the real-world OHIS projects, with their technical and community characteristics. Both results guide us to address the aspects that still need to be overcome and also to identify the criteria to help managers and IT professionals in choosing the most suitable OHIS for their context.
Methods:
We conducted a Systematic Mapping Study to review the literature and also mined source code repositories of OHIS projects. We employ well-consolidated methods from the software engineering community, and we differentiate from similar related works by the use of a more systematic method and also to evaluate OHIS projects using objective software engineering metrics and artifacts.
Results:
We found 500 papers and 151 projects, selecting 26 works to analyze thoroughly and mining 38 active OHIS repositories. We mapped the benefits and challenges to adopt OHIS projects and identified the legal and technical characteristics of them. We propose a conceptual map to illustrate the relationship among all the OHIS adoption benefits. We then correlate how technical and documental artifacts from an OHIS project affect their expected benefits and challenges. Thus, we recommend a set of artifacts and metrics well established in the OSS community as the criteria necessary to evaluate an OHIS solution from a software engineering perspective.
Conclusions:
OSS projects increase the quality of the HIS and solve several problems that are mostly linked with proprietary solutions. The OHIS ecosystem provides several possible solutions for adoption. However, one barrier to its adoption is misconceptions and misinformation on OSS in the HIS context. We address this challenge with a set of recommended aspects to OHIS project adoption to assist managers and IT professionals in evaluating OHIS solutions. Finally, we highlight the necessity of more research to cover specific technical challenges on OHIS adoption.
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