Frequently Asked Questions

We have assembled a set of FAQs to provide an overview of Open Health Tools.  We would be happy to hear from you if you have additional questions – both to provide you with the answers if we can, and to flesh out our FAQs.  Please send any questions to oht-mo@openhealthtools.org. Click on the section below to go directly to the appropriate questions:

General questions Return to top of page...

Q: What is Open Health Tools?

A: Open Health Tools is a community of open source developers, health professionals, and an ecosystem that brings together members from the health and IT professions to create a common health interoperability framework, exemplary tools and reference applications to support health information interoperability.

The fact that this software framework is available under a commercially-friendly open source license means that anyone, any company, any hospital, whether or not they are a member, can build applications using this framework – without any payment required for the software.  And using the framework, they can insure interoperability with other products built based on the framework.

Q: What is Open Health Tools’s Vision?

A: We envision building the technology to provide a world wide Health Information Exchange System dedicated to improving patient safety and patient care while improving health administrative efficiencies. Patients and their care providers will have access to vital, reliable and secure medical information at the time and place it is needed. We anticipate that this will help contain the rapid growth in health costs and will save lives.

Q: Could you say more about the benefits of this Open Source Approach?

A: Certainly.  To begin with, we should point out that our model here is the Eclipse Foundation.  There are literally thousands of companies who build products by programming plugins to the Eclipse framework, and packaging those plugins with the framework to create their commercial product.  Why:

  • By using the existing framework, they concentrate on their value-add – their distinguishing features, rather then spending time re-inventing the base code. 
  • Therefore they have lower costs of developing applications and much faster time to market
  • Since the base Eclipse code has been downloaded and used by millions (literally) of programmers, all of whom have access to the source, it is extraordinarily thoroughly tested and debugged – and so Eclipse-based products are using an extremely solid base.
  • Programs using the same Eclipse framework, through the use of plugins, are compatible – as multiple plugins can be used with a single instance of the framework
  • This has led to an extremely widespread use of Eclipse, by thousands of companies and millions of programmers. 

Our intention is to bring these same benefits to the electronic health records field.  A common, free, open source electronic health records framework with reference applications and exemplary tools.

Q: What kinds of organizations are joining Open Health Tools

A: The initial participants include:

  • government agencies involved in the delivery of health care to large groups of people and the associated coordination of electronic health records in their countries.  (We have participation from the US, UK, Canada and Australia.)
  • Vendors who supply medical software, services and equipment
  • Medical standards agencies
  • State, local and regional public health organizations

The complete list of Members is available at these two links (A - K), (L - Z).

We expect that this will expand over time to include representatives of a broad range of organizations involved in one way or another in the provision of medical care.

Q: How are you organized?

A: Open Health Tools, Inc. is formed as a nonprofit trade association, as set out in section 501(c)(6) of the US Internal Revenue Code.  The basic organization is managed by a team led by an Executive Director, a Chief Technology Officer, and a Chief Clinical Officer. There is a strong Board of Stewards. There are several technology and medical councils which have management oversight responsibilities for the architecture, planning and implementation. This management structure is to facilitate and enable the design, development and deployment of the Open Health Technology.

Q: Can you describe the Board in more detail?

A: The Board is responsible for policies, behavior, plans, priorities, technology plans and directions.  The Board is empowered to adopt rules and regulations governing the action of the Board and Open Health Tools.  The Board will approve each the charter for each Charter Project and review the major strategies to achieve the vision of Open Health Tools.

Q: Who is represented on the Board?

A: The Board contains one representative (Steward) from each member.  The Board also has voting representatives of the Project Leads and the Committers.

Q:  What are the Committees of the Board, and how do they operate?

A: There are five Standing Committees.  They include:

  • Executive Committee which reviews general affairs of Open Health Tools;
  • Membership Committee which is responsible for Membership Policies;
  • Finance Committee which  is responsible for budget review and review of financial records/reports;
  • Legal Committee which deals with licensing and IP issues; and
  • Compensation Committee which is responsible for determining compensation for Officers.

Q:  The Bylaws talk about about a Single Transferable Vote process for electing Project Leads and Committers to the Board. What is this?

A: The Single Transferable Vote process is a voting process under which each Project Lead or Committer, as applicable, shall be entitled to cast preference votes for as many candidates as there are open seats on the Board allocated to Project Lead Stewards and Committer Stewards, as applicable. Votes that are not needed to elect a candidate and votes for candidates who do not receive enough votes to be elected are transferred in accordance with the preferences of each voter.

Q: How are the requirements and technical roadmaps generated?

A: Open Health Tools has four councils which are responsible for planning and managing the development of the Open Health Technology.

  • Clinical Council which is chaired by the Chief Clinical Officer (“CCO”)  and is the primary domain expertise resource
  • Requirements Council which is co-chaired by the CCO and the Chief Technical Officer (“CTO”) and determines set of requirements
  • Architectural Council which is chaired by CTO and creates and manages high level architecture and road map of Open Health Technology
  • Planning Council which is chaired by the CTO and is responsible for seeing that the road map is implemented.

Q: Can you say something more about the technology that Open Health Tools is developing:

A: Specifically, we are going to assemble and/or develop a comprehensive, harmonized tool suite to enable definition, development and deployment of interoperable Electronic Health Records (EHRs).  The scope of these Charter Projects is intended to cover the life cycle of EHRs in the broadest sense, including development of standards and architectures, documentation and training, legacy systems, etc.  This technology includes a software platform, a set of exemplary tools and several reference applications dedicated to delivering health information when needed, in the location needed, and in a secure environment.  

This will be accomplished by combining, successful standards programs, open source development, multiple cooperating vendors and major health consumers into successful software technology deliverables based upon collaboration in an open and transparent environment.

Q: How will the technical development be organized

A: Charter Projects are run by small teams of individuals dedicated to delivering code.  Additionally, The Board may approve Charter Projects that are non-technical to develop market niches. Charter Projects are established by the Board based on the Charter Project’s statement of goals, development approach, development plans, and expected contributions which must complement existing Charter Projects.   The Charter Project must not involve potentially insurmountable IP issues.  Charter Project leads are appointed by the Chairperson, CTO, CCO, or Board to provide day-to-day management of the chartered activity.

Q: What is your relationship with Eclipse?

A: Open Health Tools has based its governance, legal and intellectual property policies, development processes, marketing, and business models on Eclipse.  Many of those working to create Open Health Tools were intimately involved with creating Eclipse.  And we will be using the Eclipse Open Health Framework (OHF) and other Eclipse software as a base for Open Health Tools’ technology.  While Eclipse is a member of Open Health Tools, the two organizations are not affiliated in a corporate sense.

Q: Since the IHTSDO is participating in OHT, does this mean that SNOMED CT will also be distributed under the EPL?

A: No. The IHTSDO standards will be available to Open Health Tools developers to develop a range of standards-based software which will utilize and interoperate with SNOMED CT, but an Affiliate license through the IHTSDO will still be required for users of the sotware to access the content of SNOMED CT.

 

Membership Frequently Asked Questions Return to top of page...

Q: How much does it cost to become a member of Open Health Tools?

A: There is no fee for joining Open Health Tools. However, all prospective members are expected to indicate their willingness to make a serious contribution to the efforts of the organization. These contributions could be assets, existing software or other IP, participation in software development, or other services. The Membership Application details this – and your acceptance as a member depends on what you are willing to bring to the table.  We would be more than willing to talk to you about this – send a note to membership at openhealthtools.org.  Our goal here is to be inclusive – and keep barriers to membership low. 

Q: What if, for some reason, we can’t make good on our promised contribution?

A: We do not require a legal commitment that binds you to making the contributions.  We are interested in companies making contributions that are in their self-interest – such as contributing programmers to the development of a software component that is of particular value to the company.  In this way, we see that companies will have a strong incentive to make good on their pledges.

Q: What are the benefits of membership?

The following table outlines the benefits of Open Health Tools membership:

Seat on the Board

Each member may appoint a Steward who will have a vote on all decisions of the board including the technical direction and organization policies.

Eligibility to sit as voting members of Committers

Committee membership is restricted to voting members. (See information on committees)

Potential to work in integrated development team with influence in project direction

While Charter Projects are open to all qualified potential contributors, only members will have a say in the overall design of the project. 

Links from the Open Health Tool Member page

Each member is provided the opportunity to post their company information, product information and logo on their own membership page.

News Stories

News links posted on OpenHealthTools.org will become a popular spot to see what is happening in the electronic health records industry

Success Stories hosted on OpenHealthTools.org

Members are able to post success stories of how their customers are using Open Health Tools based products.

Support for Press releases

Open Health Tools will provide press assistance and quotes for new member’s press releases and ongoing member product announcements.

Board Meetings

Board meetings create many opportunities to network with other professionals representing worldwide organizations throughout the healthcare field.  Members discuss and leverage shared resources to solve Member problems and grow the Open Health Tools community.

 

Q: Would we need to have a representative at each Board meeting?

A: We understand that travel and time constraints can make this difficult.  However, our Bylaws require a 50% quorum at meetings.  So, to make it easier to attend, we permit:

  • The appointment of an Alternate to represent your Steward.  (The Alternate would be another employee of your company)
  • The issuing of a proxy to the Steward from another company who could attend and vote on your behalf
  • Participation by conference call or similar facility.

Q: If we assign some staff members to work on a Charter Project, where will they work, who will they report to?

A: Developers working on a Charter Project may work anywhere they have access to a broadband internet connection.  They will become integral elements of the development process (see Committer Contributor FAQs) where the development work will be coordinated by the Project Lead. 

Q: How do I actually become a member?

It is quite simple. 

  • You fill out the Membership Application form, and send it to the address provided on that form.  In that form, you indicate your interest, and the contribution that you expect to bring to the table.
  • Also, please sign the Membership Agreement and Logo Agreement – and again send these to the address indicated on the Membership Application. 
  • We will process your application.  If there are any questions, we will get back to you.  We will have to put a vote to the Board, either at the next meeting of the Board, or through a special vote, so this process may take a month or two.  Feel free to contact membership at openhealthtools to enquire as to the status of your application.

Q: Do I need to be a member to download the software?

A: No.  Anyone who agrees to the Open Health Tools website Terms of Use may download any software.  The software will be subject to the Eclipse Public License, or an alternative license that is indicated in the download. 

Q: Do I need to be a member if I want to contribute software?

A: No – but you do have to register so that we know who you are.  There are more details on contributing software and the role of Committers at the Committer Contributor FAQ site.


Legal and Licensing Frequently Asked Questions Return to top of page...

Q: What license does Open Health Tools release software under?

A: For Charter Projects, we use the Eclipse Public License (EPL) .  The EPL is a commercially-friendly license that allows organizations to include EPL-licensed software in their commercial products, while at the same time requiring those who modify derivative works of EPL code to contribute the modifications (but not the derivative works) back to the community.  The commercially-friendly nature of the EPL has been proven over and over as hundreds of companies ship products based on EPL-licensed code.

Q: Is everything licensed under the EPL?

A: No. The Charter Projects may contain code that was distributed under a different, but compatible license such as Apache or BSD.  These are noted in the about.html files associated with the component.  Open Health Forge postings are distributed under the license as chosen by the contributor. 

Q: Can you tell me more about the EPL?

A: An excellent source of information about the EPL is the EPL FAQ’s provided by the Eclipse Foundation itself.

Q: Why does Open Health Tools use the EPL?

A: There are two answers to this.  First, Open Health Tools has used a considerable amount of Eclipse code as the base of the Open Health Tools framework and reference applications.  This code is, of course, covered by the EPL.  EPL was chosen to maintain consistency with the existing code – we didn’t want to add yet another license to the pot.  Second, we believe that EPL maintains the right balance between permitting commercial exploitation of Open Health technology, while requiring modifications, extensions, bug fixes etc to be submitted back to the community. 

Q: In the Terms of Use, you say that contributors must “unconditionally waive your moral rights in any Content you post on the Website.”  That sounds scary.  What does it mean?

A: Moral rights vary from country to country, but basically they are a right that authors have to protect the “integrity” of their work.  For example, even if you sold a painting to someone, in certain jurisdictions, you could prevent the purchaser from publicly hanging the painting upside down – as that could reflect badly on your reputation.  In software, people in some countries might be able to exercise their moral rights to prevent their work from being used for the development of nuclear energy, or in an abattoir, or by citizens of specific countries or religious groups, depending on their personal beliefs. The problem we have is that the ability to exercise moral rights to limit the use of open source software is contrary to the spirit (and licenses) of open source code – where anyone may use the code, for any purpose, subject only to the constraints in the license.  For more information on moral rights:

In the US, where there is little protection for moral rights, see http://cyber.law.harvard.edu/property/library/moralprimer.html.  

In Canada, see http://creativecommons.ca/index.php?p=moralrights.


Open Health Forge FAQs Return to top of page...

Q: What is Open Health Forge?

A: Open Health Forge is a repository where developers may post software that they feel is valuable to the eHealth industry and/or is complementary to software in the existing Charter Project code repositories. 

Q: How does this differ from the Charter Projects?

A: Forge Projects may be instituted by any registered Contributor – and do not need board approval.  The responsibility for the software license and IP issues rests with the Contributor, rather than the Open Health Tools Management Office. 

Q: So, the Open Health Forge structure is much more light-weight, and postings can be done rapidly?

A: That is correct.

Q: So, what value-add does Open Health Tools provide?

A: Open Health Tools will host the repository in which the code is developed and maintained, and will host complementary services such as forums, mailing lists and bug reporting facilities.  Also, Open Health Forge activity will be very visible to Open Health Tools members and the many visitors to the openhealthtools.org site, and may well attract additional participants. 

Q: Could an Open Health Forge development activity become a Charter Project?

A: This is certainly a possibility.  If the Forge work is of interest to members, if the licensing is compatible with existing Open Health Tools Projects (preferably the EPL), and if the code can pass an IP audit, then certainly this could happen.

Q: What happens if I think that a posting on Open Health Tools has copied my code without permission?

A: The Terms of Use included details on a process prescribed by the US Digital Millennium Copyright Act, under which you can notify us about an alleged IP infringement.