The decision to make software Open Source is not transparent to everyone, and people tend to think, WHY do they let people see their code? Anyone could take it away and make business out of it. Anyone could find weaknesses and exploit them.

The current software landscape for medical doctors in Austria is, let's face it, a bit cumbersome.

There is almost only one company left that serves over 70% of the EMR market for general practitioners, besides a few small, relatively isolated applications.

Generally, a software provider monopoly is a disadvantage for customers in the long term: Due to non-existing market competition, prices are higher as necessary and levels of output are lower than they could be.

Additionally, thousands of sensible patient data files are stored within the database of an EMR. Medical software has to store these files securely, and provide secure interfaces for data interchange with other trusted medical systems. A medical software that is not OSS (Open Source Software) nowadays means that the software can only be trusted to a certain extent. While this seems to sound like paranoia, the NSA scandal in 2013, and many other examples in the last few years (Yahoo hack, etc.) has proven the opposite. Hacks are quite common nowadays, and “hiding* data behind proprietary software is not a security feature.

Nevertheless, despite having an official data format for exporting/importing patient data, this format is old, not very well standardized, and lacks completeness: You are likely to loose some of your patient data when switching your EMR to another provider. The currently available software companies have no benefit of improving this interoperability - they would loose customers. So they try to use a lock-in philosophy, trying to reduce the possibilities of their customers.

So I want to state a few advantages of OSS and why we prefer it:

<dokuteaser>

You don't know if patient data are kept within your database of a closed source software, or transmitted to another server. While it seems extremely unlikely that the software company illegally fetches data from you, you can neither prove nor deny it. You are fully dependent on the company's information.

If your software vendor decides to not further support any part of your software, you can't do anything about that.

With OSS, every step of the software is transparent and can be proven to do what it says it does. </dokuteaser>

<dokuteaser>

OSS has better software quality. Not always. But being open for everyone, more people are looking critically at the code. Badly written code can not be hidden as easily as in closed, proprietary software.

Coverity Scan 2013: OSS has better code quality

You would not try to make typography errors on your official visible home page, would you? But you tend to write sloppily in your internal notes, right? Same with software, done by companies. </dokuteaser>

<dokuteaser>

A common misconception is that OSS is less secure because “anyone can read the code and hack into the system, because he sees the vulnerabilities”. This is only partly true.

Security vulnerabilities may be found easier in OpenSource software - and exploited, if they are found by the *wrong* people. But they can also be fixed easier – if they’re found by the *right* people.

The principle “*security through obscurity*” is commonly known as a bad practice to make a software secure. Therare plenty of demonstrations and examples in the history where “obscurity” failed. So Security could better be achieved using Open Source software. </dokuteaser>

<dokuteaser>

Be honest: you don't have much choice with proprietary software. If you want a certain feature implemented in your current EMR software, you can ask the company and hope they'll do it. If you want to switch the software company because of bad support, you loose some patient data when switching because the company didn't implement sufficient data export. With OSS, you have more options. While it does *not* mean that you have to be a programmer to have your ideas implemented, you can pay any programmer to implement a certain feature for you. Or keep the software, and go for another support company. </dokuteaser>

Software should not only be Open Source, it should also be free as in freedom. We think that free OSS offers the possibility that many small companies can take MedUX and build a support network for doctors - each company trying to make the software better, but having one standard base to build upon.

So we encourage you to get involved into MedUX in any way you could think of, fork MedUX (yet not available), improve it, and give your improvements back, to make it even better.