Comment: Opening up

Shane Tickle of IMS MAXIMS reflects on the company’s journey towards going open source

In this article, Shane Tickell, chief executive of IMS MAXIMS, reflects on the company’s journey towards going open source, what it means, and what benefits it creates for the company and the wider healthcare industry

A year ago I declared that IMS MAXIMS was considering making its MAXIMS PAS and EPR available as an open source solution to the NHS.

At that point, we were far from committed to the model, but were engaging with our customers, sounding out the market, and getting to grips with the benefits for both IMS MAXIMS and the wider health economy.

What we have realised over the last 12 months is that open source is simply another vehicle to achieving a paperless NHS that delivers better, safer, patient care

Our open source strategy has been developed with the vision of encouraging more innovation in the health service and facilitating the transition to a safer, patient-focused, paperless NHS. And this flexible approach has already taken us on an incredible journey. We have received significant interest from NHS trusts; are working closely with NHS England; have made our open source solution set, openMAXIMS, available on GitHub; signed a contract with Taunton and Somerset NHS Foundation Trust; and are now working with numerous others. To date, we are effectively the only British open source PAS and EPR supplier on the market.

What we have realised over the last 12 months is that open source is simply another vehicle to achieving a paperless NHS that delivers better, safer, patient care. This has been demonstrated by feedback at a number of events we have hosted, where guests had not attended just because they were specifically interested in open source. Instead, they said it was because they wanted an EPR that they could tailor to their own needs and that could deliver benefits to patients and staff alike.

The recent announcement by electronic car company, Tesla Motors, has really resonated with IMS MAXIMS. Last month, the car manufacturer announced that it would open source the company's entire patent portfolio as part of its wider aim to accelerate the advent of sustainable transport.

Tesla does not see other electronic car providers as a threat, but rather sees petrol and diesel car manufacturers as a danger to sustainable transport models. In the same way, IMS MAXIMS does not necessarily see other PAS and EPRs companies as competitors, but sees paper and inefficiency in the NHS as an increasing threat to providing better, safe care.

In his blog, Tesla’s chief executive, Elon Musk, wrote: ‘Putting in long hours for a corporation is hard, but putting in long hours for a cause is easy’, and that has certainly been true of so many of the people we work with, both internally and within the NHS, with regards to open source.

But, despite our commitment, there is, of course, still some resistance from the NHS and suppliers alike in the adoption of open source. And as the adoption of new technologies can take decades in the NHS, this resistance should be expected. It is now a matter of continuing to demystify the concerns about potential risk and being as transparent as possible.

The current perception among many is that taking an open source approach will mean that organisations will have to take the code and create developers and support teams in-house. With our model, this is simply not the case. Not only do we exist to assist on information governance, security issues and connectivity, but also to provide implementation and support services. Some of the most-commonly-asked questions that come up time and time again by those considering open source are about the future of the openMAXIMS – do the IMS MAXIMS development team stop there? Is there a roadmap? If ePrescribing isn’t included in it now, do we have to build it?

Our open source strategy has been developed with the vision of encouraging more innovation in the health service and facilitating the transition to a safer, patient-focused, paperless NHS

From our point of view, becoming open source is not about saying, ‘here you go – do what you want with it?’ It is about opening the solution up to scrutiny, creating a community and in turn mainstreaming improvement through development.

We have every ambition to take the product to a point that enables trusts that use it to travel higher up the Clinical Digital Maturity Index and beyond. Ultimately, the roadmap is ours to deliver, but by enabling the NHS to have greater input and influence on that roadmap, we can apply the transfer of good practice.

Musk provided a valuable lesson from Tesla’s strategy: “Technology leadership is not defined by patents, which history has repeatedly shown to be small protection against a determined competitor, but rather the ability to attract and motivate the world’s most-talented engineers.”

And the more users we have of our solutions, the more expertise, input and enhancements we will have.

One year on from our initial considerations, our open source journey is still in its infancy, but, with significant interest from trusts looking to use Tech Fund 2 funding for such a solution and an NHS organisation looking to utilise our open source solution, the misconceptions are slowly being addressed and a better understanding of how it can meet the aim of improving patient outcomes is slowly being realised. If interest continues at this rate, we have no doubt that open source in the NHS is here to stay.

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