Information and Knowledge Management using ArcGIS ModelBuilder

Jose Teixeira and Reima Suomi
Future and more rigorous research, surveying both patients and health-care professionals, should be
conducted by evaluating the studied patient-to patient solutions. Both healthcare system regulators
and police-makers should be aware of the echoes of the open-source phenomenon implications in
healthcare. Some existing policies could introduce insuperable barriers to the development
inexpensive open-source solutions in healthcare. Forcing patients that developing their one solutions,
to pay expensive certification programs, like the Certification Commission for Health Information
Technology in the USA, to use their own solution by legal manners can produce perverse results.
From the patient behavioural point of view, it is empirically observable that those patients are
progressively taking a more active role in the management of their diseases, that chronic patients
interact more and more with one another within Internet communities. From the technology point of
view, a lot of development initiatives focus on mobile devices that patients can carry along with them
in a daily basis. Moreover, the software development processes are turning less complex, and the
number of individuals with the necessary skills to develop mobile software applications is increasing.
The authors strongly believe that all these factors will intensify the observed phenomena, forecasting
a strong development of the chronic healthcare information systems in the following years.
This research has strong implications for the traditional entities developing commercial healthcare
information systems. As suggested by Lee and Mendelson (2008) the emergence of free and opensource
software solutions will increase the healthcare market competitiveness forcing commercial
entities to lower prices and increase quality. Most of the healthcare information systems producers
sell their products to the healthcare delivery organizations rather than to the patients directly. The
research authors argue that chronic care commercial players could be in a situation described by
Bower and Christiansen (1995), where corporations are so focused addressing the immediate needs
of their direct customers, that they lose the disruptive innovation potential for final end-users. It seems
possible that healthcare commercial players could benefit from the studied phenomenon both by
gathering requirements and reusing software assets from patients open-source community. Many
features were suggested by user of open-source software that commercial players should analyse.
In addition, a considerable amount of the communities criticism on existing commercial solutions
points out a lack multi-platform support and the existence of user lock-in mechanisms. For instance,
many users complain that their software only works on computers running Microsoft operating
systems; and many others complain that they lose all their medical data when purchasing a new
medical device. The studied phenomenon might force existing commercial players to invest in
software development targeting different platforms; And, for the benefit of users, this phenomenon
could pressure existing players to give up from lock-in mechanisms embedded their products.
The phenomenon will also differentiate patients, dividing them to technology-aware and technologyignorant.
The ones with skills and motivation to search for solutions from the open-source market will
be better off than those not having that capacity. As reported by Lorig et al. (1993), a patient by
working around solutions and alternatives, even when they would not be perfect or very beneficial
from the medical point of view, is a therapeutic process that will lead to the feeling of the control of the
disease, and finally to real better care results. Moreover in certain illnesses, patients themselves have
also been used to support and coach other patients facing similar challenges, in here reported
phenomenon patients are using their software skill for the benefit of other patients in similar condition.
Among many other health-care actors, patients are the ones that most benefit from this and here
reported phenomenon. The free nature of the studied software solutions enable chronic patients both
to benefit directly by using it at a reduced cost and to benefit indirectly by the market effects that these
solutions have in the extremely competitive market of chronic-care technological solutions. As
mentioned by some patients in the studied Internet communities, these open-source solutions allowed
them to capture and manage their data, without losing it with a shift of a medical device or
correspondent vendor. Moreover, several patients mentioned privacy issues reporting fears of missmanagement
their medical data by some of the medical technology vendors.
References
2010a. GGC software project text file README.en. GNU Gluco Control (GGC). Available at:
http://ggc.sourceforge.net/docs/README.en [Accessed April 15, 2010].
2010b. MyShi software project page. Available at: http://htrack.net/ [Accessed April 15, 2010].
2010c. PumpDownload software project page. Available at: http://pumpdownload.sourceforge.net/ [Accessed
April 15, 2010].
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