1. Perry, William MA, RN

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The Internet has brought the spirit of global communication and collaboration to nurses and other healthcare professionals in ways never before believed possible. These resources are offered to expand your opportunities for discussion, reference, education and research.


What is open source computing? According to the Free Software Foundation ( it is the freedom to modify, improve, and use source code for software released for the benefit of society without payment. Software has been developed and made available for a huge number of applications and disciplines. Healthcare-related software is receiving increasing attention in the open source community. In July 2002, the International Medical Informatics Association granted provisional status to a working group dedicated to the investigation of open source healthcare applications.


The UK-based Centre for Health Informatics Research and Development (CHIRAD) at describes its function as "This site will include a repository of health informatics, education and Open Source resources." Open Nurse-the nursing open source network (, being developed by Peter Murray-is an initiative to explore the application of open source software in nursing, healthcare, and nursing informatics. It has a good list of links to individual and group projects.


The Informatics Review ( has a selection of clinically focused applications. First in the list is the Vista program from the US Veterans Administration (VA) ( Vista is the electronic medical record in use at VA hospitals. Some of the other listed projects are The Good European Health Record (GEHR) (, which claims to have "the most comprehensive requirements document ever developed for the electronic health record," and The Littlefish Project (, which follows GEHR standards to "create a user friendly patient information and recall system on an open source basis with the focus on use by community-based primary healthcare organizations in the developing world or remote and rural areas or areas of need," both center on the development of an electronic medical record.


Common Open Source Medical Objects (COSMOS) located at is another repository of links to open source healthcare applications. Although currently sparse, it is expected to grow. Sourceforge "provides free services to open source developers, including project hosting, version control, bug and issue tracking, project management, backups and archives, and communication and collaboration resources". Go to to review the resources housed there.


A nonhealthcare open source application that can potentially affect a large number of computer users is Open Office ( Open Office is a suite of applications, including a word processor, spreadsheet, and presentation program. They can open and write to Microsoft Office file formats so the document you prepared at work on Microsoft Word can be opened at home using Open Office. The same is true for spreadsheets created in Excel and presentations created in PowerPoint. The software is free to download and use as both an individual or a business.


On the Macintosh side of the computing world, check out Apple's Open Source project at Although Apple's definition of open source does not strictly conform to the definition of "free software" because it does not adhere to "copyleft" principles, Apple has nevertheless made source code for the engine running OS X (which is based on Unix) available to developers as Darwin. Apple requires users to submit changes they have made to Apple's source code back to Apple (with the intent that improvements made to the source code may be released in OS updates), but any code that simply builds on Darwin is not subject to this requirement.


The Linux operating system is the enabling force behind the majority of open source projects. Originated by Linus Torvalds, who did not envision it as an open source project, it has since become the single most successful open source software (a Google search on "Halloween Documents" will reveal just how successful open source projects can be). A huge community of users has modified Linux and the resulting products are themselves released as open source applications. View the large number of Linux versions available by going to Downloading and installing Linux is not for the casual computer user. It is not like downloading Open Office to run on your Windows computer. It is a completely different operating system and requires programs written to work with that operating system.


Last but not least, and vital to Internet use, is Mozilla (, the open source Internet browser developed by the team originally responsible for Netscape, now owned by America OnLine. Although Netscape still owns some of the source code used by Mozilla and its "public license" contains restrictions similar to Apple's (any source code modified by the user must be submitted to Netscape), Mozilla is free and is written and revised by volunteers cooperating to design a browser featuring "standards compliance, performance and portability." The Mozilla team recently released a 1.1 version of the software with bug fixes and has made available a 1.2 alpha version for the PC, as well as Chimera 0.5 for Mac OS X. The Mozilla bug database, called "Bugzilla," is online, and any user can post problems to it (check the database first to be sure that your problem hasn't already been assigned) or volunteer to write fixes or review code as it is written.


There is scant information available on open source applications specifically developed for nursing. Do you have some ideas? Share them with your colleagues on the Internet. Collaborate with programmers to produce applications that improve your own workflow and those of the global community.