Open source delivers safe, efficient and modern e-health services to Warsaw's university hospital. Its integrated medical system is based completely on open source and, according to project leader and medical specialist Radosław Rzepka, is shaping the future of Poland's medical databases.
Using free and open source is the only way to correctly exchange data in medical database systems, Rzepka says. It is much easier to implement, improve, build and adapt solutions by using this type of solutions. Proprietary systems require expensive licences, yet make it impossible to really understand how information is exchanged, forcing researchers to rely on inefficient data exports.
Rzepka and his colleague Daniel Podlejski presented the e-health system built by the Medical University of Warsaw, at the Medetel conference in Luxembourg on 10 April.
Doctor Rzepka explained that even within the hospital, it is cumbersome to exchange patient health records such as X-rays, MRI and ECGs. To overcome this hurdle, the university hospital decided to develop its own modern system. The university had a few more requirements: the solution would have to be low-cost, safe, flexible and easy to use on all kinds of computing devices, ranging from workstations to smartphones. "We did not have to think long, these systems would be built as open source, as we also want to share our work with other hospitals."
The project is funded by Poland's National Centre for Research and Development and involves seven developers and nine medical specialists.
The service oriented architecture now in use at Warsaw's university hospital is built using standard open source components, including web server Nginx, Linux distribution Ubuntu, database system Postgresql and search engine Elasticsearch. The developers use programming languages Ruby and Python and web application frameworks Rails, Sinatra and Flask. The message middleware includes Rabbit MQ, Resque and Celery.
The e-health platform allows staff to share medical data, including scans, from any source. The system supports staff working from remote locations, using VPN connections and, when correctly authenticated, the records can also be accessed from a smartphone, Rzepka says, adding that he has had to assure the hospital board "that our system is sufficiently secure."
It comes complete with an online e-learning system, making anonymised cases available for teaching at the university hospital. "One of the hardest things in studying medicine is finding real, representative cases", says the medical specialist. "Our approach will allow students to learn from real observations and discussions between clinicians and medical specialist, and use anonymised records."
The system is already being used by a handful of clinics. Rzepka: "There is a large number of hospital staff involved, and it takes time to convince them of the gain in efficiency. But we're passionate, and we know this system will be useful in every clinic."