METHODS: This presentation will describe three projects that rely on CDS and have been developed using Open Source components and a common application framework. First, the ICE immunization calculation engine is a service-oriented, standards-based immunization forecasting software system that evaluates a patient’s immunization history and also generates the appropriate immunization recommendations for the patient. ICE can be deployed in diverse technical environments and is designed to easily integrate with third party clinical systems through its standards-based Web Service. Second, the Reportable Condition Knowledge Management System (RCKMS) contains a standards-based web services interface which allows EHR systems to submit initial electronic case reports to public health and evaluate them for reportability to a jurisdiction as a decision support service. Third, the Decision Support for Data Segmentation (DS2) prototype software utilizes the same Open Source CDS framework to identify and redact selected conditions from clinical summary documents. DS2 provides public health surveillance with a potentially new approach toward data collection: rather than rely on the provider to accurately send just the specific information relevant for, say, cancer or diabetes or birth defects, the provider could more easily send the entire clinical summary and DS2 could redact and remove the irrelevant clinical data. The software also includes a web-based "inference analyzer" for visualizing the effectiveness and the impact of probabilistic redaction, as well as a suite of related tools for creating, importing, and editing Continuity of Care (CCD) documents; testing redacted CCDs; and converting CCDs to Virtual Medical Record (vMR) format used for CDS.
RESULTS: All three Open Source products include web-based GUI tools that enable subject matter experts to author and manage the CDS algorithm rules, maintain terminology, and to manage and execute a set of fully automated tests, all without the intervention of software developers.
CONCLUSIONS: The presenter will review a number of important Open Source strategies for public health so that agencies can make the most of these and other Open Source solutions.