BACHELOR OF SCIENCE IN NURSING:

NURSING INFORMATICS
COURSE MODULE COURSE UNIT WEEK
2 6 7

Open Source, Free Software and Data Processing

Read course and unit objectives

Read study guide prior to class attendance
Read required learning resources; refer to unit
terminologies for jargons
Proactively participate in classroom discussions
Participate in weekly discussion board (Canvas)
Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Understand the basic concepts of open source software (OSS) and free software (FS)
2. Differentiate open source software and free software
3. Identify roles of open source software and free software in the healthcare field
4. Understand database as to:
a. Definition
b. Classification
c. Model
d. Operation
 e. Nursing Implications

Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.

Psychomotor:
1. Participate actively during class discussions and group activities
2. Express opinion and thoughts in front of the class

Saba, V., and McCormick, K. (2006) Essentials of Nursing Informatics 4th Edition, Overview of
Computers and Nursing, Historical Perspectives of Nursing and Computer (pp 70-84). New York:
McGraw-Hill Companies

Introduction

Software has gained so much in importance, not only in healthcare but in almost every sector of
society that it has become a strategic societal resource. Moreover, in recent years the software
market has shown signs of entering a much more volatile and vigorous period. This re-invigoration
of the market is due to the emergence of the open source software and free software, which has
made commercial in-roads in major segments of the software market. Most nurses use open
source software and free software (OSS/FS) without even realizing it.

OSS/FS should not be used with freeware (software offered free of charge) or shareware
(commercial software which is available to try before buying).

Free Software and Open Source Software

The basic characteristic of Free Software, as defined by its creator and leading advocate Richard
Stallman, is that the user is free to make decisions on the use of the software code.

Free software is software that meets the following criteria:

• users are free to use the program for any purpose;

• users are free to examine the software to see how it works;
 • users are free to distribute the program to others;
• users are free to improve the program

Open Source, as defined by Bruce Perens in the Open Source Initiative, is quite similar to Free
Software. The main underlying concept is that Open Source does not just mean access to and free
use of the source code. The distribution terms of Open Source Software must comply with the
following criteria:

• Freedom to redistribute
• Source code must be included
• Freedom to create derived works
• Integrity of the author's source code, i.e. amended work must be distinguished from the
original version
• No discrimination against persons or groups
• No discrimination against fields of endeavor
• Distribution of license: i.e. redistribution of the software shall include the license and must
not add further restrictions (such as non-disclosure agreements)
• The license must not be specific to a product
• The license must not restrict other software

OSS/FS Windows-Based Applications

Open Source Software and Free Software exist to common well-known applications. The following
are some of these familiar Window-based applications and their category of usage. Universal
Resource Locator (URLs) and/or website addresses are provided for the purpose of download by
the professor and typewritten in italics:

• Mozilla Firefox (Web Browser)

The premier free, open-source browser. Tabs, pop-up blocking, themes, and extensions.
Considered by many to be the world's best browser
http://www.mozilla.com/en-US/firefox/

• Miro (Video Player and Podcasting Tool)

With beautiful interface. Plays any video type (much more than windows media player).
Subscribe to video RSS, download, and watch all in one. Torrent support. Search and
download from YouTube and others
http://www.getmiro.com/

• Pidgin (Instant Messenger)

Connect to multiple IM accounts simultaneously in a single app, including: AOL IM, MSN, and
Jabber.
http://pidgin.im/
• Mozilla Thunderbird (Electronic Mail Client)
Powerful spam filtering, solid interface, and all the features needed by sophisticated nurses.
http://www.mozilla.com/en-US/thunderbird/

• Cabos (Peer-to-Peer File Sharing)

Simple, easy to use file sharing program by Gnutella network.
http://cabos.sourceforge.jp/

• OpenOffice Org. (Office Suite)

Big, full featured suite of tools for word processing and spreadsheets. Compatible with and a
free replacement for Microsoft Word documents. Also supports Open Document Format.
http://www.openoffice.org/

• GIMP (Photo Editor)

Photo editing application that rivals Photoshop in features
http://gimp-win.sourceforge.net/stable.html

OSS/FS Healthcare Applications

It is suggested that in healthcare that the development of OSS/FS could provide much more
needed competition to the current relatively closed market of commercial, propriety software.
OSS/FS could also solve many of the problems that healthcare information systems currently face.
Common OSS/FS applications are as follows:

• openEHR
The openEHR Foundation is an international, non-profit organization that is working toward the
development of interoperable, lifelong EHRs.
http://www.openehr.org

• FreeMEd
FreeMED is the flagship product of the freeMED Software Foundation as a result of many years
of work in developing OSS/FS electronic medical record (EMR) and billing system, which
focuses on the needs of the healthcare team.
http://www.freemed.org

• CARE2x
One of the few OSS/FS projects to have been originated by a surgery nurse, Elpidio Latorilla. It
aims to develop a practical, integrated healthcare information system (HIS) and is designed to
integrate the different information systems into one single efficient system.
http://www.care2x.com
• Open EMR
A free, open source medical clinic practice management (PM) and HER application. It offers a
range of functions including Practice Management features for patient scheduling and patient
demographics; online EMRs; prescription writing capability with ability to email and print
prescriptions and ability to generate files for electronic billing.
http://www.openemr.net

Healthcare Specific OSS/FS Organizations

The noble deed on development and exploration on the use of OSS/FS in the healthcare field were
initiated by numerous organizations:

• Open Source Health Care Alliance (OSHCA)

The oldest of the organizations having been formally established in Summer 2000 at a meeting
in Rome, Italy. It holds annual conferences and has email discussion list open to anyone
interested in supporting the aims and work of the organization, and is on current website
upgrade.

• International Medical Informatics Association (IMIA)

Established in October 2002, that aims to work both within IMIA and through encouraging joint
work with other OSS/FS organizations to explore issues around the use of OSS/FS within
healthcare and health informatics.

• Special Interest Group in Nursing Informatics (IMIA-NI)

The first nursing organization to establish a group dealing with OSS/FS issues, established
June 2003. The aims of IMIA-NI Working Group include leading in informing the nursing
profession worldwide about the potentials of OSS/FS and examining some claims, develop
recommendation and creative solution.

Classification of Data

There are two primary approaches in classifying data:

• Conceptual Data Types – classification based on how data will be used. These can also be
based on the source of the data. Examples: Laboratories produces “lab data”; X-ray
department produces “image data”.

• Computer-Based Data Types – classification based on computerized data type and can be
grouped into three:

o Alphanumeric – include letters and numbers in any combination but cannot perform
numeric function. Examples: hospital number, memo
 o Numeric – data used to perform numeric functions as adding, subtracting, multiplying
and dividing. It can be long integer, currency or scientific. Examples: date and time

o Logic – data that are limited to two options. Examples: yes or no; true or false; 1 and 2;
and on and off

Types of Files

Within a DBMS, there are two basic data types:

• Data Files – contain data that have been captured and stored on a computer using a software
program. The extension of the file identifies the software used to create file. Example: Microsoft
Word - .doc/.docx extension; Microsoft PowerPoint ppt/.pptx

• Processing Files – executable program or set of instructions that, when executed, causes a
computer to open or start a specific computer program. Example: running a setup.exe file will
tell the computer to begin installing a program.

Classification of Files

Database Models

• One-to-one – single data element in relation to singular data element. Example: individual
medication order
• One-to-many – a single data element related to more than one data element. Example:
Individual medication order with multiple doses
• Many-to-many – multiple data elements related to set of data element. Example: healthcare
providers to patients

Database Operations

• Input – entrance, update, modification of data

• Process – conversion of data in meaningful operations
• Output – includes online and written reports
Nursing Implications of Database Information

The basic concepts of database are not unique and have a great impact to nursing. The concept
for understanding such impact is presented in the Data to Wisdom Continuum of Abbott and
Goodwin.

The continuum begins with the raw data. As data are named, collected and organized, it becomes
information. By discovering the meaningful facts and information and the relationship between
facts, knowledge base is built. By understanding knowledge and implications, nurses are able to
manage a wide range of healthcare problems of clients.

Open-source software (OSS) - a type of computer software in which source code is released
under a license in which the copyright holder grants users the rights to study, change,
and distribute the software to anyone and for any purpose

OSW (2008), Open Source Windows, Retrieved September 6, 2019 from OSW Organization
Webpage, Website:
http://www.opensourcewindows.org/
• Visit an internet site of an OSS/FS and develop a reaction paper (minimum of 300 words) on
how can these software be maximized in the Nursing profession
• Download a research article from ScienceDirect relating to a conducted study on OSS/FS
usability. Respond to the question (minimum of 300 words): How can developers increase the
usability of health-related OSS/FS?

Saba, V., and McCormick, K. (2006) Essentials of Nursing Informatics 4th Edition, Open Source
and Free Software, Data Processing (pp 89-121). New York: McGraw-Hill Companies

SQL Server (2008), What is a Database?, Retrieved September 5, 2019 from SQL Server
Webpage, Website:
http://searchsqlserver.techtarget.com/sDefinition/0,,sid87_gci211895,00.html

Mcmillan, C. (2005), Free and Open Source Software, Retrieved September 6, 2019 from Europe’s
Information Society Webpage, Website:
http://ec.europa.eu/information_society/activities/opensource/index_en.htm

US Department of Labor (2008), Data Entry and Information Processing Workers, Retrieved
September 6, 2019 from US Labor Department Webpage: Website:
http://www.bls.gov/oco/ocos155.htm

Kibbitzer (2008), Data, Retrieved September 6, 2019 from a personal webpage, Website:
http://www.eisu2.bham.ac.uk/johnstf/revis006.htm