Why We Choose Open Source

TLDR;

We choose open source because healthcare is our collective responsibility. In the digital present, and the algorithmically intelligent future, we believe that the open model is our best shot at health equity. Collaborating as a community to build health algorithms and tools in the open helps developers (not limited to the technical kind) take charge of the type of change they want to see. At Elsa Health, we are starting by building health algorithms that mimic the decision making of experienced physicians and specialists to empower other healthcare providers and all individuals at a global level.

Check out our Open Health Algorithms Platform (Early Alpha) that we are developing in the open. Contributions, comments, and suggestions are welcomed.

---

Where We Are Now

What got us here, will not take us there. We are living in a key and pivotal moment in healthcare history. A time like no other.

A time where the world has made extraordinary steps in addressing key healthcare challenges, but, due to complexity and size of the problem, most (if not all) the low hanging fruit has been picked.

A time where, as of this writing, the world is going through the COVID-19 pandemic and the health system has buckled at the knees due to the pressure of the crisis.

A time where your political affiliation determines whether you get your evidence from scientific literature, a Facebook group post, or a message forwarded from your local councilman. An ever-deteriorating trust in government, driven in part by politics and politicians, is reducing uptake and thus effectiveness of health interventions.

A time where science and technology is so advanced that policy - and in some cases religion - is being forced to adapt or risk being totally irrelevant. The digitization of healthcare has improved the delivery of health services across the world, and the development of new diagnostic technologies is shaping the health industry.

A time where quintillions of bytes of data are produced per day, and Artificial Intelligence is going through a renaissance taking advantage of the available and affordable processing power along with the plethora of data.

And finally, a time where, despite economic prosperity and advancements in medicine, health equity is still not within reach.

We, at this very moment, live in a time with big, complex, and hairy problems. Fortunately, it is also a time where we have the tools, brains, and opportunities to find solutions to exactly these kinds of problems.

What is Open Source and What Do We Mean when Using the Term?

Open source software is software with source code (stuff computer programmers write) that anyone can inspect, modify, and enhance Ref. This means that you and I can examine the software behind the products and services we use, and depending on the licensing of that software, we can make changes, re-purpose, or even resell it.

Often abbreviated as "FOSS" or "FLOSS" - meaning Free and Open Source Software and Free Libré Open Source Software respectively - this model has been around for decades now and is making an impact on how the digital world works. Currently, almost all proprietary/ closed source software has an open source alternative.

It is at this point I feel the need to state that "Open Source" does not mean free of (monetary) cost, but it does mean free as in "freedom." Freedom to examine, modify, and enhance the software product.

When we say Open Source at Elsa Health, we are simply using the term for its spirit; we mean more than just source code as it is conventionally accepted. The spirit of openness and freedom applies to the content we create, the data we collect, the information we process, the algorithms we develop, and even the tools we use along the way. We focus more on the "open" part of "open source".

Open Source Beyond Just Software

Software is great, and it is the single most important part of all digital and computerized systems that run the world today. The skills required to create, maintain, and update software systems are non-trivial and often blur the lines between science and art. Creating software is hard, creating good software is very hard, and creating the right software (to address a challenge) is often impossible.

As we have developed our own solutions, we've come to realize that creating software and digital tools that truly address a problem requires a multidisciplinary approach that involves technical developers, problem owners, experts, researchers, policy makers, and other stakeholders. The type of collaboration required for this is not a "nice-to-have" - it is a must have.

It also means that to develop a really effective solution, open collaboration tools need to be built so that experts without technical expertise can contribute; data needs to be made openly available and accessible; structures for creating open content (such as clinical case studies) need to be put in place; results from evaluating AI models needs to be openly accessible and auditable; open communication channels for members of a community need to be present. We're talking way more than just software here.

That's why we are building an open ecosystem, created by technical developers, for problem solvers to create effective solutions.

We are developing the Open Health Algorithms Platform, which is an open source platform for the open development of health and medical algorithms and models. We are using open source software and open data and content to create open algorithms for universal health decision support.

Community, Collaboration, and Scale

Community is the holy grail. The decision to open all of our work is so that we can develop and contribute to a diverse and multidisciplinary community of healthcare providers, researchers, mathematicians, statisticians, developers, and other problem solvers.

A community working towards the single goal of solving the big and hairy problems in healthcare and technology can make a lot of progress in a relatively short amount of time. This progress can then scale and keep growing from ideas to prototypes to projects to research and eventually to implementation and impact.

Collaboration increases the skills and resources devoted to achieving a common goal, and diversifies the perspectives and problem-solving capabilities of the group working toward that goal. Mozilla Science

Developing and nurturing a community is no small feat, but it is one that must be accomplished to reap the benefits of collaboration and scale. We're building a multidisciplinary community (more on this in later posts) who can contribute to and benefit from open health solutions. Whether you're a healthcare provider, software developer, government official, patient, or active member of your health community, we would love to have you join us.

What Open Source Means for Health Equity

As a technologist at heart, I sometimes have to take off my rose-colored glasses and ask myself, "Am I building technology or am I creating a solution?" Oftentimes, I don't trust my own answers. (Fortunately my co-founder is kind enough to call me on my bullshit.) After a lot of deliberation and consultation with public health specialists, technologists, and affected communities, we believe in the future of the healthcare we are contributing to. We believe that we are building a solution to a set of big, hairy problems. And, more importantly, we believe that it will make healthcare more equitable for all.

So, what is Health Equity anyways? According to the Centers for Disease Control and Prevention (CDC), "Health equity is achieved when every person has the opportunity to 'attain his or her full health potential' and no one is 'disadvantaged from achieving this potential because of social position or other socially determined circumstances.'"

Health equity is more than just health equality, which refers to every person getting the same access to healthcare. With health equity, every person gets the services that they need, not just the services that everyone else already has access to.

The availability of powerful open source tools for healthcare means that historically underserved populations get access to personalized and specialist-level care exactly when they need it. It means that health impact organizations can build affordable, accessible, and critical tools for the populations they serve. It means that health facilities can uptake clinical decision support that has been created by health experts from around the world.

Our Committment to Build in the Open

At Elsa Health, we know how to build technology powered by Artificial Intelligence and we know how to deliver it to the people who need it the most. We choose open source not because it is easy, but because healthcare is our collective responsibility. We're committed to building solutions that let anyone contribute to the future of healthcare, as well as power current and future health services (decision support, software & hardware tools, medicine support, disease pattern monitoring, etc). We're also committed to sharing openly about our work along the way.

Thanks to the good folks at UNICEF Innovation Fund, specifically Justin Flory, we also know how important Open Source is as an organization that values impact over all else. Our contribution to humanity in these uncertain times is to support health equity by democratizing health AI and algorithms for everyone.

Reach Out to Us

To learn more about our work, or if you are interested in working together, please reach out to us through our website or follow us on social media!

To contact us directly visit our site: elsa.health/contact