I’ve got what I think is an important question for NHS England.
How do we get the best value out of the IPR (intellectual property rights) created by NHS organisations developing digital tools – Is it by freely sharing this IPR or by seeking to exploit it commercially?
Encouraging innovation, and more importantly getting it adopted across the NHS, is rightly a high priority for NHS England another is the digitisation of the NHS and in regard to the later NHS England has been a welcome and powerful advocate of transparency, participation, open data, open systems and open source.
However, as is often the case with the NHS there appears to be a lack of common purpose across the organisation and a failure to align incentives with these objects, indeed there are incentives in place that seem to be designed to discourage them.
In the context of digital tools I am increasing coming across examples of in-house or wholly NHS funded development of innovative digital tools and services where a ill-considered and a generally futile desire to exploit the IPR created by the NHS organisation concerned is acting as a serious barrier to the diffusion of innovation into other NHS organisations and at the same time denying the developing organisation the help of others to improve what they have created.
I’m all in favour of the tax-payer getting a return from the IPR created by their investment, but when the prime customer is the UK public sector, in this case the NHS, this is at best a zero-sum game and given that the economic benefit from making innovation freely available for others to use and improve is considerable I would assert that the cost to the tax-payer of restricting the free use of NHS IPR in this domain far outweighs any commercial return that might be available.
My proposition is therefore that the IPR created in digital health tools with public funding should be made available as open source for others to use and improve. If you also take certain other drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take fluvastatin at least 1 hour before or at least 4 hours after taking these medications. These products can react with fluvastatin, preventing its full absorption.
If I need to cite example to support this I would choose VistAhttp://www.worldvista.org/ and SMART Platformshttp://smartplatforms.org/ Both are examples of open source health software the development of which has been substantially funded by the US Taxpayer, but which are freely available to all. This has two benefits to its funders. Firstly, the investment is available to other US Health providers and the software benefits from input from a global community to improve and extend the products. Secondly, the availability of these products has created an ecosystem in which many commercial organisations have be able to build sustainable business models creating economic benefit.
So how then do we achieve this? Firstly, we have to educate both the NHS and the commercial vendor community as to the benefits of open source development and how this delivers best value for the NHS and creates commercial opportunities – I write more about this in future blogs.
Secondly, we have to remove pressure on NHS organisations to attempt to exploit their IPR where sharing it delivers better value to the taxpayer and we need to realign incentives to ensure this makes sense for the individual NHS organisation as well as the system as a whole. Currently we have pressure and incentives in the system that creates sub-optimisation1 and inhibit the spread of innovation in the NHS.
So my plea – If your part of an NHS organisation that has developed innovative digital tools or paid others to develop them for, don’t let them wither on the vine while you look for opportunities for commercial exploitation – These will be difficult to realise and it’s not what your organisation should be about. Look to the benefits to your organisation and the system as a whole of making your IPR open source and join me in campaigning to realign incentives to make it easier for you to do so.
1 An interesting description of sub-optimisationhttp://pespmc1.vub.ac.be/SUBOPTIM.html