Written by Tenly Snow, OpenLMIS Community Manager
At the 2017 Global Digital Health Forum (Dec. 4-6), I presented alongside Carl Leitner, Deputy Director Global Goods with the PATH Digital Square Initiative and Dave Potenziani, Senior Informatics Advisor with IntraHealth, on a panel on open source development for health. For the panel we were asked by Michael Downey, DIAL’s Director of Community, to answer a big question. A really big question:
“What if we all went away tomorrow?”
When Michael first contacted me about the session, I scanned his email pretty quickly (as I think we all do with most emails – scan, file in brain for the appropriate moment to think about it, move on), and then I read through it again, much more slowly, took a sip of coffee, and let out a big sigh.
Don’t get me wrong, I was really excited to see the question, but just, excited in that stunned into silence, slightly blank look on your face kind of excited. Because it’s a really good question. And in some ways, it’s the million dollar question that sits like a big elephant in the back of the room while we’re all busily working away on our various projects.
What is sustainability in open source for health? How might our projects survive if the key supporters were to disappear tomorrow? How are we thinking beyond our current funding sources, models, and opportunities and looking at ways to really diversify our work and our support models?
As Community Manager, I am speaking from the perspective of OpenLMIS, an open source logistics management information system that is successfully managing logistics processes in over 10,000 health facilities in seven geographies across Africa. Read more about the History and Vision of the OpenLMIS Community and Current Implementations.
Like every good, responsible open source project, OpenLMIS has thought about, and talked about, and argued about, this question of sustainability. There really isn’t one simple definition of that word, but I can focus on some of the things that we’ve thought about, some of the things we’re talking about, and some things that we’re actually trying.
Why open source?
First, what are some of the benefits to open source software? Well, to start, it’s not just software, it’s an idea. It’s a philosophy and for some, it’s a way of life. At a recent conference on open source development, one enthusiastic supporter called open source “the font of innovation for technology.” Open source technology is based on collaborative efforts and community development – its tech is flexible and achievable, and the end goal is shared benefit for all. In this way, open source supports concepts of sustainability – we are stronger united than divided.
There is, however, a dark side to open source…
No, I’m joking! But there is another side to the benefits of open source development, which is that it’s complex! In fact, as we all probably understand, all technology is complex, and there is no quick and easy way to deploy health information systems in global contexts. It also costs money. Open source doesn’t mean it’s free – there are up front and ongoing costs for implementing and sustaining a core open source product. Systems require management, guidance, and support in terms of architecture and implementation, and especially complex systems like those developed for the complicated supply chains in our focus countries.
For open source, it also takes a lot of work to manage the communities supporting those tools! Managing the partners, conversations, and processes needed to achieve feature development and community consensus for the software and initiative requires significant coordination and effort. Democracy takes work!
And there are a host of other activities around business development to identify new geographies for implementation, advocacy, maintenance of documentation and collateral, and so on that are all essential to helping an open source project thrive. While proprietary software typically has a single paid organization and team behind it to support these kinds of necessary activities, open source projects depend on a variety of strategies, models, and supporters to continue their work and be sustainable.
How is OpenLMIS addressing the question of sustainability?
What are some of the ways we are working to make OpenLMIS sustainable? What are some of things we’ve tried, or are trying currently?
Re-Architecture Project: Throughout 2016, the OpenLMIS community agreed to undertake a re-architecture process to move toward a microservices, modular-based structure. The intent of this project was to enable all implementations to use a common version of the software. Prior to this, individual implementations had the burden of maintaining their own versions. This project was a major step toward the sustainability of the initiative because implementations now can extend the software, share features, and utilize a single shared version of the software across geographies.
Project documentation: As an open source tool which has benefitted from a large amount of direct support for software development, maintaining a completely transparent and publicly available development process, as well as a large amount of project documentation, ensures that, at the very least, the tools are there so someone could pick up the OpenLMIS documentation and build off of it even if we all disappeared tomorrow.
Moving the developer “center of gravity” closer to the Africa end-user base: OpenLMIS is working to build capacity within Africa to grow and maintain the tool by engaging Africa-based software development shops and reducing the amount of software development work performed by global (and often very distant) teams. The idea behind this is that it will be more cost-effective and sustainable than utilizing US-based teams, but again, the deviant perspective is that this is a very long-term goal, not 3-5 years but 15+ years out.
Diversifying the product: OpenLMIS is continually striving to engage with other open source tools in the global health space to identify potential sources of innovation and integration. By integrating with, or being interoperable with, other open source and non-profit tools like OpenSRP, DHIS2, NexLeaf, ESMS, CommCare Supply (to name just a few), the OpenLMIS initiative can be part of a large suite of open source solutions that can meet continually evolving country needs and priorities.
Maturity model: The Global Good Maturity Model as part of the Digital Square Initiative managed by PATH is a way to benchmark progress in the OpenLMIS initiative toward key sustainability milestones like diversification of funding streams, publicly accessible technical documentation, formal community structures, and data accessibility considerations. While OpenLMIS currently falls into the “medium” and “high” ranking for many of the maturity model’s categories, we don’t pretend to know the answer to this tough question of sustainability. There are still lots of open questions about the direction of the initiative and we are always open to discussion about ways to address these challenging questions. Some of the ideas we’ve discussed are:
Business model planning: OpenLMIS has undergone a collaborative business model planning exercise with the community and funders and has developed several options for the software including conversations around hosting, Software As A Service (SaaS), conducting trainings/certifications, and expanding into new sectors like agriculture or transportation.
Academic “home:” An additional idea is around finding an academic “home” for OpenLMIS, similar to the University of Oslo’s support for DHIS2, or the University of Washington’s support for ODK. Some of the benefits include ongoing funding source, a new and constant source of developers through students, a home for institutional knowledge and documentation, diversity in thought and practice through research.
Our goal as a community and as logistics software is to imagine a better world and to achieve it through enabling better health supply chains and better data. We may not have all the answers, but we are an initiative and a community determined in making this better world a reality.
The OpenLMIS Initiative’s mission is to make powerful LMIS software available in low-resource environments – providing high-quality logistics management to improve health commodity distribution in low- and middle-income countries.
OpenLMIS increases data visibility, helping supply chain managers identify and respond to commodity needs, particularly at health facilities where lack of data significantly impacts the availability of key medicines and vaccines.
Learn more at openlmis.org, or by writing to email@example.com
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