What is Code 4 Health?

Code 4 Health is a platform operated by the NHS England Open Source Foundation, Apperta, enabling healthcare professionals to connect with technical and patient communities and work together more closely to develop code and build applications. In recent times, many technology systems have been implemented across the sector but found to be unsuitable due to lack of engagement between the users and developers; suppliers have focused on selling software, not on outcome.

What is Flexibase and how was it involved in Code 4 Health

Flexibase, built by OpusVL, is a framework of re-usable components, required by almost all business-connected web sites and intranets. Unlike common web content management systems (Wordpress, Joomla, Magento etc), Flexibase is designed to allow a developer to quickly design a platform with authentication but with much more freedom as to how all of the components are wired together, and with easy integration to other systems and databases.

The Code4Health project had short-term goals which were the initial focus of the Apperta team but looking past them, it was clear that a framework was required that would allow expansion and integration to many external systems, databases and other applications. Flexibase was identified as a solution to the short-term needs and the strategic goals of the programme therefore the Code4Health platform was built on Flexibase.

Why did the C4H project have to be Open Source?

OpusVL are working with public sector and healthcare organisations to prototype new methods of engaging suppliers and one of the key points is that the software funded by the public funds should be fully available to the public sector, and the wider community. This may seem obvious but recent history shows that the sector commonly invests in creating software but once built, has to pay again for licenses, then other departments also have to pay again, and the software is then owned by an external private company. This model is in conflict with what is best for the healthcare professional and the patient.

What are the implications of this project on day-today healthcare?

There are all sorts of healthcare applications being created by talented developers but a major issue many encounter is that they are not joined up. For example, your fitness record collected on your phone never finds it's way to your GP so although it is useful to you, it does not contribute to  your overall healthcare picture. The Code4Health platform enables app developers to use Open Standard connectors to access drugs databases, patient data and other information as well as the NHS Spine - a super highway connecting upGP's and doctors. Of course, everything within Code4Health is test data and only test endpoints are accessible, but it does allow real developers to connect to real equipment using the same methods that are used on the live systems.

What effect will this have on patients and improving care?

The goal is to improve patient outcomes by using effective technology. Providing better data to clinicians in a timely manner enables them to make more informed decisions. By using Open Source, the cost to implement is much less than using proprietary software and encourages collaboration by all involved. As applications develop, we should see better communications between the NHS and the patients, more interactivity when booking or re-arranging appointments and better resource planning.

Does it help or hinder legislation regarding the four-hour patient rule?

With better organisation of resource and rostering, time planning, availability of data and patient communication, it can only improve the service being provided. The four-hour rule is a blunt measure that can cause patients to wait four hours when they could have been dealt with much faster. Imagine being able to know the queuing time at the walk-in centre, the surgery or A&E, in some cases, you may make different decisions which reduces the queue for everyone.

Do you have any examples of applications arising from the Code 4 Health platform?

Of the 30 or so specialist communities, some of the projects that have lead to real applications in live use within NHS Trusts are:
- Open Odonto - Dental services
- OpenEP - ePrescribing
- Open-eOBs - Nursing observations
- OpenEyes - Electronic ophthalmic records

How can workers use C4H to build communities? 

Visit the Code4Health website, browse through the communities and connect with people who have a common interest or are in your area. If you have an idea and cannot find a community, sign up to create your own. NHS Hackdays are also a useful opportunity to connect with the people involved.

Will this go mainstream in the NHS and if so, when?

It is already live and communities are building. The project will evolve over time as more and more people get to know of it and engage. 

How is OpusVL driving adoption of C4H?

We are helping the NHS develop a sustainable strategy for the platform whilst helping prototype the emerging commercial models to provide Open Source to the sector in an effective way. Following on from Code4Health, mature applications are promoted to the Ripple platform which is much more focused on testing and use-cases and applications that continue to grow become candidates for live use.

What implications does the project have on a b2b environment?

The platform creates opportunities for businesses who have an Open Source model to provide ongoing value services and innovation when solutions are not yet available. This marketplace is being fostered across the wider industry by the UK Open Source Industry Association, who have the vision that all markets can benefit from similar advances.

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About OpusVL

OpusVL implement business management software and professional Open Source solutions. Developing custom solutions since 1999.