Healthcare Turns to Open Source Software

May 01, 2014 by Glen Doss, VP. Strategy & Business Development

Originally published in eHealthcare Strategy & Trends, May 2014

A growing number of health care organizations have turned to open source software to help manage their websites. Open source software is a collection of software tools and technologies that are free to use, modify and share. Two of the most popular open source platforms are the Drupal and WordPress content management systems (CMS); both platforms have experienced rapid growth within the health care industry.

The Explosive Growth of Drupal

In 2009 the White House’s official website (Whitehouse.gov) switched to Drupal, which marked a watershed moment in the adoption of this open source CMS platform. Soon, other high-profile government agencies—like the U.S. Department of Education, U.S. Department of Energy and U.S. Department of Transportation—followed suit. Similarly in health care, early Drupal adopters, like Cooper University Health Care, helped pave the way for other leading organizations (e.g., St. Louis Children’s Hospital, University of Michigan Health System, Florida Hospital, George Washington University Hospital, Memorial Sloan Kettering Cancer Center, UMass Memorial Health Care, Loyola Medicine, NYU Langone Medical Center, etc.) to move to Drupal. More than one million websites are powered by Drupal.

We moved to Drupal because we thought it would give us the most flexibility to grow and evolve at our own pace.  The platform's flexibility has helped us to meet the needs of our internal clients more efficiently and implement strategies that have contributed to unprecedented business growth through our site.
- John Odom, Senior Coordinator & Webmaster, St. Louis Children’s Hospital

List of 100+ Hospitals using Drupal

WordPress is the World’s Most Popular Content Management System

More than 12 million public websites run on WordPress. WordPress was born as blogging software but has since matured into a full featured content management system that’s being used to power both popular blogs and public websites. Many high-profile organizations have public-facing websites that are built and managed using the WordPress CMS platform; for example, Sony Music, the Dallas Mavericks, Georgia State University; and Cleveland Clinic’s HealthHub brand journalism site, which received more than 1.8 million visits in February alone. Amanda Todorovich, Cleveland Clinics Manager of Digital Engagement had this to say about their use of WordPress: “We publish 3-5 posts a day, and what I think is valuable about our open sourced platform is the range of plugins available, especially as we’ve gotten more sophisticated in our content formats – slideshows, quizzes, galleries – and integrated other editing tools/functionality into Health Hub.”

Why Use Open Source Software?

Vendor Neutral

Choosing open source technology means you are not locked into working with a specific vendor for implementation, enhancements or support. For organizations using proprietary CMS solutions, if there is a need to switch vendors, migration to a new CMS platform will be required. Fortunately for open source CMS platforms users, if there is a need to switch vendors, migration to a new CMS platform is not required. There are hundreds of qualified vendors that support these open source platforms. Learn more about our Drupal development services for healthcare.

Provides an Open, Scalable Framework

Open source software provides an open framework that offers almost limitless ability to extend and customize the system for all types of Web applications. Developers have the capability to build any custom functionality to meet their clients’ business requirements, as well as extend the functionality of any previously developed module to meet current business needs.

  • Open APIs facilitate integration with third-party systems and data sources like physician directories, leased health content, marketing platforms, e-commerce solutions and social media.
  • Responsive design (for mobile devices) is prebuilt into many themes.
  • Built-in search engine optimization (SEO) tools and best practices (e.g., custom URLs).
  • Integration with a wide variety of databases.
  • Integration with Apache SLOR search for advanced facetted search capability.
  • Flexible role-based permissions and publishing workflows.
  • Easily defined custom taxonomies.

Large, Active Developer Community

Drupal and WordPress have two of the largest and most active developer communities. As such, there are more than 16,000 prebuilt Drupal modules, and more than 30,000 WordPress plugins; these components are often leveraged to greatly speed up the development process. Custom modules and plugins can also be built to handle unique business rules and needs. An effective CMS platform should be extendable, allowing organizations to manage and distribute content, connect with audience groups, and meet current community engagement demands.

Furthermore, organizations that chose open source systems own all the hard work and resources they invest in customizing their CMS. Drupal and WordPress benefit from the contributions of the large developer network and firms that focus on implementing these solutions. All too often closed source systems fall behind the technological curve as they are bound to existing client bases and those organizations’ desire to purchase expensive platform advancements.

It’s Free

Open Source Software systems like Drupal and WordPress are free to use and customize. There are no licensing costs, which can result in huge savings when compared to the initial and recurring licensing fees of leading proprietary products. Of course, like any software project, implementing an open source CMS carries with it associated design and development costs. However, with open source software, rather than spending money on licensing costs, organizations can now devote their investment to additional website features and customization.

Drupal or WordPress?

Many organizations find themselves choosing between Drupal and WordPress. When implemented effectively, both Drupal and WordPress can support huge amounts of visitor traffic, as evidenced by the many popular sites running on these systems. Choosing the right system typically comes down to the scope of the required website features. Drupal supports more robust user workflow customization and enhanced integration with external data and third-party systems.

For large websites with complex functionality, Drupal is typically the preferred choice over WordPress. With Drupal’s added flexibility and scalability comes increased complexity. Drupal has a higher learning curve for administrators and developers than does WordPress. An organization will need in-house expertise and/or need to work with an experienced Drupal vendor like Centretek Solutions, a Maryland-based Web Services company specializing in open source solutions. Drupal also has relatively intensive hosting requirements and needs to be set up and configured by someone experienced in Drupal hosting. “We have a pretty high threshold that must be met to justify using Drupal instead of WordPress,” says Centretek’s senior Drupal Developer, Chris Slocum.

Potential Disadvantages of Open Source Software

Security Concerns

Some organizations have shied away from open source software because of perceived security concerns. The transparent nature of open source software provides malicious individuals the ability to view source code in an attempt to identify potential vulnerabilities. If properly maintained, Drupal and WordPress are inherently no less secure than closed products, but they do require ongoing maintenance to keep them secure. Open source software must be kept current in order to prevent defacement, data loss and unauthorized access. Organizations should have a definitive plan in place to manage the use and updating of plugins and modules. Both Drupal and WordPress offer a number of security features and capabilities like login history, audit trails, version control, CAPTCHA validation, SSL compatibility; and LDAP, Kerberos and NTLM authentication.

Need for Custom Development

Some organizations are more comfortable working with a CMS that is polished and ready to use out of the box. Open source CMS solutions like Drupal typically require some level of customized development and extending the default feature set through modules. Drupal can also present a steep learning curve for Web designers who lack the necessary technical skills and comfort with the templating system.

Ownership

When using open source software an organization assumes more "ownership" of the solution than under proprietary licenses. This includes responsibility for upgrades and enhancements. While many organizations feel that having ownership over their CMS is an advantage, others see it as a potential burden. Although in reality many organizations using an open source CMS rely heavily on an outside partner for these types of services.

A Bright Future for Open Source Software in Health Care

There are dozens of good CMS options on the market, and Drupal and WordPress are two options that deserve serious consideration by most organizations. This article focuses on the two most popular open source CMS platforms, but there are other lesser known options that are also worth consideration. The explosive growth of these CMS platforms in health care reflects the broader trend of large organizations embracing open source software. As these products continue to mature and alleviate outdated misperceptions, more and more organizations will migrate to them. The 2013 Future of Open Source Software Survey predicts that health care will see the second largest growth (trailing only government) in open source software usage over the next three years[1]. The survey also reported that the three most important factors for organizations choosing open source software over proprietary alternatives are: 1) better quality software; 2) freedom from vendor lock-in, and 3) flexibility of/access to large software libraries.

 

[1] 2013 Seventh Annual Future of Open Source Software Survey conducted by North Bridge Venture Partners and Black Duck Software - http://www.blackducksoftware.com/news/releases/seventh-annual-future-open-source-survey-results-show-culture-quality-and-growth.