OpenNCP beyond epSOS

Preface

This manifesto states activities and options for the future of the OpenNCP. It has been written following the discussions at the PSB meeting March 19, 2014. Note this is a living document, it is incomplete by nature and figures should be considered estimates. The paper is meant to be enhanced by the parties involved, namely epSOS PNs and, like it has been, by the participants of the OpenNCP groupCommunity.

The target audience are primarily the PNs which are considering using the OpenNCP after the end of epSOS. It can be expected that the OpenNCP will only be the first of a number of open source eHealth related developments; this paper only considers the OpenNCP while the principles and mechanics should also work for other developments.

OpenNCP Community is an interoperability asset of epSOS. Next step would be to evolve OpenNCP Ccommunity from a project related entity to an independent, neutral and open for all participation Project Office to promote cross border healthcare interoperability in practice. OpenNCP should be governed by a new roadmap of activities than will allow gathering all cross border healthcare interoperability software developments under one umbrella, allowing Member States, Industry, National Projects, Regional Projects, EU projects to request and obtain support services in that domain.

OpenNCP community needs to have a sustainable model of operation both in Governance and financial support. OpenNCP community milestone number one is to keep up OpenNCP releases valid, tested and certified until CEF is established.

Vision

"Create the information highways of the future that will enable cross border healthcare information exchange in a simple, standard based and secure approach: create the "healthcare roaming" infrastructure"

Governance Structure

Today many successful software systems are developed open source. The example of the Firefox browser comes to mind immediately. However, software which is of great interest to the general public attracts thousands of enthusiasts and nerds around the globe, while the OpenNCP is very specific and cannot rely on the spirit of meritocracy the same way. Yet we advocate that many of the principles and mechanics of shared developments apply just as well for the both kinds of software, yet governance and finance need to be adjusted.

The OpenNCP team in epSOS has proposed a governance scheme which has been discussed and supported in TPM and which has eventually been presented to the PSB, see Illustration 1. The scheme stipulates a move from a community to a committee model. It would introduce governing levels for the first time in the history of OpenNCP and effectively reduce some voluntary aspects. It will be important though to carefully balance the overall setting to fire the enthusiasm while ensuring planning dependability for the problem owners.

On the top level a Steering Committee, primarily manned by the problem owners, governs the overall direction of the OpenNCP, decides about priorities and developments, liaises with third parties and orchestrates resources. EU projects engaging in governing the OpenNCP or producing new healthcare interoperavilityinteroperability assets should be represented here as well.

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Efforts and Financing

The OpenNCP will not attract myriads of pro bono contributors, thus finance has to be ensured at least on the development level.all levels (e.g. Steering, Technical and Development) as well as activities beyond development (e.g. dissemination, marketing, testing). The sourcing of funding may change over time, while in the long run the problem owners or demand bearers as well as industry will have to accept responsibility for financing the system. Industry may also financially support the community and can act as problem owners and demand bearers as well. Project subsidies e.g. from the European Union may initially play a certain role but not exclusively and not in the long run. Relying on subsidies would mean making compromises and jeopardizing deadlines. The OpenNCP financing system may rely in EU, Participating Nations, Projects, Industry, but should always be based on a request-delivery model in order to assure release and delivery.
Here is a first indication of efforts. Note that all "meetings" are anticipated as telephone conferences, only steering committee meetings may occasionally be face-to-face. Also special events like IHE Connectathons have to be accounted for.

Steering Committee

Working schemeRegular meetings in three months intervals plus ad hoc meetings
AimControl the overall direction and development, liaise with stakeholders
MembersPN decision makers of PNs providing services with the OpenNCP,
One person of each of the EU projects providing significant support for the OpenNCP, possibly EU (ISA), chairman technically oriented, less than ten persons
EffortHalf a day per week for chairman (i.e. 10% of overall work time),
other members a few days per year
RemarksIf several countries should choose to support the development of the
OpenNCP a sub-structure may have to be created. Committee interacts with eHN/eHGI on Policy & choose projects.

Technical Committee

Working schemeProject dependent, but expected to meet about monthly,
Workload increases with new developments, no chairman required
AimSteer and control the technical development, promote new use cases
and conduct testing
MembersApplication and technical experts with management experience and
participating in e.g. EXPAND, Trillium Bridge, or e-SENS pilot (taking current projects as examples),
four to six person
EffortLess than a working week/anno if the OpenNCP is only to be
maintained, in times of new releases etc. workload may increase to 10 to 20% of overall work time

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Working schemeFlexible, demand and supply dependent
AimUndertake development and testing
MembersAny number, any time, but never below five, better 10 active
participants
EffortAnything up to 100% engagement for a limited period of time
Estimates for the development of new releases of individual programming experts (see Illustration 2 for releases and effort estimates)

Tools and Techniques

It is vital for the virtual development team to have the best possible tools available to them. During the epSOS project this requirement has been turned into reality. As per today the OpenNCP team commands a highly integrated and comfortable set of support systems including meeting support.
Code repositories and work support tools have been chosen and fed with information. The repositories are provided by the EU free of charge, the work support tool from Atlassian (https://openncp.atlassian.net/) also has no price tag attached to it as long as the development is limited to open source systems.
The Continuous Integration tool will be hosted held by the EXPAND project (until delivery to CEF or other bets suited organization)on an EU service ([http://www.egovlab.eu/) and/ or a PN's system, again no costs are expected. IHE is also preparing an offera proposal which will include the semantic servicesenvision to provide a neutral and impartial hosting place for various assets of epSOS in order to allow PNs to continue their cross border healthcare efforts. The offer is expected June 2014.
Costs have to be anticipated for Projectathon and Connectathon type events. A central support system (ticketing system) is in use within epSOS. It has shown that for the developers it is not of great importance, while for user support it may be necessary. It is expected that the free tool support system can be hosted by one of the PNs. Alternatively the feature can be integrated in the development support system on Atlassian, given it will be comfortable enough for end users (preferred route if sufficiently user-friendly).

Licinio Kustra Mano: proposed to remove next topic;

Development Scheme

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Licinio Kustra Mano: proposed to remove next topic;

Effort Estimation

The effort estimation figures presented in the next tables should be used as baselines that can and MUST be revised as long as concrete actions start to be planned. While the presented estimates rely specifically on development activities, there are other organizational activities that, depending on the OpenNCP Community strategy, should be considered for determining overarching financing needs, namely: testing, IHE CAT participation, dissemination, marketing, project management.

Quality Management

The management and assurance of the quality of new versions and releases of the OpenNCP itself but also that of the national integration has been queried by the reviewers of the fifth Annual Technical Review.
Quality management regards several aspects. epSOS developed rigid and comprehensive schemes and applied them rigorously. What worked in the beginning proved to be complicated and very time consuming towards the end of the project. This is because the number of piloting nations increased and e.g. the number of end-to-tests grew substantially.
Also it proved that a lot of the necessary know-how was either not present anymore (although available on ProjectPlace or in mails) or it could not be easily accessed because of new and thus inexperienced PNs; last but not least a number of the original "wisdom bearers" had left the project.
It is thus for more than one reason necessary to address various issues to ensure quality in a changing environment. None-exhaustive listing:

• release management of the OpenNCP
• testing and approval of national integration work and changes thereof
• release management and test and acceptance plans for new services
• change management (worked out in epSOS but geared towards a project environment)
• release and go-live planning
• planning and implementation of new versions of e.g. semantic systems
• emergency and contingency planning (e.g. for security breaches)
• technical documentation (e.g. architecture, install and operation manuals)

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Introduction

As of January 2016, the OpenNCP governance model changes as foreseen and prepared by the EXPAND project.

The OpenNCP project shifts under the direct responsibility of the European Commission, Directorate General for Health and Food Safety, DG SANTE. The goal is to move  the epSOS e-health pilot OpenNCP into the global European "Connecting Europe Facility" (CEF) framework project under the umbrella of the "eHealth Digital Service Infrastructure"(eHealth DSI).

The project is dedicated to remain open-source and the governance is designated to be driven or influenced by the OpenNCP community and health care professionals, in cooperation with the European Commission.

Guidance documents - Call CEF-TC-2015-2 on eHealth Generic Services

Source: http://ec.europa.eu/health/ehealth/policy/network/guidance_ehealthgenericservices_en.htm

• Governance model for the eHealth Digital Service Infrastructure during the CEF fundingImage Added(373 KB)
• Guideline on an Organisational Framework for eHealth National Contact PointImage Added(623 KB)
• Call for proposals concerning projects of common interest under the connecting europe facility in the field of trans-european telecommunication networksImage Added(107 KB)
• Guidelines on ePrescritpions dataset for electronic exchange under cross-border directive 2011/24/EUImage Added(2 MB) 
• Guidelines on minimum/nonexhaustive patient summary dataset for electronic exchange in accordance with the cross-border Directive 2011/24/EUImage Added(3 MB)