With most businesses and particilarly public sector organisations looking for new ways to save money and leverage their assets, perhaps its time to stop the financial invisibility of software capital investment particularly in the use of open source software. The slides take a brief look at the NHS situation and how caitalising OSS spend might help.

3. A Serious Situation

4. Where's the money going?

5. Greater Manchester
NHS Capabilities
5Boroughs
Bolton FT
CMUHFT
East Cheshire
East Lancs
GMWestMHFT
MMHSCT
Pennine Acute
Pennine FT
Salford Royal
Stockport FT
Tameside FT
Christie FT
South Manchester FT
Wigan FT
0 5 10 15 20 25 30 35
Trust range of functional capability
sub-title
Onchology e-Prescribing Observation Vital Signs
In Patient E prescribing EPR
Substance Abuse Critical Care
Clinical workflow Clinical Noting
Clinical e Prescribing Clinical Datawarehouse
Bloods Bedsys
Analytics Onchology
Cardiology Finance
Digital Dictation Clinical
Child Health System Community System
Patient Psych
Ecare Document Management
Integration BI & Data Warehousing
PACS Pharmacy
Pathology Maternity
Theatre RIS
A&E E Prescribing
Scheduling Discharge Letters
Diagnostic Reporting Order Comms
PAS
source: Digital Health Intelligence

6. Supplier Prevalencesource: Digital Health Intelligence
5Boroughs
Bolton FT
CMUHFT
East Cheshire
East Lancs
GMWestMHFT
MMHSCT
Pennine Acute
Pennine FT
Salford Royal
Stockport FT
Tameside FT
Christie FT
South Manchester FT
Wigan FT
0 5 10 15 20 25 30 35
sub-title
Xcelera Winscribe WinDIP Web Pharmacy Ward Watcher
Unisoft UG pro TTO meds TIMS Theatreman
TDHC TDBB Talking Point Synergy Symphony
Sunrise SQL SQL Somerset Cancer Register SLAM
Siemens Sharepoint Scanfile Rx Tracking Rhapsody
Review Prodacapo Prism PLICS Pharmacy
Patientrack Patient Flow Patient First Patient Centre Paris
Otter Ormis Oracle Olympus OCR
NOMAD NEP Mosaiq Modulus MIS
Miracle MetaVision Medway Medispeech Medisec
Medcon McKesson Masterlab Lorenzo LMX
LE LabCentre Keystone JCAPS iPharmacy
InView Integra Inpatient Flow Innovian In House
ICIS ICE ICBM ICAN IAPT
i.PM i.LAB i.CM Horizon Healthviews
Gecko Galaxy G2 Speech Evolution EuroKing
eTTO EPTS EPR ePMA Ensemble
EMIS eDischarge E3 E business Diamond
Dendrite DataGate DataCam Data Warehouse Data Academy
Dart CRIS Cost Master Corp Info Sys Concerto
Community Info DW CMiS Cloverleaf Clinicom Clinician
Clinical RTI Solutions CIRIS Chimera ChemoCare Centricity
CD View Ccube EDM CCH2000 Cassius Cascade
CareVue Care Plus Cardex Carddas Business Objects
Bloodtrack Bloodhound BigHand BEDS BedMan
Athena Ascribe Aria Amigos ALS
Agresso Advantis Advantage

7. The NHS IT landscape
PAS
system
PACS
system
Finance
System
Pathology
LIMS
system
Theatres
system
Observation
Vital Signs
system
Child Health
System
Cardiology
system
GP
systems
Privacy
& Information
Governance
Data Sharing
Platforms

9. QUANTITY of Software and Service Value
Q2 – changes to Q1
UNIT
PRICE
Cost of ongoing competitive
OPEN SOURCE supplier
market
TCO: no Vendor Lock-in
EXTRA
PROFIT
PRE-CONTRACT
CUSTOMER
DEMAND
1
Cost from a
CLOSED SOURCE
Supplier with natural
monopoly
2a
POST-CONTRACT
CUSTOMER
DEMAND
2b
PRE-CONTRACT
POST-CONTRACT

10. Its cheaper to own OSS
than rent closed source
£Xm
Project
Spend
CAPITAL EXPENSES
30%
Implementation
Consulting
30%
Training&
Support
OPEN SOURCE
Expense
Account
Yrs
0 for OSS
Varies but assume a
70/30 split
60% for OSS
10%
Hardware
Cost
Same for OSS
CLOSED SOURCE
Yrs
Same for both
0.5%
Strategy
Consulting
Not needed
for closed
source
30%
Licence
Cost

11. Create new capital value
source: NHS Manual
● For “in use” non-specialised property assets fair value
should be interpreted as market value for existing use.
For specialised property for which no effective market
exists, “fair value” is deemed to be the depreciated
replacement cost for a modern equivalent (MEA) asset
(i.e. one that is capable of delivering the same
throughput or volume of service). (Source: NHS
Finance Manual)
● i.e. The network/datacentre on which OSS is live can
attract the an MEA capital value equal to the value of
an equivalent closed source package license
● NHS Trusts will own the IP around their instance of OSS
● Can exploit and improve this capital in collaboration with
suppliers and partners

12. Help tackle the deficit!
● OSS allows you to innovate and create new
significant capital value from nothing!
● transfer license spend to development spend
● Save money from an ongoing highly
competitive supplier market
● avoid erosion of capital asset value from
software license amortisation
● Capitalise full software value to reduce deficit