Why Participate in 4S?

Many telemedicine projects have started with a natural focus on the new and innovative patient treatment and with less focus on the technology, either by basing the technical solution on one of the already existing expensive commercial telemedicine platforms, or by developing a new system from scratch – often re-inventing the proverbial wheel rather than integrating with existing systems that are already in use.¹⁾ The result being an impractical and/or expensive silo solution.

The page about what 4S is outlines how this situation can be improved by sharing open source modules in an ecosystem and by using (international) standards.

This page will explain how participation in this 4S ecosystem can benefit a variety of people and organisations in various ways.

• I would not implement my own sound or video processing library or a network stack for my software products, rather I would take an existing (open source) software library and use that instead. In the same way, I would take an existing (open source) library for handling telemedicine data rather than implementing one myself.
• Using the implementations of international standards found in the 4S libraries will open the doors to an international market for my software product.
• As a small enterprise, I cannot afford to develop huge healthcare systems at my own risk. However, I can offer my services for implementing single modules or adding new features to the existing open source code-base in 4S.

• Through 4S participation, I can influence the software for my own good – my employees are going to use it in the future.
• Due to the open source model, I am not bound by any provider – no vendor lock-in – and I experience more competition between providers. I also like the fact that I can choose the most competent / cheapest / (insert your favourite criteria here) provider for each task.
• Furthermore, the open source model opens up for more new (SME) providers whom I can choose between (and as a public purchaser I have the opportunity to support local SME providers).
• The (international) standards used by the 4S libraries ensures easier cross-system (and cross-sector) data sharing.
• Rather than ordering a big system development, I can (with the assistance of 4S) define smaller clearly individual components with well-defined interfaces, each of which can be developed by different providers on different contracts. This loose coupling has the advantage of lowering the system complexity. As a public purchaser it is even possible for me to keep the individual size of these parts small enough to keep the price-tags below the de minimis threshold of the EU public procurement regulations.
• As I order the development of components for a telemedicine system, I insist that the provider uses 4S libraries and deliver the newly developed code back to 4S on their terms. I realise that this is more expensive up-front, however, my contributions to the 4S code-base will benefit others (possibly including myself in the future), while the contributions others make on similar terms, will benefit me – even more than the value of my initial extra cost.
• If I find that another healthcare purchaser (perhaps using a different telemedicine platform) needs the same kind of functionality I am planning to buy, we can work together and share the development costs – rather than developing the functionality twice.

• Through 4S participation, I can influence the software for my own good – I am going to be using it in the future.
• Due to the ecosystem, I will find different software vendors offering different interoperable flavours of the same functionality, increasing the probability that I can find an app(lication) tailored to suit my particular needs.
• [Patient]: I need only a single app to manage all my conditions, and it will communicate the relevant data to the relevant caregivers, no matter which systems they use.
• [Hospital Clinician]: I get all the information about my patients in my electronic health record system, I do not need multiple applications in my daily work. It does not matter which general practitioner or other hospitals my patients go to.
• [General Practitioner]: I get all the information about my patients in my preferred application. It does not matter what conditions my patients suffer from or which hospitals my patients go to.

• What is 4S?
• Where did 4S come from?
• Where is 4S going?