Technical Platforms

Comparison of Technical Platforms

The mission of OursMedicina is to provide free, accurate and regionally unbiased healthcare information to the world. We strive to accomplish our goal by facilitating two main mass-collaborative information stores:

1.

General Healthcare Information

Generalized healthcare will include comprehensive information about diseases, procedures and pharmaceuticals presented in a fashion that the general public could understand. These articles will also be available in many different languages.

Generalized healthcare information will also include region-specific information. The differences and similarities between protocols, procedures and treatments globally must be available in a unbiased format online to improve the quality of healthcare.

2.

Medical Services/Products Rating

Medical services ratings will include both patient and physician assessment of medical services around the world. Patients will have the opportunity to rate their physicians as well as their hospitals on a relevant set of metrics. Physicians, in turn, will have an opportunity to assess each other based on experiences working with each other.

Medical products ratings will include consumer assessment on a variety of medical products including pharmaceuticals. The addition of medical devices for rating by physicians is also a possibility for this section.

Providing a resource of this magnitude will require significant participation from the international medical community as well as input from medical product and service customers. In order to facilitate such collaboration with a non-profit model, the technical components for OursMedicina must be open, engaging, stable, fast, scalable and cost-efficient as well as user-focused.

We will also investigate the various technical software options that have been narrowed down by these components, they will include: MediaWiki and Confluence.

Table of Contents

Technical Components

1.

Open-source 2.

Collaborative 3.

Code Stability 4.

Accessibility 5.

Scalability 6.

Cost-Efficiency

Technical Software Overview

1.

MediaWiki/OTRS 2.

Confluence/JIRA

1.

Open-source

Open-source applications are a necessity to our organization for several reasons: they allow for customization, longevity and independence in the long-term. Maintaining open-source software will also allow us to collaborate with other open-source projects and utilize a world-wide developer community.

2.

Collaborative

The software must be collaborative in nature; it must encourage participation and editing by the community as well as newcomers. The largest key is decreasing the barrier to entry so that non-technical contributor can edit, and this can be accomplished by way of a WYSIWYG (Plain Text) editor. In the case of OursMedicina, our target (editorial) audience will be composed of the following:

1.

Medical Doctors (Practicing) 2.

Medical Doctors (Research) 3.

Medical Students 4.

Other Medical Professionals 1.

Clinical Professionals 1.

Physician Assistants 2.

Nurses 3.

Other Assistants 2.

Tertiary Professionals 1.

Doctorates (Science) 2.

Masters (Science) 3.

Bachelors (Science) 5.

Interested Laypeople

3.

Code Stability

Base code stability is a key in the decision, as ongoing updates and software support must be available for the long-term. The platform chosen should have been through several revisions, tested in high-stress applications and proven with real-world examples. Also, platforms should have a minimum of 5 years of operational history, to ensure the overall stability and future of the application.

4.

Accessibility

The accessibility to the site is one of the largest factors to consider. We must design a system that allows for easy, intuitive editing by our primary editorial community, listed above. Since the majority of the aforementioned community does not possess advanced technical skills and knowhow, we must provide a WYSIWYG editing system that does not require proficiency in HTML mark-up or Wikitext mark-up. The plain-text editing tool is crucial because it significantly decreases the barrier to entry for medical professionals as well as the rest of the community. Also, since some editors prefer Wikitext mark-up, the option to edit in that syntax should also be available. Interoperability between Wikitext and Plaintext is a fundamental feature that must be included in the chosen software platform.

5.

Scalability

Scalability should be taken into consideration for the long-term future of the site and an application stack that is cheaply and quickly scalable is key. The ideal solution would minimize hardware resources as site activity increases. A fully scalable solution does not correlate hardware with users linearly, instead, different server roles are established and hardware resources are minimized. The software solution should have a fully scalable plan in plan that has been tested with real-world examples.

6.

Cost-efficiency

Cost-efficiency is a major factor in choosing the platform. The ideal platform stack would include free software, cheaply scalable hardware and minimized bandwidth usage.

Technical Software Overview

MediaWiki

1.

Open-source

MediaWiki is open-source software that is freely available from the Wikimedia Foundation.

2.

Collaborative

MediaWiki is used by the Wikimedia Foundation and is currently the largest public collaboration project on the Internet. A deeper analysis of the Wikipedia editorial community shows a correlation with the 90-9-1 theory, which stipulates that 90% of the users are pure users and only read/browse, 9% contribute sparingly and 1% participate often and account for the majority of the contributions. 1 MediaWiki is a prime example of a successful collaboration platform, as several other sites utilize its technology, including: Wikia, Wikihow, WOWwiki, etc. MediaWiki features various editable pages including user profiles, adminstration, discussions, portals and plug-ins. MediaWiki caters towards more technically-minded editors as all pages are fully customizable by Wikitext and html, versus plain-text editing.

3.

Stability

MediaWiki has gone through numerous revisions through its 6 year development, and has demonstrated stability in various public instances through periods of high-traffic and high-load. There are various installations of MediaWiki worldwide, notably sites under Wikimedia, Wikia, Wikihow and several others.

4.

Accessibility

Universal accessibility can be broken down into two main components: end-user and editorial accessibility.

1.

The reader experience on MediaWiki-powered sites is relatively high; it is a very simple interface that is content-rich and minimalistic. Users can access the information quickly and easily in a format that is direct and simple. 2.

Editorial accessibility, however, is much more limited. The editing base is based upon Wikitext, which requires basic html knowledge and a several hour-long learning curve. This barrier to entry provides a significant hurdle to the mass public for editing, and in the case of OurMed, specifically, to the medical community.

In terms of plain-text or WYSIWYG editors, here are the key editors with the most support and their features:

1.

FCKEdit â€“ This editor is currently in version 2.6 and displays Wikitext-to-plaintext parsing both ways. It has been in development since 2003 and supports ASP, ASP.NET, Java, ColdFushion, Perl, PHP, and JavaScript.. 2.

TinyMCE- This editor is currently in version 3.0.6.2 and is platform-independent based in JavaScript. This editor has wide integration with open-source systems including Mambo, Joomla!, Drupal and WordPress.


 * There are endless debates on which one of these editors is the best WYSIWYG tool; outside consultation and discussions have yielded mixed results. Suffice to say that either will work and it will be left up to the developer to decide.

5.

Scalability

The scalability of MediaWiki is one of its most important features and is recognized by the open-source community world-wide. MediaWiki is highly efficient, scalable and has several papers published that explain this process (Courtesy of Domas)2.

6.

Cost-efficiency

In terms of hardware costs to users as the site grows, MediaWiki will provide an excellent resource as the hardware requirements have been tested and revamped for this reason by the Wikimedia Foundation.

Atlassian (Confluence, JIRA)

1.

Open-source

Atlassian software provides open-source licenses to non-profit organizations and open-source projects such as ours. We have already secured both an open-use and open-source license from Atlassian, which are renewed on a yearly-basis. With this access, we can modify code at will and customize it to our specifications.

2.

Collaborative

Confluence is a collaborative environment much like MediaWiki, the largest difference is it was originally designed for enterprise-level collaboration. It features blogs, discussion forums, user administration, workspaces and plug-ins. The Confluence engine was designed to cater to non-technical minded editors and thus focuses on plain-text editing. There are many instances of Confluence in use, both in the private and public sectors; for private sector installation, SAP has over 750,000 users; most of which actively contribute to the intranet. For public installations, openspaces.org, wikipatterns.org, adaptavist.org, and beanlet.org to name a few. 3

3.

Stability

Confluence exhibits robust stability, as evidenced by its large-scale corporate enterprise installations. 4 Confluence has been established since 2002 and has several reputable large-scale clients including SAP.

4.

Accessibility

Since Confluence has been designed for editing by the non-technical user, its accessibility is universal. It includes a built in WYSIWYG editor (currently TinyMCE) for editing as default. This editor also allows parsing to and from Wikitext. In terms of overall design, the interface is more catered towards non-technically minded users.

5.

Scalability

Fully scalable application, to as much hardware as necessary, all within the scope of our license. It has scaled to over 750,000 users corporately.

6.

Cost-Efficiency

Similar cost-structure to scaling with MediaWiki. An example of user to cost, for 21,000 users, the hardware requirements would be 2 CPUs, a total of 3.6ghz and 4GB of memory. Once user load and activity reaches a certain number, clustering and load-balancing are tested solutions for large-scale deployments. 4

1 http://www.wikipatterns.com/display/wikipatterns/90-9-1+Theory

2 http://www.scribd.com/doc/43868/Wikipedia-site-internals-workbook-2007

3http://confluence.atlassian.com/display/DISC/Live+Customer+Sites+Powered+By+Confluence

http://akamai.infoworld.com/Atlassian_Confluence/product_84798.html?view=1&amp;curNodeId=0

4http://confluence.atlassian.com/display/DOC/Server+Hardware+Requirements+Guide