Sub-theme 7. Global health commons between pandemics and glocal health
Panel 7.2.
Open Source Hardware in the medical field
Over the past fifteen years, technological evolution allowed hobbyists and amateurs to gather, exchange information, and build innovative objects. They opened a new field of open source development; Open Source Hardware(OSH). A movement that aims to replicate the OSS model’s success but in the physical world with tangible resources. Over the past years, Open hardware products’ complexity drastically increased from merely printed simple objects in 3D to very ambitious and complex projects like an Open MRI. Some projects became real commercial successes, like Arduino, selling more than ten million units of its multipurpose electronic board. However, the comparative advantage with the proprietary model is not yet fully understood, and globally, literature is lacking due to the relative youth of the development model. The COVID pandemic recently acted as a catalyst for OSH projects that were suddenly under the spotlight worldwide. Communities helped healthcare workers to face the sanitary crisis with countless medical spare parts, respirators, or face shields projects. Although this common-based mode of production demonstrated a genuine capacity to propose pragmatical and decentralized solutions to this unprecedented situation of generalized supply chain disruption, a vast majority of these projects failed to reach the hospital bedside. These communities underestimated the gap between the willingness to share knowledge and functioning prototypes and a final product up and running in a hospital.
1. Trust Through Transparency: Provenance tracking via th Global Open Source Quality Assurance System (GOSQAS)
Global Open Source Quality Assurance System (GOSQAS), USA
The Global Open Source Quality Assurance System (GOSQAS) is an alliance of NGOs that believes in increased clinical acceptance of devices made from open source designs, or acceptance of devices produced through distributed manufacturing, can be achieved by increasing transparency around the quality and safety of these devices.
GOSQAS seeks to improve the safety and effectiveness of such devices by serving as a certifying body tailored to open source devices. The fundamental approach is expressed in the motto “Trust Through Transparency” (TTT). Devices will be tagged with a GOSQAS seal that contains URLs and identifying keys to look up all of the information maintained by GOSQAS. Fundamentally, a GOSQAS-certified device makes it convenient for an evaluator of quality to quickly discover (potentially):
1) The free-libre open source design upon which the device was made, allowing them to discover the reputation, academic writings, documentation, and testing of the design.
2) The provenance of the device itself via a public database, partially implemented with the now famous and infamous “blockchain” technology. This means that holding a device in your hands gives you a way to trace the complete manufacture and transport history of the device. This is MORE information than available for most traditional medical devices.
3) The complete provenance of the device, making it harder to sell a fake or counterfeit.
4) The detailed history of the tests performed on the device, by knowing who performed what documented quality assurance procedure or inspection at what date in what location.
2. How commons support innovative project development: Deep dive into the world of Innovation Commons
Erasumus University, The Netherlands
Innovation is often considered the holy grail of modern organizations. For a long time, innovation has been considered the result of genius or visionary’s epiphany. Research and empirical evidence have proved this assumption wrong. Modern theories suggest that innovations are often the result of circumstances that bring together knowledge previously dispersed among many actors. Thus, communities have become increasingly prominent and have been shown to be game-changers in software and, more recently, hardware development. These communities thrive when supported by digital or knowledge commons, bringing a flexible form of governance to develop and protect their collective work.
This paper focuses on an emerging form of commons: the innovation commons(IC). These commons are temporary and appear at the early stage of an innovation trajectory. They help to pool latent expertise that was initially distributed among various individuals. Hence, they contribute to assessing the feasibility of a project and to reducing any uncertainty about its execution.
We conduct a longitudinal case study of an OSH community developing a disruptive medical device and we propose a process theory to explain the temporal order and sequence in which these commons formed and disappeared.
Our paper also contributes to the nascent literature on ICs. Our case study confirms existing theories on ICs structure and further describes the disappearance of the innovation commons during project development. We provide empirical evidence that by creating the conditions needed to professionalize the community, IC was essential to the successful outcome of this decade-long collective project.
3. The material layer: only a question of energy?
Concordia University, Canada
In April 2022, I questioned whether we can “heal without redefining the rules that affect us,” and “whether medical regulations increase or hinder the capacity of a community of peers to rapidly identify and mitigate risks” (Balli and Carpentier, 2020, p. 20).
Today, I would like invite the group to explore the limits and potentials of open-source hardware through the metaphor of ourselves.
- What if we considered our physical body as fundamental hardware / infrastructure?
- To which extent do we own our body (in our social life, our dis-eases, our death)?
- How can FLOSSH principles help us preserve “our hardware” (from scarcity to abundance – Steiner, 1971)?
- Should we consider a right to repair, and a duty to take care?
- What may we miss when focusing on the tangible (mechanomorphism – Waters, 1948)?
This reflection is embedded in a practice of co-creating open-source games and controllers that rely on the breath (Balli et al, 2021). A practice that brought me to question what “breathing freely” can mean (Davchevski, 2021).
4. Les Free and Open Source Licenses (licences libres)
The Innolegal Firm, Switzerland
dont les effets juridiques décloisonnent et rivalisent les biens immatériels soumis au copyright (droits d’auteur) – constituent le centre névralgique du phénoménal succès planétaire des logiciels libres. Sans ces contrats-type, les communautés de contributeurs qui développent ces technologies en commun auraient eu grande peine à se structurer ou, en tout état, à se déployer avec la force et l’efficacité que l’on connaît. Depuis les années 2000, le progrès technique a permis d’envisager des modèles de développement technologique similaires qui s’orientent, non plus (seulement) sur les bits, mais sur les atomes. Le Open Source Hardware, dit aussi Libre Hardware, fait émergence, et promet de poursuivre son ascension. Néanmoins, son socle juridique est plus délicat et hétéroclite, car, contrairement aux modèles Open Source Software, les licences libres, conçues d’abord pour le copyright, ne suffisent pas à garantir à elles seules une sécurité juridique adéquate ; ce d’autant plus que le jeu s’opère dorénavant aussi dans le monde physique. Un usage du droit des brevets d’invention ou des designs industriels lorgne, mais effraie encore et ne résoudrait pas tout. Des Open Source Hardware Licenses ont certes été promulguées, mais qu’en savons-nous ? Enfin, qui doit se rendre responsable de cette soudaine mise en liberté des forces de la technique ? Face à tant d’incertitudes, il conviendrait d’établir des règles du jeu, en commençant par définir comment celui-ci fonctionne.
