Collaborative Contagion

Every day millions of parcels are shipped around the world, each tracked with bar codes and databases. Yet what FedEx has long achieved with boxes, few states have mastered when it comes to tracking infectious diseases. "We've used the same system for 15 years," says Dr. Bob Rolfs, Utah's state epidemiologist. "It's so old that we still largely depend on paper charts, faxes and the telephone."

By federal mandate, that antiquated system soon has to be replaced—an upgrade Utah, like many other strapped states, can ill afford. Rolfs' predicament is what Collaborative Software Initiative (CSI), a start-up based in Portland, Ore., was created to solve. The 12-person firm specializes in bringing larger organizations together to build software to address large-scale problems at a reasonable price. Tracking infectious diseases is its latest challenge. "It's all about economies of scale," says CSI founder Stuart Cohen. "We save bigger entities millions of dollars by pooling their resources and hiring us to do the dirty work."

At the heart of what CSI does is the idea that two (or 100) hands are better than one. It's a model very familiar to Cohen, the former ceo of Open Source Development Labs, the nonprofit consortium behind the Linux operating system and the Firefox Web browser. At CSI, launched with $1 million in venture capital, Cohen has again employed open source, allowing clients to adapt the firm's software to meet their needs. But he's monetized part of it. "We don't charge for the actual development," Cohen says. "Instead, companies pay us to service and manage the end product." Cohen expects annual subscription fees to be about 15% of development costs, which range from $250,000 to $3 million.

Since 9/11, the Centers for Disease Control and Prevention (cdc) has been building a national database to detect and monitor outbreaks of measles, tuberculosis and other diseases. But many products designed to help states do so are either too expensive or already outdated.

So CSI and the state of Utah—with help from Novell, its local tech company—have collaborated to assemble 15 core members, including doctors, nurses, epidemiologists and IT experts. Rolfs' staff reached out to local and county health officials to listen to their specific needs and then met regularly with CSI engineers, which let the developers revise the application frequently. "Open source allows us to provide high-quality software releases early and often," says Mike Herrick, the project leader at CSI.

Utah is now testing the resulting product, which should soon be available to all 50 states. Then each state will be able to adapt the product for free but will need to hire CSI to manage its maintenance through contracts that cost up to $450,000 a year. "We wanted to make sure that we build something useful, eventually to connect all states and the cdc," Cohen says.

To date, CSI's biggest customer is Wall Street, which needs data collection for regulatory compliance. Cohen's partner, Evan Bauer, formerly chief technology officer at Credit Suisse, has been using his clout with fellow ctos to persuade them to work with CSI rather than go it alone. It makes sense, since the same regs apply to all firms. "The dividends have been huge," Cohen says. "Public health is just the next frontier."