To develop software specifically designed to improve the ability to perform biostatistical analyses of data routinely collected in a variety of settings of care. To encourage distributed processing by deploying a prototype that could be widely applicable and amenable to further extensions.

We have designed a prototype defined as H+ MetaBase, which has the following features: a statistically oriented metadata representation; functionality on a distributed environment; ability to include clinical concepts; distribution of the processing load across sites; integration of the results through a specialised statistical engine; secure communication between sites; a common interface; based on open source.

The system has been implemented through the development of five fundamental components: a query builder, a query spooler, a partial analyser, a meta-analyser and a results viewer.

Standards, programming languages and protocols used include XML, Python, OpenSSH and the Apache Web Server for functions related to the interface and related queries. Statistical routines have been developed using SAS.

The server side application was based on a Linux platform, while three Windows NT/XP workstations were used to simulate a distributed system.

The final prototype has the ability to execute distributed queries and produce results in terms of summary statistics, univariate analysis and multivariate graphs.

The system is also extensible and allows users to customise its use to their particular case.

An example using a large database of hospital admissions has been used to test its functionality. This application has shown that statistical analysis using H+ is feasible and reliable, and that the system can be used on a routine basis in real life situations.

Software and demo are freely available as open source at a web repository that also includes other libraries: http://hplus.med.monash.edu.au.

Application of statistical analysis on distributed health databases is possible with minimal hardware/software requirements and limited assistance from skilled technicians.

The H+ MetaBase prototype, although limited in the available options, provides a foundation platform whose capabilities may be further developed and advanced.

Open source solutions may be essential to deliver easy to use, inexpensive and effective solutions.

However, knowledge exchange and multidisciplinary collaboration for health information systems need to be enhanced.

Development of a H+ web repository may constitute a strategic step in this direction.