The NHS has selected US developer Basho's open source database Riak to underpin its efforts to rebuild its Spine infrastructure.
The new project, dubbed Spine2, will replace the existing infrastructure that was implemented as part of the ill-fated NHS National Programme for IT (NPfIT).
NPfIT was slammed by MPs this month for being the "worst and most expensive contracting fiasco in the history of the public sector".
One of the key criticisms of the NPfIT – which was scrapped but cost taxpayers nearly £10bn – was that there should have been an agile development methodology applied from the start.
The Department of Health is attempting to fix the issue by using open source software, which is more agile than proprietary technology.
"The Riak NoSQL database replaces Oracle's relational database, which isn't just a switch from proprietary technology to open source, it also gives the NHS more agile and technical capabilities," said Laurent Lachal, senior analyst at research firm Ovum.
Lachal explained that other benefits of moving from Oracle's database to Riak include "lowering costs, adding more flexibility into the delivery of the project and ensuring that the project will keep on track rather than getting derailed because it is too large and ponderous".
However, he warned that agile is "quite a challenge for large, established organisations".
The Health and Social Care Information Centre (HSCIC), which runs the Spine2 project on behalf of the NHS, told Computing that it could not comment further on the new IT backbone, but said that further developments would be released in the new year.
In a statement released by Basho, the US firm claimed that the NHS selected Riak because it could "deliver a more flexible and resilient solution".
It added that the solution would enable NHS developers to make changes to Spine2 without the need for expensive systems integrators.
But Lachal claimed that any integration would occur on top of the database that the NHS has chosen.
"The integration costs will still be there but, because of agile, they will be able to make adjustments to really focus on the top priorities and ensure that they keep the cost of integration in check," he said.
Lachal went on to say that the NHS has been using open source software in numerous projects of late.
"Not just in the backend systems but also on the desktop with things like Linux. It hasn't really taken over in terms of [big] IT projects [in the NHS] but it is getting there," he said.
The Spine2 project will replace Spine1, which, at its peak, was managed by more than 2,000 staff and was supported by 1,000 servers. It is currently in the last phases of testing and is due to go live in early 2014.