Mr Andy Rae1,2, Mr Jonathan Couldridge1, Ms Vasiliki Panagi1, Dr Tim Beck1, Professor Philip Quinlan1,2
1Centre for Health Informatics, University of Nottingham, Nottingham, United Kingdom, 2Nottingham University Hospitals, Nottingham, United Kingdom
Biography:
Andy Rae is a software engineer working at the intersection of health informatics, open source, and real-world impact. Based at the Centre for Health Informatics at the University of Nottingham, Andy works across research, hospitals, and national programmes – including HDR Federated Analytics, the NHS SDE Programme, and DAREUK Trevolution – to help turn technical ideas into practical change.
0009-0004-8544-2576
Abstract:
Introduction
Bunny is a lightweight, open-source tool for patient Cohort Discovery on health datasets. But the real insight is in how it spread, and what that means for anyone trying to get software adopted in complex environments.
Built to solve a specific need inside the English National Health Service (NHS), Bunny was designed for simplicity, rapid deployment, and community ownership. Within months, it was adopted by 80% of NHS Secure Data Environments (SDEs). It is also in use at Clinical Practice Research Datalink (CPRD), covering over 40 million patient records.
This is a case study in collaborative tooling: how open infrastructure can gain traction in the NHS, what makes adoption possible, and why technical delivery alone isn’t enough without trust, timing, and a human approach.
Methods
We worked directly with SDE teams, assembling early adopters into a shared user group. Bunny was released under an MIT license, with documentation, and user feedback loops. Contributions were encouraged early and integrated quickly, creating momentum and shared ownership.
Results
Eight SDEs are now using Bunny, with five actively contributing to the codebase. Adoption required no formal mandate. Instead, this was achieved with only a tool, storytelling, and an ecosystem approach. Bunny now supports live Cohort Discovery on real data and is shaping future open-source efforts across the SDE programme.
Conclusion
Code alone doesn’t make impact. Bunny succeeded because it was trusted, usable, and open. Its journey shows how we can build shared and sustainable infrastructure in healthcare, by enabling empowered teams and collaboration.