gnu health - philosophy and main functions dr. axel braun

GNU Health – philosophy and main functionsDr. Axel Braun CC-by-SA 4.0

GNU Health - Philosophy andMain Functions Dr. Axel Braun

[email protected]

DocB on Freenode.net

@coogor

@docb:matrix.org

[email protected]


About me….

Engineer by education

Business Consultant (SCM, SAP, PM)

Free Software advocate by conviction

GNU Health Core Team

openSUSE Board Member

OFE Experts Council


The Information Gap

Many practitioners offices and hospitals suffer from inadequate management systems

Software for business and hospitals are proprietary and expensive – too expensive in most cases

As a consequence, there is no overview about financial figures, patient records, surgery rooms, beds, pharmacy and stocks – just to mention some points


The solution: Free/Libre Software

Driven by the Free Software Foundation (fsf.org) and the GNU project (gnu.org), an ecosystem of software packages is growing that puts the users freedom at the first place

The worlds most successful operating system – GNU/Linux – is part of it as well as most programs that run the Internet

There is a medical solution as well – GNU Health


Free/Libre Software

‘Free’ does not just mean you can use it for free/gratis

Free/Libre software grants the four essential freedoms:

Run the software as you like

Distribute it

Study and change the code

Distribute the changed software

Free/libre Software is the basis for digital sovereignty


Proprietary vs. Free Software Development

* Overengineerd software

* Lobbying, Slow

* Upfront license fees

* Maintenance based on license costs

* High TCO

* Proven, extensible Enterprise Software

* Collaborative, Fast

* NO license fees

* Annual subscriptions for what you use

* Lower TCO

Typical ClosedSource model

Business OpenSource Model

It’s all about -THE CUSTOMER

It’s all about -VENDOR REVENUE


Financial Freedom with Free Software

For proprietary software you pay millions of dollars license-fee upfront

Use this money to

Strengthen your national health system

Build a local eco sytem around free software

Support the development

Take back control / Digital Sovereignty


GNU Health - a complete and free software stack

Official GNU Package, from the Free Software Foundation

Open Documentation

Relies on free technology

Friendly community


80% of diseases in LMICs due to poor sanitation / unsafe water (UN)


Over 20.000 Children die every day from Social Diseases

Human Trafficking

War

Contaminated Water

Malnutrition

Drug abuse

Chagas

Prostitution

Tuberculosis

Child Labour

Domestic Violence

Malaria

HIV /AIDS

Europe

United States


Healthcare needs to be holistic...

System of HealthSystem of Disease

Person

Family

HousingExercise

Transdisciplinary

Healing

Affection

NutritionCommunity

Disease

Patient

Meds

Reactive

curingInvasive

biological

Acute

Sophisticated

Education

Work

BioPsychoSocial

Proactive

health.gnu.org


Freedom and Equity in Healthcare

GNU Health is, first and foremost, a Social Project

...with really cool technology


Developed by GNU Solidario

Group pic from GNUHealthCon 2018 in Canary Islands


Projects from the GNU Health Ecosystem


Modular and extendable

GNU Healthcore module

SocioeconomicsFamily

Laboratoy(LIMS)

Hospital

Epidemiology

Genetics

Demographics

LocalizationEN,DE,ES,PT,….

ICD-10

COVID-19contact tracing

Dental

Disability

Gynecology

Ophthalmology

NTDneglected tropical

diseases

NursingPediatricsLifestyle

Pharmacy& Stock mngt

In/Out-PatientSurgeryCryptoReporting

Book of Life

AppointmentsFinancial

Accounting

...and many more


GNU Health – Main Functional Areas


Demographics / Social Medicine

Individuals

Family

Community


Individuals / Demographics

Universal Person Identifier

SocioeconomicsEducationLifestylePhysical exerciseNutritionWorking conditions...


Book of Life

Each page represents a relevant event in a persons life

Types of pages: Demographical, Medical, Biographical and Social

With their own categories, for instance :

* Social : Exclusion, Stress, lifestyle, family, violence, food, ... * Medical : Health condition, encounter, genetics, lab, surgery,...

Linked to HMIS processes (evaluations, health conditions, genetics...)

Easy to write and read by health professionals and patients

Easy to process by machines (industry and health coding standards)

Integrates and contextualizes the information

Pages and Books of Life


Families

Family Members and their rolesFamily Affection / Functionality LevelDomiciliary Units conformantsContacts info : Key for quickly locating them in outbreaks...

Example of a “nuclear family” . They may or may not share the same Domiciliary Unit


Housing – Domiciliary Units

Address / LocationConstruction materialNumber of rooms

Sanitary conditions

BathroomsSewersElectricity...

The DU shows the people currently living in it at any given moment

The DU can be geolocated / linked to OpenStreetMap


Electronic Health Records (EHR)

Patient management

Appointments

Prescriptions

MyGNUHealth


Patient management

Patient centric approach

Medication/Appointment/Surgery history

CAGE Alcoholism screeningSmilkstein Family functionality testHenningfield recreational drug classificationPediatric Psychosocial risk (PSC from MGH)NIDA recreational drugs Database


Managing Appointments

Tabular view in chronological order Use of external calendars, like ThunderbirdStandard CalDAV interface


Prescriptions

Digitally signedIntegration with Pharmacy , Medicaments, Billing


MyGNUHealth

The GNU Health Personal Medical Health Record

Under development (Alpha)

Runs on libre devices like PinePhone and all Desktops

Qt, Kirigami, Plasma

Stores values and documents locally – keep the ownership over your documents

Synchronisation with Federation


Enterprise Resource Planning / Hospital Management

Rooms/Beds/Professionals

Laboratory / Imaging

Pharmacy / Medicaments / Supply Chain

Precision Medicine

In/Outpatient Management

Surgeries / Intensive Care

Nursing / Ambulatory Care

Ambulance Mngt / Support Center

Pediatrics / Obstetics

Financial Accounting / Billing

New: Dental / Odontogram


Rooms / Beds / Professionals


Laboratory / Imaging


Precision Medicine


Pediatrics / Obstetics

Preconception and Prenatal CareGenetic Risks and counselingObstetric evaluations / imagingNutrition and growth chartsSocioeconomicsNeonatologyImmunizations Family Functionality and Affection levelPsychosocial Risk (Mass General Hospital PSC)


Dental Module


Ministry of Health / Analytics

Federation Model

Contact Tracing (COVID,….)

Vaccination Campaigns

Injury Surveillance System

Reporting & Statistics

Integration


The GNU Health Federation

Community based, community managed

Based on collaboration instead of competition

Independent. No Lock-ins

Integrates multiple sources and actors

Generates ethical economic model

Creates strong local community

Sustainable in time


GNU Health Federation - Nationwide

Unique ID & historyPerson demographics and medical history up-to-date no matter the health institution she goes across the country

Public Money, Public Code !

Empower the communityThe person is now an active player in the system of health

Libre Software: No hidden code, no blackboxes in healthcare.

Save millions of euros in licenses that can go to improve the public health system.

The health software will be a public good.

Improve quality of careHealth professionals have better and timely patient information. Saving time and providing better healthcare


Contextualized Patient Information

Federation Account : ESPGNU777ORGGene : BRCA1 (breast cancer 1, early onset)Locus : 17q21 Protein code : P38398 . URI : https://www.uniprot.org/uniprot/P38398Natural variant : VAR_007757 // p.Cys61GlyPhenotypes: DI-02602: Breast Cancer . MIM Code : 114480

DI-01655: Ovarian Cancer . MIM Code: 167000Onset age : -Family history: Mother : C50.1 Malignant neoplasm central portion of the breast

Grandfather (maternal): Q87.4Marfan SyndromeMedical History: Type 1 Diabetes (7y) / allergic to β-lactams // appendectomy (13y) Lifestyle: Ex-smoker //...

Genetics+

Family history+

Lifestyle+

Socioeconomics

The GNU Health Federation can help finding the answer to

many genetic natural variants of unknown clinical

significance


Argentina uses GNU Health to fight COVID-19

https://diamante.gob.ar/prensa/covid-19-seguimiento-de-casos-sospechosos-a-travs-de-un-mdulo-informtico-N5100


Injury Surveillance System

Records violent injuries (accidents, robberies, self harm, sexual assaults,... )GeoreferencedICD 10 encodedContextual information (place, time, subjects involved, … )Thanks to Jamaica MoH !


Integration


Want to help?

Programming

Packaging

Testing

Translation

Documentation

Marketing


Next Talk

Wed 17. Feb 2021

1730 UTC

Dr. Edgar Hagenbichler: GNUHealth - ICD-10 coding, recipes, referrals


Join us !

www.gnuhealth.org

@gnuhealth

[email protected]


Thank you!

Questions?

gnu health - philosophy and main functions dr. axel braun

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