What is GNU Health about

The Challenge: 

The Question: 

Is it possible to deliver good, universal and free health informatics in the Public Health System ?

The Problem: 

Today's Health informatics is mostly in the hands of private corporations. This poses a threat to universality and privacy in Public System

The Solution: 

GNU Health: Freedom and Equity in Healthcare with Free Software

Channels: 

It’s mostly about changing the arrogant and irrealistic medical system, which operates outside of the communities and is based on universal, cookie-cutter solutions.

 

We’ve started the process in 2006 - our organisation,GNU Solidario, started as an educational initiative. The initial goal was to create free software with education and academic programs embedded into it, which would be accessible to remote areas in Latin America for example (I have worked there for many years).

 

The longer I worked in some of the poorer countries, the better I understood that the pressing need is actually more basic - kids need good nutrition before they can go to school. And the ever present reductionist Model of Disease has to be changed into a holistic System of Health Promotion and Disease Prevention. There are various reasons why countries fail at providing the best care possible: too much privatization, too much technology supplanting good, basic policies. Doctors being more drug sellers than anything else. Omnipresent micro-specialization, which pushes medicine even more towards seeing a person as particular organs instead of a whole, complex, bio-psicho-social-spiritual being.

 

And so we shifted towards the creation of the System of Health, a system that would integrate care providers, institutions, individuals. A system rooted in the idea of Social and Integrative Medicine, which promotes education, good nutrition, family affection, physical exercise, and sanitary housing conditions, along with the state of the art innovations in the areas of precision medicine, (epi)genetics, bioinformatics, as the best and most sustainable public policies one can make. With this concept in mind,  GNU Health (any pronunciation is OK, but I like the concept of "new") was born in 2008.

 

A little bit later, GNU took its recent shape of The Free Health and Hospital Information System, which is available in a form of wiki - dynamic as the health (care) itself and consistently updated. It can be installed and used by hospitals, governments, institutions, under a free license. As health and care are parts of a complex, multi-etiological and anthropological issues, the system we’ve created allows management and analysis of a huge amount of data and aspects:

  • Individual and community management: demographics, domiciliary units, families, operational areas and sectors, ...

  • Patient management: Socioeconomics, lifestyle, encounters / evaluations, hospitalizations, lab reports, genetics, clinical history, ...

  • Health center management: Finances, stock, pharmacy , laboratory, Dx imaging, beds, operating rooms, appointments, supply chain management, human resources, …

  • Information management: Reporting, Demographics and Epidemiology

 

Access to this information and ability to interpret and understand it is a precondition to an effective (health) care system, and it has to complement the work of nurses, teachers, mothers and fathers, social workers and doctors… Our role is to provide these institutions with a system capable of handling and processing huge amounts of data, and based on these findings - craft optimized prevention and deploy effective teams to tackle challenges. Our maps, for example, can show in real time spots in which the outbreaks of dengue happens, allowing for fast reaction. But it does much more than that - it shows the relations between health and family violence and teenage pregnancy. It underlines social determinants. It grasps the relations between economy and well-being.

 

Later on, we have added more functionalities, for example, Universal Patient’s ID that supports centralisation of information about a person - this way you’re not a new patient to each one of your doctors, but your story is accessible to health professionals.The ID does not allow the duplication of either individuals or patient medical history at the health center. On the upcoming features, the GNU Health Federation, will allow to aggregate information coming from multiple contexts, and

 

GNU Health is, in fact, a philosophy. It is about multidisciplinary communities with various tasks that contribute to more effective, more empathetic, more patient and health-oriented care. It’s about a new mindset and a new attitude of health professionals, whose work cannot be efficient without a human approach to the patients and a deep understanding of their condition. Nutrition, exercise, prevention, information, empathy, affection, family, hygiene, education, technology, housing conditions - these and many more aspects have to be taken care of and supplement each other.

 

The system is being used in various places. In Argentina and Laos, it has been implemented by neurological and trauma rehabilitation and centers a few years ago. It is being installed in Argentina in districts to manage primary health centers. The Ministry of Health of Morelos, Mexico for the province. The biggest hospital in Laos, a reference in tropical diseases, runs on it as well. The government of Jamaica started a couple of years ago the implementation project for managing the Public Health system of the island.

 

These institutions and countries are independent now from proprietary solutions, which should be the integral principle in health care. Their work and experience help to improve the community. It’s a lot of solidarity, equity and community work as a result. And they’re free from external vendors, institutions, licenses, they can modify the modules and create new ones - for example, the module dealing with Injury Surveillance System was built in response to the needs in Jamaica.

 

Money helps us move faster, but it’s the people who make us achieve really remarkable things. We understand how medicine can be improved, changed, how it needs to be adjusted to the cultural setting, and based on individual needs, precisely addressed.

Comments

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Noemi's picture

Nice to meet you @meanmicio, I'm nowhere near as knowledgeable about health systems as you, but some people here in the community are and should definitely read this (they may  have already heard about GNU Health): @Ivan Ezeigbo @wachsmuth @markomanka who can maybe help share this with networks.

Are you finding that people and established institutions are transitioning to this easily (ideologically speaking) or what do you see is an average learning curve? I'm guessing it's not a coincidence that it's becoming adopted more so in less developed areas than the big West, which are already set on their ways. 

Thank you, @Noemi !

meanmicio's picture

Thank you, @Noemi !

South is showing North the benefits of Free Software in Healthcare .  No matter the hemisphere, we have to keep re-inforcing the concepts of Community, Freedom, Independence and Dignity. Many people still have the misconception - and find attractive - about "gratis" and not about "libre".  Whenever we get a request on GNU Health, I spend quite a bit of time making sure that they get the philosophy behind the project. So, the transition is happening, but there is quite a bit of work ahead in the "developed" world, where Health is in the hand of private corporations, far from being public and universal.

GNU Health is a sister

breathinggames's picture

GNU Health is a sister initiative which we discovered at the Open Source Initiative and some time later at the Internation Symposium on Open Collaboration.

GNU Health concept is simple as free software: all people should collaborate to build a common of knowledge instead of building competitive, exclusive systems that hinder access to healthcare services of quality. GNU Health ensures that the different therapists and doctors who follow our children have the best available information about them, so that they can provide the best advices for the best health outcomes.

Thanks for all efforts put in developing this project!

Thank you @breathinggames !

meanmicio's picture

Thank you @breathinggames ! It was great and inspiring meeting you at OpenSym, and looking forward to having you at IWEEE, GNU Health Con 2016 this November !

great vision!

asimong's picture

It's a great vision. Personally, I see a direct analogy with knowledge of using open source software. If we were to arrange ourselves into levels of knowledge, with one person at each level looking after a few at the level below, then all questions could be answered without the experts being overburdened. Why not the same with health? Well, the danger is undiagnosed serious conditions, and that has to be factored in somehow. But apart from that, it's what we do anyway in a small way. If there is something the matter, we start by asking maybe an older family member, then if that person is not sure, we can ask a nurse, then a general practitioner, then a specialist....

 

Not sure how relevant this is to GNU health, but I hope the idea is of some interest.

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