Monthly Archives: December 2020

GNUHealthCon 2020. Social Medicine in a time of pandemic

16 Wednesday Dec 2020

Posted by in events, GNU Health, GNU solidario, KDE

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It was not easy… we’re so used to celebrate the GNU Health Conference (GHCon) and the International Workshop on eHealth in Emerging Economies (IWEEE) in a physical location, that changing to a virtual conference was challenging. At the end of the day, we are about Social Medicine, and social interaction is a key part of it.

The pandemic has changed many things, including the way we interact. So we decided to work on a Big Blue Button instance, and switch to virtual hugs for this year. Surprisingly, it work out very well. We had colleagues from Gabon, Brazil, Japan, Austria, United States, Argentina, Spain, Germany, Chile, Belgium, Jamaica, England, Greece and Switzerland. We didn’t have any serious issues with the connectivity, and all the live presentations went fine. Time zone difference among countries was a bit challenging, specially to our friends from Asia, but they made it!

Social Medicine, health literacy and patient activation

The non-technical talks covered key aspects in Social Medicine, Citizens, health literacy, patient activation and Global digital health records, given by Dr. Richard Fitton, Steve and Oliver, two of his patients. Armand Mpassy talked about the challenges about GNU Health for IT illiterate Case study: Patient workflow at the outpatient service.

Individual privacy and crypto

On privacy and cryptography subjects, we had talks from Isabela Bagueros from Tor, Surviving the surveillance pandemic, Ricardo Morte Ferrer on A proposal for the implementation of a Whistleblower Channel in GNU Health, and Florian Dold on GNU Taler: A payment system by the GNU Project.

openSUSE Leap, packaging GNU Health and Orthanc

On operating systems, Doug Demaio from openSUSE talked about The big Change for openSUSE Leap 15.3, the new features on the upcoming release of this great distribution, bringing sources of SUSE Linux Enterprise (SLE) closer to the community distribution. I can not stress enough the importance of getting professional support on your GNU Health installations. Health informatics should not be taken lightly, and is key to have a solid implementation of the underlying operating system components, to get the highest levels of of security, availability and performance in GNU Health.

Axel Braun, board member openSUSE and core team member of GNU Health, focused on packaging GNU Health and the openSUSE Open Build Service (OBS). The presentation Hidden Gems – the easy way to GNU Health, put the stress on making GNU Health installation even easier, in a self-contained environment.

Sébastien Jogdone, leader of the Orthanc project, presented Using WebAssembly to render medical images, an open standard that allows to run C/C++ code on a web browser. This is great news since GNU Health integrates with Orthanc PACS server.

Qt and KDE projects in the spotlight

If we think about innovation in computing, we think about Qt and KDE. GNU Health integrates this bleeding edge technology in MyGNUHealth, the GNU Health Personal Health Record for desktop and mobile devices that uses Qt and Kirigami frameworks.

Aleix Pol, president of KDE e.V., presented Delivering Software like KDE, putting emphasis on delivering code that would be valid for many different platforms, specially mobile devices.

Cristián Maureira-Fredes, leader of the Qt for Python project, in his presentation Qt for Python: past, present, and future!, talked about the history and the upcoming developments in the project, such as PySide6, the latest Python package and development environment for Qt6. MyGNUHealth is a PySide application, so we’re very happy to have Cristián and Aleix on the team!

Dimitris Kardarakos, presented a key concept on modern applications, that is convergence, the property of the application to adapt to different platforms and geometries. His talk Desktop/mobile convergent applications with Kirigami explained how this framework KDE framework, that implements the KDE Human Interface Guidelines, helps the developers create convergent, consistent applications from the same codebase. MyGNUHealth is an example of a convergent application, to be used both in the desktop as in a mobile device.

I did go into details on MyGNUHealth design in my talk, MyGNUHealth The GNU Health Personal Health Record (PHR).

Argentina leading Public Health implementations with Libre Software

Many years of methodical and intense hard work in the areas of health informatics and public health have paid off. The team lead by Dr. Fernando Sassetti, head of the Public Health department of the National University of Entre Rios, has become a reference in the world of public health, Libre Software in the public administration, and implementations of GNU Health in many primary care centers and public hospitals in Argentina.

The National Scientific and Technological Promotion Bureau (Agencia Nacional de Promoción Científica y Tecnológica), chose Dr. Sassetti project based on GNU Health as the system for management of epidemics in municipalities. Health professionals were trained in GNU Health epidemiological surveillance system, as well as the contact tracing functionality.


Ingrid Spessotti and Fiorella de la Lama on their talk Outpatient follow-up and home care of patients with suspected or confirmed COVID-19, explained some of the functionality and benefits of these GNU Health packages, for instance:

  • Real-time observatory and epidemiological surveillance
  • Automatic notification of notifiable disease to the National Ministry of Health
  • Reporting on cases and contacts
  • Calls registry, monitoring of signs and symptoms.
  • Risk factors on each individual (eg, chronic diseases, socioeonomic status…)
  • Geolocalization of suspected or confirmed cases
  • Clinical management and followup for both inpatient and outpatient cases.

Carli Scotta and Mario Puntin, presented the Design, development and implementation of a Dentistry module for GNU Health: experience at the Humberto D’Angelo Primary Care Center in Argentina, a package that will be the base for the upcoming dentistry functionality in GNU Health 3.8 series.

The GNU Health Social Medicine Awards 2020

GNU Health is a social project. In every GHCon, we recognize the people and organizations that work to deliver dignity to those who need it most around the world.

Our biggest congratulations to Prof. Angela Davis, Proactiva Open Arms and Diamante Municipality!

As you can see, we still can do great conferences in the context of the pandemic. I hope to see you and hug you in person at GHCon2021.

In the meantime, stay safe!

For this and past editions of GNUHealthCon, you can visit www.gnuhealthcon.org

GNU Health pioneers the adoption of WHO ICD-11 and ICHI standards

11 Friday Dec 2020

Posted by in GNU Health, GNU solidario, HMIS, Public Health

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GNU Health and the World Health Organization

The GNU Health project believes in coding standards, specially in those that can be widely used. In 2011, the United Nations University (UNU) adopted the GNU Health Hospital Management Information System (HMIS) component, in part because of its strong focus in social medicine and environmental health, but also because it complied with most of the World Health Organization standards.

Using WHO standards is key for global health. The GNU Health federation provides timely and accurate health information to citizens and health professionals globally. We are able to generate this large, distributed networks of information thanks to protocols and standards, that permit the aggregation of data from thousands and even millions of nodes.

GNU Health at the United Nations – International Institute for Global Health

GNU Health HMIS provides many WHO standards and UN models, such as:

  • ICD-10, International Classification of Diseases, tenth revision
  • ICD-9, Volume 3, for coding procedures
  • ICF, International Classification of Functioning, Disability & Health
  • ICPM, International Classification of Procedures in Medicine (to be replaced by ICHI)
  • WHO List of Essential Medicines
  • Pediatric growth charts
  • Vaccination schedules
  • MDG / SDG (Millennium Development Goals / Sustainable Development Goals, such as the MDG6 to tackle HIV, Malaria and Tuberculosis

Health professionals, institutions and governments around the world can trust GNU Health as the WHO compliant Hospital Management and Health information system.

GNU Health training for WHO Africa Regional Officers

Throughout these years, GNU Health and WHO have been cooperating in areas of Universal Health access, Mother and Child health or campaigns to fight HIV/AIDS, Malaria and Tuberculosis.

It has been nearly a decade of work, at the technical, functional and community level. The training of WHO regional officials, as well as to the health professionals have had a quite positive impact. Proper coding using WHO standards in GNU Health, both for health conditions and procedures / interventions result in good quality, epidemiological reports, better management of the internal resources and improved health promotion and disease prevention campaigns.

First newborn registration in the GNU Health implementation at Cameroon district hospital

Moving forward: ICD-11 and ICHI

The current International Classification of Diseases, tenth revision (ICD10) has been of great help to standardize coding health conditions, but it has its limitations and it definitely needs a review in both the coding system itself as well as the need of specific health areas.

To overcome these limitations, the World Health Organization started ICD-11, the latest revision that includes many more health conditions, the much needed areas of mental health and sexual health, as well as a great method to combine conditions, called cluster coding or postcordination. Cluster coding allows the combination of two terms in for the condition. This concept brings much more flexibility and contextualization.

In terms of health procedures, the International Classification of Health Interventions (ICHI) is estimated to be released by the end of this month. ICHI will replace the International Classification of Procedures in Medicine (ICPM).

The International Classification of Health Interventions will become the standard coding system for reporting and analyzing health procedures. In words from WHO, “the classification provides Member States, service providers, managers, and researchers with a common tool for reporting and analyzing health interventions for statistical, quality and reimbursement purposes.“.

ICHI delivers a coding method based on three axes: Target, Action and Means. It is valid for all context of health (primary care, surgical, dental, nursing, community health). It contains over 7000 interventions that can deliver at an individual or population basis.

GNU Health leads the integration of WHO References

Depending on the individual and environment, a particular pathology can have different clinical representations of the disease. Diabetes mellitus (DM) can be controlled or can have devastating consequences for the individual. Most of the times the socioeconomic determinants play a key role on the epidemiology, clinical outcomes and disease progression, and assessing health as a whole – from the molecular basis to the socioeconomic determinants – is one of the areas where GNU Health excels.

GNU Health provides the WHO International Classification of Functioning, Disability and Health, that has been key in many context, to assess the impact of the environment in many patients. This was studied in the GNU Health implementation in Laos (see my post “GNU Health: Helping Laos Heal from UXO physical and emotional trauma.“).

WHO diagram on relations among reference classifications

GNU Health is ICD-11 ready, and waiting for you

The upcoming release 3.8 for the GNU Health HMIS component includes de ICD-11 Morbidity and Mortality Statistics (MMS) linearization, as well as the existing ICF package. We are waiting for WHO to release the stable version of ICHI.

The ICD-11 will officially come into effect on 1 January 2022, so we have a year to train and get used to it. The GNU Health HMIS community server can be your perfect training companion. It’s online 24×7 and you can test the new codings in this server.

At this point, you can already start testing the ICD-11 functionality, and how it interacts with the other references as the ICF. Of course, you can become part of the GNU Health team, either as an end-user of as a member of our development and research team, and provide feedback and improvements!

These new additions will be of great help to achieve our common mission towards Universal Health Coverage and Sustainable Development Goals. At the end of the day, GNU Health is a social project that uses really cool Libre technology. I am positive that the immense majority of our health related problems, both at individual and population level, can be solved by means of Social Medicine.

As Dr. Rudolf Virchow said, Medicine is a social science, and politics is nothing else but medicine at a larger scale.