Tag Archives: GNU Health

Jérôme Lejeune Foundation adopts GNU Health

14 Saturday Jan 2023

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We start 2023 with exciting news for the medical and scientific community!

GNU Health has been adopted by he Jérôme Lejeune foundation, a leading organization in the research and management of trisomy 21 (Down Syndrome) and other intellectual disabilities of genetic origin.

Lejeune foundation has its headquarters in France, with offices in Argentina, the United States and Spain.

On December 2022, the faculty of engineering from the University of Entre Rios, represented by the dean Diego Campana and the head of the school of Public Health, Fernando Sassetti, formalized the agreement with the president of the Lejeune foundation in Argentina, Luz Morano.

The same month, I met in Madrid with the medical director and IT team of the Lejeune foundation Spain.

Luz Morano declared “[GNU Health] goes beyond the Foundation, providing the health professionals the specific features to manage a patient with trisomy 21. We are putting a project in the hands of humanity“

[GNU Health] goes beyond the Foundation, providing the health professionals the specific features to manage a patient with trisomy 21. We are putting a project in the hands of humanity

Luz Morano, President of Lejeune Foundation, Argentina

Morano also stated: “GNU Health will pave the road for the medical management, and let us focus on our two other missions: Research and the defense of patient rights“

The agreement is in the context of the GNU Health Alliance of Academic and Research Institutions that UNER has with GNU Solidario. In this sense, Fernando Sassetti explained “It provides tools for an integrative approach of those people with certain pathologies that due to the reduced number are not managed in the best way. This will benefit the organizations and health professionals, that today lack the means to do so in the best way and timely manner. It benefits the patients, in their right to have an integral health record.”

Research and Open Science

The adoption of GNUHealth by the Jérôme Lejeune Foundation opens new exciting avenues for the scientific community. In addition to the clinical management and medical history, GNU Health will enable scientists to dive into the fields of genomics, epigenetics and exposomics, gathering and processing information from multiple contexts and subjects, thanks to the distributed nature of the GNU Health Federation.

The GNU Health HMIS counts many packages and features, some of them of special interest for this project. In addition to the specific customizations for the foundation, the packages already present in GNUHealth, such as obstetrics, pediatrics, genomics, socioeconomics or lifestyle will provide a holistic approach to the person with trisomy 21 and other related conditions.

All of this will be done using exclusively Free/Libre software and open science.

People before Patients

Trisomy 21 poses challenges for the individual, their family, health professionals and the society. The scientific community needs to push the research to shed light on the etiology, physiopathology and associated clinical manifestations, such as heart defects, blood disorders or Alzheimer’s.

Most importantly, as part of the scientific community, we must put a stop to the discrimination and stigmatization. We must tear down the barriers and walls built on our societies that prevent the inclusion of individuals with trisomy 21.

As part of this effort, GNU Health provides the WHO International Classification on Functioning, disability and health (ICF). In other words, is not just the health condition or disorder we may have, but how the environmental factors and barriers influence the normal functioning and integration as individuals in the society. Many times, those physical, artificial barriers present in our daily lives are way more pernicious than the condition itself.

The strong focus of GNU Health in Social Medicine, and the way we perceive medicine as a social science will help improving the life of the person living with trisomy 21, and contribute to the much needed healing process in our societies. We need to work on the molecular basis of the health conditions, but little can be done if without empathetic, inclusive and supportive societies so people can live and enjoy life with dignity, no matter their health or socioeconomic status.

Projects like this represent the spirit of GNU Health and make me immensely proud to be part of this community.

Happy and healthy hacking!
Luis Falcon, MD
President, GNU Solidario

Links:

Happy birthday, GNU Health!

12 Wednesday Oct 2022

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On a day like this, October 12th, 2008, I registered the “Medical” project at SourceForge. Fourteen years later, GNU Health has become the Libre digital health ecosystem used by governments, hospitals, laboratories, research institutions and health professionals around the globe.

I want to sincerely thank all the professionals who believed in the project since early on… from small clinics in the African rain forest, to many public primary care institutions in Argentina, to the largest hospital in India and Asia (AIIMS).

GNU Health, the Libre digital health ecosystem

Institutions such as the University of Entre Rios in Argentina, Leibniz University Hanover, the United Nations Institute for Global Health, the World Health organization and the European Bioinformatics Institute (EBI), Digital Public Goods Alliance, have helped the GNU Health project, by providing training, implementations or valuable resources in areas related to coding standards and medical genetics.

Many thanks to our sponsors, particularly Thymbra and openSUSE who have been supporting GNU Health since day one, sponsoring our annual congress (GNUHealthCon). In addition, openSUSE has donated raspberry pi devices for development and for implementation projects, as well as packaging GNU Health for their distribution. Thank you Fosshost, for all this years of hosting the GNU Health HMIS and the BigBlueButton for our conferences!

Thank you European Open Source Observatory Repository (OSOR) / Joinup and the Free Software Foundation Europe for your work in making GNU Health a reality in Europe, specially in the Public Health sector.

Immense gratitude to the GNU operating system, particularly, to Richard Stallman -father of the Free Software movement- who in 2011 declared GNU Health an official GNU project. Since that day, all the components of the GH ecosystem are hosted in Savannah.

GNU Package
GNU Health is an official GNU Package

The GNU Health ecosystem would not exist today without the Libre Software community. Excellent Libre projects like Tryton, LibreOffice, PostgreSQL, Flask, Python, GNUPG, Apache, and many others make GNU Health a reality. We’re so happy to count with our sister community Orthanc, a great Libre Medical Imaging project that makes the perfect GNU Health partner in hospital settings and diagnostic imaging.

Last but not least: Thank you to the core team and to the community around the world: Developers, testers, translators, artists, documentation team, podcasters and journalists … I can not name you all… but the success of GNU Health belongs to you.

On a day like this, 14 years ago, the revolution for freedom and equity in healthcare began. And this is just starting…. at GNU Solidario, we’ll keep on advancing Social Medicine, and fighting so health remains a non-negotiable human right, no matter where you live. After all, GNU Health is a Social project with a little bit of technology behind.

Happy and Healthy hacking!

Luis Falcón

(Original document: https://my.gnusolidario.org/2022/10/12/happy-birthday-gnu-health/)

Cirugía Solidaria chooses GNU Health

09 Tuesday Aug 2022

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The GNU Health community keeps growing, and that makes us very proud! This time, the Spanish non-profit organization Cirugía Solidaria has chosen GNU Health as their Hospital and Lab Management system.

Cirugía Solidaria was born in 2000 by a team of surgeons, anesthetists and nurses from “Virgen de la Arrixaca Hospital”, in Murcia, Spain, with the goal to provide medical assistance and to perform surgeries to underprivileged population and those in risk of social exclusion. Currently, Cirugía Solidaria counts with a multi-disciplinary team of health professionals around Spain that just made its 20th anniversary of cooperation.

GNUHealth Hospital Management client for Cirugía Solidaria

Around a month ago I received a message from Dr. Cerezuela, expressing their willingness to be part of the GNU Health community. Their main missions currently are focused, but not limited, to the African continent.

Source: Cirugía Solidaria

After several conferences and meetings, this August 1st 2022, Cirugía Solidaria and GNU Solidario signed an agreement to cooperate in the implementation, training and maintenance of the GNU Health Hospital Management and Lab Information System in those countries and health institutions where Cirugía Solidaria will be present.

Source: Cirugía Solidaria

This is very exciting. We have many projects in different countries from Africa, and working with Cirugía Solidaria will help to generate more local capacity, to cover the needs of those health professionals and their population.

This is not just about surgeries or health informatics. GNU Health will allow Cirugía Solidaria to create sustainable projects. They will have unified clinical and surgical histories, telemedicine; assess the nutritional and educational status of the population, and many other socioeconomic determinants of health and disease.

I want to give our warmest welcome to the team of Cirurgía Solidaria, and we are very much looking forward to cooperating with this great organization, for the betterment our our societies, and for those that need it most.

About GNU Health

The GNU Health project provides the tools for individuals, health professionals, institutions and governments to proactively assess and improve the underlying determinants of health, from the socioeconomic agents to the molecular basis of disease. From primary health care to precision medicine.

GNU Health is a Libre, community driven project from GNU Solidario, a non-profit humanitarian organization focused on Social Medicine. Our project has been adopted by public and private health institutions and laboratories, multilateral organizations and national public health systems around the world.

The GNU Health project provides the tools for individuals, health professionals, institutions and governments to proactively assess and improve the underlying determinants of health, from the socioeconomic agents to the molecular basis of disease. From primary health care to precision medicine.

The following are the main components that make up the GNU Health ecosystem:

  • Social Medicine and Public HealthHospital Management (HMIS)
  • Laboratory Management (Occhiolino)
  • Personal Health Record (MyGNUHealth)
  • Bioinformatics and Medical Genetics
  • Thalamus and Federated health networks
  • GNU Health embedded on Single Board devices

GNU Health is a GNU (www.gnu.org) official package, awarded with the Free Software Foundation award of Social benefit, among others. GNU Health has been adopted by many hospitals, governments and multilateral organizations around the globe.

See also:

GNU Health : https://www.gnuhealth.org

GNU Solidario : https://www.gnusolidario.org

Digital Public Good Alliance: https://digitalpublicgoods.net/

Original post : https://my.gnusolidario.org/2022/08/09/cirugia-solidaria-chooses-gnu-health/

GNU Health declared Digital Public Good

04 Monday Apr 2022

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We are very proud to announce that the GNU Health project has been declared a Digital Public Good by the Digital Public Goods Alliance (DPGA). GNU Solidario received the announcement this Sunday, April 3rd 2022.

The Digital Public Goods Alliance is a multi-stakeholder initiative endorsed by the United Nations Secretary-General, working to accelerate the attainment of the Sustainable Development Goals in low-and middle-income countries by facilitating the discovery, development, use of, and investment in digital public goods.

Current Digital Public Good Alliance board members (2022) . German Federal Ministry for Economic Cooperation and Development (BMZ), the Government of Sierra Leone, the Norwegian Agency for Development Cooperation (Norad), iSPIRT, United Nations Development Program (UNDP) , and the United Nations Children's Fund (UNICEF).
Digital Public Good Alliance board members (2022)

Current board members of the DPGA include the German Federal Ministry for Economic Cooperation and Development (BMZ), the Government of Sierra Leone, the Norwegian Agency for Development Cooperation (Norad), iSPIRT, United Nations Development Program (UNDP) , and the United Nations Children’s Fund (UNICEF).

The goal of the DPGA and its registry is to promote digital public goods in order to create a more equitable world. Being recognized as a DPG increases the visibility, support for, and prominence of open projects that have the potential to tackle global challenges.

GNU Health is now at the Digital Public Goods registry

After its nomination to become a Digital Public Good project, GNU Health had to pass the requirements of the DPGA standards. As the DPGA states :

The Digital Public Goods Standard is a set of specifications and guidelines designed to maximise consensus about whether a digital solution conforms to the definition of a digital public good: open-source software, open data, open AI models, open standards, and open content that adhere to privacy and other applicable best practices, do no harm by design and are of high relevance for attainment of the United Nations 2030 Sustainable Development Goals (SDGs). This definition stems from the UN Secretary-General’s Roadmap for Digital Cooperation.

Digital Public Good Standards

At GNU Solidario and GNU Health we are humbled and very happy with this recognition, and accept it with profound commitment, responsibility and determination. It makes us work even harder to keep on fighting for the advancement of Social Medicine, and to give voice to the voiceless around the world.

About GNU Health

GNU Health is a Libre, community driven project from GNU Solidario, a non-profit humanitarian organization focused on Social Medicine. Our project has been adopted by public and private health institutions and laboratories, multilateral organizations and national public health systems around the world.

The GNU Health project provides the tools for individuals, health professionals, institutions and governments to proactively assess and improve the underlying determinants of health, from the socioeconomic agents to the molecular basis of disease. From primary health care to precision medicine.

The following are the main components that make up the GNU Health ecosystem:

  • Social Medicine and Public Health
  • Hospital Management (HMIS)
  • Laboratory Management (Occhiolino)
  • Personal Health Record (MyGNUHealth)
  • Bioinformatics and Medical Genetics
  • Thalamus and Federated health networks
  • GNU Health embedded on Single Board devices

GNU Health is a Free/Libre, community-driven project from GNU Solidario, that counts with a large and friendly international community. GNU Solidario celebrates GNU Health Con and the International Workshop on e-Health in Emerging Economies (IWEEE) every year, that gathers the GNU Health and social medicine advocates from around the world.

GNU Health is a GNU (www.gnu.org) official package, awarded with the Free Software Foundantion award of Social benefit, among others. GNU Health has been adopted by many hospitals, governments and multilateral organizations around the globe.

See also:

GNU Solidario : https://www.gnusolidario.org

Digital Public Good Alliance: https://digitalpublicgoods.net/

Source : https://my.gnusolidario.org/2022/04/04/gnu-health-declared-digital-public-good/

Leibniz University Hannover joins the GNU Health Alliance of Academic and Research Institutions

03 Thursday Feb 2022

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GNU Solidario and Leibniz Universität Hannover (LUH) are now partners in GNU Health, the Libre digital health ecosystem.

This agreement makes the German university a member of the GNU Health Alliance of academic and research institutions, to work on the research and development of GNU Health, the award-winning Libre digital health ecosystem.

The partnership was signed on February 2nd, 2022, by Prof. Dr.-Ing. Gabriele von Voigt, head of the Computational Health Informatics department at Leibniz Universität Hannover and Dr. Luis Falcón, president of GNU Solidario.

University of Hanover main building. Source: LUH

We are excited and looking forward to cooperate and research in areas such as privacy, distributed health networks, bioinformatics, hospital management or Personal Health Records. Leibniz Universität Hannover has been using the GNU Health Hospital Management System component for quite sometime now internally, in their health informatics department. This agreement will boost even more the adoption of the libre health ecosystem.

Some of the components from the GNU Health digital health ecosystem

Leibniz Universität Hannover is a reference for the adoption of GNU Health in European universities, serving as a model of open science and free/libre software in public academic institutions. Moreover, being part of the GNU Health Alliance of Academic and Research Institutions opens up horizons to collaborate with other universities around the world.

We are positive that this agreement will help promoting the adoption of GNU Health and Libre Software within the healthcare system and biomedical research in Europe.

The logo of Leibniz University is a visual Leibniz quote. It shows the binary number system as first outlined by Gottfried Wilhelm Leibniz in his New Year’s letter of January 1697 to Duke Rudolf August of Wolfenbüttel.

About Leibniz Universität Hannover:

The Leibniz University Hannover, long form in German Gottfried Wilhelm Leibniz Universität Hannover, is a public research university located in Hanover, Germany. Founded on 2 May 1831, it is one of the largest and oldest science and technology universities in Germany. It has nine faculties which offer 190 full and part degree programs in 38 fields of study.It was named University of Hannover in 1978. In 2006, it was named after Gottfried Wilhelm Leibniz, the 18th century mathematician and philosopher. In 2018, Leibniz University Hannover was adopted as the official English name.

Leibniz University Hannover is a member of TU9, an association of the nine leading Institutes of Technology in Germany. It is also a member of the Conference of European Schools for Advanced Engineering Education and Research (CESAER), a non-profit association of leading engineering universities in Europe. The university sponsors the German National Library of Science and Technology (TIB), the largest science and technology library in the world

Source: https://en.wikipedia.org/wiki/University_of_Hanover

About the GNU Health Alliance

The GNU Health Alliance of Academic and Research Institutions is a GNU Solidario program comprising a global network of academic and research institutions around the world with the mission of provide a sustainable solutions to the current social and biomedical challenges, using GNU Health and Free Software components.

News source: GNU Solidario https://my.gnusolidario.org/2022/02/03/leibniz-university-hannover-joins-the-gnu-health-alliance-of-academic-and-research-institutions/

GNU Health emergency response in Haiti

15 Sunday Aug 2021

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Yesterday, yet another devastating earthquake hit the southern area of Haiti.

Immediately knowing about the earthquake, we contacted our representative in Haiti, Pierre Michel Augustin, and started an emergency humanitarian response in coordination with our team in the country .

Haiti suffers from recurrent natural disasters (hurricanes, earthquakes). In the last years, Haiti has also been a victim of structural poverty and civil unrest. Haitians are strong, resilient, noble people. Haiti is the land of the free and the brave (see my post “My trip to Haiti, the land of the Free and the Brave” ), yet it seems like the world has forgotten about Haiti.

GNU Solidario emergency response campaign in Haiti: https://www.gnusolidario.org/haiti.html

Archive picture (credit: UN Photo/Marco Dormino).

We need emergency response now, but we also need to work on Social Medicine, and tackle the socioeconomic determinants that are the root cause of the structural poverty in Haiti. Only then, our Haitians brothers and sisters will be able to recover the dignity that they deserve, and grow in prosperity. We need to create the conditions, working the local community in the country to strengthen the public health and education system. GNU Health is part of this program.

Our local representative, engineer Pierre Michel Augustin, has been working in the localization of GNU Health, and by the end of 2021, we will have the GNU Health node fully operational in Limbé. The Haiti GNU Health office will provide training and support to the local and regional health professionals and institutions.

The GNU Health project focuses on helping health professionals delivering Social Medicine and health informatics.

Natural disasters have a profound impact in the short, medium and long period in any nation. The situation gets much worse when they hit impoverished nations. So, in the short term, we will put all the effort to tackle this emergency and save lives. For the medium and long term, we will continue the GNU Health node in Haiti and building the GNU Health Federation in the country, in cooperation with the local team, academic and health institutions.

Creating local capacity is key to make the project sustainable. Resources will be dedicated to build the infrastructure (hardware, network..), but the main focus and effort will be on building local capacity, and training the local team to make them independent and build a sustainable and ethical model.

Visit https://www.gnusolidario.org/haiti.html to support our mission in Haiti

In the end, technology is just a medium, and GNU Health is a social project that uses really cool Free/Libre technology and open science, for the betterment of our societies.

Please consider helping GNU Solidario humanitarian campaign in Haiti, by visiting the following link:

https://www.gnusolidario.org/haiti.html

About GNU Solidario:

GNU Solidario is a non-profit humanitarian organization focused on Social Medicine. We have missions around the globe, and our projects has been adopted by health institutions, multilateral organizations and national public health systems around the world.

GNU Solidario is the organization behind GNU Health, the award winning Free / Libre digital health ecosystem, that provides a Hospital Management System, a Lab Information System, a Personal Health Record and a distributed, Federated health network.

GNU Health is a GNU official project ( see www.gnu.org), licensed under the GNU General Public License, GPL v3+

Liberating our mobile computing

04 Friday Jun 2021

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Last week I got the PineTime, a free/libre smartwatch. In the past months, I’ve been working on MyGNUHealth and porting it to the PinePhone.

Why doing so? Because running free/libre operating systems and having control of the applications on your mobile phones and wearables is the right thing to do.

Yesterday, I told myself: “This is the day to move away from Android and take control over my phone”. And I made the switch. Now I am using a PinePhone on Manjaro running KDE plasma mobile. I have also switched my smartwatch to the PineTime.

The mobile phone and smartwatch were the last pieces of hardware and software to liberate. All my computing is now libre. No proprietary operating systems, no closed-source applications. Not on my laptop, not in my desktop, not on my phone.

Facing and overcoming the social pressure

At the moment I ditched Android, I felt an immense sense of relief and happiness. It took me back 30 years ago, early FreeBSD and GNU/Linux times, being in control of every component of my computer.

We can not put our daily life activities, electronic transactions and data in the hands of the corporations. Android phones shipped today are full of “bloatware” and closed-source applications. We can safely call most of those applications spyware.

The PinePhone is a libre computer, with a phone. All the applications are Libre Software. I have SSH, most of the cool KDE plasma applications I enjoy in the desktop, I can have them now in my pocket. Again, most importantly, I am free.

Of course, freedom comes with a price. The price to face social and corporate pressure. For instance, somebody asked me yesterday how to deal with banking without the app. My answer was, I never used an app for banking. Running a proprietary financial application is shooting at the heart of your privacy. If your bank does not let you do your transactions from any standard web browser, then change your bank. Quick digression… the financial system and the big technological corporations are desperately trying to get rid of good all coins and bills. This is yet another attack on our privacy. Nobody needs to know when, where and what I buy.

A brighter future depends on us

Some people might argue that this technology might not be ready for prime time, yet. I would say that I am ok with it, and the more we join, the more feedback we provide, and the better end result we’ll get.

The Pine64 project is mainly a community-oriented ecosystem. Its hardware, operating system and applications are from the community and for the community. I am developing MyGNUHealth Personal Health Record to be run on KDE Plasma, both for desktop and for the PinePhone and other Libre mobile devices. It is my commitment with freedom, privacy and universal healthcare to deliver health informatics in Libre, privacy focused platforms that anyone can adopt.

MyGNUHealth Personal Health Record running on the Desktop and on the PinePhone. The PineTime smartwatch as the next companion for MyGNUHealth. All these components are privacy focused, Free/Libre Software and hardware.

It depends on you to be prisoner of the corporation and massive surveillance systems, or to be in full control of your programming, health information and life. It takes commitment to achieve it… some components might be too bleeding edge or the camera might not have the highest resolutions and you won’t have the Whatsapp “app” (removing that application would actually be a blessing). It’s a very small price to pay for freedom and privacy. It’s a very small price to pay for the advancement of our society.

InfiniTime firmware upgrade using Siglo.

It’s been many years since I’ve been in the look out for a truly libre phone. After many projects that succumbed, the PinePhone is the first one that has gained momentum. Please support the PinePhone project. Support KDE plasma mobile. Support Arch, Manjaro, openSUSE, FreeBSD or your favorite Libre operating system. Support those who make Libre convergent applications that can be run on mobile devices, like Kirigami. Support InfiniTime and any free/libre firmware for smartwatches, as well as their companions as Siglo or Amazfish.

The future of Libre mobile computing is now, more than ever, in your hands.

Happy and healthy hacking.

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

11 Friday Dec 2020

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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.

GNU Health and Khadas to deliver Artificial Intelligence in Medicine

30 Wednesday Sep 2020

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It is official: GNU Solidario, the Spanish NGO behind GNU Health (GH) and Khadas Technologies have signed the “GNU Health Alliance of Academic and Research Institutions”, to research and deliver Artificial Intelligence to the world of medicine.

This is very exciting. GNU Health covers genomics, medical genetics, Dx imaging and social medicine, areas where definitely we can use the power of AI for better diagnostics, personalized treatments, decision support, disease prevention and health promotion.

The GNU Health embedded project using Khadas for Artificial Intelligence in Medicine

What is truly revolutionary is that we will be using affordable single board computers, like the Khadas VIM3, where they could work alone or in the context of the GNU Health Federation, doing massive virtual parallel computing.

Citizens, health professionals and institutions don’t have to spend millions to access the latest in technology. In GNU Health, this has always been our philosophy. Health is must be remain a universal human right, and that is what we do in GNU Health. We deliver state-of-the-art technology all over the world with Libre Software. No hidden lines of code, no hidden agenda.

One of Khadas devices, the VIM3 includes a Neural Processing Unit (NPU) that will be the heart of the AI engine.

GNU Health HMIS with genetics package running on a Khadas VIM3 Pro

We can use our GH Federation model which gathers massive information of protein natural variants, and combine it with the latest tools in Artificial Intelligence. We will be giving a giant leap, unveiling the real clinical significance of many mutations that today remain a mystery about how they would affect our health. In GNU Health we are determine to build this critical bridge between the person, the clinician and the researcher.

Another area that we’ll work on is Dx imaging. Training Khadas devices to differentiate many types of lesions will help the pathologist or the surgeon to take real-time decisions in the operating room based on the picture GNU Health camera takes and the diagnostic that the GH embedded return about the specimen.

In the upcoming GNU Health Conference – GHCon2020– , there will be sessions about this project, so we invite anyone to register at the conference, that this year will be online due to the COVID pandemics. Register at GHCon2020

GHCon2020, the annual GNU Health conference

About GNU Solidario: GNU Solidario is a non-for-profit organization that works globally, focused on Social Medicine and health informatics (using Libre Software).

GNU Solidario is the organization behind GNU Health, the award
winning Libre Health and Hospital Information System, deployed in many
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GNU Health: Helping Laos Heal from UXO physical and emotional trauma.

25 Saturday Jul 2020

Posted by in GNU Health

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Luis Falcon with the Lao CMR staff in charge at the 2 year anniversary of the implementation
GNU Health implementation anniversary at Laos Center of Medical Rehabilitation

Laos is one of the most heavily bombed countries in the world. During the period from 1964-1973, over 2 million tons of bombs were dropped by B-52 aircrafts across the 2/3 of the country during the “Secret War”. This nine-year period bombing caused thousands of deaths and a unprecedented human displacement that exceeded a hundred thousand civilians from the poorest areas of the country.

The tragic legacy of that period remains today. Thirty percent (30%) of those bombs remains active (Unexploded Ordnances – UXOs – ), causing over 300 victims every year until 2008, and now down to 50 / year. Nearly 60% of the UXOs accidents result in death, and 40% of the victims are children[1].

If the explosion does not kill the person, it causes severe traumatic injuries resulting in the amputation of limbs in many of the victims. Physical and emotional trauma that takes many years to heal. In addition, many UXO victims suffer from Post-traumatic stress disorder (PTSD), a serious condition that can be devastating for the victim and their families[2].

But there is hope. The wonderful people from Laos are resilient, and they are willing to cope and move forward. I have been in Laos several times in the last few years, in the context of GNU Health implementations both in Mahosot Hospital and the Center for Medical Rehabilitation – CMR – .

The Center for Medical Rehabilitation (CMR), located in Vientiane, is a specialized institution that helps people with disabilities and victims survivors of UXOs. The CMR, formerly known as the National Rehabilitation Center initially provided prosthetic limbs for victims of war. Today they have extended the services to provide services to children with disabilities across the country. Some of the services include medical and community based rehabilitation, special education for the deaf and the blind and vocational school for people with disabilities.

At the moment I had the meeting with the hospital directors, I knew that we had to focus both in short term surgery as well as in the long term psychological, physiotherapy and occupational therapy that would allow the person to be fully functional in the society. Again, I was facing a project in need of Social Medicine.

We trained a local multidisciplinary team of nurses, doctors, physiotherapists, social workers, computer scientists, psychologists, administrative personnel, pharmacists and accountants.

CMR nurses. The heart of the institution

It was during that period that I created the package “functioning and disability“.

General patient information and Functioning & Disability tab. Red boxes on these two sections denote UXO related information

Some of the GNU Health functional modules that CMR decided to use included surgery, socio-economics, ICD-10, nursing, physical therapy, stock, accounting, lifestyle, reporting, health services and diagnostic imaging, among others. In addition to those, we included the “functioning and disability” package.

The GNU Health “Functioning and Disability” package integrates the ideas of WHO Health Organization International Classification of Functioning, Disability and Health. This functionality complements the ICD-10 classification of diseases, with the concept of functionality. For example, after a person has been diagnosed with diabetes, we must go beyond the biology and molecular bases of the disease, and evaluate how diabetes impacts of on her daily activities and integration in the society and environment.

GNU Health contextualizes the health condition in the particular individual, key for personalized medicine. In the UXOs example, the related ICD10 codes are visible from the main chart:

  • S88 : Traumatic amputation of lower limb
  • F43.1: Post-traumatic stress disorder

This diagnostic information is relevant and key for epidemiology and statistics, but if we want to practice medicine, we must take into account the social aspect of these conditions, and how they affect the person in her particular environment.

The GNU Health Functioning and disability assessment has two sections. The first section is a summary of impairments related to the Cognitive, Visual, Hearing, Speech, Hand, Mobility and Activities and Participation .

The second section is a detailed assessment of Body functions, Body structures, Activities and Participation and Environmental factors and barriers. Each of these groups has its own set of qualifiers and components that will provide the health professionals where to put the focus to the time and the context of that person, as well as to evaluate the progression of the conditions.

We can now study, with a multi-disciplinary team, how the body structure and body functioning impairments relate to the person capacities and engagements in social activities; daily household tasks; using the current public transportation system or the level of access to Labor and employment services.

This is my concept of medicine, the assessment of the bio, psycho, social determinants of health and disease. Medicine is, first and foremost, a social science, and GNU Health is first and foremost, a social project.

Example of GNU Health person functioning and disability assessment

Celebrating the success of cooperation: During a two-year period of using GNU Health, they have provided over 67,000 medical services, automated their finances, prescriptions, stock management, medical appointments and evaluations, diagnostic imaging, and the demographics tracking for the thousands of patients they assist.

CMR Cope team helping people in Lao rural areas

Local capacity building: CMR trained its own local group of professionals who customize and maintain GNU Health, in their own Lao language. This creates a local and ethical business model, very important for the long-term sustainability of the project.

A well-deserved award. The work that CMR has been doing in Laos for the rehabilitation of their people has been magnificent. Their multidisciplinary approach to trauma, from the acute care and surgery, to the physical therapy and the work in the field is an example for many of us. CMR has helped thousands of people every year healing from the UXO physical and emotional scars, moving forward and being able to get re-inserted in society, and we are so proud to have been part of it.

A delegation of the Laos Ministry of Health presented at GNU Health Con 2016 the implementation in the Lao Center for Medical Rehabilitation – CMR – and in Mahosot hospital. We are so proud that they are part of the GNU Health community.

CMR received the GNU Health Social Medicine Award in 2016 for best Institution.

  1. – Somnuk Vorasarn, Chansaly Phommavong, Khonephet Sely. GNU Health in Mahosot Hospital – GNU Health Con 2016
  2. A cross-sectional community study of post-traumatic stress disorder and social support in Lao People’s Democratic Republic