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 health and research institutions around the globe.
About Khadas: Khadas develops superior quality, high performance single board computers for makers, developers, and tinkerers, that come with open source, professional technical support, and a global community for issue discussion & idea sharing.
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 localmultidisciplinary 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 WHOHealth 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.
– Somnuk Vorasarn, Chansaly Phommavong, Khonephet Sely. GNU Health in Mahosot Hospital – GNU Health Con 2016
A cross-sectional community study of post-traumatic stress disorder and social support in Lao People’s Democratic Republic
Existen dos tipos de miserables: las personas que sufren la miseria y aquellas que la generan.
La concentración del poder en el actual modelo socio-económico es tan injusta como insostenible. La privatización de la Salud Pública pervierte el derecho a una vida digna. La brecha social se profundiza, con ricos más ricos y pobres más pobres.
La codicia y el cortoplacismo del sistema están destruyendo la sociedad y el planeta. La contaminación medioambiental, la galopante deforestación y las granjas industriales son responsables del cambio climático que amenaza a las próximas generaciones.
Millones de animales son privados de su libertad y condenados al holocausto. Bebés arrancados del lecho materno destinados al matadero o encarcelados de por vida en mega granjas industriales en condiciones deplorables. Especismo y antropocentrismo inútil y despiadado, responsable de enfermedades cardiovasculares, cáncer, resistencia antibiótica y cambio climático.
Las corporaciones y sus gobiernos han encontrado herramientas formidables para el adoctrinamiento y vigilancia de masas. Similar a los medios de comunicación tradicionales, pero con métodos de control mucho más sofisticados que anestesian, hipnotizan y anulan el pensamiento crítico de los individuos.
Es imperativo retomar el control de nuestra libertad y dignidad, como individuos y como sociedad. La educación y el activismo social son clave para restaurarlos, y el Software Libre nos ofrece una magnífica vía para llevarlo a cabo.
El Software Libre representa lo contrario al modelo neoliberal. Entre sus fines está desarrollar comunidades, generar conocimiento y compartir recursos. Pero si queremos tener éxito, debemos afrontar y abrir un espacio para la discusión sobre las amenazas y riesgos existentes dentro y fuera de la comunidad.
En los últimos años hay un intento de desprestigiar el movimiento de Software Libre, principalmente por dos actores: La corporación del software propietario y núcleos de desarrolladores sin ética. Que la corporación y el software propietario intente dañar al Software Libre está dentro de lo esperado. Lo que requiere especial atención es el efecto deletéreo ocasionado por especuladores inescrupulosos infiltrados en la comunidad. El factor común de ambos actores es una lectura egoísta y retorcida de la libertad.
Según Richard Stallman, para que un proyecto sea Software Libre debe cumplir las cuatro libertades. Libertad para usar, estudiar, distribuir y mejorar el código. Estas “cuatro libertades” invitan a la colaboración y a construir comunidades alrededor del proyecto.
En el Software libre prevalece el sentido de libertad colectiva . La esfera colectiva tiene prioridad sobre la esfera individual. Por supuesto, el escenario ideal es que ambas libertades coexistan y se retroalimenten. Cuando la libertad individual coarta o anula la libertad colectiva, entonces no es Software Libre, aunque cumpla las cuatro libertades.
La laxitud del Software Libre está concebida para potenciar el espíritu comunitario y colaborativo. Desgraciadamente, esta flexibilidad ha permitido que se infiltren individuos y empresas miserables. Estos impostores tienen por objetivo engañar y apresar a la comunidad con sus malévolos cantos de sirena (Stallman lo denomina “Free bait” o “el anzuelo de lalibertad”).
Por ejemplo, hay quienes que, con nocturnidad y alevosía, sin previo aviso ni argumentos, se apropian, copian o bifurcan un proyecto de software libre activo. No han roto ninguna de las cuatro libertades, pero sus acciones los convierten en unos miserables que perjudican y traicionan a la comunidad.
A esos individuos les pido que mantengan sus sucias manos fuera de la comunidad, porque el Software Libre no se mancha.
La filosofía del Software Libre tiene mucho más de Libre que de Software. Cuando pensemos sobre Software Libre, pensemos en “Software que ofrece Libertad”. El software sólo es el medio para alcanzar la libertad.
En lo personal, adopté la filosofía del Software Libre como estudiante de ingeniería informática a principio de los años noventa. Actualmente, pasados veinticinco años, el Software Libre me ha permitido participar en muchos proyectos sociales y concretar principios de Medicina Social en instituciones de salud alrededor del mundo con el proyecto GNU Health.
Necesitamos avanzar, y para ello es fundamental quelosgobiernos, organizaciones multilaterales y ONGsadopten el Software Libre. Las administraciones públicas que usan software privativo entran en una contradicción. Un bien público nuncapuede estar en manos privadas. Pidamos a los partidos políticos que incluyan el Software Libre en la administración pública, y podremos ver su compromiso social.
El Software Libre enseña, sana y hacepueblos soberanos. Permite generar un modelo económico sostenible, donde personas y empresas pueden colaborar con sus servicios, generando un medio digno y ético de vida. Hoy no hay ningún motivo para usar software privativo.
Cada línea de Software Libre codifica comunidad, democracia y dignidad. Codifica justicia social y un futuro mejor para las próximas generaciones y nuestro planeta.
The workshop promotes Free Software as an effective and ethical solution to provide universality and equity in health care.
This year the theme of IWEEE is “People before Patients”. We will put the attention on health promotion and disease prevention.
Share your government experiences and ideas, such as how your government is improving Public Health with Free Software, or personal health devices using open hardware.
IWEEE is a non-profit event organized by GNU SOLIDARIO.
If you are interested to participate, please submit your presentation at: papers@iweee.org
Dr. Luis Falcón at LIBREPLANET 2015 will be presenting on March 22nd. 15:25 – 16:10 Session Block 5B:
“GNU Health: improving public health care with free software”
… LibrePlanet is an annual conference for free software enthusiasts. LibrePlanet brings together software developers, policy experts, activists and computer users to learn skills, share accomplishments and face challenges to software freedom … This year, the theme of LibrePlanet is “Free Software Everywhere.”
From GNU Solidario we would like to thank Sílex Sistemas for joining us in our GNU Health project !
“…Our commitment with the social contract of GNU Solidario also represents to us a recognition that software is much more than a business, but it is also a tool to guarantee the basic rights and the access to development and well being to mankind. Finally, it is a proof that it is possible to be ethical and to do good business.” Roberto Vasconcelos Novaes – Sílex Sistemas –
After 6 months of work, we are very happy to announce GNU Health 2.6 series. This version improves the navigation, security and data integrity (health_crypto) and audit. It has also been designed to be used in distributed environments, such a network of public hospitals in a province or country.
Here is a partial list of the new features :
* Tryton 3.2 compatibility * Universal Person Unique Identifier (PUID) * Additional / alternative identification codes are now stored in the person (party) model. * Crypto module (Document Digest, validation, digital signing/verification ) * Crypto tryton plugin (included in the backend directory of the tarball) * Revision of models for Distributed deployments * Health Archives module * New Institution model * Revised health specialties and disease groups * Remove extra submenus, for usability. * Revised medication model * Improved Obstetrics module (eg, automatic obstetric GPA calculation) * New shortcuts from the Patient and Institution Model. * Improved Genetics module * Revised Neonatolgy functionality. Newborn is assigned a PUID at birth * New directory for custom modules * Centralized Authentication / LDAP integration * Audit trails from the client (thanks Tryton 3.2) * Improved installation script (covers GNU/Linux distros and FreeBSD) * Of course, upgrade path is included.
There are many other improvements and bug fixes that have not been included in this summary document. You can read the Changelog for a detailed description of all the activity.
Note : The gnuhealth_install script tries to do a local installation, including the required Python packages. This version updates the python packages to one of the latest stable releases. If you are coming from a dedicated server for GNU Health, and used the official installation script, you should be OK. If you installed packages in a system-wide manner, then you would need to uninstall them before the update, otherwise the installation script won’t be able to upgrade them.
If you already have a GNU Health system in your health center, you should upgrade it to 2.6.0 . As always, the upgrade path is included in GNU Health. The upgrade for version 2.6.0 is straight forward :
** Official Languages. ———————– GNU Health now includes English, Chinese, French, Greek, Italian, Portuguese and Spanish, as the official languages. The language packs of the official languages are included in the GNU Health package, with all the modules, so there is no need to download.
There are over 85 GNU Health language teams in Transifex. If you are a language maintainer and want to include your language for the next stable release, please send us a mail to health@gnusolidario.org .
Thanks ! ——–
A big thank you to my colleagues from GNU Health community; GNU Solidario; Thymbra and Tryton, and to the Free Software movement.
Enjoy the new version and report any bug / issues / improvements to health@gnu.org !
PS: In the coming days we’ll be updating the Wikibook, so it reflects the new features of this version
Best,
— Luis Falcon GNU Health : Freedom and Equity in Healthcare http://health.gnu.org @gnuhealth
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