Tag Archives: Public Health

GNUHealthCon 2020. Social Medicine in a time of pandemic

16 Wednesday Dec 2020

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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.

GNU Health: Helping Laos Heal from UXO physical and emotional trauma.

25 Saturday Jul 2020

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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

Welcome to GNU Health Con 2016 – IWEEE 2016

15 Thursday Sep 2016

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After all these years of growing as a community, it’s about time together! We are very proud and happy to announce that GNU Health now has its own conference!

 

GNU Health Con is an annual conference that brings together enthusiasts and developers of the Free/Libre Health & Hospital Information System.

More info about the GNU Health Con 2016 here

You can make a reservation for your room at a special rate at HOTEL EXE  or at HOTEL ALISIOS 

Please send a mail with the GNUHealthCon or IWEEE reference to:

comercial@exelascanteras.com
jrecepcion@exelascanteras.com
reservas@exelascanteras.com  
reservas@hotelalisioscanteras.com

We`ll see you in Las Palmas ! 

http://www.gnuhealthcon.org/2016-las_palmas/registration.html

GNU Solidario and Fundación Recover Hospitales para África

01 Tuesday Mar 2016

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We are very happy to announce that on March 1st. 2016, GNU Solidario and Fundación Recover signed an agreement of cooperation.

The two NGOs will join forces in order to promote and improve health care in African hospitals, through the implementation of GNU Health.

 
 

 

A letter from Gabon to the GNU Health community

17 Sunday Jan 2016

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From Luis Falcón:
Dear GNU Health and Free Software community : 
Mr. Armand Mpassy-Nzoumbato has written this letter to the GNU Health community, that I proudly want share with all of you. It shows the importance of Free Software in real-life scenarios, delivering our motto : Freedom and Equity in Healthcare (original source)
 Gabon training
Dear Luis, Dear Axel,

First of all happy new year and congratulations to Luis and off course all others for the great work that is being accomplished. I just know a few of you guys (Luis, Selene, Cedric, Nicolas, Axel) and I just joined this community about a year ago. However, I can tell you that it is having a huge impact on the health of communities in central Africa and very soon in West Africa as well.

I implemented the lab module of GNU Health at the Medical Research Center in Franceville (Gabon). They do medical lab analyses for the population of Franceville. It has changed the face public health in this small city. People used to wait a few days before getting their lab results. Now they get their results just after a few hours. And I can tell you it can make a difference between staying alive or dying because the doctor will not be able to make a correct assessment of the medical status of the patient on time.

A number of other health institutions are very much interested in implementing GNU Health and I’ll make sure that each and every health professional has heard about GNU Health. I am working on a strategy that will ensure that a huge number of them can test the system using the Demo version on DVD. It is indeed very difficult to access the demo version online.

On behalf of all those who you are serving: the communities of Africa and of the world, the voiceless people, and who don’t even know that you exist, I say:

Thank you, Muchas Gracias

Kind regards,

Armand

GNU Health training in Franceville – Gabon –

14 Wednesday Oct 2015

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Mr. Armand Mpassy-Nzoumba, GNU Solidario representative in Africa, provided a GNU Health Training at the Centre of Medical Research of Franceville (Gabon).

These are some words from Mr. Armand Mpassy-Nzoumba about this great project:

” During the Training of GNU Health we implemented the lab modules of GNU Health. It was done in replacement of of similar software which did no longer met user requirements. The lab team, of about 15 members, was trained. After implementation we noticed a number of improvements including:

  • Improved quality of medical lab analyses
  • improved process time. It took 3 to 5 days to deliver results. Now results can be delivers the same day
  • A full patient database.
  • Improved reliability of the software. The previous one did have a number of bigs and required a lot of maintenance
  • Improved return on investment thanks to free and open source software … “

IWEEE 2015 venues

02 Wednesday Sep 2015

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We’re happy to announce that IWEEE 2015 will be held at the EXE Hotel Las Canteras on the 25th of September and at Colegio de Médicos Las Palmas on the 26th of September.

El IWEEE 2015 tendrá lugar en el EXE Hotel Las Canteras, el día 25 de septiembre y en el Colegio de Médicos de Las Palmas el día 26 de septiembre.

On September 25th we will meet at the KRAUS Lounge at the EXE Hotel Las Canteras (see map). You can also make a reservation for your room at a special rate if you mention IWEEE 2015. Please contact Marieta Gonzalez: comercial@exelascanteras.com

El día 25 de Septiembre nos reuniremos en el Salón KRAUS  del Hotel Las Canteras EXE (ver mapa). También puede reservar su habitación a un precio especial si menciona IWEEE 2015. Por favor, póngase en contacto con Marieta González: comercial@exelascanteras.com

 
On September 26th Mr. Richard Stallman will present “Free Software and Medicine” at Colegio Médicos Las Palmas (see map).

El día 26 de septiembre el Sr. Richard Stallman hablará sobre el  “Software Libre y Medicina“ en el Colegio Médicos de Las Palmas (ver mapa).

Don’t forget to register and we hope to see you in Las Palmas !

No olvide registrarse. Los esperamos en Las Palmas !

GNU Health in Laos

01 Tuesday Sep 2015

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It was a great experience to see the advances in the GNU Health implementation at the Center of Medical Rehabilitation (CMR) in Laos. 
It’s always such a pleasure and honor to see how GNU Health can make a change and help public health. Our appreciation to the Director of the Center, Khamphet Manivong, along with Bounmy Sihaphom, Sisouvanh Sangbouaboulom and Anousak Souphavanh, IT consultants from Calat.