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Thursday, December 21, 2006

Using Ubuntu Linux to solve South Africa's Medical Issues

The start of the argument about Health 2.0 got me thinking. As sexy, functional and efficient as the health software trend may be - I think we all agree on the fact that it's just not applicable in the African context... yet.

So what might be applicable? SA Doctors need lab results, need to do research, need to store and retrieve patient records (on demand)... How do you get a connected, low cost, easy to use, low maintenance technology infrastructure into South Africa's hospital system? And then keep it there?



We've been using Ubuntu Linux (a proudly South African distribution of the Linux operating system - with our very own billionaire Mark Shuttleworth as the brains) around the office a bit - mainly to do tricky techy stuff, but I've been absolutely blown away with the new version (6.06 I think). It's funky, it's African, it's VERY easy to use (provided you don't mess with settings / use installed packages - which are more than ample for everyday use) and it runs on fumes.

I've personally run Ubuntu on a P3 256mb RAM - like lightning on the highveld.

So here's the challenge:


TO MARK SHUTTLEWORTH, OUR BILLIONAIRE BRUVVA...
and all the folks at UBUNTU Linux:

Well done, chaps, excellent job. How about a project? We could secure funding (Government?) for an independent, empowered, Section 21 company to create an Ubuntu network of computers linking all SA's primary, secondary and tertiary care hospitals together.

  1. It's low cost because the operating system is free.

  2. It's low cost because it runs on the kind of computers America is throwing away.

  3. It's low maintenance, because once the networking protocols, any required software and web browser have been installed - the OS can be locked down and user logins/passwords managed fairly easily.

  4. It doesn't get viruses. Including the ones spread by the nasty germs on the kettle in the tea room (whole new post, different time).

  5. It could network and interlink over a low cost dialup, sponsored by Telkom.

  6. It could encourage the open source community (multiverse, universe... I get confused) to get together and develop some simple software for storing patient records, lab results, X-Rays and making them available to the right channels at the right time.

  7. It doesn't crash!

I think I'm onto something - if I dare say so myself. South Africans are too ready to throw away local solutions when faced with more expensive, inappropriate overseas ones. A project like this, while creating jobs and uplifting infrastructure would equip and empower our medical industry to fight a battle they're not getting a lot of help with. And we'll be doing it, the South African way.

Baragwanath is 2km wide. How would you like to run a kilometre (the phones just don't get answered) and wait in a queue (only 5 terminals work currently) for those lab results as your patient lies gasping on the slab?

This is a call. Who's in? Are the folks at Ubuntu interested in pursuing a project like this? Is there anything going on at the moment?

If I'm not mistaken - movements like this ARE the spirit of Ubuntu. Leave a comment, we're really interested in your views...


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43 comments:

Farley said...

Awesome blog. Well for those of us with a brain anyway. Though I'm not so sure the humor wouldn't be lost on a few other less fortunate souls.

Andy Hadfield said...

A man / women (Farley = fairly non-descript ja?) after our own heart. Glad you like. Spread the word lad.

Humour is always lost on stupid people. Ah. Dear.

Aaron said...

I think this is a good project. It could be a web app run on an Ubuntu server. You could set up your own dial-up network to add security to who has access to the program and only a telephone connection would be required. If you are serous about hiring a small company to implement a program feel free to get in contact with me at mukrunneraceatyahoodotcom. Please use a descriptive title as I receive a lot of span at that address(why I am willing to post it)

Sorry I am a programmer and not a businessman so I do not know if my friend's/boss' company meets the section 21 restriction you mention or not or what it is.

Oh and I am an Ubuntu user myself. The newest longterm stable release is 6.06 but the newest stable version is 6.10. I think both are very good Linux releases.

Or if you are looking for an open source free program to be written I'd be interested in helping a group with developing the program in some of my free time.

Farrell J. McGovern said...

Greetings:

I created, back in 2002, a version of Linux called MfxLinux, which is used in the medical office management field, with what my boss told me was 5,000+ installs as of the time I left the company. Thus I know the needs and wants of doctors, as well as the building of a Linux distro internals.

The challenge you present here could be solved with any flavour of Linux, not just Ubuntu, but considering it's name's origin, it would be appropriate. I wouldn't mind helping, even in just an advisory role.

You can contact me at farrell.mcgovern on the electronic post system that google runs...and hopefully, this format will prevent my email from being harvested by spammers! :-)

ttyl
Farrell

Andy Hadfield said...

Aaron - thanks for the comment mate. This is just an idea at the moment - but thank you so much for the interest. Have actually spoken to a couple of other SA bloggers as well, couple of ears pricked up. I will jot down your details and get in touch.

I think there's two things that need to be done here. Network via telkom/dial up a good idea - a telephone is pretty much the only infrastructure you can count on. The other would be stability - and also what type of software a hospital would need.

All food for thought. I'll start working on a post.

Andy Hadfield said...

Farrel - thanks for the comment and the offer to help out. Would be very interesting to get a Canadian view of this type of issue / project. Not sure if you have any experience of SA hospitals - but they are just completely and utterly different - with challenges 1st world countries wouldn't even think of.

But experience is experience as they say... Your linux solution - was that open source or proprietary... ie can we have a look at it?

SA Doc said...

Nice to see interested people. First thing to do, if you want to do this properly - is to get the Minister of Health involved. Then do a regional pilot.

MOST important thingm, and I know this is just a concept of ours at the moment, is to KEEP IT SUSTAINABLE.

Who's going to pay telephone bills and pc costs and and and

Those are the meetings that need to happen.

David said...

I presume you good people are familiar with the open source versions of the enterprise healthcare software developed by the U.S. Veterans Administration?

While it may be overkill for your needs, surely it may provide some valuable information that could be adapted to your needs?

See OpenVista: http://sourceforge.net/projects/openvista

And WorldVista:
http://sourceforge.net/projects/worldvista

Best wishes in getting your project successfully implemented!

David Neeley
Texas, USA

Andy Hadfield said...

Why thank ya kind Texan Sir... Going to have a look now, and add this to our list of interesting articles coming up on this subject...

Andrew said...

good entry! the medical area has not been cracked at all. lots of big "enterprises" with all the usual concerns - if its proprietry it must be secure and good (cos it was paid for) but the EULA says "all your own risk"!

I work in an area where high level programmers are abundant but they would much rather pay hundred of thousands of dollars on commercial Unix-based software that they could write themselves in a world-wide collaborative approach.

And you should see how absurdly bad some of the software is!! I mean infantile, slow and unable to meet event the first line of its sales hype. And costly? Oi, geval!!!

There are a good number of 'EMR' and practice management programs already, unfrotunately, none fit my needs (the authors all build systems to do what they want, and needs across medicine are diverse). Ina ddition, none are easy to install or run.

Jan Kroeze said...

Great idea. You guys should get in contact with the South African Ubuntu LoCo team. They're the guys that handle this type of thing. I'm a member there, so if I can help in any way (even if it's just installs), I'd be happy to.

The ZA forums can be found here.

Andy Hadfield said...

Andrew - amen brother. Functionality and stability are incredibly important. And in the SA context - cost is everything. I wonder whether "practice management" software would suit a hospital... I think (and I REALLY need to get SA DOC sat down to give some actual doctor feedback) the problems exist more with lab results / patient records - and less with billings, where practice management stuff MIGHT focus.

Keep an eye on the thread - if this goes anywhere - will try pull everyone together and see what can be done...

Andy Hadfield said...

Jan Kroeze - actually just discovered this thread with a bit of Googling - haven't had a chance to read - but I'll signup and drop you a mail. There's also a medical thread on the same forum here.

David B (Spain) said...

There are several places worth visiting in your quest for an open-source medical system for south africa: I hope you best luck with this proposal:

www.linuxmednews.com
www.gplmedicine.org

There are also a number of web-based free-open source Electronic Health Record already available:

www.freemed.org
www.mirrormed.org
www.gnumed.org

I think these projects are worth a look and their developers would be eager to collaborate in an effort to implement the software on further hospitals and health institutions worldwide!
Best regards from Spain:
David B.

Charles Plessy said...

Dear Dr Hadfield,

I would like to introduce you to the Debian Med project. Our goal is to create a custom debian distrubution focused on medical and pre-clinical open-source software. We are currently active in three main areas: medical practice, imaging and bioinformatics. Our webpage is:

http://www.debian.org/devel/debian-med/


As you may know, Ubuntu is mostly based on Debian packages, so our work is automatically integrated to the Medical Ubuntu project. Therefore, you may be intersted to have a look at our pages, and suggest some software of interest to be placed on top of our priority list. Our main communication channel is our mailing list:

http://lists.debian.org/debian-med/

Have a nice day,

--
Charles Plessy
Debian-Med packaging team
Wako, Saitama, Japan

Ryan Tracey said...

You might also want to take a look at http://www.bikalabs.com/ (they're in Stellenbosch; a wine-cork's throw from Cape Town).

suwit said...

linux rhce

mdgattuso said...
This comment has been removed by the author.
mdgattuso said...

You may also want to check out this eBook for help on implementing your medical software. I recently purchased an EMR for my practice and found this eBook from EMR Experts to be a great guide.

Anonymous said...

http://www.profdoc.co.za

Sigurd Fyllingsnes said...

Good work frend!!
I'm also a Ubuntu user.
And I have bin locking into opensorce for medical use, for a African project in Ethiopia.
For digital x-ray storage are there a lot of alternative. DICOM= Digital Imaging and Communications in Medicine
My best interests is for now.
CDMEDIC PACS
PacsOne Server
ConQuest
We are using PacsOne Server on our hospital for testing. Then you can use a web application to look at the images, or with a standalone client viewer.

Now we have Studio-ubuntu, Kubuntu, Xubuntu, Edubuntu, what about a mediubuntu??


Som nice links:
http://opendicom.sourceforge.net/
http://www.clubpacs.com
http://www.idoimaging.com

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electronic medical records said...

Interesting! I don't know that it could be possible. Anyway, thanks for the post. I enjoyed reading it.

-mel-

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hey, great post, couldn't agree with you more. has there been any development with your idea? any updates on this for the new year?

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