Back to Ubuntu Medical, for a short while…

First off, let me say that we were blown away with the response to what was initially just a little idea – a dream to do something to uplift technology infrastructure in the South African industry that needs it the most.

Thank you for all the responses, comments and advice.

Now comes the tricky part. What to do with all this information? Well, thankfully we’ve met a couple of keen individuals who might be able to push this project in some kind of direction – and we’ll be chatting with them over the next couple of months.

A contact in the South African medical administration (ie. Government) would be helpful!? Nothing happens in South Africa if it doesn't go through official channels. It's a project killer - so we'd prefer to meet people who can have those conversations first!

For everyone’s benefit, including my own, here’s a summary of related topics/sites/projects that people have been kind enough to post. I’ve had a look at all of them, and commented where appropriate.


GNUMed
This is an already developed (ver 0.2.3) medical system. The package seems to be built more towards practice management (which obviously entails elements of patient management – a feature we stressed was critical in the South African context). They are careful to say:

“GNUmed is not currently intended for hospital IT (Information Technology)”



But, it seems like GNUMed does support our Proudly South African operating system of choice - Ubuntu – Debian releases available here.

Here’s what I’d like to know – would GNUMed be interested in putting together a slightly friendlier interface, and seeing if the product could be adapted to a internet-networked hospital environment? If so, post a comment!


Ndiyo
Ndiyo is a project based around providing computing power to many users cheaply and efficiently. Their project provides “ultra-thin” clients available to multiple users. Need to do some more research into the offering, but this UK based NGO (it seems) might offer a potential solution to the infrastructure issues SA hospitals suffer.

It certainly sounds more effective than getting a first world donation of aging equipment that would have to be maintained on a per-machine basis?


Linux Medical News
A collection of links pointing readers to what’s going on with Linux and medical applications. I couldn’t find many examples of patient management software currently being developed – but the site seems to be more of an aggregator than anything else. Will keep an eye on it nonetheless.


Linux for Clinics
Now, THIS looked like the jackpot. Linux distribution / software / tools specifically intended for a clinic environment – however, the forums don't seem to be overly active since last year. Is this a common problem with Open Source projects? It’s not people losing interest – it’s people unable to stay dedicated to a time-consuming project? I hope I’m wrong.


Seems like they are using a portion of the Ubuntu logo for their own – but a comment by Wouter suggested they might have moved off Ubuntu to another distribution. Shall register and see!


Debian Med
Debian, as far as I can gather, is what Ubuntu Linux is based on – therefore the tools and projects listed at this site would work perfectly. Overriding concern still stands. Linux is tricky for non-techies – and having to install multiple packages which may or may not talk to each other sounds like a support nightmare.

How to get around that issue? I’m not sure…


There it is for a start. Some forums to join, some people to email. Keep subscribed - and we'll let you know if things get going!

Ubuntu Medical: Centralised patient databases in the African context

Andy eventually got me to sit down and give some prelim views. The trickiest thing, if you REALLY want to make a difference in South Africa is planning. There are a couple of lovely third world things that get in the way:

*Politicans
*Egos of management
*Distribution
*Concentrating on PATIENT MANAGEMENT, not financial management.
*Training
*Training
*Training

For instance, if the open source community can help with the situation I'm about to describe, and just this, you have no idea how much of a difference it will make to primary healthcare in this country. Build the "system" so it can be grown, sure. But little steps is the only way you'll get anywhere in a third world country.

Here's the situation. Primary healthcare patients (GP-based needs, meant to go to clinics, both rural and metro BEFORE they get referred up to secondary and tertiary centres - where they would get seen by specialists and clog up already clogged hospitals) HAVE to carry around a green piece of cardboard - their clinic card.

This card links to a manually filed medical history inside the clinic archives. To get to a hospital, you're meant to get referred - thus creating the link. If you don't, hospital doctors are practicing blind, because there is absolutely no way to retrieve paper-based files from clinics around the country.

And most patients believe they can just pitch up at hospitals with primary care problems (translation: trivial from a hospital's point of view). Small wonder we're understaffed? Especially Baragwanath.

Hospital doctor's don't need every little bit of previous scrawl - but there are some critical pieces of information that should be kept centrally on a patient database - and easily accessed at critical times. Such as: Patient diagnoses (incl the controversial HIV + - status, in code), current medication / dosages, allergies and relevant major tests (eg. CT SCAN, ECG, major blood work).

Solve that problem and you've taken a huge leap forward.

Medical Ubuntu: Coverage and first round of interesting articles.

So far, our little post-on-a-whim "Ubuntu across the medical industry" idea has been featured on (and mighty thanks to!):

• Linux Today
• Centromimir.IT
• Centromimir LiveSpace
• Shashum.Com.Ar
• The Open Source Pimp
• Netscape
• Redtram
• Linux Medical News
• Africa By Art
  

We've also started doing a bit of digging... nothing like a good idea to inspire some late night surfing-with-purpose...

Mercy Hospital Opens Arms to Open Source... (Tina Gasperson)
"For almost 100 years a group of women called the Sisters of Mercy have been instilling a spirit of excellence into Baltimore's biggest hospital, appropriately named Mercy. Right from the start, the Sisters have made it their goal to push the medical institution beyond the ordinary by creating teaching affiliations, feeding the hungry, building state-of-the-art emergency services, and launching a neighborhood health center for the inner-city poor. In today's world, all that excellence requires a solid technology infrastructure--and one open source management package to manage a variety of systems.

"Mercy's data center houses more than 200 machines running Windows, Linux, Solaris, AIX, and other, more obscure operating systems. Mercy CIO Jim Stalder says about 160 of the servers are Windows-based, but because the health care services industry is 'fragmented,' with many essential applications available only on other OSes, he also has to maintain dozens of non-Windows machines..."

OpenVista(R)
OpenVista is the open-source version of VistA, which is an enterprise grade healthcare information system developed by the U.S. Department of Veterans Affairs (VA) and deployed at nearly 1,500 facilities worldwide.

MedPix Medical Image Database Uses Healthy Dose of FOSS (Michael Stutz)
"MedPix is a sprawling online medical images database and diagnostic tool that's used around the world by radiologists, nurses, physicians, and medical students--and the whole system is powered by Linux and open source software.

"MedPix is hosted by the US federal government's health sciences university, the Uniformed Services University in Bethesda, Maryland. It's the brainchild of James G. Smirniotopoulos, M.D., a USU professor of Radiology, Neurology, and Biomedical Informatics and Clinical Sciences Chair of its Department of Radiology and Radiological Sciences..."

Interview with Fred Trotter: The Medsphere (Tony Mobily)
"Recently Medsphere, supposedly an 'Open Source' Medical Software Company, has sued its founders Scott and Steve Shreeve. Why? Medsphere claims that the Shreeves illegally released Medsphere software to Sourceforge. An 'Open Source' Software company is suing its founders for releasing code under a free license... that's a bit like Ford suing its employees for making cars.

Recently Fred Trotter has come forward with evidence that he claims makes the Medsphere lawsuit baseless. Read on for an email interview with Fred Trotter regarding who did what in the Medsphere lawsuit, and why every free software developer should care about what is happening to the Shreeves..."


Raw Matter: Free Software and Quality
"Ben Chaff argues that Free Software is better than average in terms of security when compared to the proprietary software market, but falls short of the standards that apply for software used in crash-and-people-will-die type of mission critical applications.

"I fear I have to cry foul here: developing software for the kind of systems he describes (nuclear power plant controlling, medical equipment, ...) means developing software with a large budget and a limited, relatively well specified functionality..."

Ubuntu Linux in the Medical Industry... The ball rolls.

Hello chaps... Thanks for all the interest shown in the Ubuntu story so far. We are quite serious about pursuing the merits / sustainability of such an idea - with a view to handing over implementation to a non-profit... Any feedback would be greatly appreciated.

A special thanks to the first couple of people to prick up their ears: Mike Stopforth, Aaron and Farrel. We'll keep gathering interested parties together and see what happens. That's usually how these things start.

Things we're particularly interested in, and will research for a couple of new year posts...

1. 3rd World PC Projects. Who exports old PC's and to where?
2. Sustainability. Nothing is for free anymore. If the idea on the table allows national collaboration in the medical field, and empowers the medical profession to be more efficient - who pays the bills?
3. Software. I'll bring SA Doc into the fold here - we need to figure out firstly, what do hospitals / doctors / nurses ACTUALLY need in terms of software? What's available on the Linux platform.

As Farrel says in his comment on the initial post - this could be done by pretty much any Linux distribution - but why not use the perfectly good South African one then eh? (Note to self: Proudly South African involvement?).

Would be nice to get a response out of Ubuntu themselves. These ideas sometimes have a tendency to run away with themselves - the developers and distributors themselves may be able to push this thing along the right path...

We've already started digging for interesting stuff. That post coming up next...

Oh, and a shout out to the Ubuntu Blog (unofficial) - who was looking for interesting stuff being blogged - about Ubuntu!

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...