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Wednesday, November 25, 2009
GNUmed - A Free Project For Paperless general Practice PDF Print E-mail
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Written by XOS Staff   
Wednesday, 21 October 2009 13:35
The GNUmed project builds an open source Electronic Medical Record to assist and improve longitudinal care. This is freely available medical software for Windows, Linux and Mac OS X. It is developed by a handful of medical doctors and programmers from all over the world. It can be useful to anyone documenting the health of patients including, but not limited to, doctors, physical therapists, occupational therapists ...

GnuMed is a group of practising doctors, programmers and free software enthusiasts from around the world, committed to provide a superior, free software solution for community practice. Using tried-and-true technology, GNUmed software will start out having record-keeping, but will eventually cover all aspects of medical practice, and will interface well with third-party software. Technically speaking, it tries to do things "cleanly", but takes a pragmatic rather than purist approach. Currently, GNUmed's data is accessed via business objects implemented in Python which provide and govern direct access to the PostgreSQL RDBMS, but GNUmed will also be able access various types of data stores such as other RDBMS or LDAP.

GNUmed cleanly separates the medical aspects (record keeping) from the administrative aspects (billing, storage) of a medical practice. Thereby it allows GNUmed to be internationalized to different jurisdictions.

Who is GNUmed for?

GNUmed is suitable for any health care provider interested in keeping a sound and comprehensive medical record. It is currently in use with GPs and physical therapists. GNUmed safely operates on networks of a few to many users, and supports secure, remote access. It does also operate on a single computer, which makes it possible to initially examine the software, and may suit doctors or nurse clinicians serving rural or disadvantaged areas with limited infrastructure.

This is done by installing a "localhost" database in your machine or server infrastructure. More Information on the Documentation.

What is GNUmed "NOT"?

GNUmed is not currently intended for hospital IT (Information Technology). For Free and Open Source Software (FOSS) in that area please refer to VistA/DHCP and Care2x. GNUmed is, however, intended to interface well with such systems. There may also be some departments (such as hospital associated general ambulatory care) that warrant use of GNUmed.

Why is GNUmed the way it is?

The design paradigm for GNUmed aims to achieve the widest possible (global) usability. This explains the desire to maintain conceptual separation (if not functional) between what is truly relevant to a patient's health record --- from a health and patient benefit point of view --- and the administration and the work processes (including billing) that surround it.

If one approaches development instead from the point of view of doctors' workflows, where the primary purpose of the patient data structure is to support the doctors' billing, appointment-making and other tasks, you get an entirely different data design, in which patient information gets tucked into tables to serve the tables' interests, rather than the patients'... the patient "record" thereby becoming a secondary consideration. You end up with an entirely different paradigm, one that is not broadly (internationally), let alone (necessarily) nationally usable. GNUmed's founders would consider that a tragedy. In the gnumed-devel archive can be found postings that suggest GNUmed to "resist" GUI and workflow considerations. More accurately, there is only the position that –however important may be the workflow considerations – these need to be built from, and to remain built on, a meaningful patient record.

What is the username, and password, for the public database? The username for the public database on salaam.homeunix.com is any-doc. The password is any-doc as well.

Why is it that I cannot log in to the local GNUmed database? Most likely PostgreSQL is not configured correctly, or a suitable version of the GNUmed database was not installed or upgraded. Please take a look at the Section Installing and Configuring your local Postgres server.

What computer system(s) will it run on?

GNUmed has been installed on Unix, GNU/Linux, Windows and MacOSX systems (however the Mac version depends on a technical piece to catch up). Usage of the newest (experimental) versions is suggested only for developers, and others with some more advanced computing and/or programming experience. As our community and help base grows, "installer" packages are being created and maintained for a variety of systems, linked from ...downloading, installing in the GettingStarted topic.

Is GNUmed free? Why?

GNUmed, in common with most open source software (OSS), is free but in a special way. If somebody has access to source code they could modify it, create something new and then patent the new program. They might choose not to release the source code so they could make money from their new program. The resulting program would no longer be open source and others could not improve or adapt it if they wanted to.

One of the key elements of OSS is its licensing conditions. Certain licences can specifically prevent something like this from happening. There are a number of OS (Open Source) licences, and examples of the most common ones can be found at [http://www.opensource.org/licenses]. The original and most widely known licence is the GNU General Public Licence (GPL). Under the GNU GPL you can use, copy, modify or even sell free software but the software must come with either the source files or access to the source files. If you were to sell the software, or modify it and then sell it, the GPL requires that such software also be covered by the GPL. Thus, you are required to let the buyer know that they can have the source code and they have the right to use it or modify it if they wish. They must also be told that the program is sold under the GNU General Public Licence. The effect of the GPL is that OSS is rarely sold and that most vendors make their money instead by installing OS software and otherwise supporting end users.

GNUmed is being released under the GPL because medical software is evolving from mere administrative tools towards powerful decision support systems. It is predictable that we will soon reach a state where software might make better and safer decisions than unexperienced doctors. This will sooner or later result in situations where a patient's health or even life depends on using the most sophisticated software. Given the infinite replicability of software at negligible cost, it would feel unethical to prevent those in need from having access to that software.

Visit the GNUmed Project.


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