1217 lines
55 KiB
Plaintext
1217 lines
55 KiB
Plaintext
Linux Medicine-HOWTO
|
||
|
||
Walt Pennington
|
||
|
||
tldp at pennfirm dot net
|
||
|
||
Gerardo Arnaez
|
||
|
||
<dude@mung.net>
|
||
Raintree I.T.??
|
||
Department of Advanced Skunk Works
|
||
|
||
Werner Heuser
|
||
|
||
<wehe [a[t]ta] tuxmobil.org>
|
||
Revision History
|
||
Revision 2.3 2004-03-24 Revised by: gea
|
||
Slight updates
|
||
Revision 2.2 2003-07-11 Revised by: gea
|
||
Slight updates
|
||
Revision 2.1.2 2003-04-06 Revised by: gea
|
||
Update Slicer information thanks to Matej Pivoluska. updated Werner Heuser
|
||
information
|
||
Revision 2.1.1.2 2003-02-02 Revised by: gea
|
||
Corrected typo of 'important' in article description. Thanks to Morgon
|
||
Kanter.
|
||
Revision 2.1.1.1 2003-01-05 Revised by: gea
|
||
slight update. spam-proofed emails. Note anyone that wants to help with the
|
||
vet section should 'come on down'.
|
||
Revision 2.1.1 2002-12-22 Revised by: gea
|
||
Update to re-include vet applications, but again, will mostly serve as
|
||
pointer to better information.
|
||
Revision 2.1 2002-8-24 Revised by: gea
|
||
There are too many projects. There are much better sites for information.
|
||
This document will change its focus and be more of a stable document and
|
||
pointing to active sites with better and more up-to-date information. This
|
||
document is not intended to be complete, and parts of it will seem out of
|
||
place in its new function.
|
||
Revision 2.0.5 2002-07-26 Revised by: gea
|
||
Added in OpenEMR. I also need to add back in the german sections, but will
|
||
need help on it.
|
||
Revision 2.0.4 2002-04-06 Revised by: gea
|
||
Added Kpumpe and OIO library info
|
||
Revision 2.0.3 2002-03-02 Revised by: gea
|
||
Added to install OIO on Debian system. Have started on OIO how to install
|
||
Revision 2.0.2 2002-03-02 Revised by: gea
|
||
Starting to add more to the How-To section of FreePM. The installation
|
||
section will need testing by others. Added Slicer info under a new section
|
||
Revision 2.0.1 2002-02-19 Revised by: gea
|
||
Minor changes, Changed license to GPL. Some more reorganization. Which to say
|
||
I have deleted out a ton of comments that I put that were useless. More
|
||
pimping of Debian-med.
|
||
Revision 2.0 2002-02-05 Revised by: gea
|
||
Major changes. Conversion from linux-doc to Doc-Book format. Have basically
|
||
edited out nutrition sections and most of the German section for now until I
|
||
can get help again the German section. Have switched focus of the article to
|
||
Medical informatics and applications, less to research applications which
|
||
should probably be a different article. Will most likely put these things I
|
||
will not maintain at the end, so someone else has some where to begin. Whew.
|
||
Tired from Doc-Book Conversion.
|
||
Revision 1.4.3 2002-02-5 Revised by: gea
|
||
Doing minor checks of links. no big change yet
|
||
Revision 1.4.2 2002-02-05 Revised by: gea
|
||
I have started to make structural changes to the documents. Changes Community
|
||
to the fore-front. renamed Medical Application to Medical Record Application
|
||
to make it more usable. I have not decide to change the version number as i
|
||
have just moved links around and I am trying to structure the document a
|
||
little bit better.
|
||
Revision 1.4.1 2002-02-05 Revised by: gea
|
||
Gerardo Arnaez took over maintaining this document. Some new additions, some
|
||
info on when last update. Links to sqlclinic.net and eors.org added.
|
||
Revision 1.4 Unknown Revised by: wh
|
||
XXX, minor changes
|
||
Revision 1.3 2001-03-01 Revised by: wh
|
||
added links to gnutrition, Java SmokingMeter and HL7lib - Health Level 7
|
||
Library, some other links updated, Japanese translation proposed
|
||
Revision 1.2 2000-11-04 Revised by: wh
|
||
Links to Nut, Free Practice Management, LittleFish, GNUMed, REALTIQ,
|
||
VISIdent, weight, OIO, CTSim, myPACS, BlazeLIMS, XNBC and PhysioNet added,
|
||
new document URL, minor changes
|
||
Revision 1.1 2000-04-20 Revised by: wh
|
||
links to Res Medicinae, QDS, sixpack and LinuxMedNews added, minor changes
|
||
Revision 1.0 2000-01-27 Revised by: wh
|
||
LinuDent added, preface and disclaimer added, minor changes, first official
|
||
release
|
||
Revision 0.2 2000-01-26 Revised by: wh
|
||
URLs checked, minor changes, second draft
|
||
Revision 0.1 1999-11-17 Revised by: wh
|
||
first draft
|
||
|
||
|
||
The Linux Medical How-To will serve as a nice and convenient meta resource
|
||
directing interested parties to important sites, a few well-established/meta
|
||
mailing lists.
|
||
|
||
-----------------------------------------------------------------------------
|
||
Table of Contents
|
||
1. Preface
|
||
1.1. About the Document
|
||
1.2. Update
|
||
1.3. About the Author(s)
|
||
1.4. Copyright, Disclaimer and Trademarks
|
||
1.5. Request For Comments
|
||
|
||
|
||
2. Debian-Med
|
||
2.1. DEBIAN-MED HOMEPAGE
|
||
|
||
|
||
3. Community
|
||
3.1. News
|
||
3.2. Organizations
|
||
3.3. Mailing Lists
|
||
3.4. IRC
|
||
|
||
|
||
4. Medical Record Applications
|
||
4.1. Debian Med
|
||
4.2. OpenEMR
|
||
4.3. VISTA (DHCP)
|
||
4.4. WorldVista and OpenVista
|
||
4.5. SQL Clinic
|
||
4.6. FreeB
|
||
4.7. FreeMED
|
||
4.8. Freemed-YiRC
|
||
4.9. Care2x
|
||
4.10. Medical DataServer
|
||
4.11. OpenClinic
|
||
4.12. GNUMed
|
||
4.13. GNotary
|
||
4.14. Res Medicinae
|
||
4.15. Open Infrastructure for Outcomes
|
||
4.16. LIMS - Laboratory Information Management Systems
|
||
4.17. Meditux
|
||
4.18. MEGA and Mumps Compiler
|
||
|
||
|
||
5. Medical informatics
|
||
5.1. What is it?
|
||
5.2. Good Electronic Health Record - GEHR
|
||
5.3. HL7lib - Health Level 7 Library
|
||
|
||
|
||
6. PDA
|
||
6.1. Tuxmobil PDA Information Site
|
||
6.2. Palm Pilots
|
||
6.3. Linux Devices
|
||
|
||
|
||
7. Veterinary applications
|
||
7.1. FreeVET
|
||
|
||
|
||
8. Installing a Medical Record Application (not ready yet)
|
||
8.1. CLARIFICATION
|
||
8.2. Point of this section
|
||
8.3. My Assumptions About You
|
||
8.4. OIO
|
||
8.5. FreePM
|
||
|
||
|
||
9. Imaging Applications
|
||
9.1. Slicer
|
||
|
||
|
||
10. Useful Applications
|
||
10.1. KPumpe
|
||
|
||
|
||
11. My thoughts
|
||
11.1. Too Many Projects
|
||
11.2. I am biased
|
||
11.3. I work and what is needed.
|
||
|
||
|
||
12. Credits
|
||
|
||
1. Preface
|
||
|
||
Life is the first gift, love is the second, and understanding is the third.
|
||
-- [http://www.capecod.net/??tmpiercy/] Marge Piercy
|
||
-----------------------------------------------------------------------------
|
||
|
||
1.1. About the Document
|
||
|
||
This document is part of the [http://www.linuxdoc.org] LINUX DOCUMENTATION
|
||
PROJECT - LDP.
|
||
|
||
A Japanese translation is proposed by Shouhei Nagaoka, see the [http://
|
||
www.linux.or.jp/JF/] Linux JF (Japanese FAQ) Project.
|
||
|
||
Note: Werner Heuser, no longer maintains this LDP.
|
||
-----------------------------------------------------------------------------
|
||
|
||
1.2. Update
|
||
|
||
The most up-to-date version of this document will be at the [http://
|
||
www.mung.net] mung.net
|
||
-----------------------------------------------------------------------------
|
||
|
||
1.3. About the Author(s)
|
||
|
||
Gerardo Arnaez: I am an internal medicine doctor. I am extremely concerned
|
||
with the state of medical informatics.
|
||
|
||
Werner Heuser: Working as a system administrator in the computer departments
|
||
of two German hospitals I get inspired to search for medical applications
|
||
created with Linux software. Besides this HOWTO I have written the [http://
|
||
tuxmobil.org/howtos.html] Linux-Mobile-Guide, [http://tuxmobil.org/
|
||
howtos.html] Linux-Infrared-HOWTO and the [http://tuxmobil.org/
|
||
eco_linux.html] Linux-Ecology-HOWTO.
|
||
-----------------------------------------------------------------------------
|
||
|
||
1.4. Copyright, Disclaimer and Trademarks
|
||
|
||
NOTE: This license has changed to [http://www.fsf.org/licenses/gpl.html] GPL
|
||
license.
|
||
|
||
Copyright © 2002 by Gerardo Arnaez. This document may be distributed under
|
||
the terms set forth in the [http://www.fsf.org/licenses/gpl.html] GPL
|
||
license.
|
||
|
||
Copyright © 2000 by Werner Heuser. This document may be distributed under the
|
||
terms set forth in the [http://www.linuxdoc.org/COPYRIGHT.html] LDP license.
|
||
|
||
This is free documentation. It is distributed in the hope that it will be
|
||
useful, but without any warranty. The information in this document is correct
|
||
to the best of my knowledge, but there's a always a chance I've made some
|
||
mistakes, so don't follow everything too blindly, especially if it seems
|
||
wrong. Nothing here should have a detrimental effect on your computer, but
|
||
just in case I take no responsibility for any damages incurred from the use
|
||
of the information contained herein.
|
||
|
||
Though I hope trademarks will be superfluous sometimes (you may see what I
|
||
mean at [http://www.opensource.org/osd.html] Open Source Definition : If
|
||
certain words are trademarks, the context should make it clear to whom they
|
||
belong. For example MS Windows NT implies that Windows NT belongs to
|
||
Microsoft (MS). Mac is a trademark by Apple Computer. All trademarks belong
|
||
to their respective owners.
|
||
-----------------------------------------------------------------------------
|
||
|
||
1.5. Request For Comments
|
||
|
||
If you have any comments, suggestions, new information, please tell me: <
|
||
garnaez_((AT))_yahoo.com>
|
||
-----------------------------------------------------------------------------
|
||
|
||
2. Debian-Med
|
||
|
||
2.1. DEBIAN-MED HOMEPAGE
|
||
|
||
One location to find information on medical projects is [http://
|
||
www.debian.org/devel/debian-med/] Debian-Med. Debian-Med has a very nice
|
||
listing of projects.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3. Community
|
||
|
||
3.1. News
|
||
|
||
3.1.1. LinuxMedNews
|
||
|
||
[http://www.LinuxMedNews.org/] LinuxMedNews is the unofficial news site for
|
||
Linux and medical projects. LinuxMedNews.org is designed to facilitate
|
||
announcements and sharing, of information related to open source applications
|
||
and how they are advancing the efforts of medicine worldwide. LinuxMedNews is
|
||
published using Squishdot and Zope for its news and project collection.
|
||
LinuxMedNews is intended to be an interesting and fun resource for anyone
|
||
with an interest in health care and open source.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3.1.2. The Spirit Project
|
||
|
||
[http://www.euspirit.org] The Spirit Project is a multilingual source of
|
||
open-source software that makes this document just pale in comparison. Well
|
||
designed, too big for me go over in detail, but seems to be another good
|
||
source for software development and group news.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3.2. Organizations
|
||
|
||
3.2.1. American Medical Informatics Association
|
||
|
||
[http://www.amia.org] AMIA is an association supporting the technology and
|
||
informatics for the medical community. AMIA sponsors an Open Source Working
|
||
Group. The OS-WG has providers, clinics, hospitals, hardware manufacturers
|
||
and researchers worldwide giving a broad perspective for the technology needs
|
||
and uses within medicine. AMIA does require a subscription, however AMIA
|
||
offers an associate membership for $30 for one year. At this membership
|
||
level, you can join one working group and its mailing list.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3.3. Mailing Lists
|
||
|
||
3.3.1. OpenHealth
|
||
|
||
[http://www.openhealth.com/] OpenHealth is a company owned mailing list for
|
||
community discussion of issues related to open source software development
|
||
for medical projects. This is one of the largest and most popular lists for
|
||
discussion of topics related to science and medicine and has an international
|
||
population. In late 2003 and early 2004 there were problems with users trying
|
||
to joing the list. Minoru Development, the owner of the OpenHealth List, is
|
||
working with Bud Bruegger to improve administrative issues, and since Bud has
|
||
assumed the administrative role, joining the list or resolving list issues is
|
||
typically resolved in one to two days. Join the mailing list by going [http:/
|
||
/www.openhealth.com/en/healthcare.html] Here. Minoru Development also has a
|
||
[http://www.openhealth.com/en/healthlinks.html] Link to a list of other
|
||
open-source application projects.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3.3.2. Open Source Health Care Alliance
|
||
|
||
[http://www.oshca.org/] Open Source Health Care Alliance (OSHCA) is a
|
||
collaborative forum to promote and facilitate open source software in human
|
||
and veterinary health care. At the OSCHA web site most of the information is
|
||
stale, and there is a direction to the OpenHealth mailing list.
|
||
-----------------------------------------------------------------------------
|
||
|
||
3.4. IRC
|
||
|
||
3.4.1. IRC #openmed
|
||
|
||
An IRC channel, #openmed, has been set up on irc.openprojects.net. To learn
|
||
more about IRC, click [http://www.irc.net] Here. To learn more about
|
||
Openprojects.net, click [http://www.openprojects.net] Here.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4. Medical Record Applications
|
||
|
||
4.1. Debian Med
|
||
|
||
Debian-Med is a Debian meta-project allows for installation of medical themed
|
||
appliations. Debian-Med is not a separate distribution, but is an extended
|
||
functionality for Debian users. Below you will see many applications for the
|
||
medical community. Typically, you would download and install a single
|
||
application, and resolve any issues that arise during an installation.
|
||
Debian-Med solves that installation issue. The Debian-Med project leaders
|
||
will note that an application is a medical or biosciences related
|
||
application.
|
||
|
||
After you have installed Debian, you can choose to load either a single
|
||
application, or you can choose to load Debian-Med. Loading Debian-Med will
|
||
install all of the applications that have been designated as medical or
|
||
biosciences related. The Debian-Med project can be found in the Apt-get
|
||
repositories. [http://www.debian.org/devel/debian-med/] Click here to access
|
||
the Debian-Med home page
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.2. OpenEMR
|
||
|
||
OpenEMR is a modular, HIPAA compliant, open source, practice management,
|
||
electronic medical record and prescription writing application. OpenEMR
|
||
should have billing capability using FreeB by late April 2004. The planned
|
||
billing functionality for OpenEMR will include the ability to generate ANSI
|
||
X12 or HCFA 1500 forms, or submit bills directly to Medicaid, Medicare or
|
||
private insurers. The developers on the project are actively working on
|
||
completing the billing functionality. 2.5.2 is the latest version of OpenEMR
|
||
and includes the ability to find the first available appointment on the
|
||
calendar for a provider, direct links to encounters from the calendar,
|
||
different calendar views for a provider or office staff, reporting using
|
||
phpMyAdmin and prescription writing.
|
||
|
||
OpenEMR uses Linux, Apache, MySQL and PHP. OpenEMR incorporates the work of
|
||
several open source projects such as PostCalendar from PostNuke for
|
||
calendaring, and phpMyAdmin for database reporting and manipulation. OpenEMR
|
||
is also integrating the work of FreeB for billing.
|
||
|
||
[http://www.openemr.net] At the OpenEMR.net User forum you will find several
|
||
user testimonials about installing, migrating data and customizing OpenEMR in
|
||
actual medical office environments.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.2.1. Last Update:
|
||
|
||
March 25, 2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.3. VISTA (DHCP)
|
||
|
||
[http://www.hardhats.org] VISTA is a largest and most comprehensive of open
|
||
source medical projects. VISTA is an open source application that is funded
|
||
by the federal government for use by the Veterans Administration at its
|
||
hospitals and clinics. I used this system, when I was a resident, in the VA
|
||
hospital, and it was the best system that I had used. This is a wonderful
|
||
project that I can recommend. I am not sure about the software license, but
|
||
the software and documentation are available from the U.S. Federal
|
||
Government. To obtain the software you must file a Freedom of Information Act
|
||
("FOIA") request. The current fees to obtain VISTA on CD are $53US for the
|
||
main VISTA packages and $13 for imageing. [http://hardhats.org/foia.html]
|
||
REQUESTS to get access to the software on CD. Some of the cost may be
|
||
on-line, so please email the team at hardhats.org.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.3.1. Last Update:
|
||
|
||
Constantly
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.4. WorldVista and OpenVista
|
||
|
||
[http://www.worldvista.org] WorldVista and OpenVista are open source variants
|
||
of VISTA.
|
||
|
||
WorldVista helps make healthcare information technology more affordable and
|
||
more widely available both within the United States and internationally.
|
||
WorldVistA extends and improves VistA for use outside its original setting
|
||
through such activities as developing packages for pediatrics, obstetrics,
|
||
and other hospital services not used in veterans' hospitals. WorldVistA also
|
||
helps those who choose to adopt VistA successfully master, install, and
|
||
maintain the software. As the group of VistA adopters and programmers grows,
|
||
we work to develop it into a collaborative, consensus-based, open-source
|
||
community.
|
||
|
||
The OpenVistA project will help its adopters eliminate these fees by allowing
|
||
VistA to run on the GT.M programming environment and the Linux operating
|
||
system, both of which are open source and free. Historically, VISTA required
|
||
adopters to pay licensing fees for the systems on which it runs: the
|
||
programming environment (MUMPS) and the operating system underneath (such as
|
||
Microsoft Windows or VMS). By reducing licensing costs, OpenVistA frees up
|
||
money to be spent on medicine, medical professionals, and other resources
|
||
more likely to directly improve patient care. Like all WorldVistA projects,
|
||
the OpenVistA project not only provides adopters with the software itself but
|
||
also transfers knowledge and expertise and builds long-term mutual support
|
||
relationships between adopters and the rest of the worldwide VistA community.
|
||
This software is for medical clinics, FQHC, hospitals, medicine training
|
||
facilities, and community medical clinics.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.4.1. Last Update:
|
||
|
||
12/20/2003
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.5. SQL Clinic
|
||
|
||
[http://www.sqlclinic.net] SQL clinic is an impressive application that was
|
||
developed for mental health workers, sponsored by their local hospital. What
|
||
is most impressive is the amount of documentation. SQL Clinic in its current
|
||
format may require additional customization for use outside of mental-health
|
||
projects.
|
||
|
||
SQL Clinic is designed to be reverse engineered and used for medical or other
|
||
purposes. SQL CLinic is based on Lincoln Stein's CGI.pm module and the
|
||
incredible horsepower of PostgreSQL. The developer's goal for SQL Clinic is
|
||
for the project to have utility as an example of how to access postgres via
|
||
Perl than as a mere clinical application.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.5.1. Last Update:
|
||
|
||
Feb 21, 2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.6. FreeB
|
||
|
||
[http://www.freeb.org/] FreeB is a medical billing engine. It is a collection
|
||
of formats, as well as an engine capable of connecting with any Practice
|
||
Management System that implements the FreeB API (XML-RPC). It supports
|
||
HIPAA-compliant ANSI X12 837 electronic billing and HCFA 1500 paper formats.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.6.1. Last Update
|
||
|
||
March 25, 2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.7. FreeMED
|
||
|
||
[http://www.freemed.org/] Freemed is a web based medical practice management
|
||
and electronic medical record application. FreeMED runs on Apache, a SQL
|
||
back-end (usually MySQL, but there's an SQL Abstraction for this), and PHP.
|
||
FreeMED aims to duplicate functionality of proprietary applications such as
|
||
Medical Manager, while remaining open source.
|
||
|
||
FreeMED is working on two functional additions: billing with FreeB and
|
||
reporting using Agata. FreeB will allow FreeMED users to send ANSI X12 or
|
||
HCFA 1500 forms directly to a payer. Agata, an open source replacement for
|
||
Crystal Reports, will allow a practice to create custom reports for FQHC UDS
|
||
reporting or other reporting needs.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.7.1. Last Update
|
||
|
||
March 25, 2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.8. Freemed-YiRC
|
||
|
||
[http://freemed-yirc.familyandyouth.org/] Freemed-YiRC is based on FreeMED
|
||
for use with Youth in Residential Care (YiRC) agencies. Its aim is to be a
|
||
complete package to replace legacy non-free apps which aren't customizable.
|
||
As a PHP-based application, all that is needed is a web browser with
|
||
extensive table support. It uses either Postgres or MySQL databases.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.8.1. Last Update:
|
||
|
||
11/23/2003
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.9. Care2x
|
||
|
||
[http://care2x.org/] Care2x is for hospitals and health care organizations.
|
||
It is designed to integrate the different information systems existing in
|
||
these organizations into a single efficient system. Care2x solves the
|
||
problems inherent in a network of multiple programs that are incompatible
|
||
with each other. It can integrate almost any type of services, systems,
|
||
departments, clinics, processes, data, or communication that exist in a
|
||
hospital. Care2x's design can even handle non-medical services or functions
|
||
like security or maintenance. All of its functions can be accessed with a Web
|
||
browser, and all program modules are processed on the server side.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.9.1. Last Update:
|
||
|
||
01/10/2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.10. Medical DataServer
|
||
|
||
[http://www.mii.ucla.edu/dataserver/] Medical DataServer is an XML gateway,
|
||
specially tailored for the medical domain. It provides an enterprise-quality
|
||
platform for aggregating XML-based patient medical records, in both clinical
|
||
and research applications. It is middleware, situated between clients and
|
||
traditional Health Information Systems (HIS), Radiology Information Systems
|
||
(RIS), and Picture Archive and Communication Systems (PACS). It supports
|
||
relational (SQL), SOAP, and HTTP data sources out of the box, but is highly
|
||
extensible for custom types. A suite of Web-based tools allows for the
|
||
centralized management of distributed data sources, and the rapid deployment
|
||
of new services. It addresses HIPAA concerns with query auditing, tight
|
||
integration with security mechanisms, and patient record de-identification.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.10.1. Last Update:
|
||
|
||
03/25/2004
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.11. OpenClinic
|
||
|
||
[http://openclinic.sourceforge.net/openclinic/index.html] OpenClinic
|
||
OpenClinic is an easy to use, open source medical records system. It has been
|
||
mainly developed for private clinics, surgeries, and private doctors. It is
|
||
platform independent and has a multi-language architecture.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.11.1. Last Update:
|
||
|
||
12/20/2003
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.12. GNUMed
|
||
|
||
[http://www.gnumed.org/] GNUMed is suited to doctors in community practice,
|
||
but may suit others who provide a degree of comprehensive care (general
|
||
internists, pediatricians, others). GNUMed will support a few or many
|
||
networked users with secure local or remote access. GNUMed will also operate
|
||
on a single computer. The GNUMed project recommends testing GNUMed on a
|
||
single computer to examine the software's features for a particular practice.
|
||
GNUMed is comprised of a group of practicing physicians, programmers and open
|
||
source software enthusiasts from around the world. GNUMed's data is accessed
|
||
via business objects implemented in Python directly accessing the PostgreSQL
|
||
RDBMS. GNUMed will also access various types of data stores such as other
|
||
RDBMS or LDAP.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.12.1. Last update:
|
||
|
||
12/30/2003
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.13. GNotary
|
||
|
||
[http://www.gnumed.net/gnotary/] GNOTARY is a part of the GNUMed Utility
|
||
Collection and is designed to provide the ability to notarize digital
|
||
documents using a server. The purpose of the notary for medical records is to
|
||
prove that digital documents have not been tampered with after their initial
|
||
creation date.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.13.1. Last Update:
|
||
|
||
11/26/2001
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.14. Res Medicinae
|
||
|
||
[http://resmedicinae.sourceforge.net/] Res Medicinae is to become a
|
||
comprising software solution for use in medicine which combines intuitive
|
||
ease of use with the advantages of the CYBOL programming language. It uses
|
||
latest technology adhering to common standards for medical software and will
|
||
such be open to many other medical systems.
|
||
|
||
Res Medicinae is the attempt to overcome high pricing in the realm of medical
|
||
information systems and to provide users with a free, stable, secure,
|
||
platform-independent, extensive system.
|
||
|
||
-----------------------------------------------------------------------------
|
||
4.14.1. Last Update:
|
||
|
||
10/4/2002
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.15. Open Infrastructure for Outcomes
|
||
|
||
[http://www.TxOutcome.org/] OIO is a Web-based information system for
|
||
treatment outcome management. It is in production at the Harbor/UCLA Medical
|
||
Center for clinical outcomes management and research data. Forms created with
|
||
OIO and hosted on any OIO server can be downloaded as XML files. Once
|
||
downloaded from the "Forms library" and imported into an OIO server, the
|
||
necessary database tables are automatically recreated and the imported forms
|
||
become immediately available to the users of that OIO server.
|
||
|
||
Note: This application is already in quite useful, but lacks 'already-made'
|
||
forms for use. But these can be quickly designed within the application's
|
||
interface quickly. Another to really try!
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.15.1. OIO Library
|
||
|
||
One of the interesting things about OIO project, one that makes it one of my
|
||
favorites, is the ability to share forms that others have created. However,
|
||
at this moment there are no forms present, but in the future they will be
|
||
[http://www.txoutcome.org/scripts/zope/library] Here
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.15.2. Update
|
||
|
||
I have successfully installed this and believe that this is an excellent
|
||
application. In the HOW-TO Install section, I may try to replicate all
|
||
documents or use the fine documentation and just comment on it, making
|
||
special note of problems encountered during installation and use
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.16. LIMS - Laboratory Information Management Systems
|
||
|
||
The LIMS ASTM Standard (E1578 Standard Guide for Laboratory Information
|
||
Management Systems) can be found in ASTM`s Annual Book of Standards Volume
|
||
14.01 Healthcare Informatics; Computerized Systems and Chemical and Material
|
||
Information. There is a small terminology section in this standard that
|
||
covers 25 terms that relate to LIMS. The purpose of the standard guide is to
|
||
educate new LIMS users on the purpose and functions and the process of
|
||
procuring a LIMS.
|
||
|
||
There is one other additional LIMS related standard in this book. This E2066
|
||
Standard Guide for Validation of Laboratory Information Management Systems.
|
||
The BlazeLIMS Server by [http://www.blazesystems.com/] Blaze Systems
|
||
Corporation LIMS is now supported on Linux.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.17. Meditux
|
||
|
||
[http://meditux.sourceforge.net/] Meditux is Java-servlet based software that
|
||
provides a Web interface to MySQL or potentially any relational database
|
||
engine which is JDBC capable. It was developed to support an Intranet site in
|
||
a medical intensive care unit where it was used to collect clinical and
|
||
research data.
|
||
-----------------------------------------------------------------------------
|
||
|
||
4.18. MEGA and Mumps Compiler
|
||
|
||
Mumps Compiler is a compiler for a subset of the Mumps language, a language
|
||
used mainly in health care. It is compatible with most operating systems with
|
||
a standard C compiler. License: GPL [http://home.clara.net/finch/] OMEGA is
|
||
an Open Source implementation of the M-Technology (MUMPS) programming
|
||
language. It is extend-able, and currently embedded with MySQL; it is ideal
|
||
as a trigger/validation front-end to SQL. License: free for non-commercial
|
||
use.
|
||
-----------------------------------------------------------------------------
|
||
|
||
5. Medical informatics
|
||
|
||
5.1. What is it?
|
||
|
||
My extremely brief answer would be it is the study of how medical data is
|
||
recorded, stored, retrieved, displayed and exchanged. One of the big problems
|
||
facing medicine is how to transfer medical data from one system to another.
|
||
|
||
Another answer comes from the AMIA.ORG site:
|
||
|
||
Medical informatics has to do with all aspects of
|
||
understanding and promoting the effective organization,
|
||
analysis, management, and use of information in health care.
|
||
While the field of medical informatics shares the general
|
||
scope of these interests with some other health care
|
||
specialties and disciplines, medical informatics has
|
||
developed its own areas of emphasis and approaches that have
|
||
set it apart from other disciplines and specialties. For
|
||
one, a common thread through medical informatics has been
|
||
the emphasis on technology as an integral tool to help
|
||
organize, analyze, manage, and use information. In addition,
|
||
as professionals involved at the intersection of information
|
||
and technology and health care, those in medical informatics
|
||
have historically tended to be engaged in the research,
|
||
development, and evaluation side of things, and in studying
|
||
and teaching the theoretical and methodological
|
||
underpinnings of data applications in health care. However,
|
||
today medical informatics also counts among its profession
|
||
many whose activities are focused on dimensions that include
|
||
the administration and everyday collection and use of
|
||
information in health care. For an account of some of the
|
||
definitions that describe the field in more formal and
|
||
scientific terms, click here.
|
||
--[http://www.amia.org] AMIA.ORG
|
||
-----------------------------------------------------------------------------
|
||
|
||
5.2. Good Electronic Health Record - GEHR
|
||
|
||
The [http://www.gehr.org/] Good Electronic Health Record (GEHR) , a major
|
||
part of the work of the openEHR Foundation, is an evolving electronic health
|
||
record architecture designed to be comprehensive, portable and medico-legally
|
||
robust. It has been developed from the [http://www.chime.ucl.ac.uk/HealthI/
|
||
GEHR/] Good European Health Record project requirements statement and object
|
||
model- the most comprehensive requirements documents ever developed for the
|
||
electronic health record. This website is a public resource for documents and
|
||
resources that have been used to build implementations of this record.
|
||
-----------------------------------------------------------------------------
|
||
|
||
5.3. HL7lib - Health Level 7 Library
|
||
|
||
[http://hl7lib.sourceforge.net] HL7lib Health Level 7 Library is a project
|
||
that will provide a free, correct implementation of Health Level 7 functions.
|
||
Health Level 7 is commonly used in large hospitals to send patient
|
||
information among computer systems from different vendors. Since there is no
|
||
reference implementation of HL7 many of these vendor systems vary widely in
|
||
their interpretation of HL7.
|
||
-----------------------------------------------------------------------------
|
||
|
||
6. PDA
|
||
|
||
6.1. Tuxmobil PDA Information Site
|
||
|
||
The indefatigable Werner Heuser has an extremely informative and updated
|
||
information site for Linux Based PDA's. It is at [http://tuxmobil.org/
|
||
pda_linux.html] Tuxmobil.org
|
||
-----------------------------------------------------------------------------
|
||
|
||
6.2. Palm Pilots
|
||
|
||
An increasing role in data collection for instance in hospitals, will be
|
||
played by hand-held computers (HPCs) or Personal Digital Assistants (PDAs).
|
||
More commonly known as PALMs. Linux offers way to exchange these data to
|
||
servers, for instance via the IrDA port. See [http://tuxmobi.org/howtos.html]
|
||
Infrared-HOWTO for details. A survey of non-Linux applications for the Palm
|
||
device you may find at [http://palmtops.about.com/compute/palmtops/
|
||
msub14.htm] PalmPilot Medical - Palmtops PDAs HPCs Palm - Net Links.
|
||
-----------------------------------------------------------------------------
|
||
|
||
6.3. Linux Devices
|
||
|
||
For more info, on say Sharp Zaurus SL-5000D, look [http://
|
||
www.linuxdevices.com/index.html] Here.
|
||
|
||
This section will grow as I am getting touch with a doctor who is actively
|
||
developing OB-GYNE applications to use on it
|
||
-----------------------------------------------------------------------------
|
||
|
||
7. Veterinary applications
|
||
|
||
If you have questions about this section, I urge you to email Gabriel M.
|
||
Elder (gmelder (AT/@/AT) centurytel.net)
|
||
-----------------------------------------------------------------------------
|
||
|
||
7.1. FreeVET
|
||
|
||
He writes
|
||
|
||
|
||
Earlier versions of the Medicine HOWTO included a reference to a project
|
||
known as FreeVet, a FOSS package available via QPL, aimed at being such a
|
||
solution. The project appears to have died after reaching a relatively
|
||
high level of development and maturity. The only currently accessible
|
||
information and code that I've been able to find is here: [http://
|
||
www-med-chemie.vu-wien.ac.at/mirrors/FreeVet/] FreeVet
|
||
|
||
-----------------------------------------------------------------------------
|
||
8. Installing a Medical Record Application (not ready yet)
|
||
|
||
8.1. CLARIFICATION
|
||
|
||
I will no longer aim this HOW-TO as an actual how-to. This section is
|
||
deprecated and will no longer be maintained, but will not be removed.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.2. Point of this section
|
||
|
||
This section is actually going to be the HOW-TO of this HOW-TO document. I
|
||
intend to include instructions or refer to instruction on installing what
|
||
available systems that are readily usable at this point.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.3. My Assumptions About You
|
||
|
||
I will try to be pretty cook book about how to install these applications,
|
||
which means that if I can, i will always tell you what to type (at least what
|
||
to type that works for me). The problem is that this assumes that you know
|
||
what a shell window is and can switch directories with-in, which actually
|
||
assumes a fair level of technical sophistication since most of us have gotten
|
||
used to Microsoft based Windows systems. Which is to say that a lot of us
|
||
only have interacted with a computer using a Graphics User Interface (Gui's),
|
||
and that these installation require that you be familiar with Command Line
|
||
Interfaces (CLI) like a terminal window or a shell.
|
||
|
||
If you don't know what I am talking about then I recommend you ask someone
|
||
(me possibly) about what shell windows are, and probably what a UNIX-based
|
||
Operating system looks like, especially without a GUI.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.4. OIO
|
||
|
||
8.4.1. What is it?
|
||
|
||
The OIO system starts a higher level of abstraction - starting with modeling
|
||
"forms". The forms are then used to model/build progress notes etc. The OIO
|
||
system makes use of a relational database back-end (PostgreSQL) - 1) making
|
||
the data/metadata/presentation separation more distinct, 2) making
|
||
integration with other system (e.g. legacy systems, GNUMed, SQL Clinic etc)
|
||
easier, 3) making query construction/extension easier (via SQL).
|
||
|
||
If you search the OpenHealth mailing list archives, you will see extensive
|
||
discussion regarding this in the context of GEHR and OIO. GEHR uses the same
|
||
approach but calls this intermediate level of abstraction "archetypes". The
|
||
advantage of the OIO/GEHR approach is that the metadata components can be
|
||
plug-and-play - meaning that the system can be easily extended/customized AND
|
||
portable medical records become easier to implement.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.4.2. HOW TO INSTALL OIO
|
||
|
||
8.4.2.1. A word on documentation
|
||
|
||
I can not stress how really good and how much documentation the developers of
|
||
OIO have written. There are some confusing parts, especially if you are in a
|
||
hurry. :) However, please read the install documentation at [http://
|
||
www.txoutcome.org] OIO then come back. Hopefully, I will import or streamline
|
||
the documentation since, the developers want to support OIO on all
|
||
distribution, whereas my slant is becoming more and more based on the Debian
|
||
distribution.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.4.2.2. Initial Notes on Debian Installation
|
||
|
||
8.4.2.2.1. Changes to PostgreSQL
|
||
|
||
One of the more aggravating things was find that Zope could not interact
|
||
(connect) to the PostgreSQL database. What was happening (I will give greater
|
||
detail later) is that the 'postgres' user could not be authenticated. I think
|
||
this is a problem in that Krebs authentication is not installed by default.
|
||
To fix this you need to cd /etc/PostgreSQL/ and find the pg_hba.conf file.
|
||
Using what ever editor you like, find the bit of code that tells who can and
|
||
can not access to the database. Unfortunately, the only way I could get it to
|
||
work for now is to change:
|
||
|
||
local all peer sameuser
|
||
|
||
host all 127.0.0.1 255.0.0.0 ident sameuser
|
||
|
||
host all 0.0.0.0 0.0.0.0 reject
|
||
|
||
And change it to
|
||
|
||
local all trust
|
||
|
||
host all 127.0.0.1 255.0.0.0 trust
|
||
|
||
host all 0.0.0.0 0.0.0.0 reject
|
||
|
||
-----------------------------------------------------------------------------
|
||
8.4.2.2.2. TimeStamp Error
|
||
|
||
I ran into this problem because apparently PostgreSQL does not like the
|
||
|
||
|
||
On Sat, 2 Mar 2002 dude@deletia.com wrote:
|
||
...
|
||
> I have reached the section that asks me to archive a form.
|
||
>
|
||
> I hit the 'now' button, then hit 'Create a new version' and i get the
|
||
> follow error:
|
||
> This is the source of it the html page:
|
||
> <strong>Error Value: ERROR: Bad timestamp external representation
|
||
> '2002/02/03 17:22:58 US/Pacific'
|
||
|
||
I ran into this same problem after the end of day light savings time. :-)
|
||
The reason for this is that PostgreSQL does not like US/Pacific for time
|
||
zone. The fix is to provide the time stamp in GMT time.
|
||
|
||
The fix is to add the following to the OIO/forms/archive_form/archive_b
|
||
method:
|
||
++++++++++++++++++++++++++++++++
|
||
<dtml-if time>
|
||
<dtml-call "REQUEST.set('time_string', _.str(time.toZone('GMT')))">
|
||
</dtml-if>
|
||
++++++++++++++++++++++++++++++++
|
||
(it goes right before the following, make sure time=time_string in the
|
||
parameter list)
|
||
==========================================
|
||
<!--#in "putin_archived_forms_c(
|
||
form=name,
|
||
archivedname=newname,
|
||
version=newversion_value,
|
||
time=time_string,
|
||
creator=creator,
|
||
description=description
|
||
)"-->
|
||
==========================================
|
||
So, basically the new routine converts the time stamp into GMT time - I
|
||
think GMT-7 or GMT-8 for US/Pacific, depending on daylight saving time
|
||
status.
|
||
|
||
Best regards,
|
||
|
||
Andrew
|
||
---
|
||
Andrew P. Ho, M.D.
|
||
OIO: Open Infrastructure for Outcomes
|
||
www.TxOutcome.Org
|
||
|
||
|
||
|
||
Caution Note that in the originally distribution of OIO you only see 'time=
|
||
time', when you are change the source code on this page, so make sure
|
||
to make it time=time_string.
|
||
|
||
I am told that this will be fixed in the next release 1.0
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.4.2.2.3. Port Problems
|
||
|
||
Note that Zope has changed its default port from 8080 to 9673 to avoid
|
||
conflicts with the proxy server. You will not be able to get OIO to run
|
||
correctly if you don't specify the correct ports that Zope is using. You can
|
||
correct these by clicking on the main OIO folder, and selecting the
|
||
Properties. Or you add /manage to the end of you OIO URL. For instance http:/
|
||
/localhost:8673/OIO becomes http://localhost:9673/OIO/manage
|
||
|
||
You are looking for field base_URL and form_URL and you will see that OIO has
|
||
port 8080 set up as the default. You need to change this number to 9673.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5. FreePM
|
||
|
||
8.5.1. Introduction to FreePM
|
||
|
||
This is the second application that I see that I think is actually useful for
|
||
the medical office. (One of my main concerns, as I will be using it exactly
|
||
for that.)
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.2. Where to to get it
|
||
|
||
You can get the entire package which include everything you need like Zope
|
||
products and even python from [http://www.freepm.org:8080/freepm_download/
|
||
fpm_downloads] Here and choosing FreePM-1.0b6-FULL-linux2-x86.tar.gz. This
|
||
will include all the documentation.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3. Basic Installation of FreePM
|
||
|
||
Given that Tim Cook has put together everything you need to get a fully
|
||
running FreePM application, I will first deal with installing the application
|
||
as if you downloaded the full 14MB gzipped file. However, since Zope can be
|
||
installed separately, and you may have other Zope applications going on, I
|
||
will also discuss how to install the FreePM Zope product separately from
|
||
installing Zope.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3.1. Using the 14MB FreePM download
|
||
|
||
Once you have downloaded the 14 MB package, be sure to also download the
|
||
extensions_for_1.0b6.tar.gz. At this point, it really doesn't matter what
|
||
directory you have download the gzipped tar files into, but to play it clean
|
||
and safe, I would download them or move them into their own directory. Then
|
||
go ahead and gunzip FreePM-1.0b6-FULL-linux2-x86.tar.gz to unzip the file and
|
||
then tar xvf FreePM-1.0b6-FULL-linux2-x86.tar.gz
|
||
|
||
Once the tar file has finished unpacking, you should see a new directory
|
||
called FreePM-1.0b6-FULL-linux2-x86. To make things easier I would change the
|
||
name of this directory to 'FreePM' like so mv FreePM-1.0b6-FULL-linux2-x86
|
||
FreePM
|
||
|
||
Move the extensions_for_1.0b6.tar.gz to the newly created FreePM directory
|
||
and look for the 'Extension' directory and go ahead and move it there and
|
||
unpack using the tar xvf
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3.2. Installing the Zope server
|
||
|
||
Tim Cook was smart and kind of enough to write an install script to install
|
||
the Zope. Once you are in the FreePM directory (remember, the one that you
|
||
created when you untar-ed the 14MB file), you run the script by tying ./
|
||
install
|
||
|
||
Caution DON'T FORGET TO WRITE YOUR ADMIN and PASSWORD that you will at this
|
||
point otherwise you will need to re-install the Zope server and
|
||
determine you new password for admin
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3.3. Running the Zope Server
|
||
|
||
Tim Cook also wrote two scripts to start the server and stop the server. Be
|
||
sure you our in the FreePM directory. You will know this if you see the files
|
||
'start' and 'stop' in there. It is also the same directory where you ran the
|
||
./install. To start the Zope server, type ./start. However you might want to
|
||
type ./start& to make it a background process which will free up your
|
||
terminal window. This will also allow you to stop the Zope Server by typing .
|
||
/stop instead of hitting the CRTL-C key combination, a rather blunt way of
|
||
stopping the Zope server and not an aesthetically pleasing way of stopping
|
||
the zope process.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3.4. Installing the FreePM zope products
|
||
|
||
The key thing before I talk about installing the zope products is that, the
|
||
first user, Admin, can only add other users and can not by itself actually
|
||
manage any products. You first need to add a new user and make the user a
|
||
manager before you can do anything else.
|
||
|
||
To log into the running Zope server, you need to open a browser, type in
|
||
http://127.0.0.1:8080 or depending on how new the Zope server is http://
|
||
127.0.0.1:9673. If you look at the output during the install it will tell you
|
||
what to what port to connect.
|
||
|
||
Caution Note: Using the old port 8080 would conflict, which is why Zope
|
||
changed the port connection.
|
||
At this point you should the zope introductory page, if not, make sure you
|
||
have the correct port.
|
||
|
||
Go ahead and click on the link that says Zope management interface or enter
|
||
http:127.0.0.1:8080/manage and you should the zope management screen. You
|
||
know you are in the correct section if you see a root folder at the top of
|
||
the Left Frame. To make sure we are on the same page, go ahead and click on
|
||
the Root Folder icon in the right Frame.
|
||
|
||
You then should see the list of contents of the Root Folder on the Right
|
||
Frame.
|
||
|
||
Look for and click on the acl_users folder. select add new user, fill in the
|
||
required fields. You leave the domain field blank. And then be sure sure to
|
||
select role. In this case, click on manager for this user.
|
||
|
||
I am having problems successfully logging out completely using zope, so when
|
||
you intend to switch users, be sure to completely close all browser windows.
|
||
|
||
Once you added a new user that has the role of manager, log back in. That is
|
||
to say, Close all browsers and open up a new browsers and go the the zope
|
||
management screen. You should be asked for a login at this point. Go ahead
|
||
and enter in you new user login and password.
|
||
|
||
Once you are logged in as an user (not the admin user), go ahead and click on
|
||
the Root Folder on the top of the left frame. Scroll to the bottom of the
|
||
Right Frame and you should see the Import/Export button. You see a new
|
||
screen. In the Field Import File Name, enter FreePM Product.zexp and then hit
|
||
the import button. You should see a new scree indicating success
|
||
|
||
The next step, is to again hit on the Root Folder Icon at the TOP LEFT FRAME.
|
||
Again hit the Import/Export button, but this time, you want to import
|
||
FreePM.zexp. Then hit the Import button.
|
||
|
||
Caution Note that it will take some time to import the FreePM.zexp Zope
|
||
product as it is quite large and you may get a browser error. I
|
||
almost lost hair doing this stage because I could not figure out what
|
||
was going wrong. In fact nothing was going wrong, it just took some
|
||
time to import this large (32MB) zope product. If you want to make
|
||
sure something is actually going on, I recommend using the top unix
|
||
command, which will show you that python is actively still working to
|
||
import FreePM.zexp.
|
||
-----------------------------------------------------------------------------
|
||
|
||
8.5.3.5. Running FreePM
|
||
|
||
To actually get to the FreePM, you need to open a browser and go to http://
|
||
127.0.0.1:8080/FreePM
|
||
|
||
You should see the introductory screen of FreePM. However, so far I can only
|
||
add patients but can not edit any sensitive information. This section will
|
||
need a lot of work
|
||
-----------------------------------------------------------------------------
|
||
|
||
9. Imaging Applications
|
||
|
||
9.1. Slicer
|
||
|
||
The 3D Slicer uniquely integrates several facets of image-guided medicine
|
||
into a single environment. It provides capabilities for automatic
|
||
registration (aligning data sets), semi-automatic segmentation (extracting
|
||
structures such as vessels and tumors from the data), generation of 3D
|
||
surface models (for viewing the segmented structures), 3D visualization, and
|
||
quantitative analysis (measuring distances, angles, surface areas, and
|
||
volumes) of various medical scans.
|
||
|
||
The 3D Slicer is freely available and provided as open source software. Its
|
||
design is fully modular to encourage researchers to extend its functionality.
|
||
It's new home is at [http://www.slicer.org] www.slicer.org
|
||
-----------------------------------------------------------------------------
|
||
|
||
10. Useful Applications
|
||
|
||
10.1. KPumpe
|
||
|
||
By David Weisgerber (http://freshmeat.net/users/david84/)
|
||
|
||
About: KPumpe is a diabetes diary application with support for reading
|
||
records from your glucometer. It supports the Onetouch Ultra and other
|
||
glucometers where glucomodule plugins are available.
|
||
|
||
I haven't used this one yet, but I plan on installing it at work, and getting
|
||
my patients to start using their glucose monitoring machines more.
|
||
|
||
License: GNU General Public License (GPL)
|
||
|
||
You can find out more about it [http://freshmeat.net/projects/kpumpe/] Here
|
||
-----------------------------------------------------------------------------
|
||
|
||
11. My thoughts
|
||
|
||
11.1. Too Many Projects
|
||
|
||
Having spend some time on looking at the available software, I can only say
|
||
that currently, we simply have an abundance of development, but little
|
||
progress. I keep seeing multiple projects trying to achieve the same thing,
|
||
but the resources are spread too think and so they fail. I wonder if there
|
||
were some way to concentrate the various developers onto one project. The
|
||
questions remain as to what main ideas should be focused on. Obviously the
|
||
first one should be a Medical records application. That is a coherent,
|
||
portable, way to contain, process, and use all the medical data that is
|
||
generate by a patient.
|
||
|
||
The second focus should be on software for a working clinic. This seems to be
|
||
much harder since it would involve the billing section. However this would
|
||
also include things like scheduling and multitude of forms that a clinic uses
|
||
in day to day use.
|
||
|
||
The third focus (one I know little about) would be in the more specialized
|
||
applications like Imageing, which seems to already have quite a bit of
|
||
working software, but is inherently hard to make because not everyone has
|
||
access to CT scanners and such.
|
||
-----------------------------------------------------------------------------
|
||
|
||
11.2. I am biased
|
||
|
||
The other thing I want to point out is that this is not an un-biased LDP, I
|
||
may stress something more than others because I think the foundation is
|
||
better or that I have seen it actually work, so if you feel something is not
|
||
right, please feel free to let me know.
|
||
-----------------------------------------------------------------------------
|
||
|
||
11.2.1. Debian as Standard linux distribution
|
||
|
||
I realize that urging people to consider Debian as the standard linux system
|
||
when it comes to medical applications is probably like arguing about
|
||
religions. But.. :) The point is that our audience is not Linux gurus who
|
||
only use slack or can configure applications from source tar balls. Debian
|
||
provides an extremely sophisticated and easy to use installation process that
|
||
is ideal for people who want to get a system running.
|
||
-----------------------------------------------------------------------------
|
||
|
||
11.3. I work and what is needed.
|
||
|
||
Now that I have been working for almost two weeks, here are a few things I
|
||
have learned. While a resident, I did part of my training at the VA hospitals
|
||
which had a superb information system, but it required that we type out
|
||
everything from the smallest order to the emergency stat orders. This seemed
|
||
to work well for the VA since most of the Doctors had residents do their
|
||
notes or they tended to dictate very little, writing very brief, sometimes
|
||
cryptic, notes about the status of their patient. Now that I am in the
|
||
private world, the only thing that seems to be saving medicine are the
|
||
transciptionists who take the garbled speed talk that doctors do and type out
|
||
coherent statements. The problem that I see with many of these data systems
|
||
is that seem to assume that doctors have the time which they don't (there is
|
||
barely enough time to see a patient properly let alone do all the coding and
|
||
then write out a clear note.
|
||
|
||
Several idea come out that doctors will merely have to tick off boxes on a
|
||
palm device to indicate what they did, but this is fine for billing but not
|
||
so for the actually medical record, which even though is brief contains much
|
||
more subtly then any billing coding system could have. Perhaps what we need
|
||
is to maintain the medical record in its narrative form and have a parser go
|
||
through it and pull the important bits and then it would enter this stuff
|
||
into database. It is an idea, but surely a worthwhile one since Doctors
|
||
simply can not sit around computer terminals (as I am doing, but it is a
|
||
Sunday)
|
||
-----------------------------------------------------------------------------
|
||
|
||
12. Credits
|
||
|
||
* Gref Fergusion. For putting up with my constant questions.
|
||
|
||
* AIRION Asssociates <airion@charter.net>
|
||
|
||
* K. Szabo Botond <kszabo@sol.cc.u-szeged.hu> [http://sol.cc.u-szeged.hu/
|
||
~kszabo/myPACS.html] MyPACS
|
||
|
||
* Patrick Goltzsch <Patrick.Goltzsch@Hanse.de>
|
||
|
||
* Chason Hayes MD <Chasonh (AT) hotmail.com>
|
||
|
||
* Christian Heller <christian.heller ()() tuxtax.de>
|
||
|
||
* Karsten Hilbert <Karsten.Hilbert A(T)T gmx.net>
|
||
|
||
* George B. Moody <george (AATT) mit.edu> Harvard-MIT Division of Health
|
||
Sciences and Technology
|
||
|
||
* Shouhei Nagaoka <nagaoka {ATAT} jttk.zaq.ne.jp>, Japanese translation
|
||
|
||
* Kevin Rosenberg, M.D. <kevin *** rosenberg.net>
|
||
|
||
* Andrew Sutton <ansutton [ot] sep.com>
|
||
|
||
* Ralf Stephan <ralf@ark.in-berlin.de>
|
||
|
||
* [http://ls7-www.cs.uni-dortmund.de/~wawro] Martin Wawro LS7, Department
|
||
of Computer Science, UniDO <wawro (A(T)) ls7.cs.uni-dortmund.de>
|
||
|
||
|