Linux in healthcare

Introduction

The provision of healthcare should be supported by infrastructure which is

secure
stable
efficient
effective
easy to use
flexible, to meet the needs of evolving services

This fits well with the ethos of Open Source ICT systems, including GNU-Linux. Below is a list of the basic components of a Healthcare Open Source Platform (HOSP):

Operating System

Server
Desktop

General Applications

Calendar/Scheduling/Resourcing
Messaging (e-mail, instant messaging, SMS, etc)
Word Processing
Spreadsheet
Database
Reporting
Presentation
Project Management
Image manipulation
Terminal Software
File Transfer, archiving and recovery
Web Browser

Clinical Applications

Patient Administration System (PAS)
Order communications and diagnostics reporting (including all pathology and radiology tests and tests ordered in primary care)
Discharge Letters with coding (discharge summaries, clinic and Accident and Emergency letters)
Resource Scheduling (for beds, tests, theatres)
E-Prescribing (including medicines for use after non-inpatients)
High Resolution Image examination (Ultrasound, X-ray, MRI, etc)
Clinical Reporting System - able to produce reports from any combination of Clinical Applications
Smartcard - physical card, and authentication software
Public Health and Biosurveillance

Support Applications
- For all support services (Information Technology, Estates and Facilities Management, patient complaints, etc)

Service Desk
Contracts Management
Purchasing
Stock control
Salaries and Wages
Human Resources

UK NHS

In the United Kingdom of Great Britain and Northern Ireland (UK), the National Health Service (NHS) is overseen by the Department of Health (DoH). In July 2008 the DoH produced the Health Informatics Review which highlighted system requirements for secondary care in order to meet the information needs of clinicians. It identified five key elements (termed the 'Clinical 5') to create a tipping point in the acceptability and demand for strategic IT systems. The Clinical 5 are:

a patient administration system (PAS) with integration with other systems and sophisticated reporting
order communications and diagnostics reporting (including all pathology and radiology tests and tests ordered in primary care)
discharge letters with coding (discharge summaries, clinic and Accident and Emergency letters)
scheduling (for beds, tests, theatres)
e-prescribing (including medicines for use after non-inpatients)

CfH - Systems & Services
Connecting for Health helps the NHS to deliver new computer systems and services to improve patient care and safety. Each one is showcased here in alphabetical order. Please use the navigation tools at the very top of the page for any further help.
http://www.connectingforhealth.nhs.uk/systemsandservices

Articles and Portals

The LiNHS Project
Advocation of Linux for use in the UK National Health Service
ITIL Service Lifecycle approach
NHS Theme for desktop
NHS software repository - local repository, backfilled from national repository, and then Ubuntu and other suppliers' repositories
cheap ruggedised dedicated touchscreen devices
Security - people often say that Linux is home to Hackers and would be a security risk. Linux is in fact more secure than Windows and is used by security organisations such as the US Department Of Defence, the NSA, etc.
http://www.linhs-project.blogspot.com/

Linux in Healthcare
Linux in healthcare is a tale of things seen and unseen. Linux/Open Source have enjoyed tremendous popularity in embedded systems and networks for major technologies used in healthcare that healthcare providers may not even be aware of. It has also experienced a steady adoption rate in healthcare applications. Nevertheless, the adoption rate of Linux/Open Source in healthcare lags that of other industries. Here's why, and how that could change.
http://www.linux-mag.com/id/3215

Linux Medical News
Revolutionizing Medical Education and Practice Since March, 30 2000. GNU/Linux Medical News is THE site for Linux, Free and Open Source medical software news. We actively cover news about Free and Open Source: Electronic Health Records, EHR, Medical Billing, Electronic Medical Record, EMR and Practice Managment systems.
http://linuxmednews.com/

Goomedic Informatics Portal
Open source resources for healthcare.
http://www.goomedic.com/c/articles/linux-in-medicine

Case Studies

Junta de Extramadura, Spain
The Junta de Extremadura, the regional government of Extremadura, is a pioneer in the use of Linux in the public sector. They have also developed their own Linux distribution called LinEx. The have embarked on a large-scale migration of their IT infrastructure, which includes switching 14 hospitals and over 400 local health care centers to Linux.
http://www.juntaex.es/

Ministry of Health, New Zealand
New Zealand's Ministry of Health announced in February 2005 that they were migrating servers running Windows to Linux.

Five sites for open source healthcare
If you're browsing the web looking for sites about open source healthcare, here are five I found interesting. There are a ton of sites out there, and I tried to stay away from those that talked strictly about software--instead focusing on those that tackled the issues in open source ways beyond technology.
http://opensource.com/life/10/2/five-sites-open-source-healthcare

Suppliers

Red Hat Enterprise Healthcare Platform
McKesson has joined with Red Hat (NYSE:RHT), the world's leading provider of open source solutions, to introduce the Red Hat Enterprise Healthcare Platform, a cost-effective open source information technology (IT) solution with services designed to meet the mission-critical demands of healthcare.
http://www.redhat.com/solutions/healthcare/platform.html

Novell Suse Linux
SUSE® Linux Enterprise is the serious choice for the healthcare industry—from the desktop to the data center. With SUSE Linux Enterprise, you can provide your physicians and staff with faster access to life-saving resources, safeguard your most sensitive clinical information, and take a significant bite out of IT costs.
http://www.novell.com/linux/healthcare.html

Patient OS
PatientOS (pronounced Patient-oh-es where O and S stand for Open Source) has been designed from the outset to be a Healthcare Information System (HIS). The software architecture, design patterns and framework has been built for the complexities and challenges of an enterprise wide information system. Internationalization and localization are expected, even translation into multi-byte languages such as Japanese.
http://www.patientos.org/

Axial
Axial, via our last-mile open-source appliance, enables health care systems of all types--hospital systems, EHRs, lab systems, HIEs, etc.--to share data to solve key business problems. An Axial subscription gives clients 360-degree interoperability via the Axial Appliance, which stays up-to-date with the latest software, connectors and policy content via the Axial Network. Additionally, subscribers receive unlimited technical support from Axial engineers.
http://www.axialexchange.com/

Laika
Laika analyzes and reports on the interoperability capabilities of EHR systems. This includes the testing for certification of EHR software products and networks.
http://laika.sourceforge.net/

List of open source healthcare software
The following is a list of software packages and applications licensed under an open source license or in the public domain for use in the healthcare industry. Software that is freely available, but not licensed under an open source license should be placed in the List of freeware health software.
http://en.wikipedia.org/wiki/List_of_open_source_healthcare_software

Open Smart Card Development Platform (OpenSCDP)
The Open Smart Card Development Platform (OpenSCDP) is a collection of tools for the development, test and deployment of smart card applications. It uses the capabilities of Global Platform Scripting, Profile and Messaging technology to provide unparalleled flexibility and development speed.
http://www.openscdp.org/

Kynson
Index

Penguin
Index

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