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Gnumed

Click here for information on how to participate in this project.

This paper is also available as on online slide presentation.

An Open Source Approach Towards Paperless General Practice

When going "paperless" ....

• Your data needs to be safe

• absolutely safe! At least safer than using the conventional paper based system.

• Most affordable software available at present in Australia can't deliver this single most important item: loss of data is possible, in fact happens all the time in some systems.

Why is that?

• Existing software is often built around an antiquated "hobbyist" single user database kernel like dBase / Foxpro or the more modern but unreliable MS Access

• Most of the times these packages are lacking essential data safety measures such as transaction logging or a reliable foreign key implementation

Even worse ...

• Most packages are running on unreliable platforms which

  • never have been designed to host a multi-user environment
  • do not provide even the most basic safety precautions (file system with privileges)
  • are likely to cause data loss due to system crashes even when the application software is as stable as it can get

Even if they would be stable...

• Who can guarantee me that my software vendor will still be around in 10 years to maintain my system?

• Chances are, some of the vendors won't be there in 10 years. The "closed source" approach and proprietary database systems will make it hard or impossible for third parties to take over.

So what is the solution?

• A system that

  • runs on stable & safe multi-user platforms
  • is based on a "industrial strength" client-server database kernel with at least
    • transaction logging
    • foreign key implementation
    • regression test suite
  • has the complete source code available including the source of the database kernel and all used software tools

Why Open Source ?

• Independence of a specific vendor

  • you can modify or add functionality whenever there is need for it.
  • continuation of the product is warranted even when the vendor ceases to exist
  • you are not stuck with a vendor that might prove incapable of delivering the support you need - and you realized that only after a major investment

Why Open Source (2) ?

• Data security

  • only in open source software you can exclude the existence of a trojan horse
  • Secrecy and security are usually mutually exclusive.
  • As the source code will be scrutinized by anybody who is interested, errors are more likely to be discovered

GNUMed ...

• Is developed by GP's for GP's

• runs on Linux, Solaris, freeBSD and other platforms

• is "copylefted" under the GNU GPL

GNUMed ...

• Has a familiar graphical user interface

• is based on a robust "industrial strength" SQL client server technology

GNUMed

• Will keep a second human readable local transaction file for complete transparency of all transactions

• The database design will comply with 3NF normalization to avoid incongruent and redundant data

• comes with a complete industrial strength regression test suite that allows testing of the data base core at any time

GNUMed

• Will use encryption algorithms of the highest available standards. No concessions are made to regulations restricting the essential human right of privacy.

• Stores all data encrypted so that even hardware theft does not give disallowed data access

• will provide software RAID mechanisms for those who can't afford hardware RAID systems

GNUMed

• Will use GEHR and others as a standard interface for information exchange

• the object oriented design and isolation of user interface from the database core and transaction layers in between

  • makes it easy to implement different standards such as HL7
  • allows for extreme customization without compromising system stability

GNUMed

• Is developed in a collaborative distributed approach such as Linux itself

• use of a CVS web host makes it easy for any contributor to join the development process at any stage

• as it is developed by the "coal face" without external financial pressure, it will deliver exactly what we want it to deliver!

What is in for the vendors?

• GNUMed is a complex client server system

  • the installation process usually will require professional help
  • regular updates of the drug database are still needed and will be commercial in the foreseeable future
  • Provision of on site training, service, and telephone hotline will be necessary

When is this going to happen?

• It is happening right now!

• Doctors and software developers in Australia, Norway and Germany have already started

• A CVS web host has been set up. The language (C++) and development tools (GTK+/VDK) have been agreed on

• Proposals for user interfaces, record standards and database cores are in discussion