An Asian FOSS EHR – Hospital OS – the Thai experience

Hospital OS

Thailand has developed a FOSS based EMR system for the use in Rural Hopitals. Developed using Linux, PostgreSQL and Java technologies, it is now in version 3.0. It looks quite robust and comprehensive, and it should be a very interesting project for most developing countries to get involved in.

The client is based on Java and Java Virtual Machine and the client software has to be installed on all clients, a bit of a let down as a web based interface will allow anyone to access the system quite easily without any additional addition of software. But a specialised client adds speed and security sometimes.

Report generation seems to require MS Access, which is also something to work on. Why not the new Open Office Base?

The project is funded and supported by a few organizations based in Thailand, which is a plus point for a FOSS application.

Features curently available:

• Registration and simple Electronic Medical Record system
• Out-patient service
• In-patient service
• Investigation: X-ray, Laboratory request and result report
• Pharmacy: dispensary and stock
• Cashier
• Management information system and Financial Information Management system

Please keep your health record, yourself – use PING!

With the increasing use of IT in Healthcare, private information about patients are on “public” places. Electronic patient records are maintained in hospitals and other healthcare facilities, including General Practitioners. This is a medico-legal time-bomb. Security issues, fears of Big Brother State control, privacy, safety, legal action, insurance to cover these areas are some complex issues that will come up.

One way out of this situation is to allow patients to keep their own records and be responsible for them. This will also ensure their availability to the right people, determined by the owner of the records. These are issues of identity – knowing you and yours, them and theirs!

Personal Internetworked Notary and Guardian or PING, was started few years ago as an open source project, to find such a system and make it as secure as possible.

A project of Harvard Medical School, MIT, and Children’s Hospital Boston, it has come a long way.

“PING is the world’s first personally-controlled health record system. It enables a patient to own a complete, secure copy of her medical record, integrating health information across sites of care and over time. PING is built to public standards as an open-source application platform.”

” The security model is extremely strong with each record individually encrypted. Hence, even if a server or backup tapes are comandeered, the individual records cannot be opened.”

“PING record owners can subscribe to data updates from hospital information systems, practices, and regional health information organizations (RHIOs) also known as subnetwork organizations (SNOs). PING records can also be registered with regional record locator services making their data available to institutions within the RHIOs/SNOs”

Thus, Personally Controlled Health Records are born. The PING software is composed of three components, including a client side application. The software is covered by the LGPL

http://ping.chip.org/

VistA

VistA (Veterans Health Information Systems and Technology Architecture) is the most comprehensive Medical Software System in the world. It is quite massive, and this itself is the problem. It is quite a task to deploy and it is not user friendly at all. It uses M or MUMPS programming language, not something that is heard of in modern times. To find a programmer for this language will be quite a task, and as a result that person will be very expensive to work with!

However if the government is trying to deploy a country-wide system, this is the best bet. In that case, they could hire programmers for the inital setting up. On the other hand, it is so comprehensive that it could be just used as it is without the need of a programmer.

The development of a FOSS derivative through WorldVista, using GT.M a modernized version of M that is used widely in many organizations particularly in the US, combined with OpenVistA has promoted an interest in it around the world. The GUI front-end to it is windows based, and to run it in linux, Wine was used with some success. But some functions do not work and others do not work very well. To solve this problem, CodeWeavers have come forward to port the CPRS (Computerized Patient Record System) component of VistA, a free electronic health records software application developed by the U.S. Department of Veterans Affairs, for use on Linux.

“CodeWeavers’ version of the VistA CPRS (Computerized Patient Record System) graphical user interface will be promoted by WorldVistA to non-profits as well as healthcare providers in developing nations around the world. The goal of the two organizations is to increase the viability of implementing VistA, thereby giving providers the same capabilities in records management enjoyed by their better-funded counterparts in the industrialized West.”
http://www.linuxelectrons.com/article.php/2006022013533346

However there is far to go, as some of the applications working on VistA are not free. However once Open Sourced, things can grow pretty fast as we all know!

Learning VistA maybe worthwhile. The governnments of most developing countries will benefit greatly by going with this and more than that, M via GT.M, will ride again!

Anyone for M Programming?