Health Informatics - GNU/Linux dalam Kedokteran

GNU/Linux makin banyak digunakan di berbagai bidang termasuk kedokteran.
Beberapa aplikasi GNU/Linux dalam kedokteran yang dapat saya temui di Internet diantaranya:

FreeMED
FreeMED merupakan suatu Electronic Medical Record (EMR) dan sistem manajemen praktik (Practice Management System [PMS]) open source yang diklaim stabil, efisien, dan mudah digunakan. Berpengalaman sejak 1999 dan FreeMED 0.8.2 telah diunduh (download) lebih dari 7000 kali, melebihi edisi lainnya dan berusaha menerapkan standar pelayanan kesehatan yang sesuai dengan situasi klinis.

OpenEMR
OpenEMR berupa modul aplikasi open source manajemen praktik, EMR, dan peresepan. Kemampuan melakukan sistem pembayaran (billing) pun telah dikembangkan yang terintegrasi melalui FreeB. OpenEMR menggunakan GNU/Linux, Apache, MySQL, dan PHPMyAdmin.

WorldVistA/OpenVistA
Edisi open source dari VistA (berlisensi, dengan sistem operasi MS Windows, menggunakan MUMPS) kini mengembangkan paket untuk pediatri, obstetri, dan paket lain untuk rumah sakit (RS), klinis medis, dan praktik berkelompok. Dilengkapi dengan OpenVistA yang berjalan dengan sistem operasi GNU/Linux, keduanya open source dan gratis.

Care2x
Didesain untuk mengintegrasikan sistem informasi yang ada menjadi suatu sistem yang efisien dan kompatibel. Sistem ini dinyatakan mampu menyatukan berbagai sektor pelayanan, sistem, departemen, klinik, proses, data, dan komunikasi dalam suatu RS. Berbasis web, sistem dapat terintegrasi dengan sistem keamanan atau pemeliharaan (maintenance). Semua modul dijalankan pada server.

OpenClinic
Sistem rekam medis open source untuk klinik pribadi, bedah, dan dokter praktik swasta. Tersedia multiplatform dan multibahasa.

GNUMed
Hasil kolaborasi dokter, para programmer, dan pemerhati open source software (OSS) di seluruh dunia menghasilkan suatu aplikasi yang cocok bagi dokter praktik berkelompok dan lainnya yang mampu mendukung sistem jaringan secara aman menggunakan PostgreSQL RDBMS.

The 3D Slicer
Aplikasi open source dan gratis ini untuk menampilkan gambar medis 3 dimensi per segmen disertai analisis kuantitatif (pengukuran jarak, sudut, luas permukaan, dan isi).

KPumpe
KPumpe yang juga berlisensi GPL (GNU General Public License) ini berfungsi sebagai catatan harian penderita kencing manis (diabetes) dan terintegrasi dengan beberapa glukometer.


Beberapa aplikasi di atas dan aplikasi lainnya yang berbasis debian dapat ditemui di Knoppix Medical_Live_CD
kenapa debian ya...?

Berita dan artikel GNU/Linux kedokteran dapat diakses di LinuxMedNews

Jurnal open source kedokteran dapat dikunjungi di The Journal of Free and Open Source Medical Computing (JFOSMC)

PDA di GNU/Linux memuat tentang sistem operasi GNU/Linux dalam personal digital assistant (PDA)

Jika dikembangkan di negara berkembang seperti Indonesia, apalagi di daerah dengan dana yang terbatas, mungkin dapat menjadi solusi alternatif yang legal, murah, mudah dikustomisasi dengan kebutuhan daerah, asal didukung oleh sumber daya manusia yang memadai...kalau tidak dari sekarang, kapan yaa...

CompTech - Kebijakan Open Source FK UGM

Pada diskusi panel Kebijakan dan Prospek Open Source di lingkungan FK UGM tanggal 14 Agustus 2006 lalu, hadir sebagai pembicara: Engkos Koswara dan Kemal dari Kementerian Negara Riset dan Teknologi, Bambang Prastowo (Pusat Pelayanan Teknologi Informasi dan Komunikasi [PPTIK] UGM), Jazi Eko Istiyanto (FMIPA UGM), Iwan Dwiprahasto (FK UGM), Hari Kusnanto (Sistem Informasi Manajemen Kesehatan Masyarakat, Ilmu Kesehatan Masyarakat [IKM] FK UGM), dan Nova Rusydi Setiawan (administrator jaringan FK UGM) diikuti oleh beberapa rekan mahasiswa dan pemerhati open source. Diskusi dimoderatori oleh Pak Anis Fuad.

Pak Engkos dan Pak Kemal menekankan pada isu global pengembangan Open Source Software (OSS), posisi Indonesia sebagai konsumen dan pembajak nomor wahid (Priority Watch List) piranti lunak, kebijakan pemerintah tentang Hak atas Kekayaan Intelektual (HAKI), penggunaan piranti lunak legal di pemerintahan, penghematan devisa, dan deklarasi Indonesia, Go Open Source (IGOS). Arsip program ini dapat dilihat di arsip IGOS.
Dalam sasarannya untuk meningkatkan SDM bidang teknologi informasi, maka instansi pendidikan harus dilibatkan.

Campus Agreement (CA) Microsoft dan Universitas Gadjah Mada (UGM) akan berakhir Agustus 2006 (sejak 1 Agustus 2003) ini. Untuk menghilangkan pembajakan piranti lunak di UGM, diluncurkanlah misi UGM Go Open Source (UGOS). Pak Bambang Prastowo menyampaikan untuk menghormati HAKI, kebebasan akademik, dan menciptakan prekondisi pengenalan produk open source, akan dilakukan penerapan sistem operasi dan aplikasi open source secara bertahap dan berkelanjutan pada komputer dan laptop yang tidak memiliki lisensi sistem operasi Microsoft. PPTIK akan membantu melalui pelatihan dan konsultasi.

Pak Jazi menekankan pada aplikasi office dan Internet dengan open source beserta contoh aplikasi, keunggulan dan kelemahannya.

Bagaimana dengan Fakultas Kedokteran UGM? Disampaikan bahwa beberapa PC di ruang tutorial FK telah telah menggunakan GNU/Linux. Belakangan, PC untuk akses Internet di perpustakaan FK telah menggunakan GNU/Linux.

Pak Dwiprahasto menegaskan UGM sebagai Research University dengan program internasionalnya tentu tidak dapat lepas dari dukungan teknologi informasi dan komunikasi (TIK). Terdapat keunggulan serta kelemahan masing-masing Windows dan GNU/Linux dalam dukungan akademik. Migrasi Windows ke GNU/Linux sebaiknya dipertimbangkan dengan baik sehingga nantinya mampu bersaing secara global, bukan hanya karena gratis.

Pak Hari Kusnanto memberikan contoh-contoh aplikasi open source yang dapat digunakan untuk kedokteran dan kesehatan masyarakat, serta bioinformatik. Aplikasi tersebut antara lain: OSCAR (Open Source Clinical Application Resources) dari Kanada, openEMR, Open eMed, OpenGALEN, open standard dari HL7, dan GeoDa untuk pemetaan penyakit serta risikonya menggunakan Sistem Informasi Geografis (SIG).

Mas Nova menyampaikan manajemen jaringan Internet (kabel dan nirkabel/WiFi) di FK UGM yang telah menggunakan GNU/Linux.

Jadi (pesan moralnya adalah...) migrasi ke piranti lunak open source adalah sebuah pilihan, yang penting dunia pendidikan dapat memberi contoh penggunaan piranti lunak legal dan menghargai HAKI tanpa mengurangi kebebasan dan kreativitas.


Perkembangan GNU/Linux di FK UGM dapat dilihat disini..

Gratisan di Windows dan tulisan GNU/Linux sebelumnya dapat dilihat disini..

Vaccination Information

Lots of therapists are concerned about vaccination and PLOS Medicine have published two interesting articles this month, so I'm really pleased to use the editors' summaries for this on my site. I've put links to the full more academic articles so that people who wnat more info can check it out. The two articles are:

Frequency of Adverse Events after Vaccination with Different Vaccinia Strainsby Mirjam Kretzschmar et alSmallpox vaccination has some adverse effects, occasionally infecting the brain. As smallpox became rarer, the dangers of vaccination began to outweigh its benefits. Now, however, there are fears that smallpox may be used for bioterrorism.
http://www.mytherapypractice.com/bugs_drugs_allergies/vaccination_smallpox.htm

Reduced Antibody Responses to Vaccinations in Children Exposed to Polychlorinated Biphenylsby Carsten HeilmannThe developing immune system may be damaged in some babies by exposure both before birth and after birth through breast milk to “immunotoxicants” such as polychlorinated biphenyls. This has implications for childhood vaccination programs.
http://www.mytherapypractice.com/bugs_drugs_allergies/vaccination_PCBs.html

Organic Cotton Clothing

it has been estimated that 25% of the world's insecticides are used on cotton crops. When I first heard that figure I was appalled. We eat a lot of orgnaic food so I'd assumed that the pesticide thing was pretty much taken care of... but hey I love cotton clothes.

So I was delighted to find the Seasalt brand in a local shop. Fashionable clothes made from organic cotton. In fact I spotted a top that I really liked and only then did I find out it was made from organic cotton. I'm sure there's lots of people wearing Seasalt stuff who don't care about the environment but just like the clothes, but I do so I'm really glad to be able to buy stylish well-made stuff that doesn't cost the earth (in either way).

If you're not lucky enough to live near a shop that sells Seasalt products, you can buy them online at http://www.seasaltorganic.co.uk

"Medically inappropriate treatment" - how do we decide?

There's a good piece in the NY Times today about dialysis, when and how it should be withheld, and who should decide: "Choosing a 'God Squad,' When the Mind Has Faded" by Barron Lerner, MD. Here's how it starts:Would you want your tax dollars to pay for dialysis for a patient with irreversible brain damage? In 1972, when Congress agreed to use Medicare money to finance dialysis for patients with

AHLA's Health Lawyers Weekly (Aug. 25)

Here's the table of contents from today's Health Lawyers Weekly, reprinted here with the kind permission of the AHLA:Top Stories Bush Signs Executive Order Requiring Federal Agencies To Increase Price And Quality TransparencyPresident George W. Bush signed August 22 an executive order directing federal agencies that administer or sponsor a healthcare program to increase price and quality

OTC sales of Plan B approved for adults

After years of hassling over whether to approve over-the-counter sales of the Plan B contraceptives, the FDA has finally relented and announced yesterday that the "morning after" pill would become available for purchase by adults by the end of the year. (NY Times; Wall Street Journal; Washington Post; AP/MyWay) Compared to the original application three years ago, which sought approval for

Why is 16% of GDP too much to spend on health care?

That will be one of my questions tomorrow in the first class in Health Law. I remember, back during the debate over the Clintons' plan, the tongue-in-cheek report that, at the then-current rate of health-care inflation, in 50 years 100% of our GDP would be health care ("every man, woman, and child would be in hospital beds administering IVs to one another"). Now, quite sensible people (e.g.,

New technique for deriving embryonic stem cells that doesn't destroy the embryo

You would think that a technique that allows lab techs to grow embryonic stem cell lines without destroying the embryo would be the ultimate answer to the principal objection to embryonic stem cell research. But you would be wrong.An on-line letter (1st paragraph only) at the journal Nature (requires subscription) describes the technique, as do articles posted this afternoon to the web sites of

Lysozyme, Diarrhoea, Tooth Decay & Cleanliness

One of the things I really enjoy is linking different pieces of info together and (hopefully) providing a more coherent picture. I've tried to do this with some old research and some recent research on the digestive enzyme lysozyme:

http://www.mytherapypractice.com/Medical/lysozyme.html

Internet prescribing legislation introduced in U.S. Senate

From the Federation of State Medical Boards:New legislation designed to regulate the sale of prescription drugs and controlled substances over the Internet was introduced in the U.S. Senate on Aug. 10. The “Online Pharmacy Consumer Protection Act of 2006” (SB 3834)would:Prohibit the distribution of controlled substances and prescription drugs via the Internet without a valid prescription issued

Vegan and Vegetarian Recipes

our vegan abd vegetarian recipes are proving popular so I'm hoping to add lots more over the next few months.

I've just added one for a spicy, hot chick pea recipe. I'm a great fan of chick peas. If you are too, have a look at this and our other recipes:

http://healthandgoodness.com/nutritiondiet/recipes_index.html

Latest from AHLA's Health Lawyers Weekly (18 Aug 2006)

Herewith, the table of contents of this week's American Health Lawyers' Health Lawyers Weekly (a free member benefit of AHLA):Top StoriesCMS Issues Final Quality Standards For DMEPOS SuppliersThe Centers for Medicare and Medicaid Services (CMS) released August 14 its final quality standards for suppliers of durable medical equipment, prosthetics, orthotics, supplies, (DMEPOS) and other items and

It's a good time to be in cardiology

Two items from the print press, courtesy of Modern Healthcare's "Daily Dose":In Philadelphia, heart-transplant centers abound (Philadelphia Inquirer)After a massive heart attack last year, doctors told David Kaminstein that he needed a transplant. He had the choice of five hospitals in the Philadelphia area that could do the complicated operation. That's a lot of choices -- some say too many.

Medical liability insurers profiting handsomely in wake of Texas tort reform

Three years after tort reform hit the books in Texas, the state's medical liability insurers have lowered premiums somewhat and added enormously to their bottom line, according to a story in the August 11 issue of the Austin Business Journal. The largest of them all -- Texas Medical Liability Trust -- has shown the greatest gains:The state's largest medical malpractice insurer -- Texas Medical

How Can You Build Your Child's Self Esteem

Well, back from a rain soaked cycling trip (North Sea to the Alps - 12 days riding and it rained on 9 days and we were camping!!!). It's good to be back in the office and looking after my web sites again.

Although my children are now grown up, I still have an interest in how we can help youngsters lead happy and positive lives, so I am delighted to post this sensible article by Deanne Mascle on http://www.healthandgoodness.com :

How Can You Build Your Child's Self Esteem? by Deanna MascleAs parents we know that building our child's sense of self esteem is important. There is no simple strategy but there are several effective techniques parents can use to help boost self esteem in their child.

Deanna suggests 7 sensible, do-able techniques. If you're involved with chidlren do take a look:

http://healthandgoodness.com/babieschildren/build_childs_self_esteem.html

More on emergency room practices

This from the East Bay Business Times in California . . . . Sutter Delta Medical Center, among others in the region, has cut waiting times in its ER from 4-6 hours to 1-2 hours. They've done it by being imaginative in their triaging of patients, getting noncritical patients to doctors faster than before, for instance. The hospital's director of emergency services says, "People are still using the

ER sends nonemergency patients packing

This might be a case of "dog bites man," but the Jacksonville Business Journal reports that area HCA hospitals have adopted the practice of screening emergency room patients (as required by EMTALA) and showing nonemergency patients the door (as permitted by EMTALA) with a brochure listing area clinics in their hands. Is this news, exactly? In my limited urban ER experience, you can sit in the

Kaiser fined for mismanagement of its kidney-transplant program

Considering how neurotic the organ-transplant industry is to maintain a squeaky-clean image, it's remarkable that Kaiser Permanente's been hit with a massive fine from California's Department of Managed Health Care [press release] for mismanaging its kidney-transplant program. Even more significant, for my money, is the lesson here.How many times has a health care provider tried to minimize the

Costly Drugs Force Life-Death Decisions

From the AP, a good story about the costly, high-tech armamentorium of drugs and devices that offer the promise of extending life-spans once deemed to be "terminal," but at a price that's so high, some patients simply opt out:More patients are confronting this wrenching decision, as the latest generation of pricier cancer drugs and heart implants stretches out the final months of advanced disease

More on non-heart-beating organ donors

"NHBD" is slowly being replaced by "DCD" ("donation after cardiac death"), but whatever name it goes by, these organ-donor protocols continue to get (deservedly) close scrutiny, most recently in the New Scientist. The move away from brain death and toward cardiopulmonary death is, contrary to the implications of this article, not evidence of a "new" standard for determining when death occurs, but

Latest from AHLA's Health Lawyers Weekly (11 Aug 2006)

With the permission of the American Health Lawyers Association, here's this week's Table of Contents for its Health Lawyers Weekly (free member benefit):Top StoriesCMS Projects 5.1% Reduction In Medicare Physician Payment Rates For 2007: The Centers for Medicare and Medicaid Services (CMS) is projecting a negative 5.1% update in the Medicare physician fee schedule for 2007 under the Sustainable

Lawsuit Seeking to Discipline Georgia Physicians for Participation in Executions Dismissed

From the Federation of State Medical Boards:A lawsuit seeking to require the Georgia Composite State Board of Medical Examiners to punish physicians who participate in executions was dismissed last week by a Fulton County Superior Court judge. Lawyers for seven physicians, including three physicians in Georgia, had sought to have the medical board uphold American Medical Association guidelines

Should prisoners be enrolled in riskier drug studies?

The New York Times has an interesting article on this question, spurred by a recent report of the Institute of Medicine that recommends altering the "minimal risk" standard that now applies to prisoners as long as the greater risks are accompanied by the potential of some benefit to the prisoners themselves. The IOM's press release on the report and recommendations is here.

AHLA Health Lawyers Weekly (04 Aug 2006)

With the permission of the AHLA, here's the TOC for last week's HLW [members only] (which came in while I was on vacation); this week's TOC should be available tomorrow.Top Stories CMS Issues Final IPPS Rule That Phases-In Move To Cost-Based System The Centers for Medicare and Medicaid Services (CMS) issued August 1 themuch-anticipated inpatient prospective payment system (IPPS) final rule

FDA, Barr Pharmaceuticals, reach accord over Plan B contraceptive sales

In Wednesday's paper, the NY Times reports that the FDA and the manufacturer of the Plan B contraceptive have reached an agreement that may lead to OTC sales (at least to customers 18 years of age and up; under-18's will still need a prescription) within weeks. The story doesn't refer to an earlier report that the FDA offered the deal to Barr last week, on the eve of hearings on the nomination of

NH's medical board agrees: doc has 1st Amendment right to be a jerk

As reported here earlier, a local NH court ruled that Terry Bennett's rude and crude comments to his patients were protected by the First Amendment and couldn't be the basis of a disciplinary case against the doctor. Apparently the New Hampshire State Board of Medicine agrees. As reported by Modern Healthcare today, the Boardwill not appeal a court decision that blocked a disciplinary case over