GNU Health
gnuhealth.org
gnuhealth.org
https://www.reddit.com/r/linux/comments/p5phju/progress_repo...
https://www.reddit.com/r/linux/comments/x2mls1/update_starti...
What does this mean?
Does this work in the UK or do they still ask you to verify?
There are still some alternatives but most of them now scrape or have extreme rate limiting from what I know.
They use redlib but If I remember correctly that's similar to libreddit but patched to work without api but still, its a very finnicky solution.
Like these solutions can work but I think at that point, just use a VPN but oh boy reddit detects those VPN's from what I know.
WOW UK censorship law is really something huh, can people living in the UK somehow vote to repeal that or something?
I was thinking on the scary part of as to what if many countries can seemingly connect together these pieces to genuinely have internet authoritarianism and what if they have such eggregious fees or just even a threat of it, have a little mixture of getting sanctioned if you try to move around it but damn, this is so weird, if they really want, they can genuinely escalate this more and more to block VPN's and more and more to effectively soft-lock a person from the internet. This needs to stop. Right now. Otherwise I am scared if what if multiple countries come together to stop something like tor nodes by somehow putting them in such a law. Once tor stops, all hell can break loose on the internet, its certainly possible, I never expected this but the only thing stopping UK censorship might be hopefully their incompetence of maybe not removing VPN's or this goose chase or just the fact that this is the beginning, not the end. They are testing how much they can get away with which is increasing a lot... This really made me pessimistic actually.
The only hope is that such websites can spring up more quickly than UK can take them down but what if UK sets a dangerous precedent by suing them, its definitely possible to track them down by the UK govt.
They say on their blog that https://bloat.cat/blog/updates-may-25/ that Redlib is the most resource-hungry service. The traffic figures run into terabytes a month
Some % of these could be for bypassing the UK as well
though I suppose that not even govt. can catch them,their Opsec is genuinely really good, they use monero for the servers and etc., its fascinating to see their Opsec be so secure.
Edit: I got so curious and found out that they run some servers on senko.digital which is in fact UK based but they won't still get much (I hope) because senko.digital supports monero so their opsec is secure but if they had slipped up, it wouldn't have been hard to see them being framed as they get terabytes of data and some % of data can help loop around UK censorship evil laws and they could've tried to frame him and senko being a UK company, it isn't hard to follow that they would've complied. But they use monero and I am sure that they use a vpn as well but it was certainly fun reading their Opsec and I think that its sort of perfect, I need to learn more from it actually.
So I guess its still possible to run websites without incurring the hefty fine in UK but its certainly very hard / borderline impossible and I just hope that this UK thing / similar things in other countries doesn't get any further and gets banned/repealed otherwise the internet might die.
Edit 2: maybe I gave them too much credit since either its saying Reddit is blocking redlib as always... when I try to click on any username or it just gives a flat out nginx 502 bad error... I really gave them too much credit but it was fun learning something about opsec.
( Yes, seriously. )
Many many profiles are tagged NSFW, its' not clear why, I can't imagine the majority of those have done so deliberately, perhaps it's automatic for anyone who's posted any NSFW posts ever. ( Which includes people doing so to be funny such as someone posting a huge loss in a sports sub as NSFW. )
just change from www.reddit.com to old.reddit.com and then it doesn't ask you to sign up. (atleast this works in my country)
Does this work in the UK or do they still ask you to verify?
Only thing, shame you can only set these things in new Reddit.
Being able to inspect post and comment history allowed for finding people who are absentmindedly lying, or are otherwise intentionally and persistently abusive. I believe this was the whole original motivation about such a history being available, even.
On the flipside, it does lessen the potency of various avenues of abuse. Some people would get harassed and stalked thanks to this history feature for example, and it trivialized targeted information extraction too. It also allowed for petty censorship, i.e. some subs would auto-ban people who commented in various other subs.
One might also criticize it for being a minor bandaid over a gaping hole. Your username and user avatar you still carry across subs and are not autogenerated. This means that with sufficiently wide scraping, your posts are still perfectly correlatable, collectable, and subscribeable. Within subs, the same applies to your user flair. This has benefits, i.e. it allows you to block users who you identify as inherently malicious, but it also means that all the aforementioned benefits apply only in limited ways.
Trust requires the sharing of information, privacy requires the obfuscation of information - and so I think these concerns run contrary to each other, resulting in the many solutions of the world not committing fully to either, as they are extreme and unrealistic positions in isolation. Difficult world.
https://old.reddit.com/r/Dentistry/comments/1o3hawd/prison_d...
Surprisingly it had 100 comments but no open source questions iirc so that was a bit of surprise from what I could check.
Also Offtopic or not but its sad that you can't use reddit because you are in UK but just for the sake since I want you to see the comment, I perma-linked it and uploaded it to wayback-machine/archive.org and here's the link so that you can view what I wrote
I am going to archive the whole reddit page later for you to read as well
https://web.archive.org/web/20251011181833/https://old.reddi...
Wait why is this not working wtf, Dentistry: page not found for archive wtf?
Edit: I archived the whole page as I said, here it is.
https://web.archive.org/web/20251011182126/https://old.reddi...
Hope this helps OP and maybe I will keep the archive updated for few days or give ya updates if that's something you are interested in I suppose I am not sure, just like many other things in my life.
I have had a brief touch with healthcare related software industry. The barrier to entry for any service provider seems very high (for very good reasons, I'm sure) I was wondering how a project like GNU Health could ever be used in such an environment.
His user page[1] doesn't work for you?
https://cottagemed.org/p/24/Cottage-Med
His practice also accepts payment in the form of barter: https://cottagemed.org/p/15/About-Our-Practice
I imagine there will be a niche but high-paid market integrating these GNUHealth products with existing commercial systems, and ongoing opportunities in supporting health centers using the software with planning, upgrades, and lots of phone & email support.
Combine that with most small businesses having more money than time (just pay Gmail, don’t spend the required amount of time to self host), and open-source is stuck at being hobbyists if there is no corporate sponsorship.
Are you seriously suggesting a business put their contacts in the hands of Google, who has reportedly been totally capricious with account actions in the past and is notoriously difficult to contact when problems arise?
> and open-source is stuck at being hobbyists if there is no corporate sponsorship
Corpo sponsorship required for success? I guess I better tell all the open-source projects being used by millions that they're just hobbyists now.
> The problem [...] everything digital [...] Who do I sue, and who has insurance, if something goes wrong?
I have heard of analog world nostalgia, but you refer to the pre-digital age as if you didn't live through it. It's easier to locate someone today than ever before.
Keepass only allows donations, with no benefits for corporate vs. personal sponsors
GIMP is one of the most widely known & its sponsors only lists a few companies as hardware donors
VLC anyone?
There’s no vendor here that they can sue if they were paying for a product and deploying that, but that’s a different situation and the hospital, frankly, won’t care about that. Who their supplier subsequently sues isn’t their problem.
I see this so often where people pay huge amounts of money (either buying a more expensive system or buying vs building) because 'we need the support!' and then still wind up with a bad system because the quality of the product modulated by the support offered still creates problems, and being able to blame someone else doesn't actually make the problems go away.
And even in cases where the problem is 'we might get sued', the fact that you have someone else to sue is to a large extent multiplying problems because you now have two lawsuits.
To be fair, I’m not sure if this is a huge issue. It seems a pretty standard part of business. Like, if I’m a store and I sell a product that’s faulty, the customer would file their case against my business and it’s up to me to decide how to resolve that with my supplier.
Even if the vendors are only half accurate about the solution they offer, by being paid suppliers, they are on the hook (to varying degrees). These systems are highly customized and serious headaches arise from interoperability and security. If some of that can be shifted to a vendor, it's a net positive insofar as the IT department and the compliance departments are concerned.
Some healthcare organization have invested in the technology side and become leaders in innovation but those are the exception.
There are lots of organizations that provide a throat-to-choke-as-a-service, e.g. Red Hat.
And there's plenty of consultancies which will support OSS and give you support if you need it and be your scapegoat. Red Hat, Suse, IBM come to mind and there's many others...
You sue the Red Hat-like support company with whom you ostensibly signed a contract.
If your question is who does the Red Hat-like support company sue if they want accountability for the code they are leveraging, I guess I don't understand the question or its relevance. E.g., with regard to proprietary code, who does Microsoft microsoft when Microsoft microsofts Microsoft? (Fun to write, but I don't think that sentence really makes sense.)
(1) you carry the risk or
(2) find someone that operates the software for you (on premise or SaaS) and they may also carry the risk for the premium you pay them.
There's absolutely no way that dentist will have a well-negotiated contract with SLA's and damage compensation with Google. The extent of their business relationship is that the dentist clicked a checkbox and put in their credit card details. Google does not even know they exist.
If Gmail loses all your email and accidentally kills your entire business, the absolute best outcome is a refund of your $10/month business subscription fee. The idea that they could in any way be held responsible is ludicrous.
The biggest win of all is if we had an open/extensible/maintainable data exchange format so that we could eliminate the need for paperwork. How many times must we fill out the same information, and then require the providers to keyboard it in?
I don't work in healthcare but I do use their services and every intake interaction is the same paperwork dance, so it doesn't seem to have impacted providers themselves.
There's another element that needs address as well, which is the controlled dissemination of one's medical history. It should be easy peasy technology wise, with the only blockers being political/entrenched players sabotaging it.
Beyond the wire formats, in order to eliminate the need for paperwork provider organizations also have to participate in data exchange networks. These include TEFCA, Carequality, eHealth Exchange, and some smaller regional HIEs. It all works fairly well when used correctly but many provider organizations continue to waste administrative effort and abuse their patients by failing to take advantage of the available technology. Like in many cases the necessary functionality is already built in to their EHR/PMS software but they simply don't turn it on or train their users.
Regardless of its many warts, Cobol cannot be accused of being unreadable. Verbose, yes.
Hence the "evil twin" comment :)
Ultimately that’s the point of the market. Incentivize people to take risks for rewards. Allow others to improve on proven models for lower costs. Unfortunately, government does not have any risk/reward or other market pressures.
Think of like volunteer firefighters, The Samaritans, St John Ambulance, the UK lifeguards and lifeboats (RNLI). Such organisations do usually have full time paid staff too, but the bulk of the front line work is part time volunteer.
Private practices are generally shrinking in number, so there IS NO EHR that is growing in the long term to serve them, so there CANNOT BE a trend where hospitals are exceptional, their IT buying trends are the NORM and their purpose is to code for billing. It is NOT about having or not having IT resources strictly speaking.
> hospitals use EHR to maximize billing
As a person who has worked extensively with hospitals and CHCs helping them integrate technology, this is false.
EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.
Both of you are overstating your cases. That said, it’s hard to overstate how heavily charge capture and billing are prioritized to the detriment of other aspects.
> I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.
There were major EHR deployments in the 80s through early 00s, before most government mandates. Surely later mandates were an incentive This reflects a lack of tenure.
Examples?
https://international.kaiserpermanente.org/wp-content/upload...
Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.
Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.
Yep, and more and more payors - government and private - are demanding systems that are both interoperable and audiable
Internal, bespoke systems are notoriously nightmarish for auditing
Epic has been sold in in Denmark and Finland, where it was a disaster, and then in Norway, where they failed to take lessons from the disasters. I don't think it's federal requirements which is the selling point there, though I wonder what the hell the selling point is, or what the Epic sales people put in acquirers' coffee.
But these get announced all the time, so the premise is false.
Epic is one of the few providers who can meet a larger organization's overall needs
The competitors, like eClinicalWorks, are a shadow in comparison
No doubt companies increase revenue with more efficient capture of services, costs, labor factors, etc, but I've actually been in the room with people from Epic and have heard the sales presentation. I'm betting I have a decent grasp on both what they're selling and what the buyers are asking for.
This may be true but it is different from your earlier claim about an upcoming deadline forcing any change in EHR, which was clearly false.
"Broken windows" indeed can stimulate the economy and improve the lives of people. But not _always_.
E.g. the US in 2008. Or Europe and the US in 1930.
Remember, "your spending is my income".
That is also possible and even usual with open source. The difference is you can choose the provider for each of those things, they can be different, you are not locked in.
Found in a carousel in the middle of the main site https://www.gnuhealth.org/
I was actually curious to try this out on my phone, since they claim to support mobile devices.
If running a command-line package manager is the easiest way to install this on Android, I don't want to know what harder ways exist.
I find this is quite typical for open source projects. The community still hasn't really, truly adopted mobile. I guess it's because of the need to have some sort of entity be present in the various App Stores? But if it's possible for servers, why is this so rare to have open source projects as app store vendors?
I’d never put my health data on an iPhone or Googlized phone.
It seems like that could be done with a system shipping their own white-labeled GNU Health app through the App Store
This, and the fees, and dealing with weird App stores' rules. On Android, we had F-Droid - an alternative store where one didn't need to deal with this. And as has been reported recently, Google is making changes that will essentially kill F-Droid.
The reason there's not much good open source stuff on phones compared to PCs is because the hardware is hostile to it. The few phones out there that aren't are the ones almost no one uses.
> MyGNUHealth is the GNUHealth Personal Health Record application for desktop and mobile devices
This is presented as an open source software project but it should also make a pitch to managers and doctors - the decision-makers. I put "GNU Health" into YouTube and the first few pages of results were very old and mostly amateur screencasts showing installation while one was an animated presentation with an awful robo voice. I should add none were official videos from the project team.
Then on the official site it says there's a laboratory information management component, but that is not apparent on the documentation page. This is not reassuring if I'm tasked with evaluating for potential adoption.
Next I tried looking up how the Jamaican Health Ministry is using it. The page seems to be over 10 years old: https://www.moh.gov.jm/technical-services-division/health-in... but again this is not under the control of the project team. The main team should help successful users write up their projects (the one page version) and then link to those write ups.
HN discussions:
https://news.ycombinator.com/item?id=24336039
https://news.ycombinator.com/item?id=18381969
I wonder how feasible it would be to replace the current software in practice?
https://www.hhs.gov/hipaa/for-professionals/special-topics/d...
As for Medicare, only a very limited set of data is publicly available. Larger sets are available to certain contractors and researchers but the access agreements prohibit sale to third parties. So you must have misinterpreted the content or source of the data you saw.
It shows some medicare data as owned by a private company.
But at the end of the day, it’s not what we are doing that is pushing the needle, its projects like this make existing healthcare accessible for everybody. I want to get a PhD in something related to this at some point. You guys are so insanely cool.
Automake, bash, emacs, gnucash, gnuhealth, coreutils, gnupg, gimp, grep, make, etc. are all great pieces of GNU software. Don’t take my word for it, here is a list of all the too-many-to-name gnu software used out in the world extensively:
Come on now. Gnucash is actually decent and I guess I can't complain about grep or coreutils but are you seriously claiming automake is great? The biggest mess I've even seen.
Make fundamentally can't handle spaces in paths, nor is there a sane way to split a project into multiple Makefiles.
GIMP... where to begin. Probably the name. Fortunately we have Krita now which is far superior.
Bash, wow. This is basically a list of software we've been stuck with for decades and are finally moving to good alternatives.
> Social Medicine and Public Health
> Bioinformatics and Medical Genetics
Are these that a piece of software? scopes? Intents?
> Hospital Management (HMIS)
Ok, now this is software for sure, but what exactly does this mean? There are many things to manage within a hospital. Is this software for managing inventories? Scheduling? Personnel assignments and organizational relations? Patient flow records? And - is most of this stuff really specific to hospitals? e.g. how is this different from managing, say, a hotel?
> Laboratory Management (Occhiolino)
Again not so clear what kind of management we're talking about.
> Personal Health Record (MyGNUHealth)
Ok, this I (think I) understand.
> GNU Health embedded on Single Board devices
What exactly needs to get embedded? And - what kind of device? It could be a Raspberry Pi, that's a single-board device, right? So, just another general-purpose computer, but on ARM-based silicon. Or - it could be an, I don't know, some kind of scanner, like a portable UltraSound.
Bottom line: I'm sure it's a collection of useful software but very difficult to figure out exactly what, and how it's specific to healthcare.
Laboratory Management Systems, or LMS, is laboratory software which handles laboratory orders, retrieving results from the laboratory equipment and sending back the results to the electronic patient record (EPR). It does a lot more than that of course, but basically it's a big database handling thousands of blood tests, biopsies, tissue samples, as well as worklists for staff, in order to get diagnostics results back to the clinicians.