FreePM Releases 0.8.0b

Tim Cook writes that FreePM (Free Practice Management) 0.8.0b is out: The highlights are; a much improved template management system, posting of patient charges from actions in the EMR, encounter audit code generation (more about this later), basic scheduling, ICD coding from the templates (details about this will be discussed on the FreePM list)…FreePM 0.8.0 was installed on the demo site and packages are ready for download from
http://www.freepm.org:8080/freepm_download The changes and current implementation plan may be read here. He also has some things to say about CPT codes and open source below.

** Again, the demo has reduced security protection. If you find a
function that does not execute properly it is probably because of a proxy setting I missed on the demo site. Please report it to the list and I will change it.

** About Reporting **
Any data in FreePM maybe extracted via pdf reports. After you install FreePM you simply add instances of ZpdfDocument via the management interface. If you need help with this please bring it up on the FreePM list. I plan to replace ZpdfDocument with the much more powerful ReportLab package before the 1.0 release This will allow extensive graphing functions as well.

** A WORD ABOUT CPT CODES **
I have discovered that many people do not realize that CPT codes are not available for free. It has not been determined to what extent an opensource project can use them under the Fair Use Act (this mostly covers journalists). So, I have used a very few in the demo, they are called charge_codes in FreePM. If you subscribe to the AMA’s CPT codes you may input them into the charge tables (fee schedules). Commercial support for FreePM from Free Practice Management, Inc. will include these codes.

Free/Open Source Hardware

Thanks to Horst Herb of GNUMed for these links: ‘LEON is a synthesisable VHDL model of a 32-bit SPARC* compatible processor, developed by the European Space Agency (ESA) for future space missions. To promote the SPARC architecture and enable development of system-on-a-chip
(SOC) devices using SPARC cores, ESA is making the full source code freely available under the GNU LGPL license.’ For those of you who don’t know what SPARC is, it is the processor architecture Sun Microsystems uses for its machines. You can read more from its home page here as well as at EE Times and about more open hardware here.

GEHR Release 1.0.2 Available

Thomas Beale writes that the latest Good Electronic Health Record is available: ‘This release is preparatory to two major releases in the near future:

  • COM wrapper
  • XML import/export, using Goanna, Exml and expat

These are both underway. The current release contains the framework for XML import / export. It
also makes some changes to the GOM, and makes the demographic manager a standalone application with its own database. A new version of the archetypes paper, with a lot of new changes is also
nearing release…[It is] available from the source page…The change list is at http://www.gehr.org/technical/source/changes.html#gehr_t1.0.2

The Politics of Medical Software

Can I rant for a minute? This is related to my previous posting, but I felt it needed it’s own heading. I came into healthcare via an interest in IT, not the other way around, and I’ve noticed something. All of the software that I’ve seen for the healthcare industry is one of three things: Expensive, Bad, or Both. Unfortunately, most seem to fall under the "Both" category.

Why is this? Is it because companies think that agencies are staffed with nitwits who only got into the health field to help people, and therefore know nothing about software, business, etc.? Or do they think that the demand is so high that they can fool agencies into thinking that this is the best software they’ve ever seen, and then get them to spend so much money on procuring it and making it almost work that they HAVE to stay around?

To me, it’s a pretty sad state of affairs when we have to think twice about going to a doctor’s office, nursing facility, or hospital because we’re afraid we’re going to have our leg amputated when we go in for a chronic cough. This is not the fault of the facilities themselves, but of information systems that either suck horrendously, or just are so difficult to use and to glean useful information from that they become completely unmanageable.

So far as I can see, open-source (not necessarily free) software is the key. If agencies can have someone on site to manage the software, and to adapt to all of the changes mandated by government agencies (my mother works for a phychiatric hospital, and they have still not recieved payment for medicare / medicaid claims from the early 90’s), or by changing demographics in healthcare, they will be able to keep up with the ever-changing face of medicine, as well as maybe, just maybe, turn a profit. For one, I’m not holding my breath.

Linux in the Home Care Industry?

Jason Lindsay writes: ‘…

I am the entire IT department of a medium-sized home nursing care facility in South-central Pennsylvania. We currently use Delta Health Systems to provide our clinical software. We have had what I would call a less-than-stellar experience with said company, especially relating to PPS [medicare’s Prospective Payment System] , and I’m getting close to fed up. As a self-styled linux afficionado, I am very interested in the possibilities of open-source software in the health care (or, more specifically, home care) industry. Are there any packages available that will provide a complete, end-to-end solution for home care, including PPS? If so, I’d like to hear about them.’ How about it LinuxMedNews Readers?

OpenBSD Resource Directory

A resource directory for OpenBSD (one of the world’s most secure and stable operating systems)can be found here.
Anyone in Medicine, where patient security and data accuracy is important, should try this rock-solid and ultra-secure operating system today.

The directory links to guides, tutorials, HOW-TOs and other information to help get OpenBSD up-and-running.



Anyone in Medicine (where patient security and data accuracy is important) should try this rock-solid and ultra-secure operating system today.



OpenBSD is a free, multi-platform 4.4BSD-based UNIX-like operating system. With emphasis on portability, standardization, correctness, proactive security and integrated cryptography, OpenBSD has become one of the most secure and stable operating systems available. To this day, OpenBSD has been three years without a remote hole in the default install!

Mercury Center: Stallman Responds

MercuryCenter.com has Free Software Foundation Founder Richard Stallman’s rebuttal to Microsoft Executive Jim Alchin’s recent comments that open source software threatens intellectual property rights: ‘…Microsoft uses an anticompetitive strategy called “embrace and extend”. This means they start with the technology others are using, add a minor wrinkle which is secret so that nobody else can imitate it, then use that secret wrinkle so that only Microsoft software can communicate with other Microsoft software. In some cases, this makes it hard for you to use a non-Microsoft program when others you work with use a Microsoft program. In other cases, this makes it hard for you to use a non-Microsoft program for job A if you use a Microsoft program for job B. Either way, “embrace and extend” magnifies the effect of Microsoft’s market power. In 2000, Microsoft undermined the Kerberos secure login software in this way. They added a small secret feature to their version of the Kerberos software, simply to make it incompatible. The standard, free software version of Kerberos cannot communicate with Microsoft’s modified Kerberos server. The result: anyone who wants to communicate with the Microsoft server software has to run Windows on his desktop…’ Editor’s note: while there currently is no real standard in clinical computing software to embrace and extend, the same general techniques of making clinical computing software purposely incompatible and locking in a customer apply.

Medical Volunteer Staff Scheduling?

Simon Britnell wrote in with this question:

I’m a volunteer for a non-profit medical organization.
One of our biggest problems is volunteer staff scheduling. Event organisers
contact St John (hopefully more than a week) before the event and our
coordinators start the process of ringing and emailing around our volunteers
to get people to cover the event. It’s a big job and subject to many
mistakes. To relieve the workload and reduce mistakes, I’m writing a system
which uses a web interface and an email bot to manage event coverage. We
don’t run a roster because the workload is erratic, we’d end up with people
“rostered on” when there’s nothing to do and not enough staff rostered when
the workload was heavy. Do you know of other medical orgs with similar
problems? I am 75% through the development process and would be interested
in getting the design reviewed for broader applicability.

How about it LinuxMedNews readers? Any suggestions?

Newsforge: Taking Linux To the Doctor With…

NewsForge has an interview with my Clark Kent side. Newsforge reporter Julie Bresnick worked very hard at making sense of my verbosity. I think it is an excellent summary of my personal views of medical open source: ‘…I always looked at clinical computing software for my dad. And I actually did some things in his office that were, of course, miserable failures,” laughs Valdes, tracing his path with the benefit of hindsight, “and I had the ‘greed is good’ mentality for a while. I thought, we’ll make this great clinical computing software and sell it to these dumb doctors and make a jillion dollars. Well, there’s a counter, somewhere in the world, of how many people have that idea and pursue it and fail…I’m not strictly opposed to greed but it’s not served medicine well at all. Right now the landscape for medical computing software is one of great fragmentation…’

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