Episode: 2093
Title: HPR2093: GNU Health
Source: https://hub.hackerpublicradio.org/ccdn.php?filename=/eps/hpr2093/hpr2093.mp3
Transcribed: 2025-10-18 14:14:05

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This is HPR Episode 2093 entitled GNU Hells.
It is hosted by Dave Morris and is about 20 minutes long.
The summary is, I talk to my friend Tom and his collaborator,
you and who are working on a project using GNU Hells.
This episode of HPR is brought to you by Ananasthos.com.
Get 15% discount on all shared hosting with the offer code HPR15.
That's HPR15.
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Hello everybody, this is Dave Morris for Hacker Public Radio.
And today I'm here at Napier University visiting friend Tom and his collaborator,
you and who are doing an interesting project and the project is based around GNU Health.
So we thought we'd just talk a little bit about GNU Health,
what the involvement has been with it and then speak briefly about the project.
So can you fill me in as to what GNU Health actually is then Tom?
Yeah, okay. Well, GNU Health is free and open source software.
It's F-O-D-A-S and that's the key thing about it.
It's free, first of all.
And it's come from somebody who's a medical doctor and a computer scientist
who was a consultant with SAP, Danny, with famous ERP system.
Okay, it's probably the most used ERP system in the world.
Well, Luis Falco and the leader of the GNU Health Project was a SAP consultant for many years
before he decided what he would like to do is to work with social issues and health,
particularly in developing countries.
And he just set a great deal of time and effort aside to develop a free and open source software
for hospitals, health centers, government, medical records, keeping, and small shacks,
and any way that you want to do medical outreach.
I've seen him interviewed before just just for a bit of background for people who are listening.
He was on a podcast, one of the Twitch series podcasts, his name's Escape Me right now,
but I'll put it in the show notes when I remember, but he was interviewed about GNU Health from,
is he based in Argentina or Brazil or somewhere I'm not sure?
No, I'm going to know, yeah.
Okay, okay.
Anyway, his people can refer to more about him through these various routes.
I think he's probably got a Wikipedia page too.
Yeah, if I'm right.
Yeah, yeah.
He was recognized by Richard Stalman in 2012 and the project was to
a social project that creates social good and has been adopted by the United Nations University.
It's a little bit fabulous, really.
Yeah, it's risky.
Amazing.
So you got involved with this by some means or other, what happened?
Well, yeah, I've done some work in the past with medical video conferencing and databases.
And so I was doing some consultancy last year for the Nelson Mandela Children's Hospital,
which is being built in Johannesburg.
It's an extraordinary hospital.
It's Quaternally care.
It's the highest level of pediatric intervention that can take place in the medical environment.
It's the very difficult things that you can offer for securing recovery for children
and really difficult medical circumstances.
So this hospital was built due to the efforts of something called the Nelson Mandela Children's
Hospital Trust, which was a project of the Nelson Mandela Children's Fund.
And both of these are run by Bonge Macabella, who's this extraordinary woman
who's history from being a young child in Soweto to being the CEO of the fund and the trust.
An amazing story.
But while I was there, I was helping them with some advice about their hospital information system
right as well as the video conference.
They hadn't at that point decided on what they were going to do as far as that was concerned.
You know what, yeah.
And their task was to raise the $60 million that would be involved in building a hospital.
And then the South African government said that they would run the hospital.
And that would take around about $30 million a year, something like that to make that money.
So that's a huge achievement for an effort of public concern and a children's hospital.
It makes it a second children's hospital in South Africa.
And John's book is a city of about 8 million people.
So it's a huge thing.
So of course, there's a great deal of interest in providing the health care solution
to a hospital from the private companies.
And there's a great deal of money to be made from making a good installation,
running it professionally, but also making profit from it.
I was looking into trying to help them with the procurement stages and trying to kind of give
questions that would guide and process that would maybe help to get a good deal for the hospital.
And one of the possibilities that came to my attention was going to health.
And that's when I came in touch with Luis Falcon.
And I saw what he'd achieved in Jamaica.
The one, the one more thing that I'd seen that really blew me away was that he'd made a 350-plus
installation of going to health in Jamaica from hospitals right down to the smallest facility.
And it was being used by the Ministry of Health that even by the Ministry of Health,
they were keeping them central medical records, which were then being shared around Jamaica by
all of the different places where you could get medical care.
So I also know that that was a two-year effort on behalf of Luis Falcon.
I was running a social enterprise, and he is basically running a social enterprise too.
He didn't get paid a great deal of money while he was installing because he was doing that for
the level of his heart and he profiled the concept and all of that of good stuff.
But then I started to realise it was very good, but there were issues of
how much it would cost, for instance, for a government like South Africa to see.
How much would that cost us to put in properly and what would be our responsibilities?
And then I got really fascinated about the possibility of something like
in a health competing with all these other professional providers.
It's a pretty groundbreaking stuff. I mean, there are entities in local government and
government and stuff all over the world that are using free software for various purposes,
of its systems and desktop systems and so forth, but it's still very much
grand that's being broken. And there's many factions that are fighting against it,
so we say, so it's not a simple equation by any means.
No, I'm really excited about what the Turkish did.
Paradews, Linux, and installation and the use for civic functions.
And we have good, well-developed open source solutions for civic functions,
which they do through there and have an institute for research.
So it's part of the fabric of the country that they have something
working on open source software, developing it for their own needs and then
distributing it and training people in its use.
Yeah, it's very exciting, in my good sense.
So what pointedly things when you left South Africa, what was the state of play
as far as the new health was concerned?
The new health couldn't be a contender as a solution for the Nassmandale Children's Hospital.
That was never really a possibility at that time.
It had whatever comes in has to be seen to work right away and people have to be responsible
in teams for anything that goes wrong and being there to fix times that go wrong.
So they said Africans were breaking ground in so many different ways.
They were never really going to look at something that was of this type.
Because it's still not reached a state where it can run an operation like that,
even though it's out there in Jamaica.
Well, I think it probably could.
I think it probably could with proper support.
That's what I honestly think, but it wasn't proven enough.
Right, I don't think.
So there's a bit of a risk as far as they were concerned.
And they've taken many risks and they've fairly much all paid off.
I think there's also caution coming in as you start to get to the reality of
the hospital's going to open in December of this year.
You know, from that point, it's actually got to be a working hospital.
There's nothing that they can get.
There can't be in a problem space at that point.
Then you came back to the UK.
Yeah, yeah.
To Edinburgh, in fact, it's just where we are.
And then you've got a project which is concerning
canoe health. Do you want to sort of fill in the gaps there?
Yeah, well, the one lovely thing about the hospital is it's to
accept children from other cities in South Africa,
and other countries in the southern African development community,
and probably across Africa.
The quality of the care that they will provide is just going to be so after.
It's kind of mostly deal with just people who've not,
it's not going to be a private hospital.
There will be a certain proportion of beds for private patients,
but mostly it will be for people who have needs for the service.
So they're going to be interoperating with a lot of different places,
a lot of different health centers,
possibly other hospital places.
And if a young person comes in,
they'll be in for five to ten days and then you'll go back.
So interoperability between the health resources within the hospital
and those that will want to talk to the hospital became something that
I thought would be a good idea to work in.
And if we could get and prove an installation of canoe health
that was capable of interacting with the hospital and sharing health records,
then we know that we could give to possible sister hospitals a free health care
solution that would interact with the hospital
and it would be the beginning of a conversation
possibly with national governments that actually this is a proven software solution
and possibly it could save us a fortune if we could end up with it.
So, Nipi are very kindly,
and we were looking to do this as cost effectively as possible.
So, we thought of using Raspberry Pi's.
Ten Raspberry Pi's is beautiful little things.
You probably talked a bit about it, I did.
That's been a fair bit of discussion of Raspberry Pi's on
a public right here, yeah, yeah.
But anyway, beautiful.
So, with our next year's switch,
ten of these with different free and open source software services on them
interconnect it through a switch so that we could start to look into our
probability issues between the services.
And also we've got a lovely little Nuke, an Intel Nuke,
Intel 7 processor with 500 gigs of SSD drive
and 16 gigabytes of RAM.
So, we could test virtual machines before we put them on the banks.
So, you and Livingstone has had the difficulty of dealing with all these
installations.
I'm so pleased not to be face-to-face with all these forms,
you're doing all that sort of stuff.
But we are again to the point where we've installed
five installations of Gunnay Health,
we've got a nice open source and Pax system,
Kving system.
Right, okay.
And that's for medical images and that type of images, yeah.
Which are images and space and time,
they are often animations.
So, things like MRI and those types of things which are
successive images.
Yeah, there is going to be a image file.
It's also got the personal, the visions, records,
patch to the file as well.
So, it's quite a large file.
Yeah, and in scans and several files.
So, yeah, in terms of databases,
that's a pretty heavy task, I guess.
Yeah, yeah.
A frightening task for those little pies, but so far.
Well, the Pax system, the picture archiving system,
we think that's going to be the tricky one.
But, you've got some great advice from you, Dave,
from your solution with the little USB drive.
Yeah, you're putting the SSD drives on the pies.
Which is, yeah.
So, we're going to see your cycles.
That's how it acts.
Yeah, yeah, yeah, it sounds good.
Yeah.
So, you and your involvement has been to do quite a lot of the...
The setup stuff here and one of the images
that I'll be attaching to this show is
your lovely tower of 10 pies,
which was partly your construction, I believe.
Yeah.
Yeah, so we've got the six stuff in cases.
We've got a top and a bottom,
and then just pull them between,
and then we take some screws, cut the heads off,
just join them all together.
Just stack them one on top of the other.
So, the top of one case is the bottom of the next.
So, for the top of the controls and...
All right, something like that.
Yeah, yeah, yeah.
It looks a little sure.
Yeah, yeah, yeah.
It's amazing.
Strangely.
And you're powering it all from a USB hub at the moment.
Yeah, okay, yeah.
For a USB hub.
So, what's actually happening with this setup then?
Well, we're in early stages.
We've got interoperability of some sort.
We're aiming towards the fast hospital interoperability resources,
standard health level 7, each else 7.
That's something that actually may have value
away from just what we're trying to do.
It may be valuable to other health services.
But interoperability is a huge issue
with anything to do with health records.
So, what we are hoping to do is kind of establish a place
where you can test compatibility,
that you hit or miss the HL7 standard.
And we want to be able to work and work with these people
in the open source projects to help them to hit the HL7
and support them.
So, we would like to be a centre whereby you could see an installation
of GNU Health, you could play with that demonstrate in a way.
Because I guess people will be a bit wary of something like this,
won't they?
If you mean presumably you could install this in
any from a small to a large setup,
depending on how you build it.
And some people that might actually be interested in doing this,
that maybe the smaller end are going to be
nervous of it without having a chance to see it demonstrated
and mess around with it and stuff.
So, there's quite a lot of PR and teaching and so forth
that could come out of that.
And that's what you're thinking of, am I interpreting you right?
Yeah, but I mean, my main concern is not
with the people that are lowering to a capable doing it,
imagine it's enough to want to do,
but those the high-end, when they're tasked with, say, for instance,
four weeks to make a decision about a procurement
and then they've got questions that they will take people through.
So, I would want those people to be able to say right,
but we'll spend three days looking at an e-health installation,
it's free and open source of them,
and be able to see GNU Health is one of those options
and maybe can't hear, for instance, to say right,
well, set up a hospital, a health centre and a medical
faculty at the university to be able to use the same
materials and show us it operating.
So, I really want to be able to support the professionals
actually in making difficult decisions
and the governments who have to be brave to make,
you know, the great decisions to support these things
to help them really, to show them, because now that I've met so many
of these people who are doing this work, we've talked a bit
about this before a day.
People developing these projects are not only brilliant,
they're committed, they're often just in teams of one or two,
they are the sole supporters of projects,
and they actually can do need to be supported.
The universities can definitely do that.
Yeah, and that's maybe something that's happened in the past
in some contexts, and then it's not happened so much,
because universities have been under pressure to,
to, you know, take more business-oriented view of things.
But there's, and we've seen in recent times the difficulties
of small teams supporting quite important bits of software,
like, you know, SSH and all of those types of things.
And how, you know, some guy in his bedroom,
basically developing it and supporting the world,
and, you know, sort of integrating things better together,
so that, you know, there's more places to turn to,
to get support for this type of thing.
It's definitely a highly desirable thing.
That's where I have, that's where my main interest
in making Sam is, really, because I didn't,
of course, we see burnout with people that are doing things like that.
And those who have greatly committed, well, not burnout,
they will stick with it the whole way, but I'd like to take away the sense
that just because you've done a free and open-source software package,
that you're going to do everything for a charitable donation,
I'd like them to be recognized as the consultants that they are.
I mean, for instance, Luis has got a consulting company,
and that's pretty much the income of the software,
and all that sort of stuff is all free, and he's a consultant.
But unless we can make it possible for them to make,
and I think good incomes, so if there was going to be,
one of the things we want to look into is costing
for an implementation that works.
So to work at the scenarios of all the different types of users
that would be required to use about a software for a particular
purpose, and then say to the government,
that's going to be 25 people at this level,
three people at that level, four people at that level,
and if you pay them with the average cost that's in the marketplace right now,
that will cost you extra money.
And then just to say to them, you've got the software that's free,
you can train people within your own organizations,
your own country, and you can develop it to your heart's content,
and if you want to run it, this is how much it would cost you to pay
proper salary.
And I would really like to see them properly as my keynote now.
All right, it sounds fantastic, I did.
Having heard a bit about it when it was,
when Luis Falcon was being interviewed,
it sounded to me like a great solution to the problem
that is massively expensive in other contexts,
and possibly not anywhere near it's flexible
as, you know, GNU Health is likely to be.
So we've seen horrific races of money with NHS England,
that big projects have been coiboshed,
that have cost billions of pounds of money to nothing.
At least people are watching on fragments of those sums of money,
and they're doing brilliant things.
Yes, yes, something the way, isn't it?
Yeah, okay, well, good luck with that.
Yeah, I'd like to hear how you get on.
This time goes on.
Okay, well, we'll call the whole day.
Thank you very much.
Thank you, you and thank you, Tom.
Brilliant, thank you.
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