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GNU Health

gnuhealth.org

51–60 of 138 posts

Re: GNU Health

#51
post #2

Heath centers pay unreal amounts of money for these kinds of commercial products, but in my experience the health centers themselves have very few technical resources. So the real "value" being delivered by the commercial software providers is often the setup, support, and hand-holding provided to customers who pay the crazy amounts. I imagine there will be a niche but high-paid market integrating these GNUHealth pro…

I could certainly imagine NHS England looking at this and creating something that hospitals and GPs could deploy

I'd love it if my government created a civil reserve for technology workers. Let me volunteer every weekend to help fix infrastructure so I don't have to give up my existing job.

Re: GNU Health

#52

That federation piece is super interesting. I'm actually giving a talk in Sweden this week about machine learning/AI training in the age of data sovereignty, and my suggestion was two-fold - better and more widespread adoption of things like Homomorphic Encryption and more federated systems that can distribute access and data in sovereign systems. This is a pretty important evolution in that direction!

I'm extremely interested in this topic. Would you be able to share your presentation?

Re: GNU Health

#53
post #13
post #7

Earlier quoted context omitted.

Seems like a wonderful win/win opportunity to have the software be FOSS but enable small businesses to provide hosting/support/customization. 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?

Wasn't that in fact apropriated, launched and funded in the US under the Obama administration?

You are perhaps thinking of the HITECH Act of 2009? The Obama administration didn't directly fund any open-source healthcare software. There were billions in federal grant funding available to provider organizations to purchase EHR software that met certification criteria for a certain level of interoperability and clinical functionality. This really accelerated the growth of commercial EHR vendors like Epic, as well as some smaller vendors that used FOSS within their offerings.

https://www.hipaajournal.com/hitech-act-meaningful-use/

Re: GNU Health

#54
post #2

Heath centers pay unreal amounts of money for these kinds of commercial products, but in my experience the health centers themselves have very few technical resources. So the real "value" being delivered by the commercial software providers is often the setup, support, and hand-holding provided to customers who pay the crazy amounts. I imagine there will be a niche but high-paid market integrating these GNUHealth pro…

No… hospitals use EHR to maximize billing. That is the value. 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.

Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social.

> 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.

Re: GNU Health

#55
post #24

> The easiest way to get MyGNUHealth is by installing the package from your favorite operating system / distribution. Many operating system distributions already ship MyGNUHealth. 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 thi…

This is meant to be used in hospitals. Where I live no hospital personal uses phones to manage healthcare data. They have PCs.

You seem to be living in the past. While EHRs are still primarily used from desktop PCs, all of the major ones have native mobile apps now. Clinicians appreciate being able to review patient charts and action alerts while away from a PC cart.

Re: GNU Health

#56
post #44

Earlier quoted context omitted.

I could certainly imagine NHS England looking at this and creating something that hospitals and GPs could deploy

In the US, the Veteran's Administration wrote their own EHR (Vista) which was released as public domain. They've been trying (and mostly failing) to migrate to a commercial EHR for the last seven or eight years.

Vista is ancient, and it's written in MUMPS, an evil twin of COBOL.

Re: GNU Health

#57
post #26

Nice to see support for Open source. I have seen selling of healthcare data, including medicare and medicaid data to private companies which sliced and diced it and sold to academic and drug research institutions via data marts. ETL jobs would run for months. The data included prescriptions, scans, visits, employee plans etc, for about ~200 millions of American patients. It is anonymized data, but still I always wond…

HHS publishes clear guidelines for de-identifying healthcare data (PHI). Once it has been properly de-identified (anonymized) it is no longer subject to any special controls. I am aware that some researchers have claimed that it could be theoretically possible to re-identify certain records but so far no one has been able to do so in practice so concerns seem to be overblown.

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.

https://www.cms.gov/data-research/cms-data/types-data-files

Re: GNU Health

#58
post #37

Earlier quoted context omitted.

It means you can't view people's reddit profiles in the UK. ( 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. )

As I said it on the OP's comment but I will type it here as well, sorry if it counts as spam but 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?

It does not work for me in the UK.

Re: GNU Health

#59
post #2

Heath centers pay unreal amounts of money for these kinds of commercial products, but in my experience the health centers themselves have very few technical resources. So the real "value" being delivered by the commercial software providers is often the setup, support, and hand-holding provided to customers who pay the crazy amounts. I imagine there will be a niche but high-paid market integrating these GNUHealth pro…

The problem open-source, and social media, and everything digital, has never overcome is accountability . Who do I sue, and who has insurance, if something goes wrong? 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.

Do you think a small mom-and-pop dentist can win a lawsuit against Google?

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.

Re: GNU Health

#60

Earlier quoted context omitted.

just change from www.reddit.com to old.reddit.com and then it doesn't ask you to sign up. Does this work in the UK or do they still ask you to verify?

No, but just put something like rl.bloat.cat instead of reddit.com. That'll direct to an alternative community maintained interface for Reddit that will work.

I know that alternative frontends for reddit were a huge thing which I used to use before the api fiasco

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.

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