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GNU Health

gnuhealth.org

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Re: GNU Health

#81
post #66

There was a guy on reddit a few years ago who started a dental practice with entirely open-source software and his own EHR system. Really interesting stuff, don't think anyone's posted about it here. Can't view his reddit history but he must still be using it, last commit 1 week ago. https://www.reddit.com/r/linux/comments/p5phju/progress_repo... https://www.reddit.com/r/linux/comments/x2mls1/update_starti...

That’s from the founder of Clear.dental, Dr. Tej Shah: https://clear.dental/ https://gitlab.com/cleardental https://www.linkedin.com/in/tej-shah-17829195

And the 2.0 source: https://invent.kde.org/desiotaku/cleardental

Re: GNU Health

#82
post #74
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 wonder what would happen if EU harmonized the legislation so that the EU states could go together and develop an OSS journaling system. The amount of money saved would be astronomical.

Spending money is what drives the economy. No diverse expensive healthcare software means thousands of employees don't get paid and don't spend earned money within the economy.

Re: GNU Health

#83
post #74

Earlier quoted context omitted.

I wonder what would happen if EU harmonized the legislation so that the EU states could go together and develop an OSS journaling system. The amount of money saved would be astronomical.

Spending money is what drives the economy. No diverse expensive healthcare software means thousands of employees don't get paid and don't spend earned money within the economy.

That's broken window fallacy.

Re: GNU Health

#84
No offence but GNU is not an organisation I would associate with health, usability and practical software. Noble effort no doubt. Misguided perhaps.

Re: GNU Health

#85

Earlier quoted context omitted.

Recently Reddit also made it possible to private your post and comment history, which I found a surprising number of people already do too (default for new accounts maybe?), so this is about to become a very worldwide experience anyhow :)

I've been seeing a lot of profiles have their post history invisible, and thought it was a bug. I tried to search for whether or not this was possible and couldn't find it. I'm elated to hear that this is a thing, as it protects my privacy. Just enabled it (: Only thing, shame you can only set these things in new Reddit.

I'm fairly mixed about it, personally.

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.

Re: GNU Health

#86
post #61

Earlier quoted context omitted.

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…

I dunno, QuadraMed that was used by at least NYC H&H for years before their imperiled transition to Epic prominently displayed “Revenue Cycle Management” on the splash screen of its decrepit provider facing frontend. 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 a…

> There were major EHR deployments in the 80s through early 00s, before most government mandates.

Examples?

Re: GNU Health

#87

Earlier quoted context omitted.

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…

> 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. 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 h…

> This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.

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.

Re: GNU Health

#88
post #79

Earlier quoted context omitted.

> 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. 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 h…

Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.

> They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules

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

Re: GNU Health

#89
post #51

Earlier quoted context omitted.

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.

If it was a volunteer effort without ulterior motives, it would be beneficial to society, but ultimately who is on call? Who pushes for hard, but beneficial changes that might not have immediate obvious value? Who accepts risk or responsibility.

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.

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