%include "../style.mgp" %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %center %size 11 %charset "iso8859-1" %size 10 Debian-Med %size 8 Free Software in Health Care %size 6 Integrated software environment for all medical tasks based on Debian GNU/Linux %size 4 %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Overview %%pause &a Motivation %%pause &a Status of Free Software for medicine %%pause &a What is Debian? %%pause &a What is Debian-Med? %%pause &a Why use Debian for medical care? %%pause &a How does it work? %%pause &a Summary: Goals of Debian-Med %%pause &a Future %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Motivation &a General practice %%pause &B Secure and trustworthy paperless practice management %%pause &B Easy and fast handling %%pause &a Outpatient Care %%pause &B Secure and trustworthy clinical administration %%pause &B Standardised medical record exchange %%pause &a Medical science %%pause &B Open platform for telepathology %%pause &B Open environment for medical studies %%pause &a Microbiology %%pause &B Easy to use environment for analysis of protein and DNA sequences %%pause &B Portable data formats %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Profile of target users %%pause &A Mostly less technically competent %%pause &A Unable to install upstream programs easily enough %%pause &A Not interested in administration of operating system %%pause &A Interested in a limited subset of available Free Software %%pause &A Needing easy usage %%pause &A Needing security and confidence %%pause &A Needing native-language documentation and interface %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Any solutions for those users? %%pause %mark &goalc Yes %%pause %again Yes and No. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Status of Free Software for medicine &AL Hard to use because of lacking GUI %%pause &AL Orphaned upstream %%pause &AL Strange Licenses %%pause &AL Porting issues (architectures, byte order, 32 vs 64 bit) %%pause &AL Data format not exchangeable %%pause &AL Parallel development of the same functionality %%pause &AL Based on ill-suited tools or backends %%pause &AL Target users have no idea how to install this stuff %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page GnuMed %center %image "../img/gnumed.png" %left %%pause &b Robust, secure, portable %%pause &b Professional design (Client - Server) %%pause &b Technology: PostgreSQL, several Clients (Python, Web, ...) %%pause &b Security of data has highest priority %%pause &b Not ready yet (heavy development) %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Torch (formerly known as FreePM) %center %image "../img/torch.png" %left %%pause &b Technology: Zope %%pause &b Drawback: no professional database backend %%pause &b Already in production %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Res Medicinae %center %image "../img/resmed.png" %left %%pause &b Technology: Java (causes trouble with license) %%pause &b promising but far from ready %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Tk Family Practice %center %image "../img/tkfp.png" %left %%pause &xc Technology: Tcl/Tk - portable but quite unsuitable for larger projects, &xc additional Web-Client, self made database back end %%pause &xc Already in production %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page OIO - Open Infrastructure for Outcomes %center %image "../img/oio.png" %left %%pause &b Out-patient care, robust, flexible %%pause &b Technology: Zope + PostgreSQL %%pause &b Only browser front end %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page More medical practice management &A FreeMed %%pause &B Technology: PHP + MySQL %%pause &B No appropriate database back end (PHP + MySQL) %%pause &B Development stalled %%pause &A SQL Clinic %%pause &B Psychiatric housing %%pause &B PostgreSQL + Perl web interface %%pause &A ... and others ... %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %nodefault %center %fore "white" %bgrad 0 0 48 0 1 "black" "darkblue" %size 12 %font "funny1" %%lcutin Why %%pause %font "funny2" %%lcutin does %cont %font "funny3" the %cont %font "funny4" world %cont %font "funny5" need %cont %font "funny6" this %font "funny7" whole %cont %font "funny8" lot %cont %font "funny9" of %%lcutin %font "funny10" free %%lcutin %font "funny11" programs %cont %font "funny12" to %cont %font "funny13" manage %font "funny14" patient %cont %font "funny15" data %%lcutin %font "frageb1" ¿ %cont %font "frage1" ? %cont %font "frageb2" ¿ %cont %font "frage2" ? %cont %font "frageb3" ¿ %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Reasons for this variety? &AL Historical reasons %%pause &AL Less popularity %%pause &AL Different technological decisions %%pause &AL Different concepts %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page What is Free Software? %%pause &X 1. Free Redistribution &xc The license of a Debian component may not restrict any party from \ selling or giving away the software as a component of an aggregate \ software distribution containing programs from several different \ sources. The license may not require a royalty or other fee for such sale. %%pause &X 2. Source Code &xc The program must include source code, and must allow distribution in \ source code as well as compiled form. %%pause &X 3. Derived Works &xc The license must allow modifications and derived works, and must allow \ them to be distributed under the same terms as the license of the \ original software. %%pause &X 4. Integrity of The Author's Source Code &xc The license may restrict source-code from being distributed in modified \ form _only_ if the license allows the distribution of "patch files" \ with the source code for the purpose of modifying the program at build \ time. The license must explicitly permit distribution of software built \ from modified source code. The license may require derived works to \ carry a different name or version number from the original software. \ (This is a compromise. The Debian group encourages all authors not to \ restrict any files, source or binary, from being modified.) %%pause &X 5. No Discrimination Against Persons or Groups &xc The license must not discriminate against any person or group of persons. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %nodefault %leftfill %bgrad 0 0 48 0 1 "black" "darkblue" %font "standard" &X 6. No Discrimination Against Fields of Endeavor &xc The license must not restrict anyone from making use of the program in \ a specific field of endeavor. For example, it may not restrict the \ program from being used in a business, or from being used for genetic \ research. %%pause &X 7. Distribution of License &xc The rights attached to the program must apply to all to whom the \ program is redistributed without the need for execution of an \ additional license by those parties. %%pause &X 8. License Must Not Be Specific to Debian &xc The rights attached to the program must not depend on the program's \ being part of a Debian system. If the program is extracted from Debian \ and used or distributed without Debian but otherwise within the terms \ of the program's license, all parties to whom the program is \ redistributed should have the same rights as those that are granted in \ conjunction with the Debian system. %%pause &X 9. License Must Not Contaminate Other Software &xc The license must not place restrictions on other software that is \ distributed along with the licensed software. For example, the license \ must not insist that all other programs distributed on the same medium \ must be Free Software. %%pause &X Example Licenses &xc The "GPL", "BSD", and "Artistic" licenses are examples of licenses that \ we consider "free". %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page What is Debian? %%pause &a Linux is just the kernel of your operating system. %%pause &a You need a lot of applications around. %%pause &a Those collections of software around the Linux kernel are called distributions. %%pause &a Companies that build such distributions are called distributors. %%pause &a They make money by selling their distributions in boxes, doing support and training. %%pause &a You might know Mandrake, RedHat, SuSE and others. %%pause &a Debian is just one of them. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %nodefault %center %size 17 %bgrad 0 0 48 0 1 "black" "darkblue" %font "standard" Sorry. %%pause That was wrong. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page What is Debian? (next try) The Debian Project is an association of individuals who have made \ common cause to create a free operating system. This operating system \ that we have created is called %center %size 6.5 Debian GNU/Linux, %size 5 %leftfill or simply Debian for short. Moreover, work is in progress to provide Debian for other kernels, \ including in particular the Hurd and NetBSD. There have even been \ discussions of a possible port to Windows. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Web of trust %center %image "../img/earthkeyring800.png" %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Differences to other distributions &A Debian is not a company but an organisation. %%pause &A It does not sell anything. %%pause &A Debian members (maintainers) are volunteers. %%pause &A Maintainers are working on a common goal: building the best operating \ system they can %%pause &A Largest collection of ready-to-install Free Software on the Internet %%pause &a Two ways to obtain Debian GNU/Linux %%pause &b Buying it from any %cont %font "it" other %cont %font "standard" distributor on CD %%pause &B Downloading from the Web for free %%pause &A The latter is the common way and there are really great tools to do it this way. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page What is Debian-Med? %%pause &AL Debian internal project %%pause &AL Completely integrated into Debian %%pause &A Taking care of medical software already included in Debian %%pause &AL Packaging and integrating other medical software %%pause &AL Maintaining a general infrastructure for medical users %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page History of Debian-Med %%pause &A Libre Software Meeting - Bordeaux 2001 %%pause &B Free Software in Medicine %%pause &B Raised the issue that free medical software is hard to install %%pause Thus the Debian developers who attended the conference had some Bordeaux wine at first ... %center %image "../img/history1.jpg" %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page History of Debian-Med (continued) %center %image "../img/history2.jpg" %size 4 %leftfill ... and prepared a talk afterwards when somebody said the alarming words: %%pause %size 6 %center %font "thick" There is a laptop open! %leftfill %size 4 %font "standard" %%pause That way the idea was born. %%pause The official start of the Debian-Med project was in January 2002. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Goals in detail Example: Dental Practice &AL OdontoLinux %%pause &bconc PostgreSQL, PHP, Debian package available %%pause &AL LinuDent %%pause &bconc Tcl/Tk, shared code with Tk Family Practice %%pause &remark Authors now are in touch ... %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: Integration %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Microbiology &A Debian contains a number of packages to analyze DNA and protein sequences %%pause &A Different state of development %%pause &a Different licenses %%pause &b Sometimes not DFSG compatible %%pause &B Avoids wide distribution %%pause &a Problems %%pause &b Incompatible data formats %%pause &b Problems on different hardware platforms %%pause &b Different usage %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: Apply Debian standards of quality %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Missing Free Software solutions &AL Drug database %%pause &AL Pharmacy %%pause &AL Physical therapy %%pause &AL Veterinary practice %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: Supporting developers %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Special fields &A Medical imaging %%pause &B Different proprietary image formats of medical devices %%pause &B Licensing and patent problems %%pause &A Control of medical devices %%pause &B Replacements of proprietary software on non-free systems with drawbacks regarding to functionality and security %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: Indicate advantages &goalc of Free Software to programmers %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Complex problems &A Medical research %%pause &B Powerful Applications (DHCP / VISTA) %%pause &B Telepathology (ipath) %%pause &A Medical record %%pause &B GEHR (OpenEHR) %%pause &B OIO %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: &goalc Demanding solid packaging %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Documentation &A "Traditional" weakness of Free Software %%pause &B Possibility to give contribution without high technical skills! %%pause &A Medicine HOWTO %%pause &B Part of Linux Documentation Project (LDP) %%pause &B Description of existing free medical software %%pause &B Translation would be great %%pause &A Resmedicinae Analysis Document %%pause &B Analysis of existing programs %%pause &B Specification of requirements on practice management software %%pause &B Only rudimentary English translation %%pause &B Need for this kind of analysis documents for other fields %%pause %% %%lcutin <-- this causes blinking and wrong icon position &goal Goal of Debian-Med: Packaging documentation and translations %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %nodefault %bgrad 0 0 48 0 1 "black" "darkblue" %center %image "../img/debian-med-schema-en.png" %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Why use Debian for medical care? %%pause &A Focus on security and stability %%pause &A Powerful packaging tools %%pause &A Strong quality assurance, carefully tested %%pause &A Strict rules (policy) %%pause &A Support of 11 hardware architectures %cont %size 3 (auto builders: alpha, arm, hppa, i386, ia64, m68k, mips, mipsel, powerpc, s390, sparc) %%pause &A Developed by about 1000 volunteers %%pause &A Single developers have influence on development - they just have to %cont %font "bi" do %cont %font "standard" it %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page How does it work? %%pause &A Collection of medical software by meta packages %%pause &bconc No research for available medical software necessary %%pause &bconc User is not forced to browse the whole package list of Debian %%pause &bconc Easy comparison between software covering the same task %%pause &bconc Safety against accidental removal of dependencies %%pause &bconc Conflicts to incompatible packages %%pause &bconc Easy installation %%pause &bconc Low effort for administration %%pause &A Adapted configuration inside meta packages %%pause &bconc Care for special needs of Debian-Med users %%pause &A Documentation packages %%pause &B Packaging and creating relevant documentation %%pause &B Translation %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Role: Debian-Med user &A System administrator defines group of medicine users %%pause &A Extra menu "Med" %%pause &A Users of role Med could have extra configuration %%pause &A Do not bother other users with those additional stuff %center %%pause %font "bi" Debian-Med does not develop medical software. %%pause It just smoothly packages third-party software for Debian. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Summary: Goals of Debian-Med &AL Integration of medical software %%pause &AL Apply Debian standards of quality to medical software %%pause &AL Supporting developers %%pause &AL Indicate advantages of Free Software to programmers %%pause &AL Solid packaging for huge software which is hard to install %%pause &AL Providing documentation and translation %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Problems for implementation Certification %%pause &A Health insurance companies demand correct supply of data %%pause &A User interest in accurate accounting %%pause &Aconc Only providers who are able to provide accurate data will stay in the market %%pause &Aconc No difference between Open and Closed Source %%pause &Aconc BMfGS (German Ministry of Health and Social Care): Certification of Open Source by insurance companies is possible %%pause &Aconc Precedent: Firmware for some ISDN-cards in the Linux kernel %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Problems for implementation (2) %%pause %size 6 Changed guidelines by law %%pause &A Short-dated changes necessary %%pause &Aconc Commercial support is necessary %%pause &Aconc Requirement of expert know-how (medical informatics) %%pause &Aconc Business model: Support for medical Free Software %%pause &B Software free of charge %%pause &B Earning money by %%pause &C Consulting %%pause &C Installation %%pause &C Support %%pause &C Updating %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page Future %%pause &A First steps are done ... %%pause &A Some meta packages ready %%pause &A Great interest from developers and users %%pause &A First version in Sarge %%pause &A Knoppix based Live-CD %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% %page %nodefault %bimage "../img/debian-med-back.jpg" %font "standard" %fore "white" %size 8 Further Information %font "typewriter", fore "green" &signend http://www.debian.org/devel/debian-med/ &signend Andreas Tille