Status of Free Software in health care

More common programs like a web server, or a mail user agent are installed on a vast amount of computers and have a very large user base. A large use base, in turn increases the likelihood of attracting skilled programmers that tackle unresolved problems or general improvements of the software they are using. This type of user is extremely valuable to a project, because they can implement and contribute any modification they need by themselves without having to rely on a project's manpower.

The fact that a piece of software is needed for one's own work is often the basic motivation to write Free Software. Biological software is frequently developed by scientists themselves, because they are experts in a particular topic and the development is inseparable from their research. Many authors of such software realise the benefits regarding prestige, feedback and facilitation of scientific progress that is expected from sharing their code and thus the field of computational biology is well covered by Free Software solutions.

There are many ties between adjacent fields of science and also software developers and users outside of biological research benefit from Debian Med's and similar efforts. Mutual interest in neuroimaging software led to the NeuroDebian project [NeuroDebian Team, 09 ] joining forces with Debian Med to improve the coverage of medical imaging software in Debian. Even if some important packages like the Bio Image Suite [Yale University, 2008] are not yet packaged for Debian, there is already an extensive coverage of viewers, data analysis pipelines, and development tools supporting a variety of data formats (e.g. DICOM, NIfTI) as well as other software products of particular utility in medical imaging.

Medical health record applications in patient management are considered essential by most people. As a starting point GNUmed [Hilbert, 2008] has been included into Debian. However, there are numerous similar Free Software projects that try to solve more or less the same problem, but diverge in implementation details (programming language, database server, etc.), user interface (GUI or web application) and basic concepts of work flow and philosophy. It is planned to also integrate those alternatives that fit Debian's quality standards and look promising regarding the longevity of the respective project.

Still in the medical section, Debian has also packaged the first open source pharmaceutical drugs prescriptor and drug-drug interactions checker FreeDiams [Maeker, 2010], which can run on multiple drugs database (FDA, CA, FR, ZA) as a standalone application or in connection with other medical health record applications (like for instance GNUmed).

The even larger task of managing a hospital is also tackled by several projects, of which the most famous is OpenVista[OpenVista, 2008]. As an enterprise grade health care information system it is rather complex and needs a dedicated maintenance team beyond Debian Med, with a strong technical background and familiarity with the peculiarities of OpenVista. To overcome this problem, the strategy of Debian Med is to try to involve the upstream authors into the packaging. This has started in August 2009 and we are positive that we will see OpenVista in Debian at some point in the future.

Another application for hospital management is OpenMRS[Developers, 2010], which is in preparation of being included into Debian and chances are good that this will be finished in the beginning of 2011.