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3. Status of Free Software for medicine

Because microbiology plays in many fields of medicine an important role, Debian-Med also supports this group of programs. Especially in this field, many programs lack any graphical user interface. That's why many microbiologists fear to use these programs, even though they often are of good quality. Currently there are projects to collect those command-line tools under one common GUI.

The practice management software which is currently under development normally has graphical interfaces but often they are missing ergonomic features like intuitive mouseless usage.

Several existing programs which might be useful for medical tasks are not really free in the sense of the Debian Free Software Guidelines (DFSG). Programs which are incompatible with the DFSG cannot be included in Debian. This is possibly a drawback for those programs because they could profit by spreading widely on the back of Debian over the whole world.

Often microbiological programs are developed at universities by students or graduates. Once these people leave the university the programs they developed might be orphaned; i.e., not actively maintained anymore. If their licenses are too restrictive, it may be impossible for anyone else to take over; sticking to DFSG-free licenses avoids that problem.

In medical care, often non-Intel-based architectures are used. Debian currently runs on 11 different architectures and automatic build servers normally compile software packages as necessary. If autobuilders for other architectures show problems, Debian maintainers will normally fix them and send the original authors a patch. Moreover, users can report run-time problems via the Debian Bug Tracking System.

Many programs which are written from scratch use their own non-standard file formats. However, it is often important for programs to be able to share data with each other, both for reliable exchange of patient data but also for microbiological and clinical research.

Often there are several programs which try to solve identical or similar problems. Later in this paper we illustrate this in detail for the problem of medical practice management. Normally all these programs show very interesting approaches but all of them have certain drawbacks. So joining programmers' forces might make sense here.

Sometimes the tools or backends used in free medical software are not appropriate for such applications. For instance sometimes database servers which do not use transactions are used to store patent data which is completely inacceptable. Other programs use web clients as frontend which is not really good for quick (mouseless) usage.

One important problem is that complex software packages are hard for the target users to install. But this problem can be easily solved by shipping the software as binary package - exactly what inclusion in Debian means.


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