This paper started pit by showing several examples of programs which more or less cover the same purpose. A further example are two systems to manage a dental practice:
is a dental office management software written in PHP4. It uses PostgreSQL as a database backend. Here we must face the same drawback of all web-based management systems: A web client does not fit the requirement of quick and easy handling. However, it might be a valuable add-on to a native client with an appropriate GUI. Anyway, because one of the program's developers is a Debian developer, he packaged the system for Debian.
is another dental practice management software project. It is written in Tcl/Tk and shares code with Tk Family Practice (mentioned above). While Free Software often allows developers to share code, seems that in this particular case it is quite hard. The reason is that the design of Tk Family Practice is not intended to be as flexible and modular as it should be for this purpose. Moreover the development of LinuDent seems to be stalled.
One goal of Debian-Med was to contact the authors and ask them to work together if possible to join their projects to build a system which fits all needs better than two competing systems.
This does not mean that competition would not work in Open Source development. Desktop projects like Gnome and KDE are profiting from it by learning from each other. The difference between special solutions like practice management and big desktop projects is the difference in the number of developers and users in an order of magnitude which puts development on different quality level. Thus the rules are changed here for special solutions.
Keeping this in mind even adding special stuff to maintain a dental practice to the GNUmed project might be the best idea, because GNUmed is very flexible and modular and thus easy to enhance.
An early success for Debian-Med is that the authors of these programs are in contact now.
We have to make it absolutely clear that we do not want to suppress diversity. However, the forces of Debian-Med developers are limited, so we have to concentrate on the most promising DFSG-compatible projects. In general, we try to convince upstream developers to cooperate and to focus on benefitting all interested parties. We also provide some support to people who want to build unofficial Debian packages of medical software no Debian developer has time to package. How this can be done is explained at the Debian web site under the term "Sponsor".
Debian-Med has a certain amount of volunteers which is not able to care for everything which is available. So we try to integrate the well designed and promising projects first. The more people like upstream developers and users f projects work together with Debian-Med the higher is the probability for getting the project included into Debian soon.
That means if a project provides unofficial packages of its work we evaluate the quality of these package, try to enhance them and in case they fit the Debian standards include them into the official Debian distribution. In the end we want to make Debian to the distribution of choice for medical experts by providing them with all Free Software they need in stable and high quality packages.
There are several fields of medical care which lack a Free Software solution. For instance the following things are missing:
The Drugref.org project tries to collect data in a community effort.
Some people asked in private mails whether there is some Free Software which supports pharmacy related work, but currently there is no such project known.
The situation is similar to pharmacy software.
There was a free program for veterinary practice which now is continued as proprietary project. The last GPLed version is archived but the development is stalled.
Debian-Med does not develop Free Software but it provides support for people who try to find solutions for these open problems.
In certain fields of medical care, such as medical imaging or controlling medical devices, we face some special problems regarding proprietary software, patented algorithms and medical devices without documentation for programmers.
Different proprietary image formats of medical devices prevent development of Free Software alternatives. Licensing and patent problems are another hurdle.
There are cases where people tried to write Free Software programs to control their medical devices because they did not trust the proprietary software shipped with the device. This way Free Software replacements of proprietary software which showed some drawbacks regarding security or usage are coming into existence.
Debian-Med just wants to support these efforts and tries to make software companies aware that Free Software has advantages here.
Sometimes packaging of medical software is a complex problem. There are some really powerful applications, i.e. DHCP/VISTA. This application has such a complicated setup procedure that only specialists are able to install it for production purpose. In general, Debian-Med will not be able to make these systems so simple that any child could install them. However, reducing the required skill level is still possible, and would be good - even to reduce support times of service companies which provide their software by using Debian-Med.
In general it has to be assured that software which has complex dependencies like databases and web services is adjusted optimally to work reliable for the intended purpose. This also covers tools needed to handle medical data sets.
Good documentation is kind of a “traditional” weakness of Free Software. The reason for this fact is just that programmers would rather spend their time actually coding. Moreover really good documentation needs writing rather than coding skills. Here is a good possibility for interested people to give contribution without needing high technical skills.
Here are some examples of documentation regarding Free Software for medicine which is already packaged for Debian:
is part of the Linux Documentation Project (LDP). It describes the existing free medical software and is a good overview about this topic. Translations of this document would be great.
is an analysis of existing programs which might be useful for medical care. However, the most interesting part of this document is the specification of requirements on practice management software. This is a valuable resource for all programmers of this kind of software.
Unfortunately there is only a rudimentary English translation. It really has to be translated into English completely.
Moreover similar analysis documents are needed for other fields of medical care.