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10 Years of Freedom in Healthcare

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10 Years of Freedom in Healthcare GNU Healt : "0 Years of Freedom in Healt care Dr. Luis Falcón Martín, M.D., B.Sc *alcon+,nu.org GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Health - Freedo( and Equity in Health GNU Health is, first and foremost, a Social Project ...with really cool technology GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 A1out GNU Solidario “Delivering Health and Education ith Free So#tware$ GNU Health 2 e Free Health and Hos3ital 4nformation S0stem. 5health.gnu.or,6 GNUHealthCon - IWEEE 4nternational 7or8sho3 on E-Health in Emer,ing Econo(ies. GNU Solidario first 3ro:ect :Santia,o del Estero&Argentina, 2006 GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Health - Functionality Per&on and Communit( ; 'erson& *a(ilies ; )o(iciliary Units& Health 4nstitutions& ; Socioecono(ics& li*estyle... Patient ; Medical istory& .$aluations& a33ointments ; Genetics < *a(il0 istory ; 'rescri3tions... Health In&titution )anagement ; Finances& Billin, ; Stoc8 Mana,e(ent & 3 ar(acies ; Hos3itali=ations& 4n3atient, EMS& LIMS... Health Authoritie& * )oH ; Re3ortin,& e3ide(iolo,0 ; Health ca(3ai,ns ; Federation& distri1uted ealth networ8s... GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Healt is Free/Li1re Software !reedo' to run , adapt, i'+rove and redi&tri,ute @fficial GNU 'ac8age& from t e Free Soft?are Foundation @3en Docu(entation >elies on free tec nology 4nternational com(unit0 GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 From rainforest clinics GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 To the Lar,est Public Hospital in Asia All India Institute of Medical Sciences, AIIMS Largest public health hospital in Asia GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 National Public Healt S0stems GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Healt & World Healt @rgani=ation MDG6 : Malaria, TB, HIV Essential list of medicines Neglected Tropical Diseases Immunization schedules ICD-10 ICPM MDG4 : Reduce Child mortality Pediatric growth charts GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 2 e Academia United Nations University, Kuala .u'+ur,)alasia Univer&ity o# Entre /ios, Argentina Harvard * )IT, 1oston, United "tates Univ2 )atan3as, Cuba GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Univ2 %alermo, Ital( Gnu Solidario . CC-BY- NC-SA 4.0 GNU Health Alliance o* Acade(ic and >esearc 4nstitutions GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Nature C Nurture Precision Medicine 4 Personalized Medicine GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Healt - Nature and Nurture “GNU” System of Health Current System of Disease (reductionist) People before patients biology Biology Govt / Education Community Disease Meds Biological Patient Nutrition Psychological Exercise expensive Acute Social Reactive Invasive Affection Work Housing health.gnu.org GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Genes load t e ,un& en$iron(ent pulls t e tri,,er Epigenetics "Before, genes predetermined outcomes. Now everything we do— everything we eat or smoke —can affect our gene expression and that of future generations. Dr Randy Jirtle (“agouti sisters”) Genetically identical ! GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 D.3idemics o* Unjustice” Tuberculosis : ⅓ of the world infected . Who gets sick ? "(Claude) Bernard avait raison. Le germe n'est rien, c'est le terrain qui est tout." Louis Pasteur “Epidemics of Unjustice” Dr. José Caminero GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 4(3act of Deter(inants of Healt The world needs more Social Medicine GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Medical and Famil0 History Critical Info : T1D GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Some data generating commands GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Health & Molecular basis o* Health and )isease GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Healt Genetics Personal genetic information & family history Disease genes Over 29,000 Natural Variants & their phenotypes Protein related diseases from Uniprot Linked to protein code, MIM code, Acronyms and descriptions Integrated to the person “Book of Life” GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Book of Life GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Healt 4ntegrative Medicine: Nature C Nurture “GNU” System of Health Holistic, proactive, transdisciplinary Biology Community Education Biological Nutrition Psychological Exercise Social Spiritual Affection Work Housing health.gnu.org GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 @ur life is (uc (ore t an cold (edical records Book of Life Made of “Pages of Life” Each page represents a relevant event in on a person life Types of pages: Demographical, Medical, Biographical and Social With their own categories, for instance : * Social : Exclusion, Stress, lifestyle, family, violence, food, ... * Medical : Health condition, encounter, genetics, lab, surgery,... Linked to HMIS processes (evaluations, health conditions, genetics...) Easy to write and read by health professionals and patients Easy to process by machines (industry and health coding standards) Integrates and contextualizes the information GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Sa(ple entry related to Genetics BRCA1 Federation Account : ESPGNU777ORG Gene : BRCA1 (breast cancer 1, early onset) Locus : 17q21 Protein code : P38398 . URI : https://www.uniprot.org/uniprot/P38398 Natural variant : VAR_007757 // p.Cys61Gly Phenotypes: DI-02602: Breast Cancer . MIM Code : 114480 DI-01655: Ovarian Cancer . MIM Code: 167000 Onset age : - Family history: Mother : C50.1 Malignant neoplasm central portion of the breast Grandfather (maternal): Q87.4Marfan Syndrome Medical History: Type 1 Diabetes (7y) / allergic to β-lactams // appendectomy (13y) Lifestyle: Ex-smoker //... GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Hu(an readable, (achine readable BRCA1 GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 GNU Health Federation GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 2ac8lin, current challen,es in Precision Medicine Most systems and databases work in isolation Study both genetic and environmental factors * Socioeconomic determinants of Health * Medical history * Genetic information * Family history Some natural variants are cleary pathogenic, but … There are many natural variants of unknown clinical significance . The more “Pages of Life” we collect globally, the better prediction about the risk on a particular gene / protein variant. GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Federation Com(unit0 Hu1 Community public server in Munich Demo and test environment Main Federation components: * HMIS node and PgSQL * Thalamus message server * MongoDB backend * openSUSE Leap OS The GNU Health Federation Community Hub allows developers, health practioners and research institutions from all over the world to learn, test and develop their nodes to integrate them in the Federated network. GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 @ne 7orld, @ne Healt Let’s build the largest, community-based federated health network GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0 Challen,es to discuss Privacy : Proprietary Software & operating systems are black boxes Who owns your data? Who has access to your medical information ? Too much technology and sophistication of medicine are displacing the Human Factor and Medical Humanism Health is not a business, but a NON-NEGOTIABLE Human Right Need universal Public Healthcare GNUHealt Con 20"# Luis Falcón Martín Nov 21-!%& Las Pal(as de Gran Canaria Gnu Solidario . CC-BY- NC-SA 4.0.
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