GNU Solidario

Healthcare with Free Software

Demystifying FUD

Dr.-Ing. Axel Braun, GNU Solidario [email protected]

HealthCon 2018, Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 What are FUD?

Fear Uncertainty Doubts

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 About GNU Solidario

“Delivering Health and Education with Free Software”

GNU Health The Free Health and Hospital Information System. (health.gnu.org)

GNUHealthCon - IWEEE International Workshop on E-Health in Emerging Economies.

GNU Solidario first project: Santiago del Estero, , 2006

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 GNU Health : Functionality Areas

Person and Community Person, family, Socioeconomics, lifestyle ... Domiciliary Units, Operational Areas, Institutions,

Patient Evaluations, Genetics, prescriptions, History, surgeries...

Health Institution Management Hospitalizations, Finances, Laboratory, stock, HR, ..

Health Authorities / MoH Health campaigns, epidemiology, ...

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 GNU Health is Free/Libre Software

Freedom to run , adapt, improve and redistribute

Official GNU Package, from the

Open Documentation

Relies on free technology

International community (100+ language teams)

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Characteristics of Free Software

Run Distribute Study&Change Distribute with changes

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Free Software rules the world

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: Free Software is coded by nerds in back rooms! NG RO W Many projects start small (single person, like Linus or Richard) → momentum can be huge, # of contributors rises

Many big companies contribute to free software

IBM has bought RedHat for 34.000.000.000 $ (looks like there is a market….)

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: The quality of code is bad ! NG RO W Development is driven by passion, not by pay-cheque

Peer review by many developers detects problems earlier/easier

Research has shown that OpenSource has higher quality than proprietary software(*) Bugs /1000 lines 0,7

0,6

0,5

0,4

0,3

0,2

0,1

0 OpenSource Proprietary

(*) HealthCon 2018, Las Palmas Coverty scan open source report Dr. Axel Braun 24. November 2018 http://www.h-online.com/open/news/item/Report-Open-source-software-quality-is-better-than-proprietary-software-1443437.html GNU Solidario . CC-BY- NC-SA 4.0 FUD: Anyone can change anything ! NG RO W Technically: Projects use version control systems (git, mercurial,…)

Organisational: it needs time and contribution to become a committer

Before a change gets into the code, 2 or 3 reviews are required

You can do what you want – at home, in your sandpit

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: There is no support ! NG RO W Proprietary software has ONE vendor from whom you can get support → Vendor lock-in Free software has MANY service companies → Choose your partner!

Freemium Commercial model: → Free base software → additional features for premium customers

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: Free Software is unsecure ! NG RO W Is software more secure if the code is not disclosed?

Security by obscurity has never worked

(See bug slide)

Usually faster response than commercial products (Linux-Kernel: average 6d according to Coverty)

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: What costs nothing, is nothing ! NG RO W The best things in life are free

Similar cost blocks as for proprietary software: ● Introduction & Consulting ● Project Management ● Development ● Testing ● Training ● Documentation ● Maintenance

→ but no license fees (and all the mess around it)

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 FUD: Free software has less features ! NG RO W Does not every project start small?

Do-ocracy

Free Software is about collaboration – develop and contribute

Support for open standards → Digitalization, IoT, etc requires open standards → Interoperability is key → ISO 26300

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Injury Surveillance System

Records violent injuries (accidents, robberies, self harm, sexual assaults,... ) Georeferenced ICD 10 encoded Contextual information (place, time, subjects involved, … ) Thanks to Jamaica MoH !

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 e You not get fired for buying (IBM | Microsoft | SAP|...)!ru y t rtl Pa If everything works, nobody cares

If things go odd, you are more attackable when not in mainstream

Push vs. Pull Commercial software is pushed into the company Free software needs to be pulled in

….and no company survives without free software!

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 The question about the risk ue Iss o N As CIO, you need to assure ‘keep systems running’

If things go odd, where do you put the risk?

→ select your support partner → agree on SLA → train your people → partner with your free software project → use your power to improve

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Summary

Gardner estimated in 2011, that by “2016, OSS will be included in mission-critical software portfolios within 99% of Global 2000 enterprises.”

● High software quality ● Controlled development

● Freedom

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Summary

Some big users of free software:

● Ikea ● Google, Facebook, Amazon ● SAP Hana ● Microsoft

Probably the coolest gadget - Tesla

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0 Summary

There is only one mistake you can make with Free Software:

Not to use it!

Thank you!

HealthCon 2018, Las Palmas Dr. Axel Braun 24. November 2018 GNU Solidario . CC-BY- NC-SA 4.0