GNU Health/前言



尽管在科技领域我们取得了卓越的成就, 但在今天仍然会有成千上万的儿童死于本可预防的疾病。在发展中国家,诸如疟疾、锥虫病、艾滋病、结核病或传染性腹泻等传染病摧毁了数以百万的家庭。 包括肥胖、糖尿病、心脏病、癌症或者重度抑郁综合症在内的非传染性疾病已经冲击了整个社会,但在贫困阶层中的流行性和发病率要高得多。 同样重要的是童工、人口贩运和性奴役、家庭暴力、虐待儿童或吸毒成瘾的惊人程度。复杂的、多病因学和人类学的问题也同时存在并亟待解决。

我们需要改变这种模式: 我们需要从以治病为中心的被动模式向以健康为中心的主动预防模式进行转变。 许多国家缺乏良好的公共卫生,有时是因为它们将重点放在私营部门;有时是因为他们过于强调技术。最精细复杂的技术也永远无法击败良好的初级卫生保健政策。教育、良好的营养、家庭关爱、体育锻炼和卫生住房条件是一个国家能够制定的最佳和最可持续的公共政策。 在GNU Health系统中,整合医学的概念一直存在。

GNU Health paradigm of System of Health

我于2008年启动 GNU Health 项目,以改善农村社区的初级卫生保健。尽管如今 GNU Health 项目已经成长为一个完整的健康和医院信息系统,但其初衷不改。GNU Health 有助于初级医疗保健工作, 但它决不会顶替母亲、老师、医生和社会工作者的工作。GNU Health 擅长处理和加工大量的数据. GNU Health manages demographics; patient evaluations, hospitalizations, clinical history; genetic and hereditary risks; epidemiology and health center resources (stock, finances, human resources, pharmacies, laboratory .. ), to name a few resources. Computing power and data processing improve team work and optimize health promotion and disease prevention campaigns. For example, GNU Health allows quick identification of new TBC or Dengue outbreaks by showing the index cases in a map, in real-time. It can show the trends in infestation level of vectors that transmit Chagas disease in Domiciliary Units; It can cross indicators in different communities, and relate Social determinants of Health in many conditions (family violence, teenage pregnancy, child mortality, ... ).

In 2018 we have made 10 years since our initial release. We are now a mature ecosystem, with a mature community. GNU Health now incorporates state-of-the-art technology in bioinformatics, genetics and proteomics. GNU Health brings Precision Medicine, always in the context of the person and patient, providing a holistic picture of the person that we have in front, from the biological and molecular basis of health and disease, to the socioeconomic determinants of health. The GNU Health Federation introduced in 3.4 series allows to build nationwide federated networks with thousands of heterogeneous nodes. The GNU Health federation is revolutionary, and will allow the community, the health practitioners, the research institutions and the ministries of health to have much better perspective and precise information on the individuals and their context.

The GNU Health Book of Life, and the pages of life introduce a new, trans-disciplinary way of doing medicine. Our health is much more than just cold medical records. Most of the time, our health is the result of many events related to the environment, decisions we make, and interactions with many actors, that shape our life as individuals. The GNU Health pages of life put the person on the driver seat, making them an active actor of the system of health. It also provides the health professional a great way to enter and study the health determinant factors, especially in the context of the GNU Health Federation.

GNU Health is a philosophy. It's putting Free Software as a public good, and as an integral part of Public Health. It's about equity, community work and solidarity. It's about empowering the health professionals, their health centers and their communities. It's about putting in action many aspects from the Alma-Ata Declaration.

GNU Health is about embracing System of Health paradigm, instead of the conventional system of disease that many countries are immersed today.

I hope you enjoy this book, and I count on you to join our growing community of academic institutions, NGOs, public hospitals, private companies and Multilateral organizations. Free Software in Health Care is here to stay.

eHealth for all !

Luis Falcón, MD
GNU Solidario
Las Palmas de Gran Canaria, Spain