GNU Health/前言



儘管在科技領域我們取得了卓越的成就, 但在今天仍然會有成千上萬的兒童死於本可預防的疾病。在發展中國家,諸如瘧疾、錐蟲病、愛滋病、結核病或傳染性腹瀉等傳染病摧毀了數以百萬的家庭。 包括肥胖、糖尿病、心臟病、癌症或者重度抑鬱症候群在內的非傳染性疾病已經衝擊了整個社會,但在貧困階層中的流行性和發病率要高得多。 同樣重要的是童工、人口販運和性奴役、家庭暴力、虐待兒童或吸毒成癮的驚人程度。複雜的、多病因學和人類學的問題也同時存在並亟待解決。

我們需要改變這種模式: 我們需要從以治病為中心的被動模式向以健康為中心的主動預防模式進行轉變。 許多國家缺乏良好的公共衛生,有時是因為它們將重點放在私營部門;有時是因為他們過於強調技術。最精細複雜的技術也永遠無法擊敗良好的初級衛生保健政策。教育、良好的營養、家庭關愛、體育鍛煉和衛生住房條件是一個國家能夠制定的最佳和最可持續的公共政策。 在GNU Health系統中,整合醫學的概念一直存在。

GNU Health paradigm of System of Health

我於2008年啟動 GNU Health 項目,以改善農村社區的初級衛生保健。儘管如今 GNU Health 項目已經成長為一個完整的健康和醫院信息系統,但其初衷不改。GNU Health 有助於初級醫療保健工作, 但它決不會頂替母親、老師、醫生和社會工作者的工作。GNU Health 擅長處理和加工大量的數據. 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