GNU Health

Commercial vs FOSS in healthcare IT

• Hospitals pay huge sums mainly for setup, integration, and hand-holding, not just software licenses.
• Commenters predict a niche market for consultants to integrate and support GNU Health, similar to Red Hat-style models.
• Some argue open-source plus local hosting/support firms could be a win–win for small providers.

Accountability, liability, and risk

• A major concern: “Who do I sue?” if something goes wrong with FOSS in a safety‑critical context.
• Counterpoint: in practice, the local implementer/integrator (or support vendor) is the party on the hook, regardless of proprietary vs FOSS.
• Others note that clicking “I agree” with big cloud providers (e.g., Gmail) offers almost no meaningful recourse to small practices anyway.

Interoperability and standards

• Several standards already exist (HL7, FHIR, DICOM, X12, etc.) and are sometimes mandated, but many organizations don’t enable or use them properly.
• Commenters wish for better, universally adopted formats to avoid repeated paperwork and manual data entry.

Government and large-system adoption

• Mixed views on whether entities like NHS England or the EU could adopt or jointly build an OSS EHR; some see potential, others cite bureaucracy, lack of tech capacity, and preference for big vendors.
• US examples: the VA’s VistA (public domain, now technically dated) and the HITECH-driven boom that benefited commercial EHR vendors.

EHR motivations: billing vs regulation

• One side claims EHRs primarily exist to maximize billing.
• Others say adoption was mostly driven by regulatory and payer requirements, though billing/revenue cycle functionality is heavily prioritized.
• Debate arises over migrations from bespoke EHRs to Epic‑like systems for revenue, interoperability, and audit reasons.

Scope and components of GNU Health

• Some readers find the project’s high‑level description unclear (what exactly each module does).
• Healthcare IT workers respond that terms like HMIS, LIMS/LMS, and personal health record have precise meanings in the field, and GNU Health fits into those categories.

Mobile, personal records, and app distribution

• Confusion about MyGNUHealth installation on phones; criticism that OSS often lags on mobile due to app store hurdles.
• Others stress MyGNUHealth is patient‑facing, distinct from clinician desktop systems, and that major EHRs now have native mobile apps.
• Some users want to keep health data off Big Tech platforms entirely and favor FOSS on user-controlled devices.

Privacy, data sales, and anonymization

• One commenter describes large‑scale selling of “anonymized” healthcare datasets; another cites US rules for de‑identification and claims re-identification risk is overstated so far.
• Disagreement over whether certain datasets are truly Medicare vs private supplemental plan data.

Examples and barriers to OSS adoption

• A fully FOSS dental practice (custom EHR, Linux stack) is referenced as proof of feasibility at small scale.
• Others note regulatory, legal, and risk barriers, plus the need for strong documentation, polished demos, and success stories to convince decision‑makers.

Perceptions of GNU and project presentation

• Some associate GNU with dated, hard‑to‑use software and doubt its suitability for clinical environments.
• Others defend GNU tools as widely used and practical, even if aging or imperfect.
• Criticism that GNU Health’s website, docs, and online presence (e.g., YouTube demos, case studies) are too sparse or outdated to reassure evaluators, despite the apparent technical ambition.