# GNU Health

GNU Health is a free/libre health and hospital information system with strong focus on public health and social medicine. Its functionality includes management of electronic health records and laboratory information management system.
It is designed to be multi-platform, supporting Linux distributions and FreeBSD on the server side. It uses PostgreSQL as its database engine. It is written in Python and uses the Tryton framework as one of its components.
GNU Health has been adopted by the United Nations University. In 2011, it became a GNU official package. It was awarded Best Project of Social Benefit from the Free Software Foundation at LibrePlanet 2012, at University of Massachusetts Boston.
GNU Health is a project of GNU Solidario, a non-profit non-governmental organization (NGO) that works in the areas of health and education with free software.

## History

GNU Health started in 2008 by Luis Falcón as a project for health promotion and disease prevention in rural areas. Its initial name was Medical. It has since evolved into a hospital information system, with a multi-disciplinary international team of contributors.
In August 2011, Richard Stallman declared GNU Health an official GNU Package. Following this, development was moved from SourceForge to GNU Savannah.

## Usage

GNU Health is intended for health institutions and governments, with functionality to take care of the daily clinical practice, manage resources, and to improve public health.

## Features

GNU Health uses a modular approach around the kernel, with different functionality that can be included to meet the health center's needs. Some of the main packages are:
| Package | Functionality |
| Health | Core package. Includes demographics, patients, evaluations, health centers, appointments, vaccinations, medicaments, health conditions, health professionals and other core models and functionality. |
| Accounting | Functionality for bookkeeping: Chart of Accounts, General Ledger, Invoice handling, cash journals etc. |
| Pediatrics | Main package for pediatrics (including neonatal information and pediatric psychosocial assessments). |
| Pediatric Growth Charts | Includes World Health Organization percentile and z-scores charts. |
| Gynecology and Obstetrics | Gynecology, obstetrics, perinatal and puerperium assessment and history. |
| Lifestyle | Physical exercise, diets, drug addictions, National Institute of Drug Abuse (NIDA) recreational drug database, Henningfield ratings, sexuality, risk factors, home safety, child safety. |
| Genetics | Person genetic information and family history. Includes 4200+ "disease genes" from the NCBI/GeneCards. |
| Genetics Uniprot | UniProt database on human protein natural variants and phenotypes. |
| Lab | Laboratory information management system functionality. |
| Socioeconomics | Assessment and history of education, occupation, living conditions, hostile areas, child labor and prostitution, among others. |
| Inpatient | Hospitalization, bed, operating room management. Inpatient care and nursing plans. |
| Surgery | Pre-operation checklist, procedures, operating rooms, patient surgery history. |
| Services | Groups health related services for the patient. It also allows generating invoices and billing the selected services. |
| Calendar | CalDAV and WebDAV server. Manages appointments, hospitalizations, bed and other resources. |
| QR Codes | Includes QR codes for identification on persons, patients and lab orders. |
| History | Reports for patient demographics and medical history. Electronic Health Record EHR |
| MDG6 | Millennium Development Goal 6: Functionality to fight malaria, tuberculosis and HIV/AIDS. |
| Reporting | Demographic, epidemiological and health center related information. |
| Nursing | Nursing functionality. Patient roundings, medication administration and procedures. |
| ICU | Basic intensive-care unit assessment, history and patient management. |
| Stock | Pharmacy and locations stock management. Automatic stock moves generation on medical procedures. |
| NTD | Base module to cover neglected tropical diseases. |
| NTD Chagas | NTD submodule for vector control, diagnosis, and management of chagas disease. |
| NTD Dengue | NTD submodule for vector control, diagnosis, and management of dengue fever. |
| Imaging | Diagnostic Imaging orders management functionality. |
| Orthanc | Module for integration with Orthanc PACS Server |
| Federation | Integration with the GNU Health Federation |
| Crypto | Support for document digest/record integrity check with hash functions; digital signatures and GNU Privacy Guard plugin. |
| Archives | Functionality to track legacy or paper-based patient health records. |
| Ophthalmology | Basic ophthalmology and optometry functionality. |
| Functioning and Disability | Based on WHO International Classification of Functioning, Disability and Health and Laos Center of Medical Rehabilitation. |
| ICD9 Vol 3 | WHO ICD-9-CM Volume 3 procedure codes. |
| ICD10 | WHO ICD-10 International Classification of Diseases - 10th revision |
| ICD11 | WHO ICD-11 International Classification of Diseases - 11th revision |
| ICPM | WHO International Classification of Procedures in Medicine. |
| ICD10 PCS | Procedure Coding System extension |
| Insurance | Insurance and pricelists on services and products management. |
| EMS | Ambulance and Emergency Management System. |
| Contact tracing | Assessment, identification and followup of people who may have come into contact with an infected individual. |

## Reception

* GNU Health was presented at World Health Organization session "ICT for Improving Information and Accountability for Women’s and Children's Health" in WSIS Forum 2013.
* GNU Health was awarded the Free Software Foundation's 2011 Award for Projects of Social Benefit.
* GNU Health won the awards PortalProgramas 2012, 2014 and 2015 for Most Revolutionary Free Software and Software with Largest Potential of Growth in 2012.
* GNU Health awarded Sonderpreis at Open Source Business Award 2016
* In April 2022, GNU Health was included in the Digital public goods registry

## Project milestones

* 12 October 2008: Medical project registered at SourceForge
* 2 November 2008: Medical Version 0.0.2 is released at SourceForge
* 15 April 2010: Medical is registered at Brazilian government Portal do Software Público Brasileiro (SPB)
* 31 July 2010: The Project is registered at the European Community Open Source Observatory and Repository
* 16 April 2011: Thymbra transfers GNU Health to the NGO GNU Solidario
* 18 April 2011: Medical switches the development environment from OpenERP to the Tryton framework.
* 12 June 2011: The project is renamed from Medical to GNU Health.
* 16 August 2011: version 1.3.0 is released, supporting Tryton and PostgreSQL.
* 26 August 2011: Richard Stallman declares GNU Health an official GNU Package. At this point, the development portal is moved from SourceForge to GNU Savannah.
* 29 October 2011: Release of GNU Health v 1.4.1. This version is also included at the Python Package Index – PyPI as a set of Python modules.
* 25 June 2012: Creation of a public Internet GNU Health database test server in Amsterdam.
* 9 February 2013: Release of version 1.8.0, compatible with Tryton 2.6 and Android client
* 18 March 2013: Release of version 1.8.1, with Intensive Care Unit functionality
* 7 July 2013: Release of version 2.0.0. Compatible with Tryton 2.8, New modules for Neglected tropical diseases, starting with Chagas disease. New Demographics section and Domiciliary Units management; new server installer; improvements to the surgery module (ASA physical status classification system and Revised Cardiac Risk Index).
* 22 September 2013: Release of version 2.2.0 Dengue and Diagnostic Imaging Tests.
* 14 November 2013: Release of version 2.2.2 GNU Health Patchset.
* 27 January 2014: Release of version 2.4.0
* 22 March 2014: First release of the GNU Health Live CD with GNU Health 2.4 and Tryton-Server 3.0.x on openSUSE 13.1. The Live CD offers a ready-to-run system with actual GNU Health and the Demo Database pre-installed.
* 6 July 2014: Release of version 2.6.0. Adds hash functions for document verification; digital signatures and GPG integration.
* 1 February 2015: Release of version 2.8.0. Adds Tryton 3.4 compatibility, data aggregation and synchronization features for distributed environments, a Universal Person Unique Identifier (PUID) and Universal Unique Identifier (UUID) implementation, a HL7 FHIR server, birth and death certificates, and enhanced crypto features (GNU Privacy Guard integration).
* 11 January 2016: Release of version 3.0.0: Tryton 3.8 compatibility (including web client support); Person functionality and disability module, inspired in WHO International Classification of Functioning, Disability and Health; basic Ophthalmology and Optometry functionality, and WHO ICD9 CM Volume 3 procedural codes
* 2 July 2017: Release of 3.2 series. GNU Health HMIS packages are now written in Python 3. Enhanced genetic history and UniProt package on human protein related conditions; Emergency Management System; Insurance pricelist; Improved crypto modules on laboratory and services; GNU Health Federation and Thalamus initial development.
* 26 July 2017: With the release of openSUSE Leap 42.3, GNU Health 3.2 becomes part of the standard distribution. This goes in line with automated testing using openQA and an easy, script-based setup.
* 26 November 2018: GNU Health Federation. Version 3.4 for HMIS node
* 10 November 2019: Release of version 3.6 . Integration of a person events ("Pages of Life") with Thalamus and the GNU Health Federation Health Information system. Migration from Mongodb to PostgreSQL for the HIS component. Orthanc DICOM server integration. All components in the GNU Health ecosystem use Python3.
* 24 June 2021: MyGNUHealth personal health record released.
* 3 April 2022: GNU Health included in the digital public goods registry.

## GNUHealthCon

GNUHealthCon is an annual conference organized by GNU Solidario. It provides the space for developers, implementers and community members to meet in person during three days. It includes sessions about social medicine, technical discussions, implementation cases and workshops.

## GNU Health Social Medicine awards

GNU Health Social Medicine awards ceremony is part of GNUHealthCon. The awards recognize the role of individuals and organizations committed to improve the lives of the underprivileged. There are three award categories: Individual, Organization and GNU Health Implementation.
GNU Health Social Medicine Awards
| Year | Individual | Organization | GNU Health Implementation |
| 2016 | Richard Stallman | Red Cross | Laos Center of Medical Rehabilitation (CMR) |
| 2017 | Lorena Enebral | National University of Entre Ríos | Bikop Medical Center |
| 2018 | Jose Caminero Luna | Tor Project | Bafia District Hospital |
| 2019 | Aaron Swartz | Animal Free Research UK | Jamaica Ministry of Health |
| 2020 | Angela Davis | Proactiva Open Arms | Municipality of Diamante, Argentina |
| 2021 | Luna Reyes Segura | Physicians Committee for Responsible Medicine | Insolàfrica |
| 2022 | Teresita Guadalupe Calzia | Franz Weber Foundation | Cirugía Solidaria |
| 2023 | Sébastien Jodogne | Leibniz University Hannover | Fundación Jérôme Lejeune Argentina |
| 2024 | Alexandra Elbakyan | Sea-Eye | Centre Médico Familial et Communautaire (CEMEFCO), Haiti |