gnuhealth.pdf

8/18/2019 gnuhealth.pdf

1/220

gnuhealth


2/220

Contents

1 Preface 1

1.1 Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Introduction 3

2.1 About this Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.2 GNU Health Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

2.2.1 Deploying GNU Health: Centralized vs Distributed Installations . . . . . . . . . . . . . . . 4

3 Resources 5

3.1 More GNU Health Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3.2 Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3.3 Mailing Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3.4 Twitter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3.5 IRC Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3.6 Development Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

3.7 Google+ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

3.8 Community Demo Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

4 First Steps 7

4.1 Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

5 Navigation Area 11

6 Form fields and field types 136.1 Time to Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

7 The core module 15

7.1 The Core Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

7.2 People before Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

8 Health Institutions 17

8.1 Introduction to Health Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

8.2 Creating and Updating Health Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

8.3 Health Institution Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

8.3.1 Beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

i


3/220

ii CONTENTS

8.3.2 Buildings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

8.3.3 Wards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

8.3.4 Operating Rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

8.3.5 Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

9 Domiciliary Units 21

9.1 Introduction to Domiciliary Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

9.2 The Domiciliary Units Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

10 Individuals 23

10.1 The Individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

10.2 Review of concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

10.3 Your first Individual in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

10.3.1 Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

10.3.2 Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

11 Families 26

11.1 The Family Concept in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

11.2 Managing Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

11.3 Searching Family Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

12 Health Professionals 28

12.1 The Health Professional Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

12.2 Creating and Editing Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

12.2.1 Party associated to a Health Professional . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

12.2.2 The Internal User field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

12.2.3 Health Professional specific fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

13 Medicaments 32

14 Prescriptions 33

14.1 About Prescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

14.2 Information Stored in Prescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3314.3 Prescription stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

15 Vital Records 35

15.1 About Vital Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

15.2 Birth Certificates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

15.3 Death Certificates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

15.4 Digital Signatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

16 Immunizations 40

16.1 The Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

16.2 The Immunization Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41


4/220

CONTENTS iii

16.2.1 Immunization Schedule Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

16.3 The Vaccination Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

16.4 Immunization Status Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

16.5 Vaccine stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

17 Configuration 45

17.1 The Configuration Section in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.2 Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.3 Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.4 Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.5 Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.6 Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

17.7 Institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.8 Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4617.9 Medicaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.10Immunization Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.11Misc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.11.1 Occupations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.11.2 Ethnicities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.11.3 Medical Specialities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

17.11.4 Recreational Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

17.11.5 Pediatrics Growth Charts WHO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

17.11.6 Insurances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

18 Patient Management 48

18.1 Introduction to Patient Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

18.2 Creating a party with the patient property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

18.2.1 Step 1: Party definition and demographics . . . . . . . . . . . . . . . . . . . . . . . . . . 49

18.2.2 Step 2: Enabling the patient attribute in the party . . . . . . . . . . . . . . . . . . . . . . 49

18.3 Listing the current patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

18.4 Creating a patient record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

18.5 Printing a patient ID card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

19 Patient Evaluations 52

19.1 Introduction to Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

19.2 Evaluations History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

19.3 Evaluations Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

19.3.1 Main Info Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

19.3.2 Clinical Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

19.3.3 Mental Status Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

19.3.4 Diagnosis Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

20 Patient Appointment and Admission Management 55


5/220

iv CONTENTS

20.1 Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

20.1.1 Information stored per appointement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

20.1.2 List of all appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

20.1.3 List of appointments for a specific patient . . . . . . . . . . . . . . . . . . . . . . . . . . 56

20.2 Hospitalizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

21 Laboratory Management 59

21.1 Introduction to Laboratory Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

21.2 Requesting a Laboratory Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

21.2.1 Test Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

21.3 Managing Laboratory Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

21.4 Storing Laboratory Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

21.4.1 Main Info Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

21.4.2 Extra Info Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6221.5 Printing Laboratory Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

21.6 Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

21.6.1 Lab Test Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

21.6.2 Lab Test Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

22 Financial Accounting 65

23 Analytic Accounting 66

24 Products and Services Management 6724.1 Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

24.1.1 Products basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

24.1.2 Variants basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

24.1.3 Creating new medication products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

24.2 Categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

24.3 Invoicing Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

24.3.1 Step 1: Listing Health Services to be Invoiced . . . . . . . . . . . . . . . . . . . . . . . . 68

24.3.2 Step 2: Creating the Invoice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

25 Stock Management 72

25.1 Basics of Stock Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

25.2 Stock Locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

25.3 Stock Movements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

25.4 Shipments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

25.4.1 Supplier Shipments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

25.4.2 Customer Shipments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

25.4.3 Internal Shipments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

25.5 Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

26 Purchase Administration 75


6/220

CONTENTS v

27 Access Management 76

27.1 Access Management Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

27.2 Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

27.2.1 Members Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

27.2.2 Access Permissions Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7727.3 Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

27.3.1 User Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

27.3.2 Actions Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

27.3.3 Access Permissions Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

27.3.4 Preferences Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

28 Socioeconomics 80

28.1 Introduction to Socioeconomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

28.2 Main Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8028.3 Infrastructure Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

28.4 Family Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

29 Lifestyle 82

29.1 Introduction to Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

29.2 Diet and Exercise Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

29.3 Addictions Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

29.4 Sexuality Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

29.5 Safety Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

30 Functioning and Disability 85

31 Gynecology 86

31.1 Introduction to Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

31.2 General Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

31.3 Screening Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

31.3.1 Mammography History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

31.3.2 PAP Smear History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

31.3.3 Colposcopy History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

32 Obstetrics 88

32.1 Introduction to Obstetrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

32.2 General Pregnancy Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

32.3 Prenatal Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

32.4 Perinatal and Intrapartum Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

32.4.1 Main Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

32.4.2 Additional Info Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

32.5 Puerperium Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

33 Genetics 95


7/220

vi CONTENTS

33.1 Introdcution to Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

33.2 Genetic Risks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

33.3 Family History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

34 Surgery 98

34.1 Introduction to Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

34.1.1 ICD-10-PCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

34.2 Surgeries per Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

34.3 All Surgeries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

34.4 Surgeries Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

34.4.1 Revised Cardiac Risk Index (RCRI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

35 Pediatrics 103

35.1 Introduction to Pediatrics Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

35.2 Neonatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

35.2.1 Creating a Newborn Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

35.2.2 Newborn and Mother Wristbands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104

35.3 PSC (Pediatrics Symptom Checklist) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

36 Nursing 107

36.1 Introduction to Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2 Roundings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2.1 Main Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2.2 ICU Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2.3 Procedures Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2.4 Medication Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.2.5 Stock Moves Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.3 Ambulatory Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.3.1 Main Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

36.3.2 Other Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

36.3.3 Medication Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

36.3.4 Stock Moves Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

37 Inpatient Management 109

37.1 Introduction to Inpatient Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

37.2 Admission Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

37.3 Administrative Data Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

37.3.1 Assigning a Bed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

37.4 Nutrition Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

37.4.1 Managing Beliefes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

37.4.2 Managing Therapeutic Diets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

37.5 Medication Plan Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

37.6 Care Plan Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112


8/220

CONTENTS vii

38 Intensive Care Unit 113

38.1 Introduction to the ICU Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

38.2 Patient ICU Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

38.2.1 APACHE II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

38.2.2 ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11538.2.3 GCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

38.3 Patient Rounding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

38.3.1 Neurologic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

38.3.2 Respiratory (incl. X-Ray) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

38.3.3 Drainages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

38.3.4 Cardiovascular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

38.3.5 Blood and Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

38.3.6 Digestive and Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

39 Neglected Tropical Diseases 118

39.1 Introduction to Neglected Tropical Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

39.2 Chagas Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

39.2.1 Chagas Related Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

39.2.2 Chagas Related Laboratory Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119

39.3 Dengue Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

39.3.1 Dengue Related Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

39.3.2 Dengue Related Laboratory Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

40 Reporting 122

40.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

40.2 Demographics Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

40.3 Patient Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

40.4 Top Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

40.5 Injury Surveillance System Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

40.6 Specialties by health professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

40.7 Evaluations Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

41 Demographics 124

42 Epidemiology 125

43 Installation 126

43.1 Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

43.2 Installing GNU Health on GNU/Linux and FreeBSD . . . . . . . . . . . . . . . . . . . . . . . . 126

43.2.1 Operating System requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

43.2.2 Creating the Operating System User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

43.2.3 Verify PostgreSQL authentication method . . . . . . . . . . . . . . . . . . . . . . . . . . 127

43.2.4 Creating the Database User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127


9/220

viii CONTENTS

43.2.5 Downloading and Installing GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . 128

43.3 Booting up the Tryton Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

43.4 Installation of the Tryton Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

43.4.1 Standard Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

43.4.2 Alternative Method (PIP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13043.4.3 Setting the Tryton Client Tabs Position for GNU Health . . . . . . . . . . . . . . . . . . . 130

43.4.4 Creating the GNU Health database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

43.5 Logging into the Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132

43.6 Installing the Default Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132

43.7 Creating a Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134

44 Administration 136

44.1 About the Administration Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136

44.2 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136

45 User Interface 137

46 Models 138

47 Sequences 139

48 Scheduler 140

49 Localization 141

49.1 Translating GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14149.2 About Transifex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

49.3 Installation of Language Packs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

49.4 Setting the User Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

50 Modules 144

50.1 Installing Extra Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

50.1.1 Installation Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

50.1.2 Dependencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

50.2 Available Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14450.3 Custom Modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

51 Users 146

52 Countries 147

53 WebDAV 148

54 Central Authentication 149

54.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

54.1.1 Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

54.1.2 Central Authentication Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149


10/220

CONTENTS ix

54.2 Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

54.2.1 Creating the Organization and Users on the LDAP Server . . . . . . . . . . . . . . . . . . 150

54.2.2 Configuring LDAP in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

55 Patches and Patchsets 152

55.1 About GNU Health Patchsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

55.2 Patches vs Patchsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

55.2.1 Patches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

55.2.2 Patchsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

55.3 Criteria for a New Patchset Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

55.4 Applying Patchsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

56 Upgrade 155

56.1 About GNU Health Upgrades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

56.2 Gathering Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

56.3 Prepare your Upgrade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

56.4 The Upgrade Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

57 Contributing 157

57.1 Contributors Wanted! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

57.2 Translating the Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

57.3 Writing and Translating the Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

57.4 Reporting Bugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

57.5 Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

57.5.1 Obtaining Your Copy of the Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158

57.5.2 Coding style . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158

57.5.3 Customizing and Creating Your Own Modules . . . . . . . . . . . . . . . . . . . . . . . 158

57.5.4 Submitting Patches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158

58 Backups and High-Availability 159

58.1 About the GNU Health Control Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

58.2 Invoking gnuhealth-control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

58.3 Backups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

58.4 Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

59 Security 161

59.1 Securing Your GNU Health Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

59.2 Access Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

59.2.1 Standard Ports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

59.2.2 Serverpass: The Server Password Utility . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

59.3 Public-key Cryptography in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

59.3.1 GNU Health Cryptographic Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162

59.3.2 Using Digital Signatures in GNU Health . . . . . . . . . . . . . . . . . . . . . . . . . . . 163


11/220

x CONTENTS

60 Troubleshooting 165

61 FHIR REST server 166

61.1 About FHIR and REST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166

61.2 Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166

61.3 Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166

61.4 Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

61.5 Running the Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

61.6 Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

61.6.1 Cannot connect to database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

61.6.2 No database with that name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

62 Using the FHIR REST server 168

62.1 FHIR Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

62.2 URL Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

62.3 Authentication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

62.4 Searching / Listing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

62.5 Test Server Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

63 Synchronization Guide 170

63.1 Scope of this Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

63.1.1 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

63.2 Installation of Satellites and Central instance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

63.2.1 Satellites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

63.2.2 Running the Synchronization Engine on Satellite Instances . . . . . . . . . . . . . . . . . 171

63.3 Technical Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172

63.3.1 Developers “Mini-Guide” to the Synchronization Engine . . . . . . . . . . . . . . . . . . 172

64 Release Process 173

64.1 Introduction to the GNU Health Release Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

64.1.1 Stages of the Release Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

64.2 Upcoming Release Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

64.3 Security fixes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

65 Different ways to test GNU Health 174

65.1 About this page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.2 Option 1: Connect to the Demo Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.2.1 What to do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.2.2 Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.2.3 Disadvantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.3 Option 2: Run GNU Health from CD/DVD or USB Stick . . . . . . . . . . . . . . . . . . . . . . 174

65.3.1 What to do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

65.3.2 Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175


12/220

CONTENTS xi

65.3.3 Disadvantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

65.4 Option 3: Run GNU Health in a Virtual Machine . . . . . . . . . . . . . . . . . . . . . . . . . . 175

65.4.1 What to do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

65.4.2 Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

65.4.3 Disadvantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17565.5 Option 4: Run GNU Health from Docker (Lightweight Containers) . . . . . . . . . . . . . . . . . 176

65.5.1 What to do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

65.5.2 Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

65.5.3 Disadvantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

66 The Demo database 177

66.1 Introduction to the Demo Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177

66.2 The Zenon-Betz Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177

66.2.1 Demographics Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17766.2.2 Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

66.2.3 Other Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

66.3 Online Demo Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

66.4 Local Demo Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

66.4.1 Manual Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

66.4.2 Installation Using Proteus Demo Script . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

66.5 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180

67 The Live-CD 181

68 The Live-CD 182

68.1 Download the Live-CD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

68.2 Install the Live-CD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

68.2.1 USB-Stick / Hard Disk Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

68.2.2 ISO-Image / CD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

68.3 Install the Live-CD to your hard drive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

69 Virtual Machine Images 184

69.1 Running the Virtual Machine as Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184

69.2 Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184

70 Glossary 186

70.1 ICD-10-PCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.2 Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.3 ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.4 Employee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.5 Glasgow Coma Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.6 GSC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

70.7 ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186


13/220

xii CONTENTS

70.8 Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.9 Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.10Move . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.11Party . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.12Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.13Pediatrics Symptom Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.14Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.15Person Unique Identification Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.16Product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

70.17PSC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

70.18PUID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

70.19QR Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

70.20Shipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

70.21User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

71 FAQ 189

71.1 General Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

71.2 Concepts of GNU Health and Tryton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

71.3 Demo Database . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

72 Operating System-Specific Notes 191

73 Arch Linux 192

73.1 Install dependencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

73.2 Initialize the DB cluster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

73.3 Start and enable the PostgreSQL service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

74 Debian 193


75 FreeBSD 194


75.2 Link Python and cracklib dictionaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194

75.3 Init PostgreSQL server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194

76 OpenSUSE 195

76.1 Add Password Management Repository . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195


77 Ubuntu 196


78 Trisquel 197



14/220

CONTENTS xiii

79 Packaging Guidelines 198

80 Community Pages 199

80.1 Text and image sources, contributors, and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . 200

80.1.1 Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200

80.1.2 Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202

80.1.3 Content license . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206


15/220

Chapter 1

Preface

1.1 Preface

Regardless of the remarkable achievements in technology, thousands of children will die today from preventable

diseases. Infectious diseases such as malaria, chagas, AIDS, tuberculosis or infectious diarrhea destroy millions of

families in developing countries. Noncommunicable diseases including obesity, diabetes, heart disease, cancer or

major depressive syndrome hit both the North and the South, although with much higher prevalence and incidence

among the underprivileged sectors. Equally important are the alarming levels of child labor, human trafficking and

sex slavery, family violence, child abuse or drug addiction. Complex, multi-etiological and anthropological issues

also exist that desperately need to be addressed.

We need a change of paradigm: We need to move away from the reactive Model of Disease, to the proactive Model

of Health . Many countries lack good public health, sometimes because they put the focus on the private sector;

sometimes because they give too much emphasis to technology. The most sophisticated technology will never beat

good Primary Health Care policies. Education, good nutrition, family affection, physical exercise, and sanitary hous-ing conditions are the best and most sustainable public policies one can make. The concept of Integrative Medicine

is always present in GNU Health.

I started the GNU Health project in 2008 to improve Primary Health Care (PHC) in rural communities. Today

GNU Health has grown to a full Health and Hospital Information System, but the spirit remains the same. GNU

Health complements PHC, but never will replace the work of the mother, teacher, nurse, doctor or social worker.

What GNU Health does well is handling and processing large amounts of data. 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 realtime. It can show the trends in infestation level of vectors that transmit Chagas disease in DomiciliaryUnits; It can cross indicators in different communities, and relate Social determinants of Health in many conditions

(family violence, teenage pregnancy, child mortality, ... ).

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 inmersed 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 !

1

https://en.wikipedia.org/wiki/Alma_Ata_Declaration


16/220

2 CHAPTER 1. PREFACE

GNU Health paradigm of System of Health

Luis Falcón, MD

GNU Solidario

Las Palmas de Gran Canaria, Spain


17/220

Chapter 2

Introduction

2.1 About this Book

This book provides an introduction to GNU Health, The Free Health and Hospital Information System. Unlike

traditional books, this Wikibook will be updated with the latest stable GNU Health version. Health is dynamic by

nature, so is GNU Health.

Versioning: The book will include functionality from the upcoming version, several weeks before the stable release.

This means that some texts and pictures in the book belong to the new version.

The book is organized in the following sections:

• Introduction to GNU Health

• Functional guide: Philosophy behind the project and the core functionality. Provides the information on how

to approach a GNU Health implementation.

• Modules in Detail: Information and instructions for specific modules. Each modules encompasses functionality

for a speciality (pediatrics, surgery, gynecology, socioeconomics ... )

• Technical: Installation manual, administrator’s guide

If you are starting with GNU Health, you should read the book in a linear, sequential fashion. It’s the best way to

understand the software, the project and how to implement it.

2.2 GNU Health Functionality

The main areas of GNU Health are:

• Individual and community management: demographics, domiciliary units, families, operational areas and

sectors, ...

• Patient management: Socioeconomics, lifestyle, encounters / evaluations, hospitalizations, lab reports, clin-

ical history, ...

• Health center management: Finances, stock, pharmacy , laboratory, beds, operating rooms, appointments,

supply chain management, human resources, ...

• Information management: Reporting, Demographics and Epidemiology

These areas involve a multi-disciplinary teams, with different responsibilities. For example, the individual demo-

graphics and status of the domiciliary units (DU) can be collected by social workers; the patient management by

3


18/220

4 CHAPTER 2. INTRODUCTION

health professionals ; the health center management by administrative personnel and accountants ; and the Informa-

tion produced by the health center can be processed and managed by the Ministry of Health authorities.

This is just an example to show the importance of team work in GNU Health to get be best results in your community.

2.2.1 Deploying GNU Health: Centralized vs Distributed Installations

GNU Health is scalable in functionality, database size and transactional volume. For instance, you can install GNU

Health in a single doctor office, or in country public hospitals network. Depending the type of deployment, you will

think about a centralized (single instance) vs a distributed installation.

• Single GNU Health Instance: All the information resides in a single database, and it will be accessed via

network from different workstations from the same health center (local area network) or from different health

centers.

• Distributed GNU Health instances: Under this scenario, each health center has its own database instance,

and information can be synchronized among health centers. This would be the case when you want to deploy

GNU Health in a network of hospitals, where the communication infrastructure is suboptimal.

Needless to say, choosing the deployment method requires careful study of resources (hardware, network, human

resources, security and access control, backup and disaster recovery policies, ... ) that goes beyond the scope of this

book. The two types of installations have pros and cons.

Sample Patient ID card generated by GNU Health

Unique Patient ID: In hand-written histories and in some electronic medical records, is not uncommon to find

duplicate patients or duplicate medical records. This scenario is not only costly, but it may represent a risk to the

patient.

The other problem people face in many countries is data isolation. That is, health centers don't communicate to each

other, resulting in a different medical history on each center. In other words, in many health care systems today, you

are a different person and patient on each health center you visit.

GNU Health uses a unique person and patient identifier, that does not allow the duplication of either indi-

viduals or patient medical history at the health center. It allows to export the information to the patient card, and

it provides the framework to synchronize data between health centers. For quick patient identification in different

health care network, the patient ID can be read, for example, with a QR reader, speeding up the registration process

and avoiding common human errors.

If you plan to use a distributed environment in your health network, you can find more information about in the GNU

Health Synchronization Guide.

https://en.wikibooks.org/wiki/GNU_Health/Synchronization_Guidehttps://en.wikibooks.org/wiki/GNU_Health/Synchronization_Guide


19/220

Chapter 3

Resources

3.1 More GNU Health Resources

Besides the GNU Health documentation on Wikibooks (which you are reading right now), there are several other

resources for the GNU Health community.

3.2 Website

The official GNU Health Website can be found at http://health.gnu.org

3.3 Mailing Lists

There are several mailing lists for information exchange via email:

• health: General questions and discussions about GNU Health

• health-announce: GNU Health releases and events

• health-dev: Development, requests and bugs

• health-es: General questions and discussions about GNU Health in Spanish

• health-fr: General questions and discussions about GNU Health in French

• health-pt: General questions and discussions about GNU Health in Portuguese

To subscribe to these mailing lists, please visit https://savannah.gnu.org/mail/?group=health

3.4 Twitter

For regular news updates we suggest that you follow GNU Health on Twitter at https://twitter.com/gnuhealth

3.5 IRC Channels

You can find live help at IRC in the following channels:

• #gnu-health: English

5

https://twitter.com/gnuhealthhttps://savannah.gnu.org/mail/?group=healthhttp://health.gnu.org/


20/220

6 CHAPTER 3. RESOURCES

• #gnu-health-es: Spanish

You can use any IRC client or Free node web interface

3.6 Development EnvironmentOn August 26th, 2011, the Free Software Foundation adopted GNU Health as an official GNU project. Since then,

the development environment is hosted at GNU Savannah. Besides the mailing lists, here you can post bugs, tasks

and check out the latest development version.

http://savannah.gnu.org/projects/health

3.7 Google+

The GNU Health community on Google’s social networking platform Google+ can be found at https://plus.google.

com/communities/104024590265963842407

3.8 Community Demo Server

This server is in Europe and serves as a demo server to practice and see a running system. You can find more

information in the Online Demo Database section of this book.

https://en.wikibooks.org/wiki/GNU_Health/The_Demo_database#Online_Demo_Databasehttps://plus.google.com/communities/104024590265963842407https://plus.google.com/communities/104024590265963842407http://savannah.gnu.org/projects/healthhttps://webchat.freenode.net/?channels=gnu-health


21/220

Chapter 4

First Steps

4.1 Terminology

Before we start the implementation process, it is important to get familiar with the terminology commonly used in

the rest of this book. At the beginning some words might be a bit puzzling, but with a bit of practice, you will find

this terminology quite logical.

First you should know that GNU Health builds upon other software. Even if you are not a technical personal, it might

be helpful to understand that GNU Health is an extension to Tryton, a general enterprise resource planning system

(or ERP for short) for almost any type of company or organisation. Tryton is developed in the Python programming

language, and it stores all its data in a PostgreSQL database.

The following concepts are essential to understand how GNU Health works:

Company. An example of a Party

• Party: In GNU Health, a party is an entity. An abstract concept to define someone or something that has legal

7


22/220

8 CHAPTER 4. FIRST STEPS

status. It’s the unit of the relationship in Tryton. Some examples of Parties are:

• Patients

• Companies

• Health professionals

• Health centers

• Model: The model defines each object in GNU Health. Models define the database objects (tables). gnuhealth.patient

is a model example.

• Field: The building blocks of the model. For example: age and sex are gnuhealth.patient fields.

• View: Views are the representation of the model on the screen. Most models will have an individual form to

accept data into the model and display data out from the model.

• Tree: The list format of the model. The tree view allow us to search select multiple records.

Example of a Tree list

• Form: The representation of the model on the screen that allows you to input data.

• Table: The model representation at the database server. The model gnuhealth.patient is mapped in the table

gnuhealth_patient in postgreSQL.

• Record: Each unique entry in a particular database table. For example Ana Betz isa recordon the gnuhealth_patient

table in PostgreSQL.

• Module: Modules are programs that provide specific functionality. GNU Health provides different modules

to meet your health center needs. Example of modules are Socioeconomics , Genetics and Surgery. You should

only install the modules that are actually needed for your center.

• Report: Reports allows you to dynamically print documents in Open Document / LibreOffice format (ODF),

Portable Document Format (PDF) or even directly to the printer.

• Action: Actions are processes excecuted upon one or more selected records.

• Notebook: A tabbed group of forms designed to make navigation easier.


23/220

4.1. TERMINOLOGY 9

Form view of the same record

GNU Health modular design


24/220

10 CHAPTER 4. FIRST STEPS

Sample Lab report


25/220


26/220

12 CHAPTER 5. NAVIGATION AREA

• Status bar : The lower side of the screen shows the status bar. From left to right, these are fields :

• User name : In this case we logged in as Administrator

• Organization Name : GNU Solidario Hospital

• Requests : Tryton has an internal messaging system. You will get notifications in realtime.

• Server Information : The lower right section gives you login and server information. In this example, itshows “admin@localhost:8000/demo". admin is the login name, localhost the name of the GNU Health

server, 8000 is the port where connects and demo is the database name.


27/220

Chapter 6

Form fields and field types

Let’s now go through the most relevant field types and how to properly use them. We will use the previous screenshot

of the patient as the example.

• Text fields : These type of fields allow us to enter a lot of information. You will see them normally like large

boxes. In our example, the field under “Patient Allergies and Critical Information” is a text field.

• Character fields : These type of fields are similar to the Text fields, but with a limited size. There are few

character fields and none in this example. The diet type in the lifestyle section or the Gene ID on genetics are

example for character fields.

• Date Fields : These fields will open a calendar when clicked, so you can choose the date. Alternatively, you

can enter the date manually. The date of birth is a Date field.

• DateTime Fields : Similar to the date fields, but with the addition of time. An example of this field is the

Date/time of birth of the newborn, in the neonatology module.

• Integer fields : These fields allow only integer numbers. They show a “0” by default. An example is Minutes

of physical exercise per day

• Float fields : You can enter decimal numbers. The body temperature is one example of a float field.

• Function fields : These are special fields, in the sense that they are calculated in real time, depending, most of

the time, on the values of other fields. For example, the Patient Age is a function field. Notice that the field has

a grey background, meaning that is read-only. It will calculate the current patient age in years/months/days

depending on the patient date of birth. Another example of function field is the Hospitalization Status of the

patient.

• Selection fields : These fields will let you choose from a list of options. For example, the patient Sex or the

blood type are selection fields. This type of field minimizes typing error.

• Relational fields : These fields retrieve information from a related model. They are of the form One2Many

or Many2One. Relational fields are important to keep the uniqueness of data. By using this type of fields,

you link the ID of an existing record, without duplicating information, to another record. The patient is a

relational (One2Many) field. It relates to the the party model, from where it gets all the administrative data

(Social security number, address, etc... ).

Shortcuts : [F2] will open the related record and [F3] will create a new record

• Required fields : These fields are mandatory. You must enter information or else the record won't be saved.You can quickly identify the required fields because they have a blue background. The Patient field is a required

field.

13


28/220

14 CHAPTER 6. FORM FIELDS AND FIELD TYPES

6.1 Time to Practice

Important : Make sure you are in your demo database. This demo database that you created has no important

information. You can put anything you want. You can even delete it and recreate it. Just make sure you don't use

a production database for your tests. One way to prevent accidentally entering the production database is to have a

different password for your demo database, this way if you select the wrong database, you won't be able to login.

If you do not have a demo database yet, please refer to the chapter Different ways to test GNU Health to learn how

to create your own testing environment.

It’s been a lot of information! Now is time to play around with all this information.

With the information try the following :

1. Navigate in the Main menu

2. Open the Configuration Submenu

3. Create a Physician with the Family Medicine Specialty.

https://en.wikibooks.org/wiki/GNU_Health/Different_ways_to_test_GNU_Health


29/220


30/220

16 CHAPTER 7. THE CORE MODULE

• Operational Sectors

• Health Centers

• Diseases

• Patient

• Patient Evaluation / Encounters

• Medicaments

• Treatments

There are many others models in the core module, but this subset will give you an idea of the concept. If you are not

a programmer, you don't really have to worry much about how GNU Health deals internally with dependencies and

inter-module communication. For example, if you want to install the pediatrics module health_pediatrics, it will

automatically mark the core module health for installation, as a dependency.

To learn more about GNU Health modules, please refer to the Modules chapter.

In this documentation, we will cover the functionality of the core module first before exploring the possibilities of theother modules.

7.2 People before Patients

If we want to be good in a Public Health system, the first thing we need to do is knowing our population. As I say, we

need to deal with people before patients . Whenever possible, the health center should have a census, and the list of

domiciliary units (DU) and their conditions, at least of those habitants that are part of the operational sector covered

by the health center.

From a functional and implementation point of view, we should see the GNU Health core module objects as the first

ones to be assessed. The process of collecting this information will get our health center involved with the community.

In the next chapters we will be covering how to setup a Domiciliary Unit (DU); an Individual; the habitants of a DU;Families ; Operational Areas and Operational Sectors.

Once you have that information in place, you will be able to give a new attribute to the individual when she or he first

come to your office, the patient attribute. As you can see, there are precious information and actions that can be done

in Public Health before dealing with a single patient.

https://en.wikibooks.org/wiki/GNU_Health/Modules


31/220

Chapter 8

Health Institutions

8.1 Introduction to Health Institutions

The Health Institution plays a central role in GNU Health. As a matter of fact, is the first thing you will have to create

in the installation.

Since version 2.6, the health institution is a model. It is linked to the party model, but it has many other attributes.

8.2 Creating and Updating Health Institutions

The Institutions form in GNU Health

17


32/220

18 CHAPTER 8. HEALTH INSTITUTIONS

The very first health institution that you create is special because it is also your company. Please refer to the “Create

a Company” section in the “Installation” chapter for more details.

Health institutions can be accessed in the Health → Institutions section.

8.3 Health Institution Facilities

Selecting the health institution related facilities is done from the main institution form.

A health institution can have multiple facilities and resources, such as buildings, wards, operating rooms, beds or

units.

The best way to access the health institution facilities is by clicking on the Relate button in the Institutions form as

shown in the screenshot. One of the benefits of using related records from the institution form is that the related

facility will contain the parent center, optimizing data entry and minimizing human error.

8.3.1 Beds

Beds are the most basic facilities in a health institution. Creating a bed record for each physical bed available is

important for capacity planning and for finding a patient. Each bed belongs to a ward.

Configuring Beds

Bed records in GNU Health can be managed in the Health → Configuration → Institutions → Beds section. For each

Bed record you need a corresponding Product Variant record (which stands for the individual bed) plus a Product

record (which stands for the bed category and defines its price).

Note: If you are not familiar with products in Tryton, there is more information about this concept in the chapter

“Products and Services Management”. But if you just want to configure some beds at this moment and don't care

about the details, then simply read on.

Configuring beds in GNU Health is a three step process:

1. For every category of beds, create a product record and enter the price the patient will be charged. Example:

2. For every bed available in your health institution, create a product variant record and check the Bed checkbox.

Every variant will need a code as an identifier, but you are free to use any combination of characters and numbers to

match the numbering scheme in your institution. Example:

3. For every bed available in your health institution, create a bed record and assign it to the corresponding product

variant record. A bed record stores additional information about a bed like its status (free, reserved, occupied, ...)

or the ward it belongs to. If you skip this step you will not be able to assign a patient to a bed in the hospitalization

process!

8.3.2 Buildings

Buildings simply have a name and a code. At the moment you can not enter more information.

https://en.wikibooks.org/wiki/GNU_Health/Products_and_Services_Managementhttps://en.wikibooks.org/wiki/GNU_Health/Installation#Create_a_Companyhttps://en.wikibooks.org/wiki/GNU_Health/Installation#Create_a_Company


33/220

8.3. HEALTH INSTITUTION FACILITIES 19

Configuring Buildings

Creating and editing buildings is straight forward. The only thing to keep in mind is that both the name and the code

of a building need to be unique within a given health institution.

8.3.3 Wards

Each ward belongs to one building (the physical location) and one unit (the organisational entity).

Configuring Wards

Configuring wards is staight forward. However, the Wards form allows you to enter a lot of details about a ward:

• Name: The ward name is mandatory and must be unique within a health institution.

• Building: Link to an existing building or create a new one.

• Floor Number: Indicate the floor within a building.

• Unit: Link to an existing unit or create a new one.

• Number of beds: This field is for information only. It does not reflect the number of beds you have configured

for your health institution.

• Gender: Indicate if a ward is gender specific. (If not, set it to “Unisex” which is the default value.)

• Status: Indicate if a ward has capacity for more patients. (Choose between “Beds available”, “Full”, or “Not

available”.)

The wards form allows you to indicate some special features as well:

• Telephone access

• Air conditioning

• Private bathroom

• Guest sofa-bed

• Television

• Internet access

• Refrigerator

• Microwave

8.3.4 Operating Rooms

Each operating room belongs to one building (the physical location) and one unit (the organizational entity).

Configuring Operating Rooms

The configuration of operating rooms is straight forward. A name is mandatory and must be unique within a given

health institution. Assigning an operation room to a building and/or a unit is optional. Further information about the

operation room can be stored in the Extra Info field.

8.3.5 Units

Units simply have a name and a code. At the moment you can not enter more information.


34/220

20 CHAPTER 8. HEALTH INSTITUTIONS

Configuring Units

Creating and editing units is straight forward. The only thing to keep in mind is that both the name and the code of

a unit need to be unique within a given health institution.

gnuhealth.pdf

Documents