Hi, On 2021-07-14 2:27 p.m., Jude DaShiell wrote: > Doctors and Dentists run windows as the base for all of their practice > software. I don't know of any linux software that could replace that > software either. Could it be some software house would be able to get > linux versions available and make some money? > > There's many reason behind the use of Windows. The historical reason. Plus you often need many software that are specific to one part of your practice. For example in Quebec, all doctors need to have a accounting software that is certified by the accounting board so they can bill the universal health care system. They also need a certified software to have access to the unified medical record (all hospital are linked to a huge database so anywhere you can know what test have been done, what medication is prescribed, etc) Those software are have a limited market either because of the geography (accounting and medical limited only to Quebec) or in some case because of the practice type (There's software made only for radiologists and some only for ENT doctors). All this create a somewhat small market and it would be hard for a company to be profitable in a sub part of this market. Also, there's the more complex certification of the global system. There's ANSI and ISO standard for medical equipment that has to be met by computer equipment used in medical practice. Not everything but when you talk about lab results analysis for example. This would require to certify the whole stack, including the underlying Linux OS and deal with the update. Often these system are not network linked because you can't update them too easily. Also, there's the part that "Everyone learn something in school" and for most of us, this is Windows. So you'd be asking your clerk to learn the difference with LibreOffice and adapt to this. Some things are changing, as we are all now "over Internet", I know that some provider who only offered Windows based software are now serving it as web application. So you can use it over Internet, that is mainly billing and health record management. We also have to put ourselves into others shoes. If most people here who are Debian user also adapt easily to different computer environment, even enjoy it. It's far from the case with most other user of computer system. So there must be at least a really good incentive to force a system change. And there, I cannot see it ! The savings done over license would be transferred to the cost of certifying. Where as now, once the Windows operating system is approved, you don't have to do this again for every solution you'll make. Where there's a good penetration of Linux based system is mostly where the doctors are autonomous in their own practice. For example in Africa, if I'm remembering good, even UNAIDS (UN HIV) donated funds for a open source software used to manage lab results and do epidemiology with the data. This was in Africa... The question is not "why doesn't anyone made a solution using Linux" but the question is more "what would they gain doing so" and "what would be the incentive to the user". If it take more than 2 sentence to explain the advantages of going with a Linux solution then you lost them. And this not only apply to doctors but to most professional for who the computer is only a tool, like a pen, a typewriter and a ottoscope. I'll explain a bit more to support my words... Many years ago, the health administration of Quebec was getting tired of dealing with paper billing getting in. It was time consuming for the agency to put all this into the computer themselves. But by law, they couldn't force doctor to bill thru computer. You have doctor who are 70 years old and are used to billing by hand on a tri-copy piece of paper with carbon. They know all the billing code in their head. We are in 2005 and there's people sending in load of paper, there's other doctor who send in disc (cd-rom that evolved from the old time floppy), some of them use a switched line modem (56k) and some use batch transfer over the internet thru the portal. So they put a transaction fee of 75 cents for every paper form sent, except the one that are only possible to send on paper (some type of payment where you have to justify what you did or when there's no billing code). And time goes by... It took 5 years for the doctors who sent by paper to mostly change to electronic form. So we are now in 2011 and there's still doctor doing the paper thing. So they pushed in the unified health record and paid a one-time fee to all doctor for buying computer and network equipment, also internet access plus 6 days in the year for training. And they added some payment to train the employees. Because there was a real advantage for doctors (the unified health record), they computerized their practice. Once they started being more electronic, some advantage of using the computerized system was added. For example you could save yourself from typing many information in forms by reusing it from the health record. As time passed, the doctors who still billed on paper we're going electronic. The only thing that pushed them was because it was a more useful for them, easier, it reduced the possibility of error. And now as of 2021, there's only electronic billing and all doctor have access to the unified health record. There's a need to have a good reason for a change... Practice of medicine is a very particular job. You don't always have much time to make some very important decision. And if you end up loosing time because you don't understand or need to adapt to a new computer system then you'll simply keep it the way it is now. Little story on the end. My dad called me and asked if I could go setup his home network when he moved to his new house. I went, we drink beer and have a good meal. One of his friend say "Hey, ain't you able to setup your internet yourself". And my dad to answer "Sure I can do it, even setup the firewall, the ip routing if needed and all it's needed. It ain't hard to make the necessary research if there's something you are not sure. But why don,t I do it ? Because it won't be effective for me and I'm 65 years old". Hope this give a inside look and answer some questions -- Polyna-Maude R.-Summerside -Be smart, Be wise, Support opensource development
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