My Hospital runs Linux (OR) How we closed the Windows & Opened the Doors

The Great Dream …

This post is my dream .. or has been for about 4 years.

A day that my hospital runs on full Open Source Software.

First a little about me. I am a practicing Paediatric Orthopaedic and Spine Surgeon. I am a Open Source enthusiast. I started using Linux 6 years ago and for past 4 year I am using it almost exclusively at work and home. The only time I use Windows is for the odd gaming. I do Python programming – web & desktop.

When we moved into our new hospital premises, set up 2 years ago, to start on a good note and to save start up cost I set up an Open Source Intranet (Plone) and Open Source PACS for my use at the Hospital. I also started developing my own EMR project that I speak abt in this blog.

I dreamed that the hospital will implement an all Open Source Solution. I advised them likewise.

They seemed to listen. Then FUD (Fear -Uncertainty-Doubt) took over them:

How can we follow the advise of this Non-Professional ?

What happens if we have a trouble in future and then he cant help us ?

Where do you find the Linux certified guys to help you ?

What happens if Linux is sold off to come company and it becomes a paid?

(Yes, they did actually say that ).

So they sell themselves to the “Professionals” . Our Management was no different.

It was advised that our Hospital will need the best server, a professional firewall, latest antivirus, and all windows machines. Individual desktops were advised, even for Reception area ! . This along with the latest MS Office and all the great accompaniments. … It was not cheap – It was not meant to be. The offer looked really good. The guileless management was tempted to say ‘yes’.

Then they thought they’d double check with me, just in case.

The Great Deliberation followed.

One looked at the order, I chopped off half of it. Why do you need a comp with Core2Duo, 320 GB drive, 4GB RAM and Win7Prof  for Reception, Cash ?. All that they ever use to is to login to our Hospital Software.

I suggested all Thin Clients, Open Office, Linux on Server. Firewall with Linux. No antivirus software. Intranet with Open Source and Open Source PACS system. Desktops only for Doctor chambers and Media editing.

After mustering courage and ample dosage of FUD from the Professionals, Management decided on Windows Server & Win Thin Clients. They were whining all the while saying that my idea is ill advised. I suppose he would considering that I trimmed the budget at least 5 -6 lakhs of Rupees.

So it was going to be a huge server we may never use with features and specs that many small IT companies may not have or want or need or use : Sonic wall firewall, MacAfee antivirus, MS Office on all Desktops the list went on and on… There were ThinClients at all stations and Desktop at Doctors rooms and other important admin areas only. IT was Windows everywhere.

The Professionals offered to set up the Server with domains all the security stuff. It was bundled with the purchase.

Things had barely gotten off the ground after a year of struggling to set it up. Then a 2 year jinx started.

The Great Depression followed.

The Thin Clients which needed to work with only our Hospital Software (written in Java) needs Firefox. Most stations needed this software for the daily work. Even though we had purchased the ThinClients after testing with Firefox and our Software, after implementation it was horridly slow. CPU was clocking   100 % the moment we use the software on Firefox.

The ‘Pros’ blamed it on Thin Clients. They told Mangement we told you so. You needed Desktops. Buy it and it will run things smoothly. Blame game between the ‘Pros’ and the software vendor started.

They could not sort it out for over two years. Work at the hospital suffered. We needed to replace the Thin Clients at the high workflow areas with old desktops to that we could serve.

All the while I kept telling them you move to Linux it will be all right, but they needed a ‘Pro’ to tell them that. Of course, they would not. They tried to sell us more. After `considerable study` at their HQ and evaluation of the software, they said it will be all right if the server did all the processing and asked us to shell out more for the Terminal  License for Windows.

I put my foot down and said no. I said I could make it run smoothly under Linux if they wanted, so they had better come up with a better option.

Things dragged on with no news from them even after 1 year. The Management was frustrated. Then Windows cracked and light came through. The Management decided to Open the Doors.

The Great Revival followed.

Enter Mr. Kumaran (http://www.kums.in)

Cent-OS it was then for the main server with customised `really thin` clients. One week of testing with VirtualBox and couple of flashed thin clients and the Managements saw the light of what I was saying all the while. All processing at the server. Hospital Software is fast. Staff are happy. Work gets done. Management is happy. Work get done with no money spent.

Now we have fully converted. Printing is an issue because of the WinPrinters we had purchased. Luckily most of the are aging and needs to be replaced.

The Great Leap Forward …..

Open Source Intranet Platform

• Intranet has been customised and installed.
• Used everyday at our Hospital now.
• It runs Plone with add-ons and custom scripts.
• Currently we are `fitting the gaps`
• Scheduled implementation is due next month.
• Staff seem to like the concept and are getting the hang of it.

Open Source PACS

• Set up and running at full tilt
• Currently in testing.
• Scheduled implementation in a months time.

Our setup now contains

• A main Cent-OS Server serving the Thin Clients
• A Desktop with Ubuntu 12.04 PACS Server (Staging)
• A Desktop Ubuntu 12.04 Intranet Server (Staging)
• A Desktop Ubuntu 9.04 Server for the Hospital Management Software Maintained by Software Vendor. We need to migrate this as it is aging.

So, what are we leaping to ?

• Open Source EMR
• Open Source ERP
• and more…..