I was in the ED the other day and noticed that they use a mix of Windows 7 and Windows 10. My question is two part.
- Do you know of hospitals using Linux?
- Besides legacy software and unwanted downtime, is there any reason why they wouldn’t use Linux?
It’s really about the software.
Yeah, I had a feeling it would be.
Someone who works in hospital system posted about this in a comment earlier : https://lemmy.ml/comment/9989330
Ohh, I haven’t seen that yet. I’ll have a read through.
None of the hospitals I’ve worked at (in the US) have used Linux, and I’m pretty surprised some do! Given that we used Internet Explorer up until the very last second before it was not supported, I don’t know if any change would be welcomed, unless a hospital somehow started out with Linux. But at the end of the day, it would be about to e electronic health record, if it was supported or not… I don’t know if Epic, Cerner, or AllScripts do!
they are all moving to sas… browser-based, browser agnostic systems. everyone is. people have actually learned from the IE mistake.
not there arent a few holdouts… nothing more painful than trying to bolt on new regulatory requirements to a 25 year old app. sigh
The hospital I was seemed to still be using Internet Explorer….
I wonder how the various software needs of hospitals would be with Wine? My guess would be that it wouldn’t be stable enough for them.
Equipment firmware has rigid stability constraints. Office software, if IE is good enough, a tested and unchanging version of Wine is good enough.
I can give some guesses on 2.
- Familiarity. Most people are familiar using Windows. Nurses aren’t necessarily tech savvy, so an unfamiliar system might threw them off.
- Maintenance. It’s easier to recruit people who know how to maintain Windows systems. Linux is tricky because it comes in so many different distributions, and any maintainer must be aware of these differences.
- UI sucks big time on Linux. It’s so much easier and reliable to just do a winform.
- Communication with other equipment. I guess some computers are talking to other medical equipment, and those equipment might only have drivers written in Windows, because that’s what most are using.
UI sucks big time on Linux. It’s so much easier and reliable to just do a winform.
I didn’t think about that. Makes sense though, especially when you combine the fact that most hardware will be designed with Windows in mind as you mentioned.
I wish I could say that the UI in EMRs *doesn’t * stick big time 😭
I really thought Allscripts was going to get their shit together a bit over a decade ago. We kept hearing from their reps that they were working on a much better UI.
It is still hot garbage.
There are hospitals running on SAP systems. Those servers will be 99% linux based. The rest are managed by crazy people.
Software for equipment and software for imaging etc. I work in healthcare. I’d love to use Linux but we’re stuck on software that is based on Java from 8 years ago, as the newer version is not compatible with some older equipment. Add to that, the newer version costs $500 per user to upgrade with no additional features, and this is just for one medical camera, that treats the camera like a webcam. The problem is how it stores images is in a custom database, through a server. Otherwise, the Java part should be easy enough.
Medical equipment is super expensive and they only make a few thousand of some of them. So, the software is super expensive too and not updated nor is there versions for Mac or Linux. Heck, most of them don’t officially support windows 10 or 11. It’s really frustrating too, as most are really a simple bridge that connects to the machine to give instructions or receive data. They are not usually drivers, but send data over the network. An open format would suit better for security too, as all this old software will be pretty leaky.
Helped my dad do tech support for a doc office. Even simple stuff like glucose meters barely worked on windows 7, and broke with windows 10. The web portal they used required a specific version of internet explorer to function. I think the biggest issue is always going to be how slowly these devices work in terms of drivers and software compatibility. For security and cost reasons, I’d guess.
It would be the same if they used Linux, they’d require something like Red Hat 6.0. 😄
The medical world is technically illiterate and handles a lot of money so the vendors take advantage of that to do heavy lock-in. Everything is tied down to super specific software versions, everything is proprietary, and you pay through the nose for any change.
GE imaging kit (certainly their CT scanners) do (or did for as long as I used them) run on Linux.
Did hospital IT work and 100% agree.
There’s a reason that stuff is ideally on its own separate vlan to isolate it as much as possible from the network too
Hahah yeah. 100% air gapped. About as secure as a paper door. Sometimes I feel like they just put it out in the field after they get their first successful test done and then forget about it forever.
Hell, poorer clinics use old versions of EMR/EHR software that they bought in '08 and host locally. Some of that shit barely supports Windows 7. Some of that software doesn’t support things like HL7 properly so getting the data out and into a newer one can be cost prohibitive in and of itself because you’ve got to pay someone to write a translator for a shitty database in a format that was purposefully confusing to keep vendor lock in for a vendor that went tits up a year later.
I mentioned before that I have a lot of certificates for a lot of those companies that no longer exist. If it wasn’t soul crushing I could probably make a decent living just moving people from those systems. But my soul is already a shriveled piece of garbage and I don’t want to purposely squeeze the last little bit of juice out just yet.
Most hospitals in the US don’t even use the OS as much as they use their EMR system (EPIC). You boot the computer, you double click on Epic and you login. No real interaction with the OS.
I would say laboratories would have the biggest problem with Linux. Laboratory information systems, third party software for different equipment as well as bridging software between these two are all on Windows.
Countries where they have low budget have used linux, there is an opensource hospital / health app. It tracks ambulance arrival, staffing, patient records, etc
Is that the one by the FSC
In Quebec all the TV/Internet kiosks that you pay $$$ while in bed, are using Linux, you can see it when it boots
I know Linux has little to no penetration in health equipment firmware because a lot if not most of them have hard real-time requirements that Linux just doesn’t quite reach. QNX4 is a real-time Unix flavor that has been used in fancy graphical heartbeat/multi stat monitors. Its microkernel architecture allows for a watchdog to restart individual drivers so it’s more fault tolerant.
Microkernels for the win! Monolithic kernels can be built tiny though, so they are also pretty stable
Hospitals have no IT budget and are the most insecure things around.
Additionally there staff are not exactly the most tech savvy
Compatibility, compliance and retraining,
I work IT at a hospital here in the US. The key issue is compatibility. Most of our vendor software flat-out does not support Linux at all, either on the client or server side. Shit, half of it barely even works on modern versions of Windows.
Designed for Windows 3.1
Upgrade if’n you dare
Shoot, that’s hardly an exaggeration - I was only recently able to deprecate the last of our Server 2003 instances, which was running a program originally designed for 2000 Server!
Epic, which most large hospital systems seem to run, has a Linux version but I’ve never seen it in the wild. Every healthcare worker I’ve met loathes Epic — I asked around about it because a doctor and nurse complained about it to me randomly because I’m a developer. I live near some hospitals so I often chit chat with healthcare workers who are neighbors or at bars or whatever. I wouldn’t consider people commiserating about work at a bar to be a representative sample but it seems like complaining about Epic is a thing.
I also don’t know for sure if this is 100% true but healthcare IT people have told me never to work for a hospital because HIPAA violations (like a data breach) can make the IT guy liable for the violations. I looked it up once and it seems like it’s more C-suite people who are actually held liable. (but more likely a CTO or CEO) can be held liable. But the threat is there and having another company to blame is a big reason some institutions use Windows. No one saves you if a Linux vulnerability exposes patient data.
Again, my source is barroom banter and not lived experience. Hopefully, someone with direct knowledge can correct me where I’m wrong.
If you say you work in software, a lot of people are like, “The software at my job sucks.” So, I don’t know how much to take seriously and how much is just that everyone kind of hates the indignity of paid labor.
Most of the “hospital software” (groupware) you may find is built for Windows. Most of the orchestration infrastructure running the hospital is Linux. If you go to a hospital and see nurses unlocking cabinets with badges, or scanning to track movement: Linux. Same with Pharmacies.
User interface junk, most likely Windows.
I know Kaiser has an extensive end-user system running Linux desktop based on whoknowswhat for mobile device carts and whatnot. Worry less about the desktop, and more that Linux is healthy enough to be running literally everything else, from the networks, to the physical doors in the building.
As somebody who has had to set up smartcards, yes. It’s a linux system managing that. The end-user GUI stuff is all Windows though.
There’s a surprising amount of Linux in some hospitals… but people just don’t see it. Fetal Monitors? Probably Linux. User tracking and auditing software? Also Linux. Network downtime document viewer? Linux. Heck, the software that carts use to print sheets to the network printers is CUPS.
