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.

  1. Do you know of hospitals using Linux?
  2. Besides legacy software and unwanted downtime, is there any reason why they wouldn’t use Linux?
  • 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.

  • 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.

  • 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.

  • 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.
    • If it ain’t broken, don’t fix it. Why change to Linux when Windows is doing the job?
    • 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.

    1. Our childrens hospital (besides the ICU that uses a phillips solution on windows, which integrates with the monitoring and anesthesia equipment) runs linux, however they do this in a virtual environment on windows, the reasoning I am not sure about, potentially to sandbox the electronic system they are using.

    2. Its almost exclusively to do with the software they need, it often wont run on linux or will have limited support.

  • It’s cause Epic/McKesson has complete control over the EMR world so everything has to work with them to some degree.

    GNU health is great but I haven’t seen where it could support the massive amount of legal and monetary hoops that Epic and co have to jump through as well.

    For some reason there just isn’t a lot of volunteer efforts/space for open source development in the healthcare world.

  • Countries where they have low budget have used linux, there is an opensource hospital / health app. It tracks ambulance arrival, staffing, patient records, etc

  • 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.