## Intro

Stoppers of Open Source in Medical Software in Germany

by

Christoph Lohmann <20h@r-36.net>

## The History Of Software In Ambulatory Medicine In Germany

* Before 1990 doctor unions were incorporated by the state, so the
  doctors cannot destroy the state.
	* In 1933, before Hitler and in the great depression, doctor
	  strikes threatened the state.
* In 1990 there was the reunion of the FRG and GDR.
* The doctor unions in the GDR were formed.
* Software was specified to send accounting data to the unions.
* Some data interchange format was specified.
	* Used until now.
	* Still saves our asses.
* To save the doctors from fraud, licensing for software vendors
  was introduced.

## History Goes On And Gets Bloated

* Over time, accounting got more complex due to computers.
	* It should have been the other way around.
	* This seems to be the natural course.
* See my talk of last year about accounting.
	* Accounting was first four numbers, is now a programming
	  language.

## Fossils And Politics

* Doctor functionaries are in average above 60 yrs old and now face
  politicans believing in the religion of digitalisation.
* German politicans always have the economy as top priority.
* Doctor functionaries are not allowed to say anything against the
  state and government.
	* It is all a big show.
	* See second slide and history and incorporation.

## The Circle Of Corruption

* The doctor union now keeps licensing high.
	* There are personel changes inbetween software vendors and the
	  doctor union.
	* This prevents new vendors from entering the market.
	* Doctors are forced to use just this software.

Example:
	For getting some libreoffice medication plan with QR code to
	be licenced this costs 10k EUR and a doctor 600 EUR initial plus
	20 EUR per month more to maintain the libreoffice template.

* The whole system is corrupted and needs a big explosion.

## Why Is Open Source The Only Option?

* Medicine is so complex, one company cannot afford the resources to
  build such software.
* Making medical software requires experts from all over the world.
* See encryption: To analyze and maintain crypto, only a handful of people
  have the knowledge in the world.
* During corona only open source software succeeded.
* There is no rectification for the old licensing model when people's lifes
  are at stake.

## Questions?

Anyone has questions?

## Thanks

Thank you for listening!

And comments please go to:

	Christoph Lohmann <20h@r-36.net>