 Hello and please let me begin my speech with my thanks to the organizer of this event and for their work. I also would like to thank them to let me present our work today because it is very, very outside of what you have, what you are used to present here. I am Eric Maquere, I am a French medical doctor working on an emergency department. I am a C++ QT developer and the main creator of the Free MedForm project and actually the main developer too. Jim Booster who helped on the preparation of this presentation is a Canadian physician. He is part of the GLUMED project and joined our team last year. You can find all the information about our project on our main website. I am used to present medical things and you will maybe find this presentation too many or not enough but I would like you to feel this like very interesting. Free MedForm is a suite of medical applications including an electronic medical record, a prescriber and drug interaction checker. There are other applications available. Actually we have an accountancy manager that is on the way and some clinical coding assistants. The project is driven by a community of medical doctors and computer scientists and workers over the pulse of a French team. All applications of the project are freely available with the full source code listed in GPL3. We are actually supported by OpenSUSE Medical and Debian Med teams. We hope that Federal Medical will include us in their work as soon as possible. So when Free MedForm was started, a special attention was paid to drug-drug interaction management, drug-drug interaction. We identified the source data freely available from governmental agencies and from review of literatures. As the OpenSUSE community lacked a free standalone prescriber software, we decided to create it using the prescriber plugin of the Free MedForm electronic medical record. It is called FreeJams. FreeJams is actually stable and usable in current practice. FreeJams allow a user to create complex prescriptions and test drug-drug interactions. So all applications are available for Linux, macOS, Windows and maybe FreeBSD. We have an issue with AirPath if someone wants to work on this. The project is C++ using Qt libraries and the massive usage of ModelViewController architecture is the central of the application. All applications are built using dynamic libraries and plugins architecture. We are actually using only SQLite for local database, drug database, interaction database and passion database. My SQL version is on the way. All roadmaps, issues and specifications of applications are available on our main website. So here is what I can present to you today. How does FreeMedForm work? FreeMedForm is a really small executable just like Qt Creator. Linked to many libraries, we have the medical utilities library which contains the most medical calculations. Utilities contains helpers, dialogue helpers, message loggers and MVC helpers and some other widgets. The translation library contains all the translatable strings so you don't have to worry in your code about translate this, translate this. The interaction system library is extracted from the Qt Creator project and adapted to our project. It contains the plugins manager. At startup time, plugins manager does load every plugin of the FreeMedForm project or the FreeJams. Both applications use the same code and interdependency of plugins is managed by the plugin manager. I have here represented some channels of communication between some plugins that defining the drug interaction engine. We have the main window and drugs plugins which are mainly the user interface and the drug base plugin which owns all drug interactions engine and which is the one who goes search data from database. All plugins can communicate with the core plugin. Core plugin is a central place of the application. There is a single and unique instance of I-Core interface core which gives you access to the interface patient that gives you access to all patients data and calculations. So if drug base needs some information here, pass is designed here. How does work the drug interaction engine? This is really easy. The interaction engine analyses all combination of drugs per couple. Each active substance of drugs are linked to an internationally recognized, I need my notes here, coding system and persistent over time called ATC. ATC means anatomical, therapeutic, chemical. The ATC classification is owned and listened to by the World Health Organization. So when the link is done, the drug interaction engine can calculate all interactions. So as you can see the first work that we have the medical team have to do here is to link active substance to ATC. ATC is widely recognized. The drug interaction engine calculates interaction in real time so each time users add or remove a drug, all interactions are recalculated. This is easy because it is just an integer, a list of integers to compare and are stored so you can easily recall them. We build two different tips of alert to limit the alert fatigue. The alert fatigue is well known and defined as a phenomenon caused by excessive warnings including irrelevant, non-significant or repetitive use alerts that can lead practitioners to override all alerts. So the drug interaction does not make sense if all alerts are override. So we define two kinds of alerts, one dynamic alert who needs the user validation to proceed and one static alert that is just a remembrance by icons in the different view. These alerts can be easily configured at their level in the application preference. So as the open source medical community lacks free prescriber and drug interaction tester we decided to create an interoperability to free jams using XML exchange file and the command line. So external non-free med forms electronic medical record can call free jam and retrieve data from it. Free med form does not have to worry about this because it is a plug-in of it. If you have a web-based electronic medical record we are starting to create an open-react web service which is written in Java using the same database with the conjunction of the free med team and care2x and synapse. We hope that some new team will come. Here GnuMed and Medintux already use the interoperability of free jams. Here is a screenshot of free jams. We have at the top the patient data. The plus button toggles a detailed view of the patient. When you want to prescribe you always want to know the patient precautions. We have here all drugs allergy, drugs intolerance and in future versions we will have disease, coded disease of patient, active, not active. All allergies or intolerance can be coded using the ATC classification, the drugs brand name or the international non-proprietary names. We have here the template manager. The template is a full complex prescription that can be easily reused using the drag and drop functionality. Here is the content of the atrial fibrillation with heart failure. Here is the last screenshot of this talk. The drug-drug interaction synthesis dialogue because we want to have something to a simple view. All interactions are selectable here. And full risk information and management texts are provided in two languages, French and English. I thank Jean Boussard for his help on translating every French message. Here are the interacting drugs related to this interaction. Level is remembered here by icons. You can choose what level you want to see. Here you have a link to the main source of drug interaction used to calculate this. When you click on bibliography for some of drug interaction provided by the free-med form team, you can have a full PubMed bibliography including the full reference and the complete abstract when available. This was a really hard work. So I am here because I need you. We need you. We need developers. Free-med form is a great and big project. It's really young, only two years. Actually, we don't have any funds. We need lots of developers and maybe if someone wants, some funds will be welcome. Code is available as package with each release of application or inside the subversion at Google Code. Our main website is freemedform.com. A mailing list is provided. This is the central place where we discuss all issues, specifications and roadmaps to every application. We talk French and English. We prefer English but we can talk French too. I would like to kiss my wife and child because they support my devs and my absence when I am working. I would like to thank all the free-med form team. I saw Olivier walking on the open-react project. Thank you.