DOC - Introduction

About Obsidian MEDILIG

Obsidian MEDILIG is at the same time:

  • a powerful flexible rich text editor where you can embed any type of media
  • a tool for keeping freely notes and other media files about your patients and your practice or clinic
  • a complete patient information system that allows you to organize and automate your clinical workflow in the way that suits you best
    It's like having a second digital brain designed to become your indispensable assistant and companion. With this advanced medical information management system, healthcare professionals can focus more on providing care, having immediate and organized access to all the essential information for their patients.

Fig. 1: The left panel displays the file explorer, the center shows the text editor with an open file, and the right panel shows the front-matter properties of the file.
Fig. 1: The left panel displays the file explorer, the center shows the text editor with an open file, and the right panel shows the front-matter properties of the file.

Advantages of Obsidian MEDILIG in the Healthcare Sector

The benefits of using Obsidian MEDILIG in the healthcare sector are numerous:

  1. Improved Quality of Care
    Physicians have immediate access to the full history of visits and tests, enabling more accurate diagnoses and personalized treatments.
  2. Faster Service
    Instant access to data speeds up examinations and decision-making processes.
  3. Personal Data Security
    The Local-First and Offline-First design philosophy ensures the best possible protection of sensitive medical information for both patients and healthcare professionals.
  4. Easier Second Opinions
    Easy access to and transfer of medical data facilitates the process of obtaining second opinions from other specialists (No Data Lock-in).
  5. Continuity of Care
    In case of a change in physician or healthcare provider, the complete medical record remains readily available, ensuring continuity of care.
  6. Patient Awareness and Involvement
    Patients can better understand their health status and actively participate in health care management, as doctors can easily present and explain their findings.
  7. Reduced Medical Errors
    A comprehensive and organized patient file reduces the risk of miscommunication or omission of critical information.
  8. Improved Communication Between Specialties
    Collaboration between different medical specialties involved in patient care is made easier and more effective.
  9. Long-Term Monitoring
    Supports the consistent tracking of chronic conditions and the early detection of changes in a patient’s health.
  10. Connected Knowledge and Instant Navigation
    Internal links between notes and documents allow healthcare professionals to navigate quickly and efficiently between related pieces of information reaching exactly what they need when they need it.

In summary, Obsidian MEDILIG contributes to a more comprehensive, efficient, and secure approach to patient's health management by offering powerful tools for daily clinical use.

A few words about the attractive features of Obsidian note taking application

The MEDILIG patient medical record is built on top of Obsidian and its highly active plugin ecosystem (plugins), with many external developers creating tools and extensions to enhance its capabilities. Obsidian is a popular note-taking application that operates on a local folder of plain-text Markdown files. It is designed to help users organize and structure information in a highly flexible way.

Within just a few years of its initial release in March 2020, Obsidian had already attracted over 4 million users worldwide.

The powerful features that make Obsidian stand out::

  • Linked Notes & Graph View: Obsidian allows you to create connections between notes, forming a "network of information" that can be visualized through the graph view, effectively reflecting synthetic/analytical thinking. Linked notes make it easier to navigate between related topics. In Obsidian MEDILIG, all medical information is interconnected within the patient record folder.

Fig.2: The interconnected files within the patient’s medical record, such as profile, medications, multimedia, visit, clinical case, medical history
Fig.2: The interconnected files within the patient’s medical record, such as profile, medications, multimedia, visit, clinical case, medical history

  • Plugins & Customization: Obsidian offers hundreds of plugins that add features such as task management and calendars. These can easily change the look and feel of the application and make it highly customizable according to the user’s needs.
  • Local-First Design: Obsidian is designed primarily to work with local files stored on your device. This means that all your notes are saved as Markdown text files on your local disk rather than on a remote server controlled by the application developers. Since your data is stored locally, you have full control: you can create backups, move files to another location, sync them with cloud services of your choice, or even use version control systems like Git to track changes.
  • Offline-First Design: Obsidian works fully offline, meaning you don’t need an internet connection to access your notes or use most of its features. This makes the application more reliable in situations where connectivity is limited and ensures that your data does not need to be sent to any server to be accessed or edited. This further enhances the privacy and security of your data.
  • No Data Lock-In: Your notes remain fully accessible and portable, meaning you can switch to another note-taking tool at any time without losing access to your data. All notes in Obsidian are simply Markdown text files (text-only files), which allows easy editing and data export, as well as using the same content with other applications and any plain-text editor that supports Markdown or generally formatted text files. This open format ensures that your data stays under your control and is not dependent on the lifecycle or business model of any specific application. Using Markdown as the core file format guarantees long-term readability and portability of your content.
  • No tracking or analytics: The developers of Obsidian are committed to not including any form of tracking or data analytics in the application. This means your usage data, habits, and content are neither monitored nor collected, ensuring that your privacy is respected. This stands in stark contrast to many other applications that generate revenue from user data through analytics or targeted advertising.

Obsidian MEDILIG architectural design and implementation principles

The architectural design and implementation approach is called "app over a graph network of files" and is applied for the first time in Obsidian MEDILIG. Obsidian MEDILIG extends the fundamental principles and key differentiators of Obsidian compared to similar software, while introducing advanced features typically associated with web/desktop applications, such as:

  • Reusable self-contained components: In MEDILIG Obsidian, patient folder files are created from components. These are reusable, self-contained Markdown files that embed code blocks from three plugins (dataview, meta-bind, templater), data properties (frontmatter), and content (formatted Markdown text).
  • Fully Automated Object Generation: Automated processes for creating interconnected entities (visit, medications, medical history, etc.) related to the electronic patient folder. The structure and organization of folders and files are automatically created by Obsidian MEDILIG in your personal Obsidian Vault, as well as the interconnections between them (see Fig.2) with internal links (internal links) present in the content of the files.
    Fig.3: The image shows folders and files corresponding to patient's scheduled appointments (Consultation) and the patient folder Patient/100 that includes a clinical case (.clincase), two visits (.encounter), medications (.drugs), etc.
    Fig.3: The image shows folders and files corresponding to patient's scheduled appointments (Consultation) and the patient folder Patient/100 that includes a clinical case (.clincase), two visits (.encounter), medications (.drugs), etc.
  • Fully automated template content generation: The predefined forms and layout used for organizing information and recording medical data in Obsidian MEDILIG in a consistent and structured way are based on templates. For example, for each patient, a record (file with .patient extension) is automatically created, showing the patient’s name, age, contact phone number, visit history, and a link to the current clinical case. There are also buttons that allow the user to navigate to other records (files) or create new ones (see Fig.4).

Templates help healthcare professionals enter data, such as medical history, cases, symptoms, diagnoses, and treatments following a standardized pattern. This promotes consistency in records, reduces errors, and improves the quality of care.

Fig.4: Each document (file) is transformed into a dynamic, interactive experience, similar to what you would encounter in a classic user interface of any application.
Fig.4: Each document (file) is transformed into a dynamic, interactive experience, similar to what you would encounter in a classic user interface of any application.

  • In the image below, we see the template that generates the above file.

    Fig.5: An example of a template component that generates the text and interactive elements shown in **Fig.4**.
    Fig.5: An example of a template component that generates the text and interactive elements shown in Fig.4.

  • Dynamic Content Integration and interactivity: The seamless integration of code, text, and the representation of information through diagrams, tables, and other visualizations is achieved within a single document. As a result, each file in the medical record gathers all necessary elements and serves as a comprehensive means of presenting information. In the same way, each static document is transformed into a dynamic, interactive experience similar to a traditional user interface in any typical application (Fig.4).

  • Enhanced Metadata Structure and Complex Data types: In Obsidian MEDILIG, each file type also serves as a metadata type used to describe and present the corresponding entity. For example, in Fig.6, we see the Front-matter placed at the top of every Markdown file that corresponds to a patient visit. The front-matter contains structured data, resembling database entries. However, the connections between files form a graph-like structure (Fig.2), allowing for complex relationships without the need for a separate graph database. This approach simplifies development, as data and presentation are managed in the same file. This reduces system complexity and makes it easier to maintain and adapt.

    Fig.6: Obsidian frontmatter metadata
    Fig.6: Obsidian frontmatter metadata

  • Data-Content Integration: In the design philosophy of Obsidian MEDILIG, there is no clear separation between data and content. Each file acts as an autonomous unit that contains both structured data (in the front-matter) and rich content, including interactive elements. This contrasts with traditional applications, where data is typically stored separately from its presentation, for example, in a database backend with a distinct frontend for display. In Obsidian MEDILIG, the integration of data and content into a single Markdown file allows for simpler development, easier customization, and a more cohesive user experience.

  • Data Querying and Manipulation: Based on the Obsidian Dataview plugin and the front-matter of the files created in the patient folder, Obsidian MEDILIG can generate customized dynamic data views (tables) for various purposes, such as patient monitoring lists, statistical data for research, or summary reports for administrative purposes (Fig.7).

    Fig.7: Dynamic view of a physician’s scheduled appointments based on the current week of the year
    Fig.7: Dynamic view of a physician’s scheduled appointments based on the current week of the year

  • Asset Management: The management and organization of multimedia in Obsidian MEDILIG is one of its powerful features. The user feeds the patient’s medical folder with videos, images, audio, or PDF, Word, Excel files, which are automatically recorded with coded names and added to the front-matter of a medical document (Fig.8). These files are displayed inside cards showing their description, capture date, and original filename. The process is very simple, and in this way, the user has at their disposal a complete and integrated network of medical information for the patient.

    Fig.8: In the right panel, the multimedia folder inside the patient’s folder (Patient/100) is open. These are presented to the user as multimedia cards within a medical document (mdoc100-1-1.document) that is linked to the patient’s case.
    Fig.8: In the right panel, the multimedia folder inside the patient’s folder (Patient/100) is open. These are presented to the user as multimedia cards within a medical document (mdoc100-1-1.document) that is linked to the patient’s case.

  • A graph network of medical information: The use of Obsidian's internal links in medical patient records can prove to be extremely useful and effective in practice (see use of internal links). The system allows for direct and easy interconnection of patient information or the embedding of content (also known as transclusion or Obsidian embedding) from notes or multimedia that are scattered across different files and in specific paragraphs, headers, or any text block. In Obsidian MEDILIG this becomes even easier and faster due to the automatic coded naming of files. Additionally, the use of aliases allows for easy searching and referencing of patients and facilitates rapid access to any file in their medical record. Furthermore, in the interconnected network of medical information in Obsidian MEDILIG, the display and visualization of incoming (backlinks) and outgoing (outgoing links) links (Fig. 9) in each patient record file not only facilitate rapid access to related information, but also highlight non-obvious correlations, thus supporting a holistic approach to medical care and informed decision-making.

    Fig. 9: Network of interconnected information for the patient file with the coded naming pat100.patient where the incoming links (backlinks) from other files that connect to it are displayed. Also for the home page Obsidian MEDILIG v0.9.1.el the outgoing links are displayed. Every reference from any file in Obsidian MEDILIG to the patient file, e.g. pat101.patient, automatically creates a new connection and simultaneously updates its backlinks as well
    Fig. 9: Network of interconnected information for the patient file with the coded naming pat100.patient where the incoming links (backlinks) from other files that connect to it are displayed. Also for the home page Obsidian MEDILIG v0.9.1.el the outgoing links are displayed. Every reference from any file in Obsidian MEDILIG to the patient file, e.g. pat101.patient, automatically creates a new connection and simultaneously updates its backlinks as well

  • Low-Code Development: Thanks to the abundance of plugins, primarily dataview, meta-bind, and templater, Obsidian MEDILIG manages to transform into an extremely flexible platform for Low-Code Development. The dataview allows users to manage and display their data with advanced queries, facilitating the organization and analysis of information. The meta-bind offers the capability of dynamic metadata binding, enabling process automation and the creation of more complex and interactive applications. Finally, the templater allows the creation of templates for frequently used structures and code, accelerating the development process and ensuring consistency in applications. These plugins, in combination, make Obsidian MEDILIG a valuable tool for developers and non-programmers who wish to accelerate the application development process and information management.

  • Alarm and Reminders: With the integration of the Obsidian Reminder Plugin, it enables automatic creation of reminders for important medical actions, such as scheduling of clinical procedures or follow-up examinations. Through system and application notifications, it informs the user about upcoming or overdue actions via system notifications, helping with timely case management. It offers options for managing reminders, such as confirming completion, postponing, or dismissing, adapting the functionality to the user's needs. In this way, it helps monitor patient compliance with required examinations or treatments, minimizes the risk of omitting important actions due to human error or workload, and ensures that all necessary actions for patient care are performed in a timely manner.

  • Calendar Time Planner: With the integration of the Obsidian Full Calendar Plugin into Obsidian MEDILIG, the system gains even more powerful capabilities for managing patient visits. Each appointment is linked to the clinical data of the patient's visit. All appointments can be displayed in the calendar in various ways such as monthly, weekly, daily view, or list view and can be managed accordingly. Furthermore, based on the calendar time planner, the doctor can see the list of his patients and various characteristics of those who are scheduled to be seen during the current week.

  • Interactive computational documents: Obsidian has several similarities to Jupyter notebook and Mathematica notebook. All three tools are examples of interactive computational documents that allow users to create, organize, and share information in a structured way. They use the concept of "notes", pages that can contain formatted text, code, and multimedia. However, while Jupyter and Mathematica focus more on code execution and data representation, Obsidian is more oriented toward information management and creating interconnected notes. The notebook interface has now been widely adopted as the new paradigm for live user interaction.

đź‘‘ Backers and Sponsors

Thank you to all our supporters! If you find Obsidian MEDILIG useful, we would greatly appreciate a donation of €9 or more. You can contribute via: PayPal, or Ko-fi.

Your generosity helps us maintain and expand our project. Additionally, your contributions will allow us to release a public version of the project on GitHub. Please also remember that many key features and functions of Obsidian MEDILIG are based on plugins, whose creators also expect some financial assistance.

Thank you for your support!