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10 responses to "Develop Your Own EMR - Are You Crazy?"

1. # Nick Selvaggio commented on May 14th, 2006:

   Taking on the task of developing such a system is a HUGE task but as more and more technologies emerge to enable more agile development methods such as Flex, Rails, etc… the actual “programming” involved become much less daunting and time consuming. I guess the key would be to make a system which would enable doctors to concentrate on what they need and not all the tech know how which comes along with such an undertaking. Even then you still have a large amount of work. What do you think about maybe open source communities building and supporting such systems?

   Interesting post.

   Thanks.

   Nick Selvaggio

2. # Fredric Mitchell commented on May 15th, 2006:

   I was going to say the same. Instead of going the Micro$oft way and trying to engage in the ‘profits are everything’ world, why not use an existing CMS like Plone or phpNuke and spend time customizing portlets or modules? The only trade-off would obviously be that the physicians would have to rely on the community of programmers for updates and bug fixes instead being able to piont the finger at sue-able company.

3. # ClickRich commented on May 16th, 2006:

   And who would support it? You need the capabilities of a support organisation which is only likely to be cost effective over many customers’ support fees. Do not have the developers doing support!

   Also, you need a vibrant community of users to do post-Beta debugging and achieve anything like tolerable stability.

   Configure what is off the shelf, but bespoke is dangerous territory.

4. # administrator commented on May 16th, 2006:

   Nick,
   My take on open source communities is that the open source EMR communities haven’t quite made it yet. They are making a lot of progress and there are a number of people committing a lot of time to the process, but they just aren’t where they need to be in my opinion. I expect that within the next 2 years they can be considered a viable option.

   The other major problem with open source EMR projects is that there isn’t enough of a community to support the project at this point. If you needed help I don’t think there are enough open source EMR developers to help you out. I guess you could dip into the open source development community as a whole, but if you do that your essentially developing your own EMR. A good open source community shares a lot of the development. There’s just not enough people to share with yet. I hope this changes.

   I don’t know too much about flex and rails, but from the programming languages I’ve seen we are still a long way from separating the technical from the development process.

5. # administrator commented on May 16th, 2006:

   Fredric,
   Are you serious when you suggest that someone use Plone or phpNuke for an EMR system? They are good products that have their place, but being used as an EMR system would be a huge mistake. Talk about opening yourself up to vulnerabilities. There’s no way I’d trust the security of those 2 systems to keep my patient information private. There’s just too much risk. They weren’t designed with privacy in mind.

   Privacy aside I still think it’s a bad option since it would take so much programming to make it usable as an EMR.

   The idea of having Microsft as a sue-able company is a very fine point. Sure is a nice security blanket. I’m just not sure I know many lawyers that think they have a chance against Microsoft’s lawyer department.

6. # administrator commented on May 16th, 2006:

   Amen to beta testing! Developing your own EMR means you’re the beta test site and will forever be the beta test site. At least you have the developer’s attention if there is a problem, but just plan on problems. It’s a part of the EMR development process.

7. # William Bryson commented on May 16th, 2006:

   In addition to the functionality of an EMR for a particular site there is the issue of interoperability. Eventually, to reap the real benefits of these solutions we need full communication and accessibility between systems, across the nation. That would be my greatest concern about implementing anything less than the best quality application (within obvious budgetary restraints).

8. # Chris Wilkerson commented on May 22nd, 2006:

   Many of today’s EMRs are pleasantly so sophisticated, that an end user can make many custom changes, at one time, only available if you had the code!

   Dr. C.M.Wilkerson
   CARSON DOCTORS GROUP
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   Carson Ca 90745
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   http://www.Digital-Doc.com
   ——————————
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   http://www.MedicalTabletPC.com

9. # Al Borges MD commented on September 2nd, 2006:

   Hi Chris!

   A long time ago I came to the conclusion that writing my own was the way to go, and I’ve never looked back. These are some of the reasons why:

   1) There are inexpensive software programming platforms that are made to help you in your endeavors using programming languages that are easy to work with. In the past I started out with Paradox for DOS then ported everything to MS Office using Visual Basic for Applications.
   2) Building your own EMR is amazing and entertaining. If I want a particular feature, I’ll add it in within 24 hours. Sometimes I bring up an expensive EMR and reverse engineer the feature into my system.
   3) Over the lifetime of practicing medicine I will have the advantage of not having to go through the incessant upgrade process which over time will cost hundreds of thousands of dollars.

   You guys are just too negative. It’s not that difficult…

   Cheers,
   Al

10. # A.Singhal, MD commented on October 12th, 2006:

    I agree with Dr.Borges. It is really not that hard to have a functional EMR. I am a neonatologist and am forced to use an extremely user unfriendly system at the University hospital. However, I designed a whole EMR for my wife’s Allergy practice using microsoft accesss without writing a single line of VBA code. As Dr. Borges said, any update, new report or form can be created within a few hours. With a little help from a programmer, I am planning to add workflow management and integrated document management. Again, I don’t think it is going to take more than a couple of days to accomplish. The advantage of such a program is that it is clean, simple and without the clutter of tons of screens and buttons.