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January 27, 2009

The Right Open Source (Free) EMR Model

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I’ve had a huge interest in the open source EMR and Free EMR movement.  Turns out my readers are just as interested in a Free EMR as I am.  However, we probably have different reasoning.  I think the power of open source is in having a crowd of people that are all contributing and sharing in the software development.

The problem I’ve had with most open source EMR projects is that I haven’t seen any that have had a large and committed enough community to really sustain development.  Granted, it’s been a few months/years since I’ve really looked into most of the open source EMR packages, so please correct me if there are some open source EMR communities that I should consider looking at again, but I digress.  My point is that without a strong developer community, open source is not a very good alternative.

I recently came across elementalClinic which I believe is using the open source EMR development model correctly.  I’ve never used the elementalClinic EMR so I can’t comment on its featureset (although it looks like it’s a mental health EMR), but what I do find interesting is how their funding development of their open source EMR.

In a recent comment on EMR and HIPAA, Alex said that elementalClinic has 150 paying customers that are using the software with somewhere around 500 people downloading the software.  This seems like the perfect model for developing an Open Source EMR.  150 paying customers that provide a solid foundation development team for the open source project.  Now, I think that 500 is a rather small number of downloads, but is a good start to creating a vibrant community of open source developers that will build on top of the foundation 150 paying customers.

Many would wonder why the 150 paying customers would fund everyone else downloading it for free.  There are a number of different reasons as far as premium support, custom features, etc that they might be paying to receive.  However, the best reasons is because by leaving it open source they can utlize the development and feedback from those using the free, open source download of the EMR.

Plus, having the license be open source means that any one of those 150 paying customers could decide to take the code from their current EMR install and take it in another direction.  In open source they call it a fork in the development.  How easy would it be to create a foundation EMR with a fork for every specialty: pediatrics, oncology, urology, etc.  Would be pretty neat and a great reason to do open source.

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    7 responses to "The Right Open Source (Free) EMR Model"

    1. # Alex commented on January 28th, 2009:

      I’d encourage anyone who wants to give elementalClinic a try to either check out our demo or download the source code and install it on your own servers. You can do all this at elementalclinic.com

    2. # HITECH Basically Excludes Open Source EHR If They Select CCHIT | EMR (EHR) and HIPAA pingbacked on June 13th, 2009:

      [...] Free and Open Source in Healthcare Un-conference this summer or possibly what I think is the right open source EMR model. I’ve also cautioned about whether “free EMR” is really free. Ok, I could go on [...]

    3. # Indra commented on January 5th, 2010:

      How about VistA (the software used by VA hospitals around the country).

      In my view, this is the best EMR software so far.

    4. # John commented on January 5th, 2010:

      Indra,
      VistA definitely seems like a reasonable option for a hospital system EMR. However, it’s not a very good solution for a small ambulatory clinic. Thus the need for another open source EMR solution.

    5. # Umair commented on June 21st, 2010:

      i have install and check element clinic and it works really fine . will do some more coding to make it better

    6. # Jose Garin commented on February 16th, 2011:

      How does OPEN software become certified?

    7. # John commented on February 16th, 2011:

      Jose,
      It’s a good question. I heard OpenEMR was getting together to try to get the CCHIT Certification way back when. I should follow up with the guy who told me about this and see if it ever happened or how it’s going now.

      Word is that there will also be a site certification for small practices similar to the one that they have available for hospitals now. That way it would cover open source EMR and in house developed EMR software.

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