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Open EMR’s Death, Collaborative Health Record, and Improving EMR

Posted on December 29, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


It seems a little ironic that an EMR vendor would write about wanting an open source EMR to die. Although, I couldn’t help but read the irony that this person chose not to be involved in the open EMR community because people weren’t getting involved in the community. A good old chicken and egg problem. Instead of contributing to the community so that it would be more vibrant, they chose to go out and develop EVERYTHING. The reality is that this person just wanted to build an EMR business. They didn’t want a real open source EMR community. There’s nothing wrong with wanting to build an EMR business, but it’s very different than contributing to a great open source EMR community and build a business.

As the author mentions, the Open EMR community isn’t going anywhere. In the hospital space, the Vista community isn’t going anywhere either. I will be interested to see how Open EMR handles MU. They did stage 1, but future stages are still a question mark from what I’ve seen. Of course, they could go radical and not worry about meaningful use. It will be interesting to see.


I’ve always loved the idea of the collaborative care record. Unfortunately, I don’t see much movement by the healthcare industry to make it a reality.


A lot of people are going to start asking this question. I believe it will be a couple years before this discussion really goes mainstream in hospitals (possibly post-MU), but it will be an important discussion. Of course, this isn’t a new discussion. It’s always a question of whether it’s best to improve the software you have or rip and replace. In the ambulatory side I predict we’re going to start seeing a lot of ripping and replacing of EHR software.

Open vs Closed EHR Systems with Jonathan Bush

Posted on June 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yesterday I had a video interview scheduled with Jonathan Bush from athenahealth. It was going to be broadcast live on my burgeoning EHR Videos website (Subscibe for EHR Video Email Updates) using the Google Plus Hangout technology. Everything was set until Google Plus HOA (Hangouts On Air as they’re called) wouldn’t load. It was a system wide problem and so we were unable to broadcast the interview. However, Jonathan and I were able to see each other and so we just did a more traditional interview about the subject of open vs closed EHR systems.

As you can imagine Jonathan had plenty to say on the subject of open versus closed EHR systems. We started the discussion discussing the business model of closed EHR systems and how looking at many EHR companies that seemed to be a very good business model. I asked him what was so bad about being closed.

Jonathan then told me that a closed EHR system is a great business model for the software vendor if you can get it. However, he said that as the product category matures the closed systems will get disrupted by more open options. In fact, at one point in our conversation he suggested that once some of the players become truly open, the other EHR vendors will have to follow along.

I was offered one caveat by Jonathan. He was curious if Epic was the exception to this rule. He wondered if Epic had so much money that they could last well beyond most companies. This cash could provide them the runway and opportunity to reinvent themselves along with those companies trying to disrupt them. Although, the most powerful comment made in regards to Epic was when he suggested that Epic has clients that benefit from Epic’s closed nature as well.

Another powerful comment he made was, “Affordable sounds like decline.” The concept is really interesting. Basically, so many EHR vendors have been able to charge an outrageous premium with amazing margins for their EHR software. If they were to choose to lower their price, many could misinterpret that decision as the company cutting prices to increase sales that have dropped off. Certainly the argument can be made that EHR vendors don’t need to charge what they do. However, image is important and could be influenced by a price drop.

While it’s always fun to talk about Epic with Jonathan, I also pressed him on why athenahealth wasn’t more open in the things they do. Couldn’t some of the same arguments made against closed EHR systems be applied just as easily to athenahealth? For example, why isn’t the athenahealth API more open?

In one of his more contemplative responses, Jonathan acknowledged that athenahealth was heading down the path of closed EHR systems. He saw that they were headed in a similar direction with their business model and so they had to decide if that’s the direction they wanted to continue or if they wanted to move towards a more open EHR model. He mentioned their More Disruption Please program and how the number of companies they were working with in that program was a sign of their move to be more open.

Jonathan admitted that the athenahealth API wasn’t where it should be, but that the goal was to have an API for every surface area of athenahealth. I wish we had this comment on video so we could really hold him to it. I love the idea of every surface area of an EHR being available through an API.

I also pressed Jonathan a little bit about CommonWell and whether it would be open to everyone and anyone that wanted to participate. He responded, “We expect every single maker of health information technology to obtain a key for every patient they have and see where that patient has been.” That was a pretty broad statement about openness. He did suggest that CommonWell was the right approach of knowing where the data was stored as opposed to storing every single person’s data in every clinic. It had to be a distributed patient records model.

Jonathan did also tell me that they’d recently got a call from Epic to work with them to build API connections with all the information in Epic. We’ll see if this is a step towards a more open Epic. Although, it still seems to follow the same pattern Judy discussed when she called Epic the most open EHR system she knew. She’s ok opening up with strategic partners.

I ended the conversation with me asking Jonathan what could be done to make the business model of being open work in healthcare. He mentioned two topics that deserve more time and their own dedicated post: a repriced athenaclinicals based on order and anti kick back laws as an obstacle for exchange of information. Both were preventing a market for health information. Our time ran out so I couldn’t dig into these subjects more. I’m going to see if Jonathan or someone from athenahealth would be willing to do a couple future guest blog posts on the subject.

As you can see, I covered a lot of ground with Jonathan in the 10 minutes we had. Imagine if we’d had the full 30 minutes. Plus, you could have heard it straight from him. I’m certain we’ll be inviting Jonathan back for another interview in our series of EHR Videos.

OpenEMR Passes HITECH EHR Certification

Posted on August 20, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

LinuxMedNews just posted the announcement that OpenEMR is now a certified EHR. Here’s the quote from their announcement:

It’s official! OpenEMR has passed all ONC certification tests as a fully qualified emr that can be used to attest for incentive moneys. The official posting: http://onc-chpl.force.com/ehrcert/EHRProductDetail?id=a0X30000003mNwTEAU&retURL= appeared on the website 2011/08/19. Congratulations to all involved! OpenEMR 4.1 should be ready for download in a few weeks.

This is a really big announcement for the open source ambulatory EHR community. A number of other open source EHR are certified, but they’re mostly for the hospital EHR space. So, it’s a great thing for OpenEMR to provide an open source EHR to the ambulatory space.

Plus, I have to admit that it’s pretty great that an open source community can pull together the funds to actually be certified. The programming and development time is one thing, but getting the $20-30k to be certified is a big deal that I’m sure took a lot of effort. I actually wish I knew more about the process they used to achieve the EHR certification.

Now, OpenEMR users better start digging into resources like Meaningful Use Mondays. EHR Certification is the first step, but showing meaningful use of that certified EHR is the next one.

Big thanks to an avid follower of OpenEMR – Jojo the HITMAN who informed me of the news.