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Does Open Source Offer The Solution?

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DrK Posted: 12-28-2008 3:48 PM

Roy posted an article that of several things suggested that open source is a viable way to go. One reason is that it would allow for end users to modify the EMR to their needs. Agree? Disagree?

What's happening out there? What open source projects are happening? Which ones are in use?

Lowell

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open source only works with large communities of developers.

and unless you're computer literate, you'll end up paying many $$$ to get the changes you want.  and once you have changes, you have a fork which has to be maintained.

 

Graham
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Dr. K,

What features do you think users are wanting to customize in their own version of this open source product? What is missing out there?

I think in another thread ktdodson mentioned that he wants to develop features that current EMRs don't have and Graham asked what those features are, so I am asking here again....

What is it that people want, that is not out there already? If you tell us, we will build it (... and maybe they will come Big Smile)

Margalit

 

 

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There is one thing I've wanted in an EMR, and haven't seen ( but then I haven't looked at many ) ... and I'm currently coding it now Cool

Will it attract more mice ?  Dunno .. but that's not my aim.  I just look for things that will help me better manage my patients.

It's something that could be easily added to Purkinje as well.

Graham
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You going to keep me guessing....?Big Smile

Margalit Gur-Arie

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Yep!

Have a few guesses ... I'd be interested to see what you might think it might be.

Graham
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How cruel.... Smile

OK... I'll play along....

This is what I think we are lacking now...and this is also what we are working on...

  1. Integrated IVR
  2. Mobile access from smart phone. We have charge capture, but I want more than that....
  3. Better Health Management functionality
  4. Paying bills through patient portal
  5. Better online help

Did I hit anything? Do I get the big stuffed bear? Big Smile

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Nah ... sorry you missed.

I did mention that I am interested in things that help manage patients so immediately all except 3 are excluded.

Of course you may have this feature already .. I don't know.  But it's something I expressed a wish for in the last 2 years on this site Smile

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It's to do with semantic interoperability, and using a digital asset dissemination architecture based upon web standards, to create unique views of digital artifacts.

Graham
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I would have never guessed that.....

Are you familiar with Fedora Commons? Is it something similar to that you are trying to acomplish?

 

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No, never heard of Fedora Commons... interesting though.

What I am trying to do is something very simple!  Big Smile

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elidan:

What is it that people want, that is not out there already?

If I understand open source then it's not that we don't have the needed features. Rather, it's more of a how they perform. I see open source as allowing people to modify how things are done...to be more creative.

For example, say I wanted to do something along the lines of educating patients about their illnesses after they receive a diagnosis. This capability exists today but it's cumbersome in that I would have to do a bunch of things to print out health ed content. What if I was part of an IPA that had a health educator and after I selected the icd-9 the patient was automatically enrolled in an opted in program whereby they received email about their icd-9 and a call from a health educator.

I see open source as allowing some programmer to figure out how to do that for the IPA. I see it that the IPA could hire this task out to developers who would leverage what's new in open source vs. the IPA perhaps not being able to offer this feature to patients because their existing proprietary software couldn't offer this feature or not offer it in an efficient manner.

I may be misunderstanding open source but I see it as freeing up creativity.

Lowell

 

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DrK:

Does Open Source Offer The Solution?

I thought at first you were asking does open source have the answer to life, the universe and everything.  Perhaps because I just got back from the UK and the nostalgia of Arthur Dents finally discovering 42 was fresh in my mind.

For me Open Source is a philosophy and a tool, I like the thought of tumbling the big vendors under a penguin emblem and I like the concept of adding value to the world, rather than employing more lawyers.  But more importantly, similar to others that frequent this forum I enjoy writing software, more specifically software that helps clinicians.  It is challenging of course, but it is the challenge that makes it interesting. Clinicians are invariably a smart bunch of people and I have met many much smarter than I that are in desperate need of software - something that I have an aptitude for producing.

I also believe I can create a viable business competing on 'services' not proprietary software.  I like to compete.  I also believe that an open source project which grows large enough to attract a critical mass of people will quickly catch up with the commercial systems.

PatientOS has quadrupled the number of employees this year (hehe gotta luv stats) and we signed a large multi-faciliy hospital implementation contract which has kicked off and I believe that between that and a number of other oppportunities in the making 2009 will be a fun year.  While our main focus is evolving PatientOS as a hospital information system, we do have clinics live and soon ready to go live and I expect an ASP version to be available in the spring - in the meantime we are ever expanding support to EMR Consultants and other groups deploying PatientOS locally.

Our Patient Portal just went live officially with patients submitting demographic updates, medication requests, and health updates.  The forms drive the workflow of the clinic as they fill and ship medications.  Later we will integrate scheduling for patient self appointment booking and paypal for automated billing for meds.

Fax integration is relatively simple using a fax service (myfax) and we are close to release 0.90 which will provide the CMS1500 ready to print and integrate our selected claims billing.  I like Athenas model for billing and it will be tempting to follow suit as we have full-time employees available for support.

Lowell you have stated your needs have simplified?  Having worked closely with a clinic in Egypt on their simple requirements I don't believe you for a minute because ultimately a physicians office is like a mini hospital except the physician is the CEO, CIO, management layer and sometimes the tech support too...

But while my bandwidth is rapidly diminishing I offer you the opportunity to remote desktop to a production ready environment, have your forms designed and if you are truly looking for a lifestyle change, a dive into the world of open source - though I warn you know it is highly addictive :-)

Greg

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Open Source is the future

 

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gchiu:

open source only works with large communities of developers.

and unless you're computer literate, you'll end up paying many $$ to get the changes you want.  and once you have changes, you have a fork which has to be maintained.

Actually there is a lot of open source that software developers use that has not been developed by large communities.  And even large systems usually have a relatively small number of active contributors. 

I am not a big fan of the projects that hold you over a gun and say 'pay us if you want changes' - those projects, and probably few and far between, are not really different from commercial systems except for the licensing.

Personally I do not believe very many clinicians have the time and energy to code anything - not even simple scripts and so I have spent the largest effort in building GUI tools which do the same job.  It is an ongoing effort and an iterative process to make the tools simpler and simpler but the ultimate goal is that the physician or designated administrator can configure, maintain and even evolve the system without any developer support.

Greg

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What happens when something "breaks"? Who fixes the software? What are the risks of implementing now and then in 2 years the software is not supported?

This may seem like the making sof the case for the current crop of vendors but it's not. As for me I would be more comfortable with an open source EMR that has a substantial enough following that will increase the odds of the software sticking around.

Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com

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