FreePM is an opensource electronic medical record application. So why would a physician want to trust their most important data to a free piece of software?

First, physicians must be convinced that any software is usable and will save them time. As a group, physicians have heard how great ‘this’ is going to be, whatever ‘this’ is, far too many times. They have been duped out of thousands of dollars upfront, only to find out that things aren’t as simple and always cost more than they were led to believe. Many of the existing medical related applications were designed by programmers instead of physicians. Some were designed by a group of two or three physicians, “in their own likeness”.

Opensource software in general and FreePM in particular offers a workable alternative. But, to be realistic there is always a cost whether it’s time or money. With opensource software it doesn’t have to be both. The individual physician / practice can decide based on their time and skills available where that balance is going to be.

A key reason for using opensource is the security of knowing that there will never come a time when your business is forced to change or upgrade applications because of market forces outside of your control. As long as you have the complete source code, are permitted by license to modify it and it is written in a reasonably popular programming language you will be able to maintain it. Opensource applications are typically developed by a small core of people too. The advantage from a design perspective is that there are no hidden secrets. There may be literally hundreds or even thousands of ‘advisors’ on the design and direction of an opensource project.

FreePM meets all of these goals. Hundreds of physicians from all walks of life and many informatics professionals and programmers have been involved at some point in the design and development of FreePM. This is how the decision was first made to offer a web browser interface. It may be limited in functionality compared to a client/server GUI, but it is far better than a text terminal and it eases implementation issues by not requiring hardware upgrades in 99.9% of the practices. Essentially any device with a web browser can be a FreePM client. In the true spirit of opensource development the Zope application server platform was chosen. Zope (http://www.zope.org/About) is also an opensource product developed by Digital Creations, Inc. (http://www.digicool.com/home.html). Zope is written in the popular and easy to learn Python (http://www.python.org) programming language. This makes FreePM truly opensource from the ground up and if you include the fact that it runs on Linux (as well as other Unix and Microsoft Operating systems), it could be said FreePM is opensource from the roots up. Hardware requirements are minimal compared to many other systems. Client hardware as stated above requires a frames and javascript capable browser and the server can be anything from an Intel 486 (not recommended for practical use) to an IBM S/390 (running Linux). When will the next hardware upgrade be required? When the old stuff wears out.

So what makes FreePM different from a design perspective from the other EMR offerings? The basic philosophical starting point for one thing. Most of the other EMRs are built using relational database management systems. The systems were built using the same concepts (often by the same people) as transactional processing systems. These same companies had been successful in delivering medical billing applications. It seemed logical that they could successfully build electronic medical records systems too. The problem with this concept is that modeling a billing system and modeling how physicians interact with patients is very different, even if they are both medical related. A medical record is more related to content management than it is to data management. The Zope framework and the Python language make it possible to create an electronic medical record that more closely models, but extends the availability and interactivity of a paper based medical record.

FreePM is designed from the concept that all activity in a physician’s practice begins with the patient encounter. The laptop or other browser enabled device simply takes the place of the paper record during the patient interview. With a well designed set of templates, the physician checks off a few boxes, selects required tests and / or medications and clicks a button to generate the coded patient note and the charge(s) are created in the patient account. Of course this sounds easy (see the first paragraph). To be honest, there is considerable setup work before this is reality. But think about the longer term payoffs. How long would it take you to recover a few hours spent setting up this system if you reduced your paper filing cost by 98%? Your actual paper and toner costs by 98%? Misplaced/misfiled records by 100%? Never have to take a call from a pharmacist again to confirm a medication or dosage because you faxed or printed the prescriptions? How much could you improve patient care if you could do outcomes research on your patient records? Relate family members by relationship or disease? The list goes on but it is covered in many healthcare publications so I won’t reproduced it here.

So you’re not a Zope/Python guru? Owning the source code is only a feature if you can get someone to modify and maintain it. While Python is gaining in popularity, there isn’t an expert in every rural town yet. Free Practice Management, Inc. was established to provide what ever level of service you require. The company founders consist of the developers, physicians and investors with a common goal of delivering a quality of service level unheard of in the medical community. The first level of service is via the free mailing list. You can join this list at http://lists.sourceforge.net/lists/listinfo/freepm-discuss for other information about the company contact information is available on the web site at http://www.freepm.com You will also find links to the demo and where to download the source code on this site.