Do you want open source medical software, but need something viable now? Although closed-source, X-Med may be the solution you are looking for. Company president, Alex Chigos wagers $1 that his company was the first medical practice management software to run under Linux. Any takers? He says that X-Med has been available for Linux over 5 years and is currently working in nearly 200 doctors, clinics and service bureaus. Chigos has long experience and interesting views of Linus Torvalds, Linux distributions (Caldera yes, RedHat no), Windows (usually doesn’t need it) and of course, X-Med.
‘I think Linus Torvalds should be given a Nobel Prize.’ But will Chigos ever publish the source code for X-Med? ‘I probably won’t…there is the thinking that you give the program away free and pay for the support, but our software doesn’t require much support…People that make a lot of money from support rather than sales takes a parasitic approach. The buyers definitely need to re-think their purchase if that’s the case.
Chigos was a SCO Unix developer/reseller for 20 years but has no kind words for them: ‘They became more nasty, arrogant and expensive over the years so I stopped working with them. It got to be that they would charge $500 up front for a question and sometimes the answer was ‘we don’t know’ but they still got my $500.’
Chigos favorite distribution is Caldera: ‘I tried Slackware at first, was not impressed, but was with Caldera. Our software worked with almost no modification the first time we tried to run it. Caldera is also nice when you call them.’ He has found that RedHat has ‘less debugged’ components upon release and that Caldera comes right out of the box with ftp, uucp and other programs X-Med needs working flawlessly. Whereas RedHat is a ‘…monster getting it to work. If you want a Linux implementation that works first time, everytime right out of the box, Caldera Open-Linux E-Desktop is the one to go with. It’s got a really nice graphical installation utility.’
He thinks other medical vendors have already moved in the Windows direction, following consumers. ‘That’s fine because that is fewer competitors for me. Most of our clients do not use Windows at all. Windows is a black box, ‘no user serviceable parts inside’. When problems occur it costs $395/question. That’s a lot of money. Linux is 100% user serviceable, they even include the source code. Another neat thing about Linux is that it will run on an Apple, it will go anywhere.’
Chigos believes that people are looking for an alternative to Microsoft Windows. ‘…IBM, DEll, [and] Compaq have already embraced Linux. Anybody who thinks Linux is not ready for prime time, they need to visit the people at the top of the food chain and see what they think.’
The biggest problem with X-Med according to Chigos are the lack of document scanning or transmission facilities. His main competitors are Medic and Medical Manager but states that ‘I have replaced both, Doctors say they like it [X-Med] much more.’ X-Med is character based, not GUI, but runs graphically under Windows using a software bridge called Multi-View, which is a thin-client terminal emulator. ‘Windows users are usually satisfied with this. You have the power, performance and stability of Linux, with a Windows interface.’ He says X-Med ‘…does everything you would expect: electronic claims, Medicare/Medicaid, Blue Cross and Blue Shield direct as well as private insurance through one of two clearing houses. EDSS or Envoy…clients..use net terminals that cost $495 each and can have multi-sessions and plug-in network printers at each station.
Chigos reports that because of Linux emphasis on networking, it is ‘…very easy and very inexpensive to do. We get extremely good performance supporting multiple practices over 56K modems, ISDN, frame-relay and T1 lines.’ He reports that a Podiatry group in Ft. Meyers reduced their phone bill by $3000 a month using X-Med. Other benefits of Linux are that it gives the user multi-tasking capabilities that allow workers to continue working on financials, printing and doing patient records without making a patient wait or tie up a terminal.
Chigos prefers a host-based network over a peer to peer one. ‘By concentrating the power in the host, the power and resources in the terminals become less relevant. You get the full power and speed of say a 733Mhz server at each terminal. With Windows you have to duplicate that power on each workstation. With Windows your power is lowered to the weakest link in the chain. He also likes Linux stability: ‘…your system just doesn’t go down.’
When asked what makes X-Med special from the other guys, Chigos says: ‘…we streamline functions to just a few screens. Under Medic and MedicalManager you have to go through several screens. X-Med puts it all in one place. We have concentrated more functions onto fewer screens and let you get the job done with fewer steps and less stress. The software requires almost no support, it is stable, easy to use and easy to learn. Training is usually not an issue.’
For the basic purchase price all of X-Med’s functions are included, there are no add ons and you get unlimited users. Service contracts are ‘…roughtly 10% of the purchase price per person per year. The system is compatible with Dragon Naturally Speaking Professional. However, it requires Windows. The system also works with PAM-2000 a proprietary pt. appointment scheduling system which automatically calls patients to remind them of appointments and recalls in which the patient is reminded to call to make an appointment.
If you can’t wait for open source medical software to become a reality, X-Med may be just the thing to get started with Linux.