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 Posted by Ignacio Valdes, MD, MS on Monday June 14, 2004 @ 01:50 AMfrom the Medical-Open-Source-Development dept. Here's about as good a summary as you can get of currently active Free and Open Source Software EHR/EMR projects courtesy of Dan Johnson, MD. Dr. Johnson is the author of the earliest known writings on Free and Open Source Software in medicine. He continues his activity in this area. Digg this article June 11, 2004, Dear Dr. Rollow, Mr. Weir, and Mr Moy: Thank you for speaking to me this week about DOQ-IT and open source software. I promised that by today I would have prepared a summary of open source EHR projects that I'm aware of. There is some very exciting work going on. I will give you, below, a precis of each project and links. I will cc the folks that offered me their information so that (a) you'll have contact information and (b) they can correct any misrepresentations that I inadvertently create. I will also post this note to the open source healthcare discussion list, so the folks there can correct my errors. You can tune into that discussion by sending an e-mail to openhealth-list-request@minoru-development.com with "subscribe" as the subject. An archive of past messages is available at www.mail-archive.com . In addition, here's a link to a comprehensive, well-documented essay on open source software and its market: http://www.dwheeler.com/oss_fs_why.html It is very long; its author has kept it up do date for at least 4 years, and I've found it a useful encyclopedia of open source references. An extensive list of open source health care software resources is maintained at http://www.minoru-development.com/en/healthlinks.html#projects (but is not current beyond 2002). Other lists of open source EHR projects are at http://www.debian.org/devel/debian-med/practice and http://mtdata.com/drred/public_html/webpage.html as well as http://www.linuxmednews.com/, the open-source healthcare new site, run by the psychiatrist Iganacio Valdes, MD, which maintains an excellent list at http://www.linuxmednews.com/linuxmednews/LMNProjects/Projects/folder_contents Now follows the list of open-source EHR vendors. 1: Project: tkfp http://tkfp.sourceforge.net/ Lead: Alexander Caldwell M.D. alcald2000@yahoo.com Developers: 10 Use in practices: 2 Tech support: informal, active Supports billing: yes Lab interface: yes Special feature: designed to incorporate practice guidelines: Has integration with "MedMapper" -- http://medmapper.sourceforge.net/ -- an interactive electronic algorithm-like decision support system that is the brainchild of David Pepper M.D. drpepper@ucsfresno.edu This allows tight integration of decision support for the EMR with documentation in the patient record. This system prompts physicians in real time, creating dynamically editable templates for our note writing that allow best practice and practice guidelines to be incorporated directly into the note templates. A *very* interesting concept; *not* formally commercial. 2: Project: OpenEMed http://65.125.35.7/ http://openemed.org/ Lead: David Forslund forslund@mail.com Developers: several Use in practices: being installed as part of the SHARE project in Mendocino County, CA. Tech support: informal, active Supports billing: no Lab import: yes Special features: OpenEMed is a set of distributed healthcare information service components built around the OMG distributed object specifications and the HL7 (and other) data standards and is written in Java for platform portability. In addition, it includes a complete JSP client implementation of a infectious disease monitoring system (B-SAFER) for use in an Urgent Care setting. This includes filters for a variety of data feeds including HL7, CSV, SQL, flat files, and XML. This powerful and flexible tool is being used to acquire a variety of data from multiple hospital systems. Also included is a example of a simple immunization registry pilot. The power of using these components in a variety of settings can ultimately lead to a fully distributed medical record accessible by a patient. This could be ideal in a regional healthcare management scenario. David Forslund has done some simply amazing work interconnecting regional hospitals with disparate information systems in the Southwest, and this project is an outgrowth of his work. 3: Projects: OSCAR http://67.69.12.117/ and EGADSS http://sourceforge.net/projects/egadss/ and http://www.netlab.uvic.ca:8008/sites/public/default.aspx plus http://www.vch.ca/health_services/PHCN/UBC-VCH-BC-CDSS%20Services%20April%202004.pdf and http://www.cms.hhs.gov/quality/ClinicalMeasures.pdf Leads: David Chan, MD (OSCAR), (contact Joseph Dal Molin, dalmolin@e-cology.ca Morgan Price, MD (EGADSS) priceless@familymed.ca Developers: 5, full time, employed Use in practices: 4 or more in Canada (fully portable to the US) Tech support: available commercially in Canada Supports billing: partial, in Canada Lab import: yes Special features: OSCAR is a full-fledged office EHR developed by Dr. David Chan of the McMasters University Family Practice program in Hamilton, Ontario. This is the most sophisticated and complete open source EHR. Dr. Chan has earned significant grant support for development; the developers are eager to have US practices adopt and extend OSCAR. EGADSS is under initial development; it is designed to be a stand alone reminder system that can interface with an EMR. EGADSS stands for Evidence-based Guideline And Decision Support System. 4: Project: OpenEMR http://www.openemr.net/ Lead: Walt Pennington wpennington@pennfirm.com Developers: 6 Use in practice: 175 clinics using or evaluating OpenEMR; International use: Uganda pilot beginning Tech support: available commercially from the Pennington Firm Supports billing: yes Supports lab import: in development Special features: a functioning, commercially thriving, commercial product based on the open source development model. Pennington Firm http://www.PennFirm.com 402 West Broadway 4th Floor San Diego, CA 92101-3554 619-696-5050 or 888-480-5050 Updated 10/09/2004 by IV: 5: Project: VistA Lead: US Veterans Administration, OpenVistA see http://www.worldvista.org/ https://sourceforge.net/projects/worldvista/ http://www.pacifichui.org/OpenVista/ Medsphere: http://www.medsphere.com/home/ http://sourceforge.net/projects/openvista Contact: Summer Bond summer.bond@medsphere.com Medsphere 65 Enterprise Aliso Viejo, CA 92656 310-271-1232 Developers: several Use in practice: hospital-based system Developers: 5 in house Sites: 7 hospitals Tech support: full, commercial Supports billing: yes Supports lab: yes, and everything else Special features: This is an example of VistA being ported to the private sector. VistA is capable, I understand, of being a physician office EHR, but I am not aware of commercial availability for this. I believe that it is being used in the office setting in American Samoa. 6: Project: TORCH http://www.openparadigms.com/ Lead: Tim Cook Tim@openparadigms.com Developers: 100+ Sites: Not tallied (I believe that Tim has a commercial product, based on TORCH, in several practices that he supports commercially.) Tech support: informal Supports billing: yes, using FreeB (http://freeb.org/) Supports lab interfaces: yes Able to support QI guidelines: yes Special features: TORCH is unique in that it is an actively-developed code base that is available to developers. The TORCH2 project is an object oriented and completely open source EHR composed of components for; billing, practice management, accounting, clinical coding, customizable workflow, graphing package, remote and local scheduling using standard iCal documents, granular security model, audit trail of every action, template and free text input is user selectable, voice recognition (with additional software), hand writing recognition (with additional hardware and software) and has interfaces for PCs, PDAs and iPhones. 7: Project: CHLCare Lead: Thomas Lewis MD Contact: Marilyn Wetterhahn (?sp), Special Projects Primary Care Coalition of Montgomery County 8757 Georgia Avenue, Silver Spring, MD 20910 (301) 628-3405 Details: none available see http://www.egovos.org/Conferences/PastConf/March03/Agenda/TLewis/ http://www.coolheads.com/egov/combined/topicmap/s51/abstract.html Special features: This is an Open Source, enrollment based, encounter based, thin, broad, web based, extensible electronic medical record for primary care support. I have heard a presentation on this system, but can locate no information. 8: Project: FreeMED http://www.freemed.org/ Lead: Jeff Buchbinder Developers: several Sites: at least one. FreeMED was developed., I believe, circa 1997, for the practice of Jeff's father, making it truly the first open source EHR. Tech support: http://www.freemed.org/mailman/listinfo/support Supports billing: yes, through FreeB http://freeb.org/ Supports lab: not known Special features: I'm sorry; I'm ignorant. There are other open source health care projects as well, I'm confident that I've missed one or more that are mature and deployed. but this is what I'm able to provide over lunch and after patient care is finished. As a Wisconsin PRO (MetaStar) trustee, I'm excited about the potential that DOQ-IT has for beginning to bring coherence to the healthcare office EHR arena. Sincerely, Dan Johnson md 715-235-9671 < | >
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