Open Source Observatory

The Open Source Observatory ‘is intended to encourage the spread and use of Best Practices in Europe’, according to its
While not primarily health-related, it may help to address one of the issues that was identified as a potential driver for open source (ie the availability of case studies) at the recent IMIA/British Computer Society Health Informatics Committee thinktank meeting (Marwell, UK, February 2004). The need for such resources is an issue that has surfaced in a number of disucssions in recent months – there may be a case for trying to work with the resource, rather than reinvent it.
The Observatory is provided by the European Commission.

Live from the 9th Annual VistA Community Meeting

We are reporting live from the 9th annual VistA community meeting on the campus of Rice University in Houston, Texas. According to WorldVistA President Rick Marshall, this meeting originally grew from the need for the people inside the Veterans Administration and outside the Veterans Administration to get together to talk about VistA. It has grown into much more than that since then to include the group that is creating a completely free/open-source stack of the Veterans Administration VistA healthcare software collectively called OpenVistA. More developments as they occur.

OpenEMR Announces 2.5, Videos, and Prescriptions

Walt Pennington has numerous announcements about “OpenEMR”: *Earlier this week we released OpenEMR v. 2.5 which now contains prescribing of medications…’* and much more. Read more for the full text of the announcement.

Earlier this week we released OpenEMR v. 2.5 which now contains
prescribing of medications.

We also created several flash videos to demonstrate OpenEMR features
which can be found at

For those of you that are unfamiliar with OpenEMR, it is an open source
practice management and electronic medical record application. We are
creating OpenEMR to compete with and be a replacement for Health Pro,
MegaWest and Medical Manager. We are now in the process of finalizing
billing using FreeB and anticipate having those features implemented and
tested by the end of April 2004.

1. Find first available appointment by provider;
2. Support available from Pennington Firm, Synitech or other companies;
3. Extensive patient demographic information;
4. Different calendar views for medical providers and office staff;
5. Reporting using phpMyAdmin;
6. Database manipulation using phpMyAdmin;
7. Several community supported mailing lists and forums;
8. Electronic medical records;
9. Ability to bill ICD and CPT codes at the end of an encounter (CPT
codes must be separately licensed from the AMA and a .tar with CPTs are
available from Pennington Firm);
10. Medication search;
11. Add prescribed medicines to patient history;
12. Send prescriptions to in-house pharmacy;
13. Send prescriptions by email or fax to other pharmacies; and
14. Print prescriptions.

In late April OpenEMR will have additional functionality for billing
using FreeB.
1. Approved by Medi-Cal (California Medicaid) for submitting claims;
2. Ability to submit ANSI X12 or HCFA forms;
3. Clearinghouse with explicit support for OpenEMR and FreeB;
4. Separate billing interface to allow changes to be made in the event
of billing errors; and
5. Ability to print HCFA forms for billing.

As an open source application, OpenEMR can be downloaded and used. At we are regularly adding new content for documentation,
screen shots and video illustrations.

For those clinics or billing companies that need assistance with
installing and supporting OpenEMR, we offer several support packages to
install and customize OpenEMR for the clinic, and also provide training,
including on-site installation and training.

We want to thank those that assisted with the migration of the
openhealth list which now allows us to post information concerning our

Walt Pennington
Pennington Firm
402 West Broadway
4th Floor
San Diego, CA 92101-3554

Houston, We Have a Problem Part II

As reported in Houston, We Have A Problem Part I in December 2002 about the Harris County Hospital District blowing $75 million on a Health IT ‘upgrade’ that was behind schedule and error-prone. Now the head of HCHD is resigning in part because of it: ‘…His resignation comes amid increasing tension between the CEO and the board the last several months, much of it surrounding questions over the district’s purchasing and information technology efforts… When will medicine come to its senses about proprietary Health IT software?

Alchemists vs. Chemists in Medicine

This (long) e-Week interview with Eric S. Raymond I think summarizes the Alchemist position prevalent in much of clinical medicine with regard to its software today: ‘Page 8:…The occult school of alchemy didn’t turn into the science of chemistry until alchemists abandoned the practice of secrecy and instead started sharing results with each other and checking each other’s experiments. And that was a very early stage in the development of modern science and engineering. It happened about 400 years ago. And the thing that we’ve discovered over the last 400 years, as we’ve pursued experimental science and developed engineering from an art into a craft into a repeatable discipline, is that human beings doing complex, creative work, doing design work, make mistakes. There is no way to mechanically check the results of creative work. If you could do that, it wouldn’t be creative work; it would be something you could do with a machine. So the only way to check complex, creative work for correctness is by the critical judgment of peer experts…’

MedicalBillersNetwork Scam?

Editor’s Note: A Yahoo Group’s discussion list for possible MBN victims has been opened. Please join the group instead of posting here as this subject is off topic of Linux Medical News. Recent discussion by Linux Medical News readers and a Better Business Bureau report has revealed that MedicalBillersNetwork may be a scam. ‘I have just finished the training with medical billers network. I became suspicious when I realized their information, medicare training, and dotor database was dated 2001. A three-year old doctor database is of no value to anyone. Also, the alleged thirty hours of training became more like 100 hours of training…’ Updated: 4/6/2004 Judging by the number of comments, the consensus of opinion appears to be that Medical Billers Network is a scam.

Love in the fMRI

Nothing Free and Open Source in this, just an interesting article on the use of functional MRI to discover what parts of the brain are activated when people are in love, and when they’ve been rejected. Short version: ‘…The chief sections affected by the photo rapture test were the caudate nucleus (a lump deep in the reptilian brain that helps creatures ”detect and perceive a reward” and focus their attention on anything that might bring arousal, pleasure and satisfaction) and the ventral tegmental area (V.T.A.), which Fisher describes as the dopamine ”mother lode.” Some 6,000 images later, her hypothesis was proved right: the caudate and the V.T.A. lit up like a scoreboard every time the lover saw the image of the loved…’

PSI, A Medical VISA?

Healthcare Informatics has an article on forming a bank-like collaboration for Health IT: ‘More than 30 years ago, competing banks formed the VISA credit card collaborative and, together with the merchants, built a real-time, private financial information exchange at the point of service. Transactions are processed for less than one cent. Some people wonder, If the banking industry can do this, why can’t healthcare? Well, it can…’ Thanks to David Derauf for this link.

Upcoming Release – Prescription and Billing in OpenEMR

OpenEMR will have new functionality for prescriptions, pharmacies and billing. This is a pre-release notice of upcoming prescription functionality in OpenEMR. As part of our work on billing using FreeB with OpenEMR, we have added functionality for prescriptions.

Our work on prescriptions allows providers to:
1. Prescribe a new medication;

2. View patients’ existing prescription;

3. Send the prescription to the in-house pharmacy;

4. Send a prescription by email, fax or print to the patient’s pharmacy;

5. Lookup drugs in the Internet database; and

6. Special login for pharmacists to view prescriptions pending for fulfillment.


We have successfully submitted bills to Medi-Cal, and have tied all FreeB fields to OpenEMR. We are creating a separate billing interface to allow changes for bills when there is a formatting or entry error. Our anticipated release date for OpenEMR with billing using FreeB is late April 2004.


Clinics using OpenEMR’s billing features will be able to send bills to Medi-Cal, a clearninghouse, or to print HCFA forms. With additional customization, OpenEMR can submit bills to any payer.


Billing companies will be able to use OpenEMR with FreeB to offer practice management and EMR services to their clients, and to use FreeB to replace some of their existing billing applications.

For news and announcements on OpenEMR, please subscribe to the OpenEMR announcements mailing list.