The Newfoundland and Labrador Medical Association (NLMA) has announced its intention to develop its provincial electronic medical record (EMR) using open source software (OSS). NeLL, as the EMR project is known, will network all the province’s 1,000 physicians. In its first phase, NeLL will include electronic prescribing, billing, and charting. NeLL will run on a Linux desktop, which will be the default and only supported operating system on PCs shipped with NeLL.
The project will take an existing OS EMR and expand the functionality, contributing the results of the work back to the open source community.
The electronic prescribing function will not simply be a way of printing off a computer-generated prescription. The goal will be to work with the Newfoundland and Labrador Centre for Health Information and the province’s pharmacists to provide electronic delivery of the prescription to the patient’s pharmacy of choice. The benefits from such a system are many, from improved safety through increased legibility of prescriptions, elimination of lost, stolen or forged prescriptions, allowing access to the patient’s drug profile while prescribing (ending double doctoring for narcotics and other street drugs) and drug/drug interaction surveillance at the time of prescribing.
Open source software was chosen for a number of reasons. OSS lends itself to localization to best suit the needs and functionality of the physician community. Change will not be driven by a software vendor’s corporate need for profit. OSS avoids vendor lock and is more secure, two important factors when dealing with vital systems and confidential information.
In evaluating open source EMR’s, the NLMA has narrowed the field to a short list of existing OS EMR’s. The aim is to develop an EMR that is modular and flexible, such that could be used in other jurisdictions (particularly but not limited to Canada) with proper localization. In addition, it is hoped to combine the work done in NeLL with work being done at the Faculty of Family Medicine at the University of British Columbia towards integration of decision support.
The NLMA is working with its private sector partner, Unisys Canada, in the development and deployment of NeLL. The NLMA is also pursuing other research and development opportunities for NeLL. It is hoped that the development of NeLL will form a focus allowing the Memorial University of Newfoundland community to pursue academic research around electronic medical recordry. The NLMA is also pursuing the research and development opportunities Nell presents with the Canadian National Research Council.
Discussions between the NLMA and Unisys are ongoing, but it is hoped that development will begin September 2004, with deployment planned during 2006.