Successful health IT software is difficult to create from scratch. Over 70% of Health IT software projects are either outright failures, or “challenged”. The MirrorMed project shows how Free and Open Source Software (FOSS) in medicine can create a successful electronic medical record/electronic health record(EMR/EHR) by using code from several projects: OpenEMR, FreeMed, Uversa’s ClearHealth and the FreeB medical billing project. Together, these projects have threaded the needle and become the few that survive the real world in Health IT.
Using the easy to install xammp (apache, MySQL, PHP) product with PHP 4 makes MirrorMed relatively simple to install on Linux, and somewhat more difficult to install on Windows (not officially supported). (update: 4/16/06, I’ve found that using WinZip to un-pack mirrormed causes a problem. Un-packing with powerArchiver works, other unzip packages have not been tested.)
Like most FOSS products, support and development forums are readily available on the MirrorMed website. As well, paid support contracts are available for all products mentioned in this article. There are at least 30 installations of OpenEMR derivatives such as MirrorMed.
By itself, the MirrorMed project could not exist without the OpenEMR, FreeMed, ClearHealth of FreeB projects. All of these projects share code with one another and have created a viable sub-industry with multiple players around one another’s products. This substrate is actually very stable because the products and their source code are available more or less perpetually on the internet. As well, present and past versions are not subject to corporate buy-outs or failures.
Doing the same amalgam with proprietary medical software would likely require exchanges of money, licensing and/or complex relationships among several parties. Such relationships can quickly become un-wieldy, expensive, dysfunctional and slow. Relationships in the FOSS world can have a spectrum from crucial to entirely optional and un-necessary using FOSS licenses in medicine.
Many in medicine are un-used to having such freedom and have grown accustomed to thinking that long-term, expensive relationships and proprietary technology is normal and necessary. They often find it strange, un-believable and too-good-to-be-true to live and work in the free and open source world.
These screenshots of MirrorMed’s patient information screen, billing and schedule shows that proceeding in a FOSS manner in health IT is not only possible but preferred. Installation guides and documentation for MirrorMed and all of the products that make it up are available on the MirrorMed site.