Think your CCHIT certified, proprietary EMR from a ‘big’ corporation is a safe bet? Think again. Remember Enron? From GPLmedicine.org comes news that a recently #1 ranked, CCHIT certified EMR company, AcerMed, is either severely crippled or has bit the dust. Why is this significant?

It is significant because Electronic Medical Record software isn’t like a restaurant chain. People’s lives depend upon it. Many EMR software acquisition decision makers think that a proprietary EMR from a ‘big’ company that is CCHIT certified is ‘safe’ and ‘isn’t going to go away soon’. Many in the Free and Open Source Software licensed EMR crowd know that this is an utterly false sense of security and that the only safe bet is a non-proprietary FOSS licensed EMR. Further that it is un-ethical to do it any other way.

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Government Technology News has a wide-ranging article on Free and Open Source Software in Medicine: “Doctors are fed up with the we-own-you, vendor lock-in, phone-home-to-the-mother-ship-to-do-anything status quo,” he said.

In addition, open source health IT applications are hitting their late teens, with more growth coming. What will be available in the next year, he said, will likely challenge anything in the proprietary world.

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IBM’s Eishay Smith, Enfold Systems Alan Runyan and a few others will be speaking at a one day symposium in Houston entitled ‘Free and Open Source Software (FOSS) for Healthcare: Progress and Promise’ This will be held at:
School of Health Information Sciences, UT-Houston
University Center Tower
7000 Fannin, 14th Floor
Tuesday, April 24th
Read on for the full agenda and registration info.

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Scott Shreeve, MD
weighs -in on the recent Practice Fusion announcement: ‘All this “paradigm shifting” and “revolutionary” talk is good – way good – and part of the fulfillment of the vision that so many within healthcare IT have had. However, the means by which they are able to deliver it FREELY raise the inevitable red flags. I have several major issues with the enabling mechanism of this “free”dom (or more appropriately Free Dumb).

While I have never been a huge privacy guy, and not being an information conspiracy theorist, I am still pretty concerned about how personal health information can be utilized…’

Updated 12/16/07: one reader (below) says that this is a ‘bait and switch’. You knew it had to happen. According to this article, Practice Fusion, Inc. has announced a partnership with Google to provide no-cost electronic medical record software to physicians supported by advertising. ‘Practice Fusion is not the only company offering Internet-based medical-record systems. “We just happened to find a way to subsidize the cost of it,” said Ryan Howard, the company’s chief executive officer…’

Signs that things are changing: The California Healthcare Foundation report ‘Open Source Software: A Primer for Health Care Leaders was its 3rd most popular report for 2006. Linux Medical News readers where alerted to this report at its inception. The complete top ten list is:

1. The Guide to Medi-Cal Programs
2. Snapshot: Health Care Costs 101
3. Open Source Software: A Primer for Health Care Leaders
4. Health Care in the Express Lane: The Emergence of Retail Clinics
5. IT Tools for Chronic Disease Management: How Do They Measure Up?
6. Medi-Cal Facts and Figures: A Look at California’s Medicaid Program
7. Consumers in Health Care: Creating Decision-Support Tools That Work
8. Guide to Health Programs in English
9. The Medicare Drug Benefit: How Good Are the Options?
10. Snapshot: Employer-Based Insurance: Coverage and Cost

Alert reader Yeb Havinga wrote in with news that HL7 JavaSIG code is now available with a possibly open source license it is calling the “Health Level-7 Public License For JAVA” Will it make a difference?

The National E Prescribing Patient Safety Initiative, press release here is an e-prescribing juggernaut aimed at providing ‘free’ e-prescribing for all doctors. ‘…The challenge, according to the eHealth Initiative, is that fewer than 1 in 5 of the nation�s practicing physicians currently process prescriptions electronically. Studies indicate that most physicians have been reluctant to adopt electronic prescribing largely because of the cost of the systems, and a perception that the technology requires too much time to learn and install. NEPSI will help address those barriers by providing physicians simple, safe and secure electronic prescribing at no cost…’ This initiative raises a number of questions currently not answered: Who gets the e-prescribing data? Is this really free? What is in it for Allscripts?

Free Software Magazine has an article by frequent Linux Medical News contributor Fred Trotter on the ‘Tivoization’ of Healthcare: ‘Tivoization is a real threat to users freedom, but only when you consider the appropriate context. It�s not just a question of controlling hardware, more importantly its about controlling data. This issue becomes clearer when you consider health software instead of television software…’

The age of the all-browser based Electronic Medical Record/Electronic Health Record (EMR/EHR) is upon us. Local area network (LAN) based EMR’s upon which older generation EMR’s companies have built their products is dead. This paradigm shift is occurring now. This development threatens Free and Open Source medical software, practitioners and patients as they have never been threatened before.

Prior to all-browser based EMR/EHR’s, proprietary vendors of these softwares have to at least provide binary executables which are somewhat tangible and somewhat owned (depending upon the contract) by the purchaser. Free and Open Source Software (FOSS) vendors of EMR/EHR software are ideal and preferred because they provide the source code as well. With the advent of all-browser based EMR/EHR’s, no binary programs, much less source-code is provided. Only the service is provided. The software is wholly owned by the service provider and is not even distributed.

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