One hesitation when it comes to starting your own medical practice might be having to pay for an electronic medical record (EMR). But there are free electronic medical records available, such as OpenEMR.
I’m going to focus on OpenEMR because it seems to have the largest community support and is the most refined. EMR’s are also referred to as EHR’s, electronic health records, same shit.
Commercial EMR, which is what most doctors use, could be somewhere around $500 per user. Even worse, many will nickel and dime you for add-ons and extra users. There are hosting fees and add-on fees.
Open Source Software
This website is built on an open source software called wordpress. Though the software is free, many have built on top of WP and created nifty plugins. Some of these are free and others you have to pay for.
The same is true for OpenEMR. You can connect to other services you like which are paid but at least your EMR is free. For example, you might pay $9.99/month for your favorite patient messaging system to integrate with your free EMR.
Google Chrome isn’t open source, even though it’s free. But there is an open source version of it called Chromium. All the code and infrastructure is open to view and available for the public to contribute to and work on and use.
You know what else is open source? Your Android OS on your phone. In fact, Android OS also runs on many TV’s, tablets, laptops, and even car interfaces. The manufacturer can build on top of it instead of having to reinvent the wheel.
Open Source for Doctors
For the physician who is starting their own medical practice, it’s great having access to open source software. Even if it’s not the perfect fit, at least you can build on top of it to make it right.
Whether you’re an NP or MD or DO who is opening their own medical practice, you’ll need some or all of the following:
- electronic medical records
- scheduling software
- inventory management software (pharmaceuticals)
- billing software
- prescribing software
- lab interface
- imaging interface
There are multiple open source projects for damn near anything you might need as a doctor. They even have open source software for hospitals, such as Bahmni.
The reason I’m not going to list 20 different open source softwares is because openEMR happens to include everything you need in the list above and it is truly free.
Furthermore, many of your vendors, such as labs and imaging centers, will have their own platforms which you can use for free. Or they might have API’s which they will let you use in order to integrate into your EMR.
Before we delve into OpenEMR, I’ll mention another option, OpenMRS. This is another free EMR software which you can use. You can demo this one by going to their demo site and logging using the credentials they provide.
1. Demo the EMR
Start out by test driving this free open source electronic medical record. Go to the demo page and login using the credentials they provide. Within 10.5 seconds you’ll be inside the user interface and can click around as if you’re in a real patient visit.
You can try the patient interface in the same demo environment. That way you know what your patients will experience.
Here is a diarrhea list of all the features you get with this free software:
- it’s free
- written in PHP language
- can be installed cloud-based, i.e. AWS
- accessible from any web interface
- commercial support available if desired
- provider portal
- access levels for different individuals (billers, nurse, physician)
- patient portal
- send patient medical records through Direct Messaging
- online payments for patients
- collect patient demographics
- patient scheduling with built-in scheduler
- DICOM medical image viewer
- e-prescribing (Newcrop, Allscripts, Weno Exchange)
- in-office med dispensing support
- clinical decision rules
- email reminders
- mobile app
- can be integrated with dictation
- ANSI x12, Office Ally, ZirMED for electronic billing
- ONC certified
- support for 5010 standards
- community support through online forums
- interoperability (CCDA, FHIR support)
- ability to create patient forms
- Meaningful Use measurements
- Clinical Quality Measures
You might find some negative reviews about OpenEMR but I warn you to take that with a grain of salt. The software is free. Many physicians don’t seem to understand the concept of free.
Free means that there isn’t someone who is going to spoon feed you, hold your hand, burp you, and come running when you have a boo boo. There will be a steep learning curve but you can always find help on the community forums. You can also hire 3rd party companies which will help install the software and help you get started – that’s the hardest part.
Don’t be one of the entitled people above who uses a free software and complaints and doesn’t add to the open source community. Post on the forum, learn from others, and pass on the knowledge.
If your practice succeeds, consider donating to their cause so that they can propagate this goodness.
5. Medical Image Viewing
The way an open source software works is that nerds around the globe contribute to it from the goodness of their heart. They believe in it and want to hone their skills.
This is how the medical image viewing extension was added to OpenEMR. And that’s how this software will continue to grow and get better.
You can check out their tutorial on integrating e-prescribing. They support Allscripts and Weno and Newcrop.
This is used to send a script digitally to a pharmacy. Though it can be done through fax or email as well.
7. Patient Messaging
They use MedEx which is a paid patient messaging platform that’s HIPAA compliant. So, I’m not sure if this patient messaging has to be done through a paid wall or if it’s free somehow. Let me know in the comments below.
There seem to be free open source programs available for HIPAA compliant patient communication. So even if MedEx is only a paid option, it’s not the end of the world.
Many doctors don’t know this, but sending a text message or email to your patient is not HIPAA compliant. You are not protecting their PHI.
The scheduling module is built into OpenEMR. It even comes with automatic reminders which are sent out to patients. The calendar interface seems decent.
You can make appointments for patients and it even supports multiple locations, if you have more than one clinic.
A Totally Different Alternative
I admit, before writing this post, I’d been brainwashed as much as anyone else. But then I started searching online and asking Google questions and realized that many of us don’t even need an EMR.
Imagine you have a tiny little STD clinic. Or maybe a small birth control dispensary. Maybe a medical marijuana clinics or a lumps and bumps clinics. Why the shit do you need a crazy ass EMR system? All you need is a HIPAA compliant, secure place to write something down under a patient’s name.
My G-Suite business account with Google is also HIPAA compliant and if I needed to, they would sign a BAA with me. That’s another option and it only costs around $12/month.