What is an open source EHR?

The electronic health record (EHR) that contains a patient’s medical data can be the key to providing the highest quality care for that patient. Interoperability, in particular, is a critical piece of an EHR solution that enables all providers caring for the patient to input and view information in real time. The ability to easily access relevant data, including history and diagnoses, can mean the difference in the patient’s care. An EHR can be cloud-based, server-based, or open-sourced. When making a decision about an EHR solution, the provider may ask “what is an open source EHR?”

Experts describe open source software as “computer software with a licensing provision that enables the users to modify, utilize, and distribute unmodified or modified versions.” Open source software is typically referred to as free, known as FOSS (free open source software) as well as FLOSS (libre and open source software), although there is usually a minimal cost associated with it. Source code is available for the software and FOSS has subsequently developed into many different distribution models.

Open source EHRs have pros and cons for the independent practice. FOSS is easy to obtain, easily downloaded from repositories with no restrictive licensing terms and no software licensing fees. However, according to the experts, the challenges in healthcare include “long-term support organization, funding and ownership for EHR certification, open-source business models, medical informatics and domain specific issues, functionality-based limitations, usability issues, challenges in resource-restricted environments, and challenges related human factors.”

Elation’s best-in-class EHR solution offers Collaborative Health Records, API to connect third party apps, and a hosted database for advanced analytics – everything the independent practice needs to deliver personal and informed care.

Specific pros and cons of an open source EHR include:

Cost: Open source EHRs must still be purchased, even though they are referred to as free, but the price may be lower than a proprietary EHR. However, the independent practice will also need to pay for hardware and infrastructure, support and maintenance, implementation and training, and any proprietary databases it chooses to include. All of this is without the depth of support and secure backing of a vendor. In addition, the practice could face indemnification and liability risks typically covered by the vendor.

Access and collaboration: While it is relatively easy to acquire an open source EHR, implementing it without the support of a qualified vendor may be difficult and time consuming. Downloading the open source EHR from the web is usually quick and the independent practice can review development ideas and experiences posted by the community using the EHR solution. However, implementing an EHR system is a complex process and can be difficult without the expertise of the vendor to handle the process, including training the practice team on its proper use.

Development and clinical decision support: The open source EHR enables flexibility with the software source code for the independent practice to customize the solution for its own specific needs. Again, though, there is no vendor support for the modifications, so it is up to the practice to make the changes. The user interface on an open source EHR may not be as user friendly as one developed by a qualified vendor. In addition, not all open source EHRs offer the extensive depth of clinical decision support options that support the providers’ decision making and enhance the patient’s safety and well-being.

The primary concern that most healthcare professionals have about an open source EHR is the issue of privacy and security. Ensuring the security of patient data is a critical piece of choosing the proper EHR solution for an independent practice, especially when sharing information with the patient and with other providers caring for the patient.