OpenEMR Advantages

On Paying for Systems

While there is a lot of data on the potential benefit of electronic health records on public health in United States, the next obvious problem is how to get these systems paid for so the public can start "reaping" the benefits. Estimates for national health care systems are as high as 10 billion.

From the American Academy of Family Physicians: "In 2003, I had the opportunity to review EHRs again as the chair of an EHR committee for our 86-physician, multi site primary care medical group in Tucson, Arizona. What I learned is that, whether for a large multi specialty group or a solo physician's office, EHRs are now ready for prime time. My group agreed. Subsequently we signed a contract that commits us to investing more than $2 million over the next five years in an EHR. And that's in a group where doctors function economically much like solo physicians and are compensated 100 percent based on productivity."

Patient note creation speed has improved dramatically with point-and-click technology, more sophisticated templates and integration of dictation with templates. With the addition of functions such as electronic prescribing, allergy checking, drug-interaction checking and remote chart access, EHRs can do things that paper charts just can't. EHRs are now more user-friendly than ever, and with each new software version release, things just keep getting better.

Cost estimates can be hard to pin down. You need to include not just the software vendor's quote, but also the cost of hardware, network upgrades and computer personnel (contracted and/or hired). For a top-of-the-line EHR, plan on an initial investment of $15,000 to $30,000 per physician for software, hardware, implementation and training. But remember, you'll be amortizing that cost over five years or so. Also expect a 15-percent to 18-percent annual software support fee, which covers upgrades and service. In total, expect annual costs of $5,000 to $15,000 over the first five years."

OpenEMR Advantages Over Paid Software

OpenEMR has no software cost.

• You can download and install it for free.
• Upgrades are free.
• Free On-line support - with a large established community including the developers actually responsible for writing the code.

There are hardware, implementation, training and maintenance costs. Unless you or your practice have the technical skills necessary to install the software, back-up your data and upgrade the software as needed, these costs are likely to similar to implementing a comparable proprietary system.

All of the Open Source Software Advantages apply to OpenEMR. Avoiding the problems of software sennesence and vendor lock-in. As described by Ignacio Valdez of Linux Medical News.

1. Sunsetting, corporate buy-outs, bankruptcy, patient outliving their software.
2. Mobile workforce: 1 doctor 5 practice settings 5 different EMR GUI's in 1 week. Training, re-training, re-re-training.
3. Disaster preparedness (see item 2 above).
4. Vendor lock-in.
5. Duplication of engineering costs.
6. Meta-applications built on substrate without asking permission: simulators, bio-surveillance, yet-to-be-conceived apps.
7. Ensuring confidentiality.
8. Software forensics in the case of malfeasance.
9. Error reduction studies and engineering in a proprietary software mosaic.
10. No one vendor with enough engineering resources.
11. Corporate agenda not in harmony with customer needs.