FAQ

What is OpenEMR?

OpenEMR is an Open Source electronic medical record and medical practice management software. For more details, check out the project website at http://www.open-emr.org and the OpenEMR Features Page.

What is the quickest way for me to evaluate OpenEMR?

We host an OpenEMR online demo here at: OpenEMR Demo

We also offer an OpenEMR Virtual Appliance here: OpenEMR Virtual Appliance

We also offer multiple download packages here: OpenEMR Downloads

Is OpenEMR ONC certified?

OpenEMR 4.1 is certified as a Complete Ambulatory EHR (http://tinyurl.com/4sgaw8a).

What is OpenEMR's default password?

The default password is 'pass'

Are other languages supported?

Currently OpenEMR is functional in several languages. If you have an interest in helping translate OpenEMR into your native language, please let us know. We will be glad to add your language to the list and help get you started on the translation. Our latest information on the translation projects can be found on the OpenEMR Internationalization Development wiki page.

What are the correct PHP settings (can be found in the php.ini file) ?

We recommend the following PHP setting, which can be set in the php.ini file (If you do modify this file, remember to restart your web server (usually Apache) to apply the new settings):

short_open_tag = On

max_execution_time = 60

max_input_time = 90

memory_limit = 128M

display_errors = Off

log_errors = On

register_globals = Off

post_max_size = 30M

file_uploads = On

upload_max_filesize = 30M

error_reporting = E_ALL & ~E_NOTICE & ~E_STRICT

If using a version less than 4.0, then also need the below setting:

magic_quotes_gpc = On

What is CAMOS?

CAMOS (Computer Aided Medical Ordering System) is an additional feature. Original intentions where to "Make your choice and get it in the Files" kind of approach.

This feature needs below configuration:

• Goto: Administration => Other => Forms => CAMOS register => enable; back to current visit and use.
• You will find the installed CAMOS under Miscellaneous.
• Beware of the fact that this feature has its own recipe, diagnose, and many other options.
• Its highly flexible approach is, once understood, a nice shortcut for many medical observations/interventions.

More details and the CAMOS User manual can be found on the CAMOS Module wiki page.

What are Layout Based Visit Forms?

LBV Forms is an additional feature. To be used to create personal forms. Some extra Forms you wanted to have in your OEMR version.

More details and the LBV Forms manual can be found in the LBV Forms module wiki page.

What is ImageMagick?

This is imaging conversion software used by OpenEMR in the Patients->Report screen to convert pdf images to jpg images. In linux, this is almost always installed by default, so rarely causes problems in linux. However, if you are using Windows, then you will need to install ImageMagick and Ghostscript(gs871w32.exe file). When you install ImageMagick, ensure you install it as the Adminstrator and also ensure you select to allow it to configure it with your Path. After installing these programs in Windows, then restart Windows. For Windows, will require OpenEMR 3.2.0 (with latest patch installed) or later for ImageMagick to work.

How to include a photograph in the patient demographics screen?

A document category called 'Patient Photograph' is now a default part of OpenEMR 4.0+. You need only upload a photo of any size (don't be silly and load a 10 mega pixel poster). The photo will show up in the Photo/ID section on the Patient Summary page with a click-able thumbnail image.

note below instructions are only needed for OpenEMR versions less than 4.0:

Create an additional sub-directory In Documents under patient ID. Administration => Practice => Documents => Edit Documents. Click :Patient Information and create a Sub-Directory. Name it: Patient Photograph

Now activate a Patient/Client. Go to Current Client => Medical Record => Documents => go to Sub-Directory Patient Photograph.

Upload the Client's photograph. (Be sure to place it in Patient Photograph sub directory under patient own name. Photo should be: 320x240. Photo will show in Patient Demographics page. (Remember no directory or no photo, no visible picture!)

That is it. Details created with the advise given on OEMR Developers Forum as advise from Mark L.

Can OpenEMR be setup for multiple clinics?

Yes, OpenEMR can be modified to run with separate clinics/facilities. There are two options:

1) If you want to share the scheduling, patient data and physician data between clinics/facilities, then can input each facility here.

• Go to Administration > Facilities > and define your locations :
• It is also possible for a provider to be linked to only one facility to see only his/her patients in that facility.

• Set Administration->Features->Restrict Users to Facilities and then set the facility in Administrion->Users.

2) Can create numerous completely separate OpenEMR installations on the same server with the Multisite Module.

• See the Multiple Sites Module wiki page for instructions

• Multiple Sites Module changes OpenEMR to be used so each install is separated and can run in its own space and make administration better from a central site. Remember running 200-300 facilities on a single server would be tremendous load for that server.

Can OpenEMR keep track of drug and product inventory

Yes, it can. The drug and tracking of other non-drug materials is turned on at Administration->Globals->Features->'Drug and Products'

• See the Inventory Module wiki page for further instructions

How to submit successfully an eligibility request to Availity

How use "Report - Eligibility 270 Inquiry Batch".

While implementing all the efforts the send the right information you might get from the Clearing house:

Remember, it automatically pulls insurance eligibility. The clearing house an X12 partner, is giving this error in red "* Clearing house info required for EDI 270 batch creation".

This is just a warning, you can ignore it. Refer the following link for workflow document:

http://sourceforge.net/tracker/?func=detail&aid=3019716&group_id=60081&atid=1245239

The same problem is compiled as follows:

1) Made a new patient

2) Made a new insurance company

3) Made and X12 partner

4) Added insurance to the patient's primary

5) Made an appt for today

6) Went to the report and put date from (anything basically) and to today

7) Hit refresh and the patient showed up

8) Then choose an X12 Partner

Click: 'Create Batch' and send the text file via x12 stuff while using Availity.

First 2 times I missed ISA06 and GS02. (Means: failed)

Third time Interchange Note: Duplicate Interchange Control Number (means failed)

Response of Availity: They are getting duplicate control number.

There can be some programming issues with Eligibility:

1. Control number sequence increment

2. Selected Receiver ID Qualifier (ISA07) as Duns, but it generates file content as ZZ (instead of 01).

3. Application Sender Code (GS02)

This value is picked from Receiver ID (ISA08).

N.B: Availity guidelines are in page 29 of http://www.availity.com/documents/edi_guide.pdf.

Other problems encountered:

1. Report lists only patients that have had appointments in the calender. I see the sense in this, so you can check eligibility of up-coming patients, but not all our clients are scheduled in the EMR most of them are never on the calender. It would be nice to check eligibility across the board.

2. Selecting an X12 partner does not restrict the list to just the insurance companies using that X12 partner. Also, with no check boxes/radio buttons, you must "delete" each item in the list individually to edit them from the generated list.

3. Provider for the eligibility check seems to be from the calendar as well. There is sense in this and understandable, is there is a simply way for checking for eligibility against the facility NPI instead of against a particular billing provider, as the provider on the calendar might very well not actually be the billing provider.

After some fixes there still might be the same error from Availity.

These are the X12 settings for X12 PARTNER: AVAILITY ID: "EIN" RECEIVER ID QUALIFIER (ISA07):Duns (Dun & Bradstreet) RECEIVER ID (ISA08):030240928 SENDER ID QULAIFER(ISA05):Mutually Defined SENDER ID(ISA06): AV09311993 ISA14:Yes SUBMITTER EDI ACCESS NUMBER(PER06):V07432 VERSION:004010X098A1 PROCESSING FORMAT: standard Question: Am I missing anything? Has anyone successfully submitted an eligibility request to Availity? What other errors might Availity show, not related to OEMR: AVAILITY TA1 INTERCHANGE ACKNOWLEDGEMENT Customer ID: 0023558 File Status: REJECTED Date Received: 2011-04-16 Time Received: 15:20:14.435 Filename: elig-270..2011-02-01.2011-04-16.txt File Control Number: 895446777 ******************************************************************************** Interchange acknowledged: TA101 ******************************************************************************** Interchange Date: 110416 Interchange Time: 1514 Interchange Status: The Transmitted Interchange Control Structure Header and Trailer are Rejected Because of Errors. Interchange Note: Unknown Interchange Receiver ID------ END OF REPORT ---------------- Their system will be down from 16apr 1700- tomorrow. Sometimes you need to call and find out what is necessary to correct. This might be a good hint as to what is screwy: ISA*00*0000000 *00*0000000000*ZZ*AV09311993 *01*AV09311993 *110416*1514*U*00401*895446777*1*P*:~GS*HS*AV01101957*030240928 Lots of zeros.....Not good. should be blank spaces. ISA01-04 ARE used by some companies, and should be configurable in OpenEMR. These are modified files for claims and x12 partner configuration:

http://starfrontiers.org/khvcode/Openemr/x12_header_mod.zip

Part of these files include a new edit html that allows to configure X12 partner data with the elements in ORDER, 

instead of any mismatched mishmash order that can be encountered. Also possible to allow configuration of the whole header. Compiled: There is need for sql-queries patch updates. Have the 4.1 upgrade added as well (probably the 3.2 upgrade also). Have to use the 270 the new X12 partner variables this might provide OEMR with a complete new system. Advise: Could utilize my files to make changes here, and allow these values to have configurable settings. Without such, I won't (and a lot of folks in Fl &IL won't) be able to use it for everyone. Once this is done, I believe a lot of recurring issues will be solved. You could integrate my includes, use those fields/variables the way I have done in my x12 gen changes. As per the standard, the Zeros in the interchange header segment are valid if no information is present for that data element (e.g. ISA01-04). If needed this can be made configurable. It is also possible to see an interchange note in the "AVAILITY TA1 INTERCHANGE ACKNOWLEDGEMENT Report": Interchange Note: Unknown Interchange Receiver ID could be the cause of error. Could be an error in the header segment information OR any other issue. To find any error it helps to make a print screen. It helps resolve the ISA Errors.

Following GS Errors might give some ideas:

Below are default settings GS01 (Functional ID Code):HS GS02 (Sender Identifier):AV09311993 GS03 (Receiver Identifier):030240928 GS08 (Version): 004010X092A1 GS04 (Date):CCYYMMDD GS05 (Time):HHMMSS GS06 (EDI Group Control Number):000000002

While reviewing the Availity EDI Guide it is clear there is no GE segment in the batch generated by OpenEMR.

After numerous submissions, I finally got Availity to accept OpenEMR's eligibility request (270).

Unfortunately, OpenEMR is unable to read the 271 reports generated by Availity.

Following are the necessary changes to make, (in order for OpenEMR generated batch to be accepted): (Use EDI Notepad to make the changes.)

Item : Default Value : Correct Value Receiver Qualifier : ZZ Mutually Defined : 01 Duns (Dun & Bradstreet) Sender Identifier: AV09311993 : AV01101957 Time : HHMMSS : HHMM

What is FreeB?

FreeB is now obsolete. Previous to OpenEMR version 2.9.0, FreeB was a separate program that created insurance claims. However, in OpenEMR versions 2.9.0 and later the insurance billing engine is included in OpenEMR.

What is SQL-Ledger?

SQL-Ledger is now obsolete. Previous to version 3.0.0, SQL-Ledger was a separate accounting program to manage accounts receivable. However, in OpenEMR versions 3.0.0 and later the management of accounts receivables is included in OpenEMR.

What is GACL or php-GACL?

GACL or gacl is a short cut form for phpGACL. This is an acronym meaning Generic Access Control Lists. It allows fine grained control over OpenEMR. As an example, the physician can be permitted to view sensitive patient information, while the receptionist is unable to view this sensitive patient information.

Since OpenEMR version 3.0.0, access controls (php-GACL) is included in OpenEMR, thus requiring no separate installation or configuration. Administration of access controls is performed within OpenEMR in the Administration->acl menu.

In OpenEMR versions 2.9.0 and earlier, php-GACL was actually installed separately.

Can I Charge for the OpenEMR Software?

OpenEMR is licensed under the terms of the GNU General Public License (GNU GPL). This license makes few restrictions on the exchange of money for products or services.

What you can do:

• You can charge for your time for installation and any hardware you provide.
• You can charge for IT maintenance of the operating system and installation of OpenEMR upgrades, maintaining back ups etc.
• You can charge for making software modifications to the system as needed.
• You can charge a fee for the OpenEMR package as long as you follow these guidelines [1], [2], and [3]

What you must do:

• You must provide the source code in plain text to your clients.
• You must provide a copy of the General GPL license. The General GPL license is actually included with the OpenEMR release. (See Also: [4])

What you can not do:

• You can cannot mix OpenEMR with modules that are proprietary or closed source. For example you can only use modules that are also Open Source or Free Software. Open Source is defined by the OSI; Free Software is defined by the FSF; they are virtually identical.

Optional:

• If you modify the system you can charge for your efforts. We do ask that you consider releasing your improvements back to the project under the GNU GPL licensing.

What are the Terms and conditions of the System?

• See the file COPYING in the release
• GNU General Public License on the GNU Project's website.

As per the website OpenEMR is open source so can we change the logos, functionality of the software, as we are having sms, other solutions that can be implemented?

• Yes. With the exception that you may not remove the GPL license. The other terms and conditions listed above must be followed. If you incorporate other open source software it is legally easiest to use licenses that are similar. As examples Mozilla has its own Open Source license but it allows activities that are not permitted under the General GPL. So technically using software modules with Mozilla style licenses is not a problem as long as they do not conflict with the General GPL. But things can get very sticky in a way that it is difficult to operate legally. So in general it is better to only combine similar licenses.
• You can charge for the changes in functionality. But the OpenEMR software must remain under the GPL license. The problem that comes up is that if you do not release your code back to the project, every time we release a new version you have to update your version with the changes that you made. The only other option is to not upgrade your OpenEMR as the new releases come out. Releasing your code back to the project under the GPL licensing means that each subsequent upgrade already includes your changes.

What license fee or other charges we have to pay OpenEMR team for the above modifications and implementations?

• None. The software is free and open source, subject to the restrictions listed above.

Can I Add more information to this FAQ page?

YES, just register for the wiki.

• Whatever you think is of any help for the community and what avoids similar questions and same answers could be added.