10 questions when deciding to go open source (or with OpenEMR)
1. Is the EHR cost efficient?
Open source EHR is an incredible opportunity to create a near-perfect EHR system from scratch (and OpenEMR is a good place to start). But it also means that the developer and user take on many of the costs that a vendor would normally manage. Consider server setup fees (as well as updates and maintenance), monthly hosting fees, an e-prescription subscription (if you need one), any lab interface cost, and the potential price tag of backup, disaster recovery, support and user training.
2. Can we try the system before we buy it?
Some EHR providers will allow you to try the system before you commit, but open source gives you this opportunity always. The try-before-you-buy approach lets you get a comprehensive understanding for what you really want, particularly before investing a lot of money and time into one solution.
3. Can we leave and/or change EHRs at any time?
The health IT market is still dominated with a few big systems. Those companies make it difficult (and sometimes very painful) to switch to a new EHR. OpenEMR allows its users the flexibility to leave at any time.
Note: not all organizations make it difficult to leave or change. If you determine that there is too much overhead cost and work associated with OpenEMR, consider researching those flexible providers.
4. Is the system flexible and/or customizable?
This particular question leads to the following additional questions like, does your open source EHR integrate with other systems you might need for your practice, such as e-prescribing modules, laboratories or clearinghouses? How complicated is it to hook into that healthcare ecosystem? You can create open source to fit whatever the need – but do you have the expertise in-house to do so efficiently?
5. What is the security of the EHR installation?
According to Open Source Survey, security matters when choosing new software, and most users believe that open source is more secure, on average, than proprietary software. Though it seems counter-intuitive, open source is available for all and therefore any flaw is immediately rectified. Good news in a world that is more and more vulnerable to hackers or data breaches.
6. Who owns the data?
Here, we go back to big health IT companies –many health IT providers own the data of their customers. This creates huge issues when you are trying to transition to another system – it can make the transition longer than necessary and oftentimes, more complicated. With open source (and some nimbler IT companies), you have the rights to your data at all times.
7. Is the EHR easy for unskilled users to navigate?
All EHR design is not created equally. Not to mention, there is an incredible amount of burnout in the medical profession – and a number of sources that point to eHealth tech as part of the cause. If you are designing your own system based on open source code, this is definitely an aspect to keep in mind.
8. Is it possible to have a cloud solution?
Setting up local servers is time consuming and cumbersome – but oftentimes, so is navigating the cost and setup process of hosting your solution on the cloud. It’s not impossible – but if using an open source solution, it is one cost factor to keep in mind. Some estimates come in around $400/month for cloud hosting and maintenance.
9. Who do you go to for support and maintenance issues?
OpenEMR forums are robust. They are a community of talented developers who have an incredible amount of skill and expertise in the industry, but when you do have to pay for specialized help, there can be a hefty price tag attached. The flip-side of the coin makes an argument for having a provider on hand 24/7 who can answer your questions and consult on (or solve) any issues you might encounter.
10. What other fees might you encounter while implementing the solution?
This point is often connected to the flexibility question, as well as cloud hosting. When you decide to go open source, the user has an incredible amount of freedom. With that freedom can come a number of other, hidden costs – like we mentioned earlier with integrations (as e-prescribing modules, laboratories or clearinghouses) or hosting fees or acquiring outside assistance.
The founders of blueEHR and ZH Healthcare cut their teeth developing open source EHR, particularly OpenEMR. They started their health IT journey as some of the leading developers of OpenEMR, going so far as to be the chairman of the board for the OpenEMR non-profit. With that experience, they built blueEHR from scratch.
While we bring our own bias to the table (of course we believe that blueEHR could be the solution for most niche clinics and practices), we also understand the plethora of available eHealth solutions and the associated nuances with each. If you would like to learn more about the pros and cons of an open source EMR, reach out to us today!