TECH: Open source EMRs — how open is open? And will it matter?

cAt the most excellent HISTalk blog, there’s an interview with Scott Shreeve, Medsphere Co-Founder and Chief Medical Officer. Now MrHISTalk has once again got one up on THCB as when I was due to interview Scott (or was it his brother Steve?) at TEPR, he didn’t show up — at least not in the 5 minutes window I gave him before I wondered onto the next booth! But what’s clear is that the enthusiasm of his account of how Medspehere is creating a cheap hospital EMR based on VistA has at least somewhat won over MrHISTalk, a man known for his somewhat cynical account of the likelihood of open source actually getting anywhere in health care. You should absolutely read that interview, which incidentally as much as anything really shows that MrHISTalk knows his stuff and does his homework.

On the other hand I’ve also been corresponding with another true believer, Fred Trotter, who is responsible for the FreeB open source billing system. The Medsphere guys seem to be sidestepping the question of whether they are going to put their version of the VistA code back into the open source domain. And Fred seems suspicious that they will not. I hope to have Fred (and hopefully others involved in this discussion too) writing for THCB shortly, but in the meantime go check out Fred’s credo and think about whether the radical open source philosophy he espouses is a good fit for health care, and/or whether Medsphere’s reworking of VistA is the answer for smaller hospitals, and who gets all this stuff to the small practices who really need it.

Finally, you may have noticed that I didn’t answer the question I posed in this post’s title. But for those of you who are concerned as to why this stuff matters read Joe Kraus’ (Excite founder and former dangerous 4×4 driver at the Stanford Ski lodge) article on the relative costs of working with Linux and proprietary formats. Just think about the real impact of a ten-fold reduction in IT costs in the next ten years.

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