Question about setting up and using OpenEMR for a new practice

Management and Administration
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#1

My mother is a nurse practitioner who has expressed an interest in opening a home-based private practice to care for patients in our local community in rural Iowa/potential telehealth. She is unsure of what EMR system would be the best fit for her business and has tasked me with figuring that out.

I am 23 years old and an aspiring programmer with an interest in, and some experience with, IT, mostly entry-level software development and cybersecurity. Also, a big fan of open-source but I haven’t yet had the opportunity to contribute to any projects.

My questions are:

  1. Do you think that OpenEMR is something that I could set up for her myself?
  2. Is OpenEMR something that a lone developer could handle?
  3. What kind of timeline do you think it would take to implement OpenEMR as a solution?
  4. Is there a different solution or approach that you would recommend instead?

If you think I could set it up for her,
5. How would you recommend setting it up? (a cloud-based version, or should I install and configure the application on a secure, local machine?)

I understand that there would be quite a few challenges in taking up this sort of project and I want to be sure that I’m well-informed about how best to proceed. Thanks for any guidance you can provide and the work you do!

#2

Hi Daniel-
I’m not a dev so I can’t address all of what you’d need for dev work, but I have done a lot of customer support and user training in OpenEMR.

To your questions:

  1. I don’t know your expertise but generally speaking OpenEMR is designed to be set up and maintained by a qualified individual rather than a team of IT gurus. I can’t address installing it in the cloud but for a standalone local server it’s entirely manageable. The OpenEMR wiki has a lot of docs on the topic. Here’s the wiki front page,
    https://www.open-emr.org/wiki/index.php/OpenEMR_Wiki_Home_Page
    You might bebefit from poking around there. Keep in mind the OpenEMR project has been around a while and docs for the old versions are still there.

And here are links to installation instructions for the 2 main OSes.
https://www.open-emr.org/wiki/index.php/OpenEMR_5.0.2_Linux_Installation
https://www.open-emr.org/wiki/index.php/OpenEMR_5.0.2_Windows_Installation

  1. Lone developers very commonly manage OpenEMR. However, being a FOSS project, a lot of support and advice can be found on this forum, in the appropriate categories of postings, so you’re never truly alone. But if you’re talking about a single provider EMR instance it won’t take a lot of management; the defaults are pretty well thought out.

  2. The timeline for deployment completely depends on what your needs are. EMRs are highly specialized applications and manage very complex operations so are not put into production without some effort. Of course this is the same with any other EMR/ PM solution you’d look at. In the work I’ve done with our organizationally less complex customers it can take a couple months between the initial contact with us through system setup and training to going live.

Some considerations:

  • Would your NP need to e-prescribe medications? That capability is not included in OpenEMR, you’d need to subscribe to that service with the authorized eRx vendors, MI-Squared or ZH Health who can be contacted through the professional support page in the wiki.
    https://www.open-emr.org/wiki/index.php/Professional_Support
  • documentation of the user- side setup and also basic user workflows is available in the wiki linked above and some is also on YouTube. Just search for ‘OpenEMR’ and ignore anything for versions before 4.0
  • if she will be using the billing module, that will take some specialist expertise to setup and use. Otherwise it’s not too difficult to simply print out monthly invoices and mail them to the customers.
  • if she has any specialized data entry forms she needs to use, that will require a learning curve to grasp creating the ‘LBF’ forms.
  1. I am biased in favor of FOSS, and OpenEMR is the most mature FOSS project out there for individual- provider small practices. Other FOSS EHRs exist for much larger health systems, or some are much less capable, and I have not researched them.
    If you’re thinking of going with proprietary EHRs, the only ones within financial reach of a small practice are the ‘free’ ones which of course monetize their access to your use of the app. Some of which trade on your patient data in some fashion, and some of those involve what I consider reprehensible lapses in ethics. Besides, nearly all the ‘free’ proprietary solutions are web based, which may be an obstacle in rural areas.

Hope that answered your questions and feel free to come back with more.

By the way, if you’re a big fan of FOSS, the OpenEMR project is a great place to get experience. I started out with a brand new BS Comp Sci degree in Health Informatics, got to doing documentation for this project and am now employed by one of the Pro Support organizations.

Regards- Harley