Hire someone is generally good advice if you cannot get the tech that makes something go, but I understand that given your level of expertise in software you justifiably feel that you should be able to self support. I would recommend looking into OpenEMR, Tolven, ClearHealth and OpenMRS all of which would be easier for someone with general Linux skills to support.

-FT

I installed both Astronaut WorldVistA and OpenVistA. I’m pretty knowledgeable about Linux and systems in general, but not so much about GT.M/MUMPS.

When I went to the VistA community (e.g. N.A.), they merely respond : “hire someone.”

As if I have the money in my small practice to hire an installation and support company.

The open source community is not really that much more helpful than proprietary companies…l

I agree wholeheartedly that the proposed solution is inadequate for the doctor. The described Explorer/Notepad solution is even less functional than dictation with either voice recognition or transcription and indexed storage. There is nothing wrong with this approach any moreso than keeping paper charts – except perhaps that it is greener than paper. Still, filling out paper and scanning would probably be an improvement. If you don’t have structured data then keeping notes as text is no better than keeping them as indexed images.

I am no fan of government certifications but they often address real needs and problems. I think we should all try to be as HIPAA compliant as possible when it comes to patient privacy, security and backup whether or not there is any certification. Keeping patient records as text files on a doctors laptop strikes me as irresponsible without clearly identified programatic, process and human resources to help the doc protect and secure it. Otherwise it is again no different than doctors keeping paper charts in the trunks of their cars.

I loudly applaud creative thinking for simpler, less expensive solutions for doctors. They deserve a lot more help than either the industry or government is giving them (HITECT and PQRI incentives notwithstanding). But, I think you do the doctor a disservice to limit your recommendation only to open source options. As many faults as the proprietary vendors have, there are at least a few proprietary products that actually do the the job for the doctor. I do like your recommendation that “if you can wait for a great open source emr, do so.

But what makes you think that the open source community is even capable of designing and creating such a solution. The industry, with its tight relationships with large numbers of providers providing input and combined with organized and well funded development staffs have been mediocre at best in coming up with that.