I have been personally involved with groups that are looking for EMR's from small vision care offices; to my current role at a Community Mental Health organization; as well as the Vermont State Hospital.
The cost of an EMR is one small component of a decision, say a 5-10% issue. A bigger concern is support, maintenance, state reporting, and having someone help you through implementation who had done previous implementations. If there was a large organization beind a FOSS EMR that was a solid product, they would have no problem competing at the same price point the closed source EMR's are selling for. EMR's are not applications -- they are philosophies. When you commit to using an EMR the software you choose is only a small portion of the entire cost. Without a strong vendor with experience and clients to backup their product; FOSS will *always* be a non-starter for midsize to large organizations. It might make sense to the single doctor office; but even then; whats a $10k EMR that just works out of the box and you can call for support vs. something that might be broken invarious detremental ways (theres no one to sue when a patient dies because the EMR didnt save the drug alergy). This isnt VITL's fault -- it would be honestly dangerous and inappropriate for them to suggest an open source EMR for the sake of FOSS inclusion. If VITL's role was drastically different (support and develop a FOSS EMR for Vermont) then it might make sense -- but their role isn't that of developer or implementor -- its to build a network to share information between established EMR's. Please keep flames off list -- I will gladly reply. Stan On Thu, Jan 15, 2009 at 8:30 AM, Dan Connelly <[email protected] > wrote: > Balu: > > Please, let's continue a discussion on-line about VITL's position on FOSS. > > In particular, can you post to VAGUE (or re-post if I missed it) your > correspondence with Mr. Hans C. Kastensmith of Capitol Health Associates > concerning VITL's not having recommended any FOSS EMRs. > > i see that his (un-dated) reply to you is posted here: > http://www.vitl.net/uploads/1225882351.pdf > > In any case, I am curious as to what standards VITL needs and how a FOSS > system could comply. I assume that CCHIT certification is horribly > expensive and that this is part of the problem. Am I correct? > > -- Dan Connelly > > > > Balu Raman wrote: > > On 1/14/09, Stanley Brinkerhoff <[email protected]> <[email protected]> > wrote: > > > Where can I read more about your statement that "The provider is the > cheapest component of the health care system.". > > Stan > > > > It is not written any where that I know of, but one can come to that > conclusion if you do some research from the cost of one encounter with > provider. By provider I mean the Primary care provider, and does not > include specialists. By the way, primary care providers are getting > scarce. The cost of practicing is the reason and payments to primary > care hasn't kept up with the extra costs imposed by the system. My > statement is based on experience managing a primary care practice for > 20 years. If you discount all the technology, bureaucracy, insurance > executives compensation etc etc costs, the provider's cost is minimal. > Compare that with the lawyer's. > > We are wandering off the main topic of this list. If you want to > discuss you can contact me off the list. > > - balu > > > > >
