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If you are creating fat clients, .NET is the way to go, most likely. If you want web based, J2EE has a lot of open-source compenents you can use to get your application networked via HL7
HAPI is a java-based open source HL7 library:
http://hl7api.sourceforge.net/
JEngine can quickly route HL7 messages to & from your application:
http://jengine.org/
If your software is open source, or you can use open source components, OpenEMR can give you a leg up for clinical demographic and medical data management. It's neither .NET nor J2EE, rather it is PHP/MySQL
http://www.openemr.net/index.php

If you will be interfacing to large hospitals or medical centers, you will most likely bump into Cerner http://www.cerner.com/ or McKesson HBOC http://www.mckesson.com/homeflash.html. While these companies are a bit out of scope for your question, you might want to reserach them as they are the biggest players in the field. Good luck, it is an interesting time in the health care IT field.

-- Ignacio Valdes, MD, MS
-- Editor: Linux Medical News

Also look at openemr , an open source medical record management system. (Also on sourceforge .)

I've been working in Healthcare IT for nearly 9 years. As an open source advocate, I am really excited by the progress and interest I've seen lately in FOSS solutions in the healthcare realm. There was a time that I thought the open source model would never work in vertical markets. Boy, am I glad I was wrong! Check out LinuxMedNews to get an idea of how much is happening in this area.

Here are some links to projects that I find interesting and seem to have the most traction:

• FreeMed
• OpenEMR
• TORCH
• OiO
• WorldVistA / OpenVistA
• Care2x

There are many, many more. These are just some that came to mind. If you work in healthcare, do yourself a favor and check out this thriving community!

OpenEMR is, overall, a good application with all the features we need. However, I'm dreading the inevitable deluge of support calls I'm going to get because of the sloppy UI. For example...

Consider this screen for scheduling an appointment for a patient. The first time I went to this screen I thought I had clicked the wrong link. It just didn't seem to be about scheduling an appointment. The most prominent form is for finding a new patient... very confusing considering that I just came from a patient record where I clicked "new appointment". Then I realized that the "new appointment" form is scrunched down in the lower right corner like a bad afterthought. Even then it's confusing. The "Time" and "Duration" fields don't line up correctly. It doesn't provide a calendar with which to juxtapose the new appointment with other appointments. If you click the "first available appointment", by default it tells you that it can't find any appointments.

OpenEMR will be much better than the dreck that they've been using down in the clinic, but it's still not good enough. Hopefully I can tweak it and submit the changes back to the development group.

It is a OpenSource ( I couldn't find the license, but probably its GPL'd) Electronic Medical Record system. It looks great, I will probably be demoing it for some Doctors in the near future. ( once I get some time to install it myself, check the code etc... )

from the site: www.openemr.net
OpenEMR is a Free, Open Source medical clinic practice management and electronic medical record application. OpenEMR offers

• 1. Practice Management features for patient scheduling, patient demographics;
• 2. Electronic Medical Records, creating an on-line record of your encounters;
• 3. Ability to enter CPT and ICD codes at the end of a patient encounter;
• 4. Advanced reporting capabilities with phpMyAdmin, which is now packaged with OpenEMR;
• 5. Prescription writing capability with ability to email or print prescriptions;
• 6. HL7 support to parse HL7 messages; and
• 7. HIPAA compliance.

The $1,500 billing application is only that, a billing application for one provider. If you need to add additional providers, you need to pay additional fees. Want to send bills directly to a payer, not likely as these applications require clearinghouses or medical billing companies. Again, all this application is providing is billing, not practice management, EMR or prescriptions.

OpenEMR.net is designed to meet practice management, EMR, prescription and/or billing needs of a clinic. OpenEMR using FreeB will be able to submit bills directly to a payer, print bills, correct electronic submissions and communicate with clearinghouses or medical billing companies.

A fairer comparison of OpenEMR would be to applications such as NextGen, Medical Manager, Health Pro or MegaWest. NextGen's ASP version requires a $5,000 for setup and $595 per month per provider. In a six provider clinic with two locations the one time costs would likely be over $75,000 (migration costs of $70,000-$100,000 plus an ASP setup fee of $5,000) with ongoing costs of over $40,000 annually.

If a clinic is looking for only a billing application, that cannot be integrated with any other application then the $1,500 billing application may meet their needs. If the clinic needs a broader solution for practice management, EMR, prescriptions and billing, then OpenEMR.net or other open source applications may meet that need.

The $1,500 billing application is only that, a billing application for one provider. If you need to add additional providers, you need to pay additional fees. Want to send bills directly to a payer, not likely as these applications require clearinghouses or medical billing companies. Again, all this application is providing is billing, not practice management, EMR or prescriptions.

OpenEMR.net is designed to meet practice management, EMR, prescription and/or billing needs of a clinic. OpenEMR using FreeB will be able to submit bills directly to a payer, print bills, correct electronic submissions and communicate with clearinghouses or medical billing companies.

A fairer comparison of OpenEMR would be to applications such as NextGen, Medical Manager, Health Pro or MegaWest. NextGen's ASP version requires a $5,000 for setup and $595 per month per provider. In a six provider clinic with two locations the one time costs would likely be over $75,000 (migration costs of $70,000-$100,000 plus an ASP setup fee of $5,000) with ongoing costs of over $40,000 annually.

If a clinic is looking for only a billing application, that cannot be integrated with any other application then the $1,500 billing application may meet their needs. If the clinic needs a broader solution for practice management, EMR, prescriptions and billing, then OpenEMR.net or other open source applications may meet that need.

The $1,500 billing application is only that, a billing application for one provider. If you need to add additional providers, you need to pay additional fees. Want to send bills directly to a payer, not likely as these applications require clearinghouses or medical billing companies. Again, all this application is providing is billing, not practice management, EMR or prescriptions.

OpenEMR.net is designed to meet practice management, EMR, prescription and/or billing needs of a clinic. OpenEMR using FreeB will be able to submit bills directly to a payer, print bills, correct electronic submissions and communicate with clearinghouses or medical billing companies.

A fairer comparison of OpenEMR would be to applications such as NextGen, Medical Manager, Health Pro or MegaWest. NextGen's ASP version requires a $5,000 for setup and $595 per month per provider. In a six provider clinic with two locations the one time costs would likely be over $75,000 (migration costs of $70,000-$100,000 plus an ASP setup fee of $5,000) with ongoing costs of over $40,000 annually.

If a clinic is looking for only a billing application, that cannot be integrated with any other application then the $1,500 billing application may meet their needs. If the clinic needs a broader solution for practice management, EMR, prescriptions and billing, then OpenEMR.net or other open source applications may meet that need.

The $1,500 billing application is only that, a billing application for one provider. If you need to add additional providers, you need to pay additional fees. Want to send bills directly to a payer, not likely as these applications require clearinghouses or medical billing companies. Again, all this application is providing is billing, not practice management, EMR or prescriptions.

OpenEMR.net is designed to meet practice management, EMR, prescription and/or billing needs of a clinic. OpenEMR using FreeB will be able to submit bills directly to a payer, print bills, correct electronic submissions and communicate with clearinghouses or medical billing companies.

A fairer comparison of OpenEMR would be to applications such as NextGen, Medical Manager, Health Pro or MegaWest. NextGen's ASP version requires a $5,000 for setup and $595 per month per provider. In a six provider clinic with two locations the one time costs would likely be over $75,000 (migration costs of $70,000-$100,000 plus an ASP setup fee of $5,000) with ongoing costs of over $40,000 annually.

If a clinic is looking for only a billing application, that cannot be integrated with any other application then the $1,500 billing application may meet their needs. If the clinic needs a broader solution for practice management, EMR, prescriptions and billing, then OpenEMR.net or other open source applications may meet that need.

We are designing OpenEMR to be a replacement for applications such as Health Pro, Medical Manager and MegaWest. OpenEMR's practice management features include extensive patient demographics, ability to find the first available appointment for a provider, manage provider's by patient and multiple payers. For reporting we use phpMyAdmin, and clinics can create their own reports, or we can assist them with creating reports.

OpenEMR's electronic medical record features include creating encounters using on-line forms, prescribe drugs and save the drugs in the patients' history, and billing with ICD and CPT codes at the end of an encounter.

We have successfully submitted test data to Medi-Cal, and Medi-Cal has accepted that data as properly formatted. We have tied all of OpenEMR's fields to FreeB, and are now finalizing and testing OpenEMR for billing, and anticipate finishing these features in April 2004.

At OpenEMR.net we have videos showing OpenEMR's practice management and electronic medical record features.

We are designing OpenEMR to be a replacement for applications such as Health Pro, Medical Manager and MegaWest. OpenEMR's practice management features include extensive patient demographics, ability to find the first available appointment for a provider, manage provider's by patient and multiple payers. For reporting we use phpMyAdmin, and clinics can create their own reports, or we can assist them with creating reports.

OpenEMR's electronic medical record features include creating encounters using on-line forms, prescribe drugs and save the drugs in the patients' history, and billing with ICD and CPT codes at the end of an encounter.

We have successfully submitted test data to Medi-Cal, and Medi-Cal has accepted that data as properly formatted. We have tied all of OpenEMR's fields to FreeB, and are now finalizing and testing OpenEMR for billing, and anticipate finishing these features in April 2004.

At OpenEMR.net we have videos showing OpenEMR's practice management and electronic medical record features.