Slashdot Mirror
Open Source Medical Billing Software
tr0tt3r writes "There is a thriving community of people who are devoted to using Free and Open Source Software to run Medical Practices. While there are many projects that are capable of tracking patient data and scheduling functions, there has been no way to run a Doctors office using GPL software because there was no GPL Medical Billing. This is mostly due to the difficulty of handling HCFA 1500 alongside EDI formats like X12.Recently
several different projects have banded together to create FreeB the first GPL medical billing system."
For once, the old "Foxtrot" comic-strip joke is not off-topic.
Don't blame Durga. I voted for Centauri.
Gee, I can't think of a better way to waste my time. What other profession gives away their work for free? I guess software developers' time and skill is completely worthless. Congratulations!
The doctor I know is earning over $250 K per year. Commercial applications in the field come in $500-1500 range. There is no incentive for doctor to go to something with open source, since that money will be spent on something else anyway, like new chairs for the office, to have more tax write-offs.
Of course, you can give him a lecture on Richard Stallman's philosophy, but that might not work next time you need an eye exam or dental appointment.
I got my start in security doing secure medical databases and so I have been tracking this for quite some time. The real issue is not dealing with the doctors (since they rarely make the descisions) but the head nurse, billing and office managers. Plus most medical billing systems or emr systems are incredibly proprietary. It just isn't worth their time. To get to see the actual descision makers is nigh impossible anyways, unless you are going to pay for an office visit. As for rich doctors, well maybe specialists but paying off student loans and the costs of running a practice tends to eat into the moneies that doctors make for quite a while. In the long run 1500 a year just is not much of a savings in the grand sceme of things for an office. To retrain the employees would easily cost more than this and with the multi year contracts most emr and billing systems have teh window is pretty narrow too. On a 5 year contract they will start pushing for a renewal after only 2-3 years. The only way this can really spread is virally. Get it into the schools ( where the systems are usually donated anyway so not much luck there) or into a doctor's office run by your family ( then you are limited to a single site). Research databases ( what I did for a couple of years) are different in that every system is custom and there open standards are very important so you can retrieve the data forever.
BTW the systems work well together and while freeb needs some polish its well on its way.
Sorry for the rambling post
Bad Panda! No Bamboo for you! In matters of importance ACs will not be responded to. Want to say something critical,OK
No free medicine, no free software.
Ecce Europa - Web Design for Business
I used to work for a Home Health Care softare company. ( I was a part of the last big round of layoffs ). Seeing HCFA 1500 brought back a flood of memories. I was originally on the legacy AIX team, but was 'promoted' to the Windows version. I had seen a few sites that were starting to get into OSS medical software when was I first out of work but I never really looked into. Maybe I'll see what's going on and do some coding.
Just wanted to point out debian-med. A customized debian distribution cenetered around the tasks of a medical practice.
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.
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.
Richard Stallman's philosphy is NOT that the software is free of charge, it is that you are free to improve or change it because you have the source code. (free as in freedom, not free as in free beer). Open Source software is free as in freedom when you look at RedHat and other's who package working software. Sure, you can download the software for free, but the hope is that you will improve it and return it to the community as your *payment*.
Mike www.sharecube.com
And one thing I can relay is, doctors are by and large, very, very cheap in the IT area and resistant to change and if what they have works, its fine, because any change potentially could screw up their currently working cash flow from insurance companies. Also this is usually due to the huge licensing fees they are charged to get their PMS software in the first place and the support package that goes with it. Maybe this is just in the NY/NJ/PA/MD area, but I've seen DOS machines on IPX BNC networks in beautiful modern offices, or crusty old SCO *gasp* or AIX boxes, while more relaible, the staff hates using the software on them. And usually the version of their billing software was at least 5-6 years and a good many versions old. If it works, fine, right?
Well these software frankensteins are basically all patchwork to conform to the latest changes in HIPAA and EDI and just bugs in general. And as long as the doctors money still comes in, they don't care, the billing staff may have to jump thru 80 hoops every month and run odd command line batch files and scripts and patches to the patches to make sure their money comes in, but if the money is there, the doc don't care.
Now, start having the cash come in slow or late and suddenly the sky is the limit for an overhaul. Or the PMS vendor basically plays hard-ball and tells them outright "your shit is 3 versions and 5 years old, we're not supporting it anymore"
Free open source seems a shoe-in but one thing that they don't mind paying for and feel is more important than the fact they are running old,old technology is the support, cause when something is on the fritz they need someones ass to ream and have fix it. So straight open source is nice because you forgo the software licensing, but without a vendor to provide them support, they'd never go for it.
Sounds like a classic:
Sehr geehrter Toilettenbenutzer!