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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."
I recieved a quote for a WinOMS CS install in the $18,000 range last January. This was for an office of 5 people. We ended up turning it down and going with their local competitor's $15,000 offer, instead.
--Life may have no meaning, or, even worse, it may have a meaning of which you disapprove.
You do not understand how vertical markets work at all.
A software vendor who designs billing software for doctors, public utilities, car dealership management, etc doesn't give a shit about open source software. The software is generally accounting software that a 2nd year CS student and and accounting major could write and some sort of interface to send data to an EDI system (for billing and receivables) and whatever the accountants want to audit the books.
Plus, 1/2 of the time the "hard part" (ie EDI interface) is just some library licensed from another vendor.
We're not talking about complicated problems here... and collaborating with other developers doesn't add too much value.
The vertical market business model is to lock your customer into your software and violate him with license and support costs. And it works. If a small doctor's office gets 16,000 transactions per year, than an $8,000/yr licence "only" costs $0.50 per transaction.
If you were using open source software, the doctor could go to anybody for support... and the vertical software vendor would go out of business.
Conformity is the jailer of freedom and enemy of growth. -JFK
Just wanted to point out debian-med. A customized debian distribution cenetered around the tasks of a medical practice.
Actually there is all kinds of incentive for doctors to choose an open source medical/billing database.
The number one is cost and ease of integration with other systems. Not all doctors are rich. Some doctors run their own private practices -- and frankly I think we need more of those doctors, and less of the "How many patients can I see in fifteen minutes?" kind.
The cost of running your own private practice is huge, and any way to cut the administrative costs would be a great boon. FreeB would cut the costs in two ways, one because it's free-as-in-beer and two because it's open source and therefore easier to integrate with other systems.
Seriously, I used to date a guy (IANAW) who ran his own private practice. It's great, he gets about a half hour with every patient, he handles all his own emergency calls and he leaves a few timeslots open each day for emergency visits. It's everything you want in your doctor, but he really did bitch about the absurd costs of running Microsoft everything, as well as the absurd costs of the medical database he had to run on top of it.
An Active Directory server plus a SQL Server plus Office plus two desktops, that's a ton of bullshit for a sole proprietor to be paying for. There wasn't an open source alternative for me to recommend at the time, but I'm glad there is now, it might encourage more like him to go solo.
This project can really fill a need for low-cost, small medical practices.
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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.
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!