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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 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
The first one is always free.
There is a lot of money in this niche market. Making a GPLd billing package would be the thin edge of the wedge to getting FOSS developers in the door.
FOSS developers don't work for nothing (some do). The ideal model is work for hire improving and releasing GPL'd source code. But yeah somewhere along the way in every FOSS project somebody has to give away the code to get the ball rolling. The code stays free but if an end user wants a custom change, they have to pay. The could pay the company who the bought the proprietary software to change their own system (big $$$'s since they have a monopoly on their own code), or they can go to the original developers of the GPL'd code, or even hire anyone else who is willing to learn the code base.
With FOSS development model it is true that we won't make megabucks off of royalty and license fees. But for the individual developer I think it has been that way for quite a while, anyway.
> You missed the point. :-)
Well, this time you made some
>The customers don't give a shit. A smallish medical practice has something like $2 million in "sales" per year. $5-20k is pissing in the ocean.
Customers don't care about saving 20K in licensing fees? With each upgrade? I'll bet plenty of small practices do. Anyway, money is money.
>Doctors want their shit to work so the insurance companies pay for his services. That's it. They do not care about open source and likely prefer to deal with the vendors that they know about.
That's a good point: Doctors don't care about FOSS. What they do care about is getting a good product at a reasonable price, just like any business does. But I don't think FOSS implies crap. In fact, once it is stable the quality is typically high. I'm not buying the implied argument here that FOSS doesn't work.
>The other thing is that EDI and other standards that vertical applications must adhere to are not free. The standards and specs are not open and often cost signifigant sums of money.
Standards are not patents. You only have to pay once to get the standard, so buying all the standards necessary for a FOSS is possible. They could also be donated by third parties. Also there are typically publicly available drafts of standards leading up to the final standard which are public. These are normally sufficient for getting development 90% of the way along.
Keep in mind that $20K a year can be CHEAP for a medical billing system. And while most docs are likely to be gunshy about using FOSS before it's proven, they most certainly DO care about $20K -- let alone the $150K that some of the larger practices are shelling out. Some very good tech people are beginning to recomment FOSS wherever possible, and some of them will have earned the doctors trusts. We'll see some rollouts, and it'll be interesting to see how that affects the industry as a whole. Keep in mind that while it hasn't happened yet, some of the high dollar charges are going to go away, insurance companies are looking more and more closely at medical bills. It's an important step -- and it's a da*n good thing!