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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."
For once, the old "Foxtrot" comic-strip joke is not off-topic.
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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
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No free medicine, no free software.
Ecce Europa - Web Design for Business
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.
>You do not understand how vertical markets work at all.
Ah, disappointment... I was expecting you to disagree with me factually in some way...
Of course the existing vendors don't care about FOSS (other than to be afraid of it). Why should they? FOSS will disrupt their proprietary business model, as it is currently disrupting all proprietary software business models.
Yeah, FOSS software is how customers will be freed from being violated (to use your term) by license costs, although not support costs. There aren't going to be a bunch of developers giving out free support on IRC for this kind of specialty software. It ain't the fun stuff, that's for sure. As you say it's nothing complicated... that means boring work.
And well, it turns out that it is good for the doctor who can go to anybody for support. But if you've ever done any contracting you would know that once a customer has a vendor they trust who offers them a rate that fits their budget, they tend to stay with that vendor barring some cataclysm or bad service.
Think of it this way... FOSS gives the customer what they want... reasonable prices and no vendor lock-in. And it breaks the market wide open for anyone who wants to enter it since there are no complicated license deals/agreements. It's called "competition" and though the entrenched, established vendors would rather not have any, efforts like this seem to imply it is coming.
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.
Wow, a lucrative publishing contract! I don't have to be evil anymore. --Meteor
There are many non-profit clinincs that operate on shoe-string budgets with donated equipment and doctor time. I think many of these might be interested in a package like this.
Not all doctors make six figures and most doctors donate some time to work on indigint patients.
Cheap storage VM.