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OpenEMR: Electronic Medical Records and Medical Practice Management Software

open-emr.org

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Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#81
post #68
post #58

Earlier quoted context omitted.

Your homepage there has a heavy focus on health records. Have you considered building upon the FHIR standard?

Double bonus for this, we've been working with FHIR at Lumiata and it's quite good for certain things. Difficulty is that most EMRs as is work with tabular databases, and FHIR isn't quite organized that way. It does require some work to translate the tables people usually have into that format. Still a native FHIR EMR would be really cool! [EDIT]: https://www.hl7.org/fhir/ for the interested

Lumiata looks super interesting. Ps your https is expired?

As a company trying to use machine learning to predict healthcare risk, what do you look for in a format to work with? How do you deal with incomplete data / incorrectly formatted data?

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#82
post #77

EMR is simply too messy for openEMR to put a dent in the issue. I truely wish it were different. If insurance carriers are permitted to operate across state lines in the future, i think there is a chance of a Google or Microsoft getting into the space which I think is the right way to go. Right now, the large companies managing EMR and huge monoliths that simply don't care about innovation. They are like defense cont…

Google actually gave it a shot, and then eventually gave up. https://en.wikipedia.org/wiki/Google_Health

That sounds more like a patient portal used by patients. Building something for physicians, nurses, revenue personnel, lab personnel, and practice managers is a completely different game.

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#83
My first permanent IT job was actually working with practice management software. It worked across multiple jurisdictions with fairly minimal changes - an appointment is an appointment in any country.

I actually suspect it violated several laws - I remember I had full access to a database stored offshore where patient notes were there in plain text, along with their names and addresses. I emailed the privacy commission about it but they wanted to me to name names and I was scared of losing my job.

So yeah, I hope you encrypt notes.

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#85
post #15

Earlier quoted context omitted.

As a programmer for an American EHR firm -- all of the market share already belongs to one of those companies you malign. You could not have had the government sponsor some new software which would eliminate a billion dollar software market. It's a non-starter. All the hospitals already are signed on multi-year contracts with those large providers. Some of the EHR providers began writing medical software for hospital…

> The crux you may not realize is how customized every major hospital system expects their EHR software to be. The crux that you may not realize is that this customization was done mostly to boost profits and promote vendor lock-in. This was aided by the .gov failing to make public and standardized requirements for things like medical records (and no, referring to an AAMI or whatever doc that costs serious coin to vi…

>Cerner, Allscripts, and others aren't much better.

Allscripts is a dumpster fire. I'm quitting my job that deals with them in the next 6 months and traveling.

Most of the EMRs established lock-ins when interface design was still pretty primitive compared to today: before WPF, C#, decent browsers, and javascript libraries. This sucks because we have to deal with extremely verbose code in laying things out. Meanwhile, modern web and desktop design has skyrocketed ahead of these old beasts, so they look extremely dated when we'll soon have a new generation of med students walking in who have grown up with mobile phones, tablets, Chrome, FireFox, IE11, and Win 7 and their beautiful interfaces and design by comparison.

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#86

Does anyone know of a EMR system that could house my household/personal health data? One of the struggles I have is organizing my own health data in a singular place with structured data formats, document uploads, etc. The closest thing I have found is http://mymedicalapp.com/ but it appears to have been abandoned by the developer.

picnichealth.com

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#87

Does anyone know of a EMR system that could house my household/personal health data? One of the struggles I have is organizing my own health data in a singular place with structured data formats, document uploads, etc. The closest thing I have found is http://mymedicalapp.com/ but it appears to have been abandoned by the developer.

[deleted]

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#88

Does anyone know of a EMR system that could house my household/personal health data? One of the struggles I have is organizing my own health data in a singular place with structured data formats, document uploads, etc. The closest thing I have found is http://mymedicalapp.com/ but it appears to have been abandoned by the developer.

[deleted]

Re: OpenEMR: Electronic Medical Records and Medical Practice Management Software

#90
post #68

Earlier quoted context omitted.

Double bonus for this, we've been working with FHIR at Lumiata and it's quite good for certain things. Difficulty is that most EMRs as is work with tabular databases, and FHIR isn't quite organized that way. It does require some work to translate the tables people usually have into that format. Still a native FHIR EMR would be really cool! [EDIT]: https://www.hl7.org/fhir/ for the interested

Lumiata looks super interesting. Ps your https is expired? As a company trying to use machine learning to predict healthcare risk, what do you look for in a format to work with? How do you deal with incomplete data / incorrectly formatted data?

Above all we want a data format that's consistent.

The nice thing about FHIR is that it quickly allows us to join up all the data for a single patient, and all the pieces of data we need are always in the same, standards-compliant place. It also does a good job of defining what datatype to expect when you access a part of the patient record (low bar, but yeah, medical data :( ).

The bad part about FHIR is that it's so heavily nested and flexible that it can get annoying to extract some of the data. For example, the date that something happened is accessible by a different key or keys based on the type of event that happened. Same with trying to access what doctor was responsible for that event. That's meaningful medically, and one-size-fits-all in these things is hard, but I have to jump through all sorts of hoops to get to it and write lots of "if this then that" code to get the same information. There are also some odd omissions. For example ethnicity isn't super consistently represented.

For incomplete data, we deal with very large numbers of patients so some of that washes out in the aggregate as we build models. If the data for a given patient is truly incomplete, we then simply don't use that patient. We do a few other things, but can't go into much detail here ;).

Incorrectly formatted data drives me nuts. It's super manual. We pass things through a series of filters and reshaping that helps cut down on the problem, but it sucks. A lot. Not much to do but try to figure out rules for common data entry or format screwups.

re. HTTPS, yeah it's screwed up in a couple ways but we're getting it fixed. The public website has nothing to do with how we secure/transfer/handle client data though.

If you've got more questions, I'd be happy to email, feel free to reach out at ntilmans@lumiata.com

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