Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

OpenEMR: Open-source medical record software

open-emr.org

Post reply on HN
Print view View original

61–70 of 95 posts

Re: OpenEMR: Open-source medical record software

#61

Post by lostlogin »

aprilthird2021 wrote: post #38
gagagaga7 wrote: post #25

Doctor here, I hate EMRs, they are oppressive, in many ways they make things worse for patients. I think the future of EMR is no EMR. An LLM that takes multimodal input (audio, video, images, observations etc etc) and outputs whatever is required (a podcast summary of clinic patients, a checklist relevant to a patient’s condition in preop) is the future. Forcing doctors, nurses and allied health to manually document…

> Multimodal LLMs will also replace much of medicine and nursing which is good. You should read up on the history of AI in medicine. 30-40 years ago they had rudimentary (by our current era understanding) systems that basically equalled and beat physicians in diagnosing and prescribing medicine to patients when given a list of symptoms (sources at the end). None of these ever had any uptake because physicians didn't…

> Ultimately credentialed professionals like medicine and law will never be replaced by LLMs because LLMs cannot be held responsible for the medical regimes they place patients under (or the legal advice they give).

It’s not quite the same as what you are saying, but things are changing quickly.

Software is diagnosing pathology in radiology now. Software made up at least 3/4 of the pixels in the MRI scans I acquire. Sometimes it makes up more than that as every second slice is made up too.

Clinic letters are being written by applications that listen to the consult with the patient and write up a summary (for the clinician to authorise).

Re: OpenEMR: Open-source medical record software

#63

Post by FloatArtifact »

gagagaga7 wrote: post #49
mikeqq2024 wrote: post #46

Earlier quoted context omitted.

"Multimodal LLMs will also replace much of medicine and nursing which is good" Mind elaborate how is this done?

For starters, ward nurses spend 25-35% of their time doing documentation. This is doing patient notes, transcribing vitals, filling in forms and checklists, logging in and out of workstations, etc etc. Much of this could be replaced by audio/video input. Secondly, if the LLM can identify at risk patients or drug checks, you don’t need a nurse or 2 nurses to dispense medications or identify at risk patients. Multimoda…

Sounds like you don't have a very good understanding of what nurses actually do nor do you appreciate them.

Re: OpenEMR: Open-source medical record software

#64

Post by tormeh »

dvh wrote: post #51

I worked in EMR company and the amount of monthly legislative changes was insane. Insurance companies always changed their data formats every month. I think they did it because if hospital's monthly export contained some error they could hold their money for couple days more. So anyway when our country switched to euro, the deadline came and the insurance company still didn't publish format for the new month. They we…

Isn't there some legal action that could have been taken against this? These are not changing requirements - this is sabotage.

Re: OpenEMR: Open-source medical record software

#65

Post by eisa01 »

shigawire wrote: post #4
Taikonerd wrote: post #2

OpenEMR seems like it could have a market opportunity, in principle. The EMR market in the US is dominated by two big, unpopular systems (Cerner and Epic). A smaller, nimbler competitor could make inroads among health systems that don't like that duopoly. Does anyone have any stories about setting up / using OpenEMR?

As someone (biased) who works with one of those two, I have a hard time believing the complexity of installing an EMR can be handled by this type of project. The challenges are not the challenges of tech. They aren't sexy. It is just really boring and complex business logic and the strength of both those companies is the vast amount of support they provide during install and future maintenance. The problem is less ab…

Why do the Epic deployments in e.g., Norway and Denmark fail?

The most recent "Helseplatformen" in Norway has not been successful according to the practitioners, citing lack of support and training

Re: OpenEMR: Open-source medical record software

#66

Post by gruturo »

oezi wrote: post #56
aprilthird2021 wrote: post #38

Earlier quoted context omitted.

> Multimodal LLMs will also replace much of medicine and nursing which is good. You should read up on the history of AI in medicine. 30-40 years ago they had rudimentary (by our current era understanding) systems that basically equalled and beat physicians in diagnosing and prescribing medicine to patients when given a list of symptoms (sources at the end). None of these ever had any uptake because physicians didn't…

Never is a very strong word. In particular considering what changed in just 100 years in medicine. It is hard to imagine that any kind of textual computer input will persist more than 20 years in the future.

Always bet on text (http://graydon2.dreamwidth.org/193447.html and on HN at https://news.ycombinator.com/item?id=8451271)

But really. Always, always bet on text. Chances are it'll work in 10000 years if we still exist.

Re: OpenEMR: Open-source medical record software

#68

Post by nradov »

dvh wrote: post #51

I worked in EMR company and the amount of monthly legislative changes was insane. Insurance companies always changed their data formats every month. I think they did it because if hospital's monthly export contained some error they could hold their money for couple days more. So anyway when our country switched to euro, the deadline came and the insurance company still didn't publish format for the new month. They we…

In the USA at least there is a single mandated technical standard for providers to send claims to payers (insurance companies). Changes to the technical format are infrequent, although some payers do change their coverage rules all the time.

https://www.cms.gov/priorities/key-initiatives/burden-reduct...

Re: OpenEMR: Open-source medical record software

#69

Post by Taikonerd »

duffpkg wrote: post #40

I was the main contributor and maintainer to OpenEMR about ~20 years ago and then decided it was irredeemable and started over with ClearHealth/HealthCloud. Shockingly some of my code code lives on (from PHP 3). I am reluctant to say don't use it but if you do please don't expose it to anything public, which sadly happens most of the time. There are some real problems that exist in that code base from a security and…

On the page, they talk about being ONC certified: [0]

Does ONC certification test for that kind of thing? They briefly mention "security"...

[0]: https://www.open-emr.org/blog/openemr-achieves-onc-certifica...

Re: OpenEMR: Open-source medical record software

#70

Post by Taikonerd »

teekert wrote: post #62

I think nowadays OpenEHR [0] is the most credible option for a FOSS EMR/EHR solution. In my understanding (not 100% sure) in Sweden OpenEHR is obligatory for hospitals. [0] https://openehr.org/

I was confused before: parent post is talking about OpenEHR with an "H", which is different from OpenEMR.

Is OpenEHR actually code, or just a set of standards? Their web page says, "openEHR is a non‑profit organisation that publishes technical standards for an EHR platform along with domain‑developed clinical models to define content."

Post reply on HN