The Right Open Source (Free) EMR Model

I’ve had a huge interest in the open source EMR and Free EMR movement.  Turns out my readers are just as interested in a Free EMR as I am.  However, we probably have different reasoning.  I think the power of open source is in having a crowd of people that are all contributing and sharing in the software development.

The problem I’ve had with most open source EMR projects is that I haven’t seen any that have had a large and committed enough community to really sustain development.  Granted, it’s been a few months/years since I’ve really looked into most of the open source EMR packages, so please correct me if there are some open source EMR communities that I should consider looking at again, but I digress.  My point is that without a strong developer community, open source is not a very good alternative.

I recently came across elementalClinic which I believe is using the open source EMR development model correctly.  I’ve never used the elementalClinic EMR so I can’t comment on its featureset (although it looks like it’s a mental health EMR), but what I do find interesting is how their funding development of their open source EMR.

In a recent comment on EMR and HIPAA, Alex said that elementalClinic has 150 paying customers that are using the software with somewhere around 500 people downloading the software.  This seems like the perfect model for developing an Open Source EMR.  150 paying customers that provide a solid foundation development team for the open source project.  Now, I think that 500 is a rather small number of downloads, but is a good start to creating a vibrant community of open source developers that will build on top of the foundation 150 paying customers.

Many would wonder why the 150 paying customers would fund everyone else downloading it for free.  There are a number of different reasons as far as premium support, custom features, etc that they might be paying to receive.  However, the best reasons is because by leaving it open source they can utlize the development and feedback from those using the free, open source download of the EMR.

Plus, having the license be open source means that any one of those 150 paying customers could decide to take the code from their current EMR install and take it in another direction.  In open source they call it a fork in the development.  How easy would it be to create a foundation EMR with a fork for every specialty: pediatrics, oncology, urology, etc.  Would be pretty neat and a great reason to do open source.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • How about VistA (the software used by VA hospitals around the country).

    In my view, this is the best EMR software so far.

  • Indra,
    VistA definitely seems like a reasonable option for a hospital system EMR. However, it’s not a very good solution for a small ambulatory clinic. Thus the need for another open source EMR solution.

  • Jose,
    It’s a good question. I heard OpenEMR was getting together to try to get the CCHIT Certification way back when. I should follow up with the guy who told me about this and see if it ever happened or how it’s going now.

    Word is that there will also be a site certification for small practices similar to the one that they have available for hospitals now. That way it would cover open source EMR and in house developed EMR software.

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