OpenEMR Success Story

A little while back I read an interesting EMR success story using the open source EMR appropriately named OpenEMR. The story is by Joe Holzer and I got his permission to republish it here for all to enjoy. You can find more about Joe on his website (not the normal website) or at his email I think you’ll enjoy his story and some of the unique ways he used OpenEMR to address some challenging problems along with his passion for open source EMR software:

I have implemented OpenEMR in a number of sites, and I advise on its use in their forums at My wife Lynne was my first “client”, and her use of FREE OpenEMR allowed her to eliminate all need for my services as her business office manager, as well as all clearinghouse costs, as it prepares both X12 and CMS 1500 directly.

Because she has a house call practice, and G3 dependability is a joke, I converted the Linux web-based OpenEMR to stand-alone on her windows tablet notebook. That works especially well with the VPN I used, since her biller is at another location entirely, but can do the billing whenever Lynne is at a hotspot without Lynne even having to be aware of it. And every night it backs itself up to our server, which is always accessible by the biller for looking at information which is no more than 24 hours old.

What Lynne gets in her practice is first and foremost the ability to eliminate all the lugging of paper records and the risk of their damage by the elements, etc., to say nothing of the nightly HIPAA backup security which paper could never afford. She uses the hotspots to connect to Allscripts for her FREE e-Rx so she can get the Medicare 2% incentive for 2009, which was simple to setup in OpenEMR both because it is open source, so can be made to do whatever the user wants for greatest efficiency and effectivity for their individual practice, and because it is designed for flexibility in configuration. In fact, the latest version, 3.1.0 just released, is the ONLY EMR system I am aware of which is operable in the native language of the user on a shared system with multiple users. So an inner-city clinic with primarily latino population, but also english speakers, need not have ALL its staff be bi-lingual. And yet it is STILL FREE.

You can see some of the support I have provided others as a volunteer at the OpenEMR forums at as ideaman911.

That ANY intelligent user would pay for a proprietary system merely makes me question their grades in economics. Checkout for details.

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.


  • That sounds good. But not all doctors are married to IT pros. If Lynne was not your wife – about how much would you have charged for your services to set it up and/or ongoing maintenance/upgrade fees?

  • Sounds like more well educated, highly trained, beautiful doctors need to marry more IT pros;-) No, I’m not available either, but I like to fend for IT pros.

    I actually don’t know Joe’s specific pricing, but I believe it would be reasonable. In fact, most open source work that I’ve seen done is usually quite reasonable. The challenges are more finding someone with the interest and time to be able to help you. The other challenge is sometimes the philosophical challenges of what happens with some of the work you pay them to do. For example, many will want the code that you paid to develop to be open source as well. Some people might not understand or appreciate what that really means and can be hard to understand to someone new to it.

  • what will it mean for a private practice looking to adopt a cheap EMR system when 2015 comes?
    Does the HITECH bill impose penalties for practices that have not adopted a CCHIT certified system?
    I would think that the penalties would be a big hindrance for private practices looking to to adopt EMRs.

  • Robert,
    First, cheap EMR doesn’t necessarily mean that you can’t get the HITECH act money. There are inexpensive EMR software that will still qualify for the EMR stimulus money.

    Also, HITECH act doesn’t require CCHIT certification at all. In fact, they’ve said that they don’t recognize the CCHIT certification, but have chosen to have their own certification criteria (which is still yet to be made official).

    The HITECH act does require you to use a “certified EHR” to receive the EMR stimulus money and eventually will be subject to 1-5% penalties to Medicare payments in a few years.

    Some practices this will be pretty significant, but others don’t really care. In fact, many are leaving Medicare behind since it pays less even without the penalties.

    All of this said, you can find a reasonable priced EMR software that will avoid the penalties as well. Just most of the reasonably priced ones aren’t CCHIT certified since they didn’t want to spend all the money to be CCHIT certified since many found no value in the certification.

  • First of all, Joe Holzer. Thanks for the kind words.

    A free open source EMR like OpenEMR can usually be installed and maintained for about 10% of the cost of the usual proprietary EMR.

    As the project leader of OpenEMR I can appreciate all of the concerns. We are currently working on CCHIT ARRA “Meaningful Use” certification and hope to have this completed by early 2010. We then intend to roll right on through to get full CCHIT Comprehensive certification by the end of 2010. We are using the 2011 certification criteria. We are already adding advanced features that are not required till 2013.

    The most common user comment is “well, it is easy to use”. The second comment is “It’s one of the best I have used”.

    OpenEMR is turning into a cutting edge, comprehensive software package.

    And yes. It is and will remain free.

    Sam Bowen, MD

  • Sam,
    10% sounds a little low from my experience. Especially with doctors who like so many things customized to their liking. However, it’s still a cost effective route if the doctor is willing to understand what it means to use open source EMR software.

    Can you help me understand why OpenEMR is going for CCHIT certification? I understand completely why you want to be a certified EHR to get the stimulus money, but I don’t understand why you’d waste development time and money to become fully CCHIT certified. Very sad.

  • Dear John,

    I have been using OpenEMR in my practice for the last six years. Getting “Certified” means adding a “bunch of stuff” that I may never use in my practice. As a practicing physician I am not particularly happy about the situation. The facts are that when we try to promote OpenEMR the first thing out the mouth of the physician is “Are you certified”. When they hear the answer “no” they just stop listening.

    Our intent at this time is to satisfy “Meaningful Use” as defined by HHS which is what is necessary for medical practices to apply for stimulus money. It is quickly becoming less clear who the certifying organization will be by the time we are ready to apply. However, CCHIT is the only functional certification body at this time. We are very much aware of the shifting sands upon which we stand and what it means to be “certified” is a moving target. “Fully certified” may soon have no meaning.

    I don’t mean to disappoint but we are just struggling with the situation as it exists.

    Sam Bowen, MD
    Open Source Medical Software

  • I understand and appreciate your struggles. I also appreciate your candor. I’ll be working my best to support your cause of informing doctors about the meaning (or lack thereof) of the term certified.

    An incredible challenge to change people’s perceptions.

  • Just to set the record straight, OpenEMR was certified as a full EMR in March of 2012.

    Anyone reading this should know that not only is OpenEMR fully Certified for MU, but that it’s a robust choice of firms that implement, host service and support OpenEMR. The 10% number cited above by Dr. Bowen is not fluff; The annual cost of ownership for an average practice of our firm’s hosted, software-as-a-service implementation of OpenEMR is between $6,000 and $10,000 in their first year, all-in. That includes installation, minor customizations, training and on-call support. In following years, it’s more like 3,000-4,000 a year.


  • While I wish that I could give an exact figure, it does vary per practice. External services such as costs for interfaces to labs and ePerscribing will obviously factor in terms of charges per office, user, providers, etc. Being that your firm #AXEO offers a SaaS-based EMR, you are probably very familiar with this.

    Access to our hosted OpenEMR offering is currently unlimited, just as it would be if you would be implementing OpenEMR on-premises or in a data center.

  • Nathan,

    Thanks for the info. AXEO provides software development services for practices that need or want their own PM and/or EMR. We are not in the generalized market with a product at this time. We can also assist HIT providers that want to transition their product to the cloud, or just move-up from their legacy system.

    We are also familiar with OpenEMR and will look into supporting it.

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