# Please respond by Nov. 5th: Known Free/Open Source EHR/EMR Deployment Count.
**URL:** https://discourse.openehr.org/t/please-respond-by-nov-5th-known-free-open-source-ehr-emr-deployment-count/14838
**Category:** Clinical (archive)
**Created:** [3 November 2008 20:36 UTC](https://discourse.openehr.org/t/please-respond-by-nov-5th-known-free-open-source-ehr-emr-deployment-count/14838 "2008-11-03T20:36:16Z")
**Posts on this page:** 3
**Page:** 1
### Author:  [@Ignacio\_Valdes](https://discourse.openehr.org/u/Ignacio_Valdes)
#### Post date: [3 November 2008 20:36 UTC](https://discourse.openehr.org/t/please-respond-by-nov-5th-known-free-open-source-ehr-emr-deployment-count/14838/1 "2008-11-03T20:36:16Z")
The un-official, Draft 7 of the upcoming American Medical Informatics
Association Open Source Working Group white paper to be voted on
November 9th can be found [http://ignaciovaldes.com/amia](http://ignaciovaldes.com/amia). It will be
voted on for ratification on November 9th-11th or so. Action is needed
on your part to answer the question: If open source is so great why is
no one using it? There is no aggregate data that I can find to counter
this opinion. If you know of a Free/Open Source EHR/EMR deployment and
could please send three pieces of information on each deployment that
you have by Wednesday November 5th: General Location, software version
and most importantly NUMBER OF PATIENTS IN SYSTEM. This paper could
have national impact with this data. Please respond by email to
ivaldes@hal-pc.org if you are able to obtain this data.
-- IV
---
### Author:  [@Bruce\_Wilder](https://discourse.openehr.org/u/Bruce_Wilder)
#### Post date: [6 November 2008 17:36 UTC](https://discourse.openehr.org/t/please-respond-by-nov-5th-known-free-open-source-ehr-emr-deployment-count/14838/2 "2008-11-06T17:36:44Z")
Ignacio,
I cannot provide you with any numbers, but have a few
comments as to why open source systems are not widely
deployed:
1) Physicians, and probably many institutions, don't
really understand the concept of open source code, and
the potential advantages, which include cost savings,
protection against obsolescence, and the ability to
meaningfully influence the architecture of the EHR
system, among others ( I have made a few inroads with
organizations such as the American Medical
Association, the American Public Health Association,
and the American Bar Association).
2) The word open suggests to many that there is no
security (where in fact, and as you point out in your
draft, systems may be more secure (also see HIMSS
White Paper, June 2008)).
3) Proprietary systems are heavily marketed. No one
is marketing open source EHR to a comparable degree
(you make this point, but perhaps it could be
elaborated upon).
HR 6898, introduced 9/15/08 (Stark, D-CA, and Camp,
R-MI) and referred to the House Committees on Energy
and Commerce, Ways and Means, and Science and
Technology, includes making available open source
(VistA or comparable) EHR at a nominal cost, and
provides for a consortium to govern the development
and updating of such a system. Its recent White
Paper on open source EHR notwithstanding, HIMSS now
opposes these provisions. There was similar (and
successful) opposition to a plan by David Brailler,
when he was the ONCHIT, to promote open source EHR
three or four years ago. The impetus behind both of
these opposition fronts is protection of the
proprietary interests of EHR software vendors, couched
in terms of the protection of innovation (but, as you
seem to say, traditional copyright protection isn't
the exclusive path to innovation, e.g. Encarta sold
for $500+ a few years ago, and is now available on
eBay for around $25 if anybody is stupid enough to buy
it instead of using Wikipedia).
Cheers,
Bruce
> The un-official, Draft 7 of the upcoming American
> Medical Informatics
> Association Open Source Working Group white paper to
> be voted on
> November 9th can be found
> [http://ignaciovaldes.com/amia](http://ignaciovaldes.com/amia). It will be
> voted on for ratification on November 9th-11th or
> so. Action is needed
> on your part to answer the question: If open source
> is so great why is
> no one using it? There is no aggregate data that I
> can find to counter
> this opinion. If you know of a Free/Open Source
> EHR/EMR deployment and
> could please send three pieces of information on
> each deployment that
> you have by Wednesday November 5th: General
> Location, software version
> and most importantly NUMBER OF PATIENTS IN SYSTEM.
> This paper could
> have national impact with this data. Please respond
> by email to
> ivaldes@hal-pc.org if you are able to obtain this
> data.
>
> -- IV
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> openEHR-clinical mailing list
> openEHR-clinical@openehr.org
[http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical](http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical)
>
Bruce L. Wilder, MD MPH JD
Interprofessional Systems, Ltd.
436 Seventh Avenue, Suite 1050
Pittsburgh, PA 15219-1826
Tel 412 683-6015 (Toll Free 1-866-594-6015)
Fax 412 683-6430
Changing health care for the 21st century
---
### Author:  [@Ignacio\_Valdes](https://discourse.openehr.org/u/Ignacio_Valdes)
#### Post date: [6 November 2008 17:48 UTC](https://discourse.openehr.org/t/please-respond-by-nov-5th-known-free-open-source-ehr-emr-deployment-count/14838/3 "2008-11-06T17:48:03Z")
That is a good summary. I have reported on and opined in public with
similar here:
[http://linuxmednews.com/1222724497](http://linuxmednews.com/1222724497)
[http://linuxmednews.com/1222727586](http://linuxmednews.com/1222727586)
There are many motivations for AMIA OS-WG white paper and you point
out some of them. I would rather not have federal intervention, but at
the same time as you said I'd rather real solutions not be ignored.
One motivation for a count of number of patients in FOSS systems is
that it is a number that practitioners and policymakers might be able
to understand.
-- IV