Top open-source electronic health records (EHR) in 2024
Compare OpenEMR vs GNU Health vs FreeMED vs OpenMRS
These are all open-source Electronic Health Record (EHR) and medical practice management systems, each designed to serve healthcare providers with different needs.
| Feature/Aspect | OpenEMR | GNU Health | FreeMED | OpenMRS |
|---|---|---|---|---|
| Purpose/Focus | Complete EHR, practice management, medical billing, and scheduling | Integrated Hospital and Health Information System (EHR, HIS) | EHR with a focus on medical billing and practice management | Platform for building and managing EHR systems, primarily in resource-limited settings |
| Target Audience | Clinics, hospitals, and health centers of all sizes | Hospitals, clinics, and health centers focused on public health and primary care | Clinics, small hospitals, and solo practices | Global health organizations, hospitals, clinics, NGOs, primarily in developing regions |
| License | Open-source (GNU General Public License v2) | Open-source (GNU General Public License v3) | Open-source (GNU General Public License v2) | Open-source (Mozilla Public License 2.0) |
| Key Features | – Medical records – Billing & insurance management – Scheduling – Lab integration – E-prescribing – Telemedicine support – Patient portal – Multilingual support | – EHR – Hospital management system – Laboratory management – Immunization tracking – Social medicine integration – Health demographics analysis – International Classification of Diseases (ICD) support | – EHR – Billing and financial management – Scheduling – Custom forms – Appointment management – Prescription management – Multilingual support | – Patient records – Encounter management – Modular and customizable architecture – Reporting and analytics – Drug management – Lab results and order tracking – Multilingual support |
| Customization | Highly customizable, supports modules and plugins | Customizable to meet specific healthcare needs, especially in public health | Limited customization, but supports custom forms and workflows | Highly customizable, modular design for different health care needs, particularly in global health |
| Scalability | Scales well from small clinics to larger hospitals | Scales to large public health systems, community healthcare | Best suited for small to mid-sized practices | Highly scalable, ideal for global health implementations in resource-constrained settings |
| User Interface (UI) | – User-friendly but somewhat outdated – Desktop and web-based | – Clean but complex – Web-based – Desktop via GNU Health HMIS (health management information system) | – Functional but dated – Desktop and web-based | – Minimalistic and functional – Web-based |
| Multilingual Support | Yes, multiple languages supported | Yes, multilingual and localization support | Yes, multilingual support | Yes, multilingual support |
| Clinical Features | – Patient records – Lab integration – Prescription management – Clinical decision support (CDSS) – Reporting and analytics – Telemedicine | – EHR with a focus on public health – Social medicine – Immunization management – Lab management – Family and community health tracking | – Patient records – Prescription management – Lab order tracking – Customizable clinical forms | – Patient records – Drug and treatment order tracking – Lab integration – Reporting and analytics for clinical outcomes |
| Billing & Financials | Full billing integration, supports insurance claims, ICD-10, CPT, and EDI | Basic billing and financial management | Comprehensive billing, insurance claims, invoicing, CPT, ICD support | No native billing, requires integration or customization for billing systems |
| Regulatory Compliance | – HIPAA compliance (with proper configuration) – Supports ICD-10, CPT, and HL7 standards | – Compliant with ICD-10 standards – Public health-focused but requires customization for country-specific compliance | – Supports ICD-10, CPT – Customizable for HIPAA and other local regulations | – ICD-10 and HL7 support – Can be adapted for compliance in specific countries |
| Telemedicine | Yes, supports integration with telemedicine tools | Not natively, but can be customized for telemedicine support | No native support, but can be integrated with third-party tools | No native telemedicine, requires third-party integration |
| Deployment Options | – On-premise – Cloud-based | – On-premise – Web-based | – On-premise – Web-based | – Web-based – Can be hosted on-premise or cloud-based |
| Mobile Support | Limited, requires third-party apps or custom integration | Limited, focuses on desktop and web | No native mobile app support | Limited, primarily web-based but mobile-friendly modules available |
| Community Support | Strong community, global reach with frequent updates | Smaller community, active in global health and public sector | Smaller community, support mainly via forums | Large, global community, with a focus on global health and low-resource settings |
| Developer Support | Strong, with an active development community and frequent updates | Active community, with global healthcare developers contributing | Smaller developer community, slower update cycle | Large developer community, open to collaboration, frequent updates |
| Security | – SSL support – Role-based access control (RBAC) – Data encryption | – Role-based access control – Data encryption – Customizable for local regulations | – Role-based access – Encryption support – Customizable | – SSL support – RBAC – Can be customized to meet various security needs |
| Integration | – HL7 and FHIR standards support – Integration with third-party systems (labs, imaging, etc.) | Integrates with third-party lab systems, customizable for HIS | Integration with labs, billing systems, and third-party applications | Integrates well with third-party systems via APIs, HL7, and custom connectors |
| Best Use Case | Comprehensive solution for clinics, hospitals, and multi-specialty practices | Public health initiatives, hospitals, and clinics focused on social medicine and community health | Small to medium-sized practices looking for an open-source EHR with billing functionality | Resource-limited settings, NGOs, global health organizations, and hospitals in developing countries |
Detailed Comparison of Key Aspects
1. Ease of Use and UI:
- OpenEMR: Has a more functional, though somewhat dated interface. It’s designed to cater to various types of healthcare providers with both web-based and desktop versions.
- GNU Health: Offers a more advanced interface but is geared towards public health systems, which may require a learning curve for small practice users.
- FreeMED: Simple, albeit outdated, interface. Best suited for small to mid-sized clinics but doesn’t have the polish of newer platforms.
- OpenMRS: Minimalistic and straightforward, designed for clinics and hospitals in resource-limited settings. It focuses on functionality over design.
2. Customization:
- OpenEMR: Extremely customizable, supports various third-party modules and plugins for specific workflows. Can be adapted to fit a wide range of healthcare needs.
- GNU Health: Highly customizable for public health systems and hospitals, but may not be as versatile in a traditional clinical setting.
- FreeMED: Offers customization through custom forms and workflows, but lacks the flexibility and modularity of OpenMRS or OpenEMR.
- OpenMRS: One of the most flexible and customizable platforms. It’s designed to be built upon and adapted for various healthcare environments, especially in resource-limited areas.
3. Global Health and Public Health Focus:
- OpenMRS and GNU Health are specifically designed with global health and public health initiatives in mind, making them ideal for community health programs, large-scale health initiatives, and hospitals in developing countries. OpenMRS is more focused on primary care and hospital systems, while GNU Health integrates more aspects of social medicine and public health.
4. Billing and Financial Management:
- OpenEMR and FreeMED both offer integrated billing systems, making them suitable for private practices or clinics that need a comprehensive billing solution.
- GNU Health and OpenMRS, while focused more on health information management, do not have strong built-in billing functionality but can be customized to include basic financial management.
5. Community and Support:
- OpenMRS and OpenEMR have the largest global communities, ensuring frequent updates and a wide range of community-driven solutions. Both systems are heavily supported by developers and users worldwide.
- GNU Health has a smaller but dedicated community, primarily focused on global health initiatives.
- FreeMED has a relatively smaller community with fewer updates, but it is stable and functional for small practices.
6. Telemedicine Support:
- OpenEMR is the only solution among these that has built-in support for telemedicine, making it a better choice for clinics wanting to offer virtual consultations without relying on third-party integrations.
Electronic Health Record (EHR) and Hospital Information System (HIS)
The terms Electronic Health Record (EHR) and Hospital Information System (HIS) refer to different but related systems used in healthcare. Below is a detailed comparison to highlight the differences between the two:
| Feature/Aspect | Electronic Health Record (EHR) | Hospital Information System (HIS) |
|---|---|---|
| Definition | An Electronic Health Record (EHR) is a digital version of a patient’s medical history, used to store and manage health information across different healthcare providers. | A Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage all aspects of a hospital’s operations, including medical, administrative, financial, and legal functionalities. |
| Primary Focus | Manages patient-specific clinical information such as medical history, diagnoses, medications, treatment plans, immunizations, allergies, lab test results, and patient progress notes. | Manages the entire hospital’s operations, including patient registration, billing, scheduling, inventory, financial records, employee data, and departmental workflows (such as pharmacy, labs, radiology). |
| Scope | Focuses on the clinical and health-related data of individual patients across different care settings. Used in clinics, hospitals, and by healthcare providers to improve patient care coordination. | Encompasses all operational, administrative, and clinical processes of a hospital or healthcare facility. It integrates various hospital departments (HR, finance, clinical, supply chain) into one unified system. |
| Data Managed | – Patient medical records – Lab results – Diagnoses and treatments – Prescriptions – Care coordination – Clinical notes | – Patient admission/discharge – Billing, payments, and insurance claims – Scheduling and appointment management – Pharmacy, radiology, and lab integration – Staff management – Inventory and supply chain management |
| Users | Primarily used by doctors, nurses, and healthcare providers for clinical care and patient record management. | Used by hospital administrators, finance departments, clinical staff, HR, and management to oversee all hospital activities and optimize resource utilization. |
| Patient Focused | Yes—designed to provide a complete medical record of the patient’s health history and current treatments, allowing for care continuity across multiple healthcare providers. | Partially—while HIS includes clinical records, it is designed to manage hospital operations in a broader sense, rather than just focusing on patient care. |
| Integration | Often integrates with lab systems, pharmacy systems, billing systems, and other healthcare systems to give a complete view of patient care. | Integrates EHR systems, financial systems, inventory management, radiology, HR, billing, and other departmental modules, making it a more comprehensive solution for hospital management. |
| Examples | – OpenEMR – Epic Systems – Cerner – Allscripts | – Meditech – SAP for Healthcare – McKesson – Cerner Millennium (as HIS) – GNU Health (as HIS + EHR) |
| Main Modules | – Clinical notes – E-prescribing – Lab results – Patient demographics – Treatment plans – Care coordination | – Patient registration – Billing and claims – Scheduling – Bed management – Staff management – Inventory and supply management – Pharmacy and lab management |
| Complexity | Typically focuses on one major aspect of healthcare—patient health records—with less emphasis on hospital-wide operations. | A more complex, integrated system that handles multiple departments and functions within a hospital, from patient care to HR, finance, and supply chain management. |
| Access and Usage | Designed for real-time access by multiple healthcare providers (doctors, nurses, lab technicians) to support clinical decisions and coordinate patient care. | Used by administrative staff, management, and clinical staff for managing patient records, hospital workflows, scheduling, finances, inventory, and more. |
| Regulatory Compliance | Must comply with clinical standards and healthcare regulations (e.g., HIPAA in the US, GDPR in Europe) to ensure the privacy and security of patient health information. | Must comply with both clinical regulations (e.g., HIPAA, GDPR) and administrative regulations (e.g., financial and operational laws) that govern hospital operations. |
| Examples of Use | – A doctor using the EHR to access a patient’s past medical history and prescribe medication. – A lab technician entering test results into the patient’s EHR. | – A hospital using HIS to track patient admissions, manage billing, process insurance claims, and schedule surgeries. – The pharmacy department using HIS to manage drug inventory and prescribe medicines. |
| Deployment | EHR systems can be stand-alone or integrated into larger systems, often available as both on-premise and cloud-based solutions. | HIS is usually complex, integrated, and deployed on a larger scale as a hospital-wide system, often hosted on-premise or cloud-based in larger facilities. |
OpenEMR
OpenEMR is an open-source electronic health records (EHR) and medical practice management software. If you are looking for alternatives to OpenEMR, here are some genuine open-source and proprietary alternatives that offer similar functionality, such as electronic health records (EHR), practice management, patient scheduling, and billing features:
1. GNU Health
- Type: Open-source
- Features: GNU Health is an EHR and hospital information system designed for health professionals. It supports primary care, hospital management, and patient tracking.
- Key Functions:
- Medical record management
- Laboratory management
- Billing and financial management
- Patient demographics and appointments
- Best For: Hospitals, clinics, and health centers focused on general healthcare and primary care.
- Website: GNU Health
2. FreeMED
- Type: Open-source
- Features: FreeMED is another open-source EHR system for managing medical records, billing, and scheduling. It focuses on adaptability and can be customized to fit various medical workflows.
- Key Functions:
- Patient records and demographics
- Medical billing and insurance management
- Prescription management
- Customizable forms and workflows
- Best For: Clinics and practices that need a customizable EHR system.
- Website: FreeMED
3. OpenMRS
- Type: Open-source
- Features: OpenMRS is a flexible, community-developed platform used to manage medical records. It is widely used in developing countries and is designed to handle a variety of medical data, including patient records and reporting.
- Key Functions:
- Modular architecture allows customization
- Supports patient medical histories and encounter management
- Clinical data collection and reporting
- Multilingual support
- Best For: Global health organizations, NGOs, and hospitals with limited resources.
- Website: OpenMRS
4. Oscar EMR
- Type: Open-source
- Features: Oscar EMR is a Canadian open-source EHR solution that includes functionality for billing, patient records, and scheduling. It was initially developed for use in Ontario, Canada, but has spread globally.
- Key Functions:
- Patient management
- Billing and insurance processing
- E-prescriptions
- Lab integration
- Appointment scheduling
- Best For: Clinics and practices that need comprehensive EHR solutions with billing and appointment scheduling.
- Website: Oscar EMR
5. MedKey
- Type: Open-source
- Features: MedKey is an open-source EHR system designed to be a complete platform for medical records and practice management. It allows practitioners to maintain and track patient health records and integrates easily with third-party systems.
- Key Functions:
- Patient records and history management
- Billing and financial reports
- Appointment management
- Laboratory and radiology modules
- Best For: Small to medium-sized practices that need a simple, efficient EHR platform.
- Website: MedKey
6. Practice Fusion
- Type: Proprietary (with a free version available)
- Features: Practice Fusion is a cloud-based EHR system used by healthcare providers for patient management, charting, e-prescribing, and medical billing. While it’s not open-source, it’s widely used in smaller practices due to its user-friendly interface and free option.
- Key Functions:
- Patient charting and scheduling
- E-prescriptions
- Lab and imaging integration
- Patient referrals and clinical summaries
- Best For: Small practices, primary care providers, and outpatient clinics looking for an affordable cloud-based EHR.
- Website: Practice Fusion
7. DrChrono
- Type: Proprietary (with free trial available)
- Features: DrChrono is a comprehensive EHR and practice management solution designed to meet the needs of small to medium-sized healthcare providers. It offers patient scheduling, billing, and e-prescription capabilities.
- Key Functions:
- Patient records management
- Customizable medical templates
- Telemedicine integration
- Medical billing and scheduling
- Best For: Small to medium-sized practices, especially those offering telemedicine services.
- Website: DrChrono
8. ChARM EHR
- Type: Proprietary (with a free tier for small practices)
- Features: ChARM EHR is a cloud-based, HIPAA-compliant EHR system that focuses on patient management, telemedicine, and practice management. It’s designed for small to medium-sized practices.
- Key Functions:
- Telemedicine integration
- Electronic prescribing (eRx)
- Patient portal and engagement tools
- Billing and practice management
- Best For: Healthcare providers looking for a lightweight, cloud-based EHR solution with telemedicine capabilities.
- Website: ChARM EHR
Choosing the Right Alternative
The best alternative to OpenEMR depends on the specific needs of your practice. Here are some key considerations:
- Open-source vs. Proprietary: If you need a cost-effective, customizable solution, open-source alternatives like GNU Health, FreeMED, or OpenMRS may be the best options. For more polished and feature-complete systems, proprietary solutions like DrChrono or Practice Fusion could be better.
- Customization: Open-source systems generally allow for more flexibility in terms of customization. If your practice has unique workflows or requires specific integrations, a platform like OpenMRS or Oscar EMR may be ideal.
- Telemedicine and Cloud Support: If you need telemedicine integration or prefer a cloud-based solution, platforms like ChARM EHR or DrChrono are great options.
- Size of the Practice: Larger hospitals and health systems might benefit more from robust platforms like GNU Health, while smaller practices may prefer the simplicity of Practice Fusion or Oscar EMR.
Each of these alternatives offers a comprehensive solution that can replace or complement the features provided by OpenEMR. Depending on the needs of your practice, you can select the one that fits best.