Links to Comparison of Open-Source Electronic Health Record Systems Based on Functional and User Performance Criteria [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Healthc Inform Res. 20.19 Apr;25(2):89-98
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Open-source Electronic Health Record (EHR) systems have gained importance. The main aim of our research is to guide organizational choice by comparing the features, functionality, and user-facing system performance of the five most popular open-source EHR systems.
We performed qualitative content analysis with a directed approach on recently published literature (2012-2017) to develop an integrated set of criteria to compare the EHR systems. The functional criteria are an integration of the literature, meaningful use criteria, and the Institute of Medicine’s functional requirements of EHR, whereas the user-facing system performance is based on the time required to perform basic tasks within the EHR system.
Based on the Alexa web ranking and Google Trends, the five most popular EHR systems at the time of our study were OSHERA VistA, GNU Health, the Open Medical Record System (OpenMRS), Open Electronic Medical Record (OpenEMR), and OpenEHR. We also found the trends in popularity of the EHR systems and the locations where they were more popular than others. OpenEMR met all the 32 functional criteria, OSHERA VistA met 28, OpenMRS met 12 fully and 11 partially, OpenEHR-based EHR met 10 fully and 3 partially, and GNU Health met the least with only 10 criteria fully and 2 partially.
Based on our functional criteria, OpenEMR is the most promising EHR system, closely followed by VistA. With regards to user-facing system performance, OpenMRS has superior performance in comparison to OpenEMR.
1. Comparison with Meaningful Use CriteriaIn the context of health information technology, meaningful
use is defined as the minimum US standard required for using EHR systems and for exchanging information between
providers, between providers and insurance companies,
and between providers and patients.
2. Core FunctionalitiesOpenEMR and OSEHRA VistA have all the eight-core functionalities, while other systems are lacking a few. Health
information and data, result management, decision support,
and administrative processes are the functionalities available
in all the selected EHR systems.
3. PerformanceThe top two performing systems were OpenMRS and
4. DocumentationOpenEMR, OSEHRA VistA, OpenMRS, and GNU Health
have good documentation. OSEHRA VistA has a very detailed package list including their descriptions and implementation guide.
5. ConclusionInvestigating available open-source EHR systems is necessary, but few studies have compared the existing open-source EHR systems. These studies on available open-source EHR systems are not exhaustive, especially on security and interoperability. In this study, the top five globally ranked
EHR systems were compared using integrated criteria that
we developed.Based on our findings, in terms of functionality, OpenEMR is the most promising EHR system, closely
followed by VistA. Other systems were found to be lacking
in a US-specific functional requirement, but also in some security and interoperability requirements.Regarding performance on the most common user tasks, OpenMRS achieves superior performance in comparison to OpenEMR.