Open-source health information technology: A case study of electronic medical records

• Open-source software and its associated development model hold the promise of solving enduring problems associated with healthcare software such as high cost and low adoption.
• Open-source development provides a unique platform that enlists contributions from various stakeholders toward creating a common good.
• We present a case study of open-source software in ambulatory case and demonstrate the benefits and the challenges associated with open-source development.

ObjectivesOpen-source software (OSS) has achieved widespread adoption in many domains such as server operating systems, enterprise tools, and databases. We review the status of open-source in healthcare and discuss the potential of open-source to resolve some of the challenges surrounding the wide adoption of Health IT in North America. Specifically, we address aspects that are unique to using open-source in ambulatory care. We present the case of a Canadian open-source electronic medical record system (EMR) named OSCAR that is widely adopted by primary care units and family physicians in Canada.Target audienceHealth practitioners, health technology managers and policy makers.MethodsA case study based on semi-structured interviews with various stakeholders of the EMR including users (medical and staff), developers, and service providers. In addition, we assess arguments presented in the literature for and against open-source software in healthcare in light of the OSCAR EMR.Results and conclusionsOpen-source development provides a unique platform that enlists contributions from various stakeholders toward creating a common good. As evident from the OSCAR case, the dynamics of OSS development are potential solutions for the low adoption of technology in healthcare. In particular the low cost of acquisition and maintenance, the high degree of customizability, and the community of users are important advantages of OSS EMR. On the other hand, the lack of understanding of OSS model and the unavailability of trusty support providers are unique challenges facing OSS EMR.