Are open source EMRs a threat to HIMSS?


You know, unless I'm misreading things, it seems that the leadership of HIMSS dislikes Rep. Pete Stark's pending health IT bill largely because--gasp--it calls for the federally-sponsored development of an open-source EMR. HIMSS CEO H. Stephen Lieber has gone so far as to say that the development of an open-source EMR by the federal government would undercut the free market. Did I hear you right, Mr. Lieber? Because somehow, that doesn't sound right.

For one thing, the market already has WorldVista, the CMS-backed effort to create an ambulatory EMR based on the VA's outstanding VistA platform, but that's another issue. If HIMSS is deeply opposed to its development, I haven't seen any evidence of it. Not only is it open source-based, but WorldVista also meets CCHIT standards, which means that non-profit hospitals can give it away and not worry about kickback accusations. (Though open-source software is free, hospitals might spend some development time customizing it, so financial concerns do come into play.)

Also, I'm a bit baffled by the idea that creating an open-source EMR interferes with market for developing commercial development of EMRs. I've been observing the development of open-source products since the movement first took root, and that just isn't how it works. Certainly, over time a mature open-source product--like today's Linux--can eventually become a corporate standard, but given the open-source development process, it takes quite some time for such products to work their way into enterprises. And if companies like Epic and NextGen and the like can't adapt and compete, with the large amount of time they have to do so, they hardly deserve their market share.

Truthfully, though I believe Rep. Stark's intentions are good; I don't think developing another open-source EMR will be any kind of panacea. For one thing, the reasons some hospitals and medical practices aren't adopting EMRs goes well beyond cost, so giving them free software isn't a solution on its own. Besides, as you know well if you're a health IT manager, adopting an open-source EMR involves a whole new level of commitment to customization, training and support. In other words, free software isn't free.

Still, I think it's a more positive and thoughtful step than many bills have proposed before, and generally speaking, I believe it's moving in the right direction. Why an organization like HIMSS would discourage its passage the way it has is frankly beyond me. If anyone at HIMSS (or elsewhere) wants to explain this to me, I'd love to hear from you. - Anne

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