Healthc Inform Res.  2019 Apr;25(2):89-98. 10.4258/hir.2019.25.2.89.

Comparison of Open-Source Electronic Health Record Systems Based on Functional and User Performance Criteria

• Purkayastha S
• Allam R
• Maity P
• Gichoya JW

• KMID: 2445005
• DOI: http://doi.org/10.4258/hir.2019.25.2.89

Abstract

OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Electronic Health Record; Decision Support Systems; Clinical; Medical Order Entry Systems; Electronic Prescribing

MeSH Terms

Electronic Health Records*
Electronic Prescribing
Meaningful Use
Medical Order Entry Systems
Medical Records

Figure

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  Figure 1 PRISMA flowchart outlining the process of systematic review.

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  Figure 2 Flowchart illustrating the methods of the current study. EHR: Electronic Health Record.

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  Figure 3 Comparison of interest over time (August 2017 to August 2018) for the five EHR systems. EMR: Electronic Medical Record, EHR: Electronic Health Record, MRS: Medical Record System.

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  Figure 4 Interest of the five selected EHR systems by region. EMR: Electronic Medical Record, EHR: Electronic Health Record, MRS: Medical Record System.

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  Figure 5 Patient education with messages and reminders in Open Electronic Medical Record (OpenEMR).

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  Figure 6 Generation of e-prescriptions in GNU Health.

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