title: Open source EMR software: profiling, insights and hands-on analysis.
abstract: BACKGROUND
  The use of open source software in health informatics is increasingly advocated by authors in the literature. Although there is no clear evidence of the superiority of the current open source applications in the healthcare field, the number of available open source applications online is growing and they are gaining greater prominence. This repertoire of open source options is of a great value for any future-planner interested in adopting an electronic medical/health record system, whether selecting an existent application or building a new one. The following questions arise. How do the available open source options compare to each other with respect to functionality, usability and security? Can an implementer of an open source application find sufficient support both as a user and as a developer, and to what extent? Does the available literature provide adequate answers to such questions? This review attempts to shed some light on these aspects.
  
  
  OBJECTIVE
  The objective of this study is to provide more comprehensive guidance from an implementer perspective toward the available alternatives of open source healthcare software, particularly in the field of electronic medical/health records.
  
  
  METHODS
  The design of this study is twofold. In the first part, we profile the published literature on a sample of existent and active open source software in the healthcare area. The purpose of this part is to provide a summary of the available guides and studies relative to the sampled systems, and to identify any gaps in the published literature with respect to our research questions. In the second part, we investigate those alternative systems relative to a set of metrics, by actually installing the software and reporting a hands-on experience of the installation process, usability, as well as other factors.
  
  
  RESULTS
  The literature covers many aspects of open source software implementation and utilization in healthcare practice. Roughly, those aspects could be distilled into a basic taxonomy, making the literature landscape more perceivable. Nevertheless, the surveyed articles fall short of fulfilling the targeted objective of providing clear reference to potential implementers. The hands-on study contributed a more detailed comparative guide relative to our set of assessment measures. Overall, no system seems to satisfy an industry-standard measure, particularly in security and interoperability. The systems, as software applications, feel similar from a usability perspective and share a common set of functionality, though they vary considerably in community support and activity.
  
  
  CONCLUSIONS
  More detailed analysis of popular open source software can benefit the potential implementers of electronic health/medical records systems. The number of examined systems and the measures by which to compare them vary across studies, but still rewarding insights start to emerge. Our work is one step toward that goal. Our overall conclusion is that open source options in the medical field are still far behind the highly acknowledged open source products in other domains, e.g. operating systems market share.
authors: Department of Computer System & Technology, Faculty of Computer Science & IT, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia.
authors: M L M
authors: ML
authors: Kiah
authors: Faculty of Engineering, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia.
authors: Ahmed
authors: A
authors: Haiqi
authors: Department of Computer System & Technology, Faculty of Computer Science & IT, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia.
authors: B B
authors: BB
authors: Zaidan
authors: Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris, Tanjong Malim, Perak, Malaysia. Electronic address: aws.alaa@gmail.com.
authors: A A
authors: AA
authors: Zaidan
mesh_terms: D057286:Electronic Health Records / Q000458:organization & administration*; D055991:Health Records, Personal; D020407:Internet; D008498:Medical Record Linkage / Q000379:methods*; D012984:Software; D012985:Software Design
keywords: EHR; EMR; Open source software; Security; Usability