[Guest post by clinicea – cloud software for clinic management]

Which is better?

OpenMRS

OpenMRS is a patient-centric application, meaning data is captured about interactions between a health care provider and a patient. If you primarily intend to capture data about something other than the patient (for example, about lab specimens), you should consider other alternatives.

An open-source approach derives both benefits and challenges. Similar to other fields, the healthcare sector profits from the availability and constant improvement that open source offers:

• For one, it’s free.
• The possibility of modifying the source code to fit the needs of the specific niche being served, as opposed to pre-built proprietary software that cannot match this approach in terms of customization.
• Continuing software enhancements are available through the open-source community.
• Unrestricted development, enabling otherwise costly implementations on older, still common, software platforms that would not be considered by software companies as economically viable solutions.
• No marketing pressures, an important ethical point in a field where economic decisions may affect the quality of care provided.

In addition to obvious practical uses, open-source software faces challenges in being adopted as a mainstream solution in the medical field.

• User assumes more “ownership” of the solution than under proprietary licenses, including initiation of upgrades, enhancements, configuration, support of software and backup. This eventually becomes expensive as clinics do not usually afford specialized professionals in dealing with eventual errors.
• Changes in workflows and customizations are possible but not practical. For a Doctor to search out and employ a programmer would not be easy. It also defeats the purpose of deploying an EMR, as it was supposed to save the Doctor time and make things more efficient for the Clinic.
• OpenMRS does not print any prescriptions or investigation orders.
• It also does not provide any electronic billing.
• The administrator panel is not user-friendly as it is crowded with menus. Menu names are very technical and keep a user guessing their use.
• It does not provide a calendar for appointments. Apparently, Open MRS does not find it a key feature of the ‘developing nations’.
• Reliability and security of confidential data must be ensured in any medical system. This is a challenge for open source software as it provides everyone with access to the source code, including potential attackers. Any unpatched vulnerability can be used by attackers.
• Often no single source to support all aspects of the application as this is usually done via community forums and other users.

Clinicea

Clinicea is a global brand having offices in India, Singapore, Australia, Pakistan and Kenya. It provides a single extensible framework that generates clinical layouts and templates unique for each speciality without requiring any code re-write. This solution is offered as a utility service i.e. SaaS and it requires no specialized hardware. Benefits of this cloud-based solution include.

• 24 hr access. As it is hosted on a cloud, users can access it from anywhere with an internet connection.
• Clinicea takes on complete responsibility for all maintenance. In addition, geographically spread out data centres with built-in redundancy handle any type of hardware or software failure thus ensuring your system is always up.
• It uses one of the best commercial databases that are driven for performance and unlimited in size.
• No upfront costs as with standalone solutions that require in-house heavy-duty servers.
• All upgrades are included as part of your monthly subscription package, therefore, ensuring continuity despite technological advancements in hardware and software.
• Through cutting-edge technology, Clinicea is able to mimic your paper-based forms, clinical templates and the workflow of your practice. This means you are able to do what you were doing before, only faster and more efficiently.

Before making any decision I would strongly recommend that you look at the total cost of ownership of the software. $50 may look expensive especially if you are comparing it to the alternative of a solution that you can download and use for free. Ask yourself a number of questions:

1. What is the database limit of the software?
2. How much do I need to pay once my data size has hit the limit mentioned above (usually 5,500 USD to 9,000 USD)?
3. Can I access this solution from outside my clinic?
4. Can I get basic customization free of cost and how long would I need to wait for it to be done?
5. What is my AMC (Annual Maintenance Cost) per year (typically 25-40%).
6. Is all training provided once I get the solution?
7. How secure is my patient data on an open-source solution?

 

Differences between OpenMRS and Clinicea

 

Software	Open MRS	Clinicea
Specialities Supported	4	20
Typical Settings
Community Clinic	√	√
Government Hospital	×	√
Private Hospital	×	√
Physical Therapy	×	√
Multispecialty Clinic	×	√
System Features
Central concept dictionary	√	×
Security	User Authentication	User Authentication
Privilege-based access	√	√
Multiple identifiers per patient	√	×
Data entry/export	√	√
Modular architecture	√	√
Patient workflows	√	√
Cohort management	√	×
Relationships	√	√
Patient merging	√	×
Multiple Language Support	√	×
Support for complex data	√	√
Reporting tools	√	√
Person attributes	√	√
Appointments via SMS	×	√
Manage Multiple Clinics	√	√
Drug Database	×	Over 7000 generic
Pharmacy & Inventory	×	√
Calendar Scheduling	×	√
Print Prescriptions/Investigations	×	√
Medical Records	√	√
Billing and Referral	×	√
Use anytime, anywhere	Only on-premises	√
Premium Support	×	√
Unlimited Data	×	√
Customizable	√	√
Onsite Training	×	√
Patient Portal	×	√
Pricing	Free	$50 Per Month
System Requirements
Internet	Not Required	Required
Processor	1 GHz	2.5GHz
RAM	256 MB	2GB
Browser	Mozilla Firefox	Google Chrome
Server	Onsite Server Required	Not Required
Back-Up	RAID	Not Required

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References:

http://www.opensourcejournal.ro/2011-Volume03/number01/paper001-fullpaper.pdf

https://wiki.openmrs.org/display/docs/Introduction+to+OpenMRS