NOSH ChartingSystem

A new open source health charting system for doctors.

Commandment #2

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Thou shall construct modular systems – given the chaotic nature of hospitals

Although NOSH ChartingSystem was not specifically targeted for hospitals when first designed, I can say with confidence that my system was designed to be flexible and modular in the sense that it can be easily modified for different purposes.  With all the different subspecialists out there, I knew that one system type will not fit all.  On a bigger scale, with all the different doctors in one specialty, one system type will not fit all.  I’ve heard comments from current health IT advocates that doctors will have to “learn” to use their systems because they just have to.  It is clearly a lack of respect and not understanding the way a doctor works that there is so much disdain for current EHR systems.

One of the upcoming design elements that NOSH ChartingSystem will have as more and more physicians use the system is that there will be a customizable template engine that will cater to each individual user.  The engine makes it easier for each physician to customize their own EHR experience to their own workflow patterns.

One of the advantages of open source software, including NOSH ChartingSystem is that one can “take apart” the system and figure out how it is put together and using common scripting language that most computer programmers know how to use (like PHP and Javascript), one can reconfigure it to their own needs.  This is where the benefits of open source really come into play and how this really falls in the realm of possibility for meeting these 10 commandments…because of it is open.  No one entity “owns” the code.  Ultimately, the doctor owns the system that they use and they are free to modify it or ask for modifications when they want.  I don’t know the future, but I sure want the doctors to be in the driver’s seat (see Commandment #1) because they are what’s important in this investment in electronic health records.

Someone asked me, how can you make money off of this project?  Isn’t it worth something?  Yes, I feel that this project is worth something.  More importantly  however, I feel that the value of my services do not come from the code and licensing of the EHR itself, but for providing the services to successfully implement this EHR alongside with your practice.  That is what is missing in current health IT implementations these days.  They expect the doctor to pay exorbitant amounts for the product when in fact the fallacy with all of these systems is the implementation.  Common examples are the website of Drexel University professor Dr. Scot Silverstein.

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Author: shihjay

I am a family physician and previous medical director for a child abuse assessment center. I am now promoting my new electronic health record system (NOSH ChartingSystem) that I have developed and used for myself in my private practice since 2010 and now I want to share it to the rest of the doctoring world.

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