NOSH ChartingSystem

A new open source health charting system for doctors.

Commandment #4 and #5

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Thou shall build a system that allows easy and rapid programming development and modification

I’ve gone over  some of this in the last post, so I won’t spend too much time into it again.  In brief, NOSH ChartingSystem is open source and uses PHP and Javascript as its primary programming language, so it allows for easy and rapid development and modification without fear of penalty or breaking the user license.   In the subsequent commandment about cost-benefit, this has HUGE implications for an organization using any EHR system but the benefit will be much greater.  One of the future versions of NOSH ChartingSystem, because of it’s modular nature and it’s use of PHP and Javascript (specifically jQuery), is that a pure mobile app is very possible and easy to develop.

Thou shall build a system that has consistently rapid response time and is easy for the non-computernik to use

If you check out the live demonstration, what sets NOSH ChartingSystem apart from other systems, even some other web-based EHR’s, is the speed at which information is presented to the user.  The key to this visual performance boost is AJAX.  Most web programmers will obviously know what this is, and it has revolutionized the way web pages are presented, from Google, Gmail, Amazon…you name it.  For the layperson “non-computernik” (I love that term., sounds like Mork and Mindy…oops I revealed my age, or a Kraftwerk song..too bad nobody uses it these days!), this is the way I can best describe the difference between AJAX and non-AJAX:

In the old, non-AJAX way, you tell the web page something you want and when you press Enter or click a button, the information goes to the server and if there is a lot of information related to what you asked for, the server will send that information back to you on a web page in one big package.  The web browser then has to take the time to open up the package and then organize the information so that you can see the response.  Over time, it becomes inefficient and cumbersome to do this over and over again because sometimes you only need a small snippet of the response, not the whole thing.

In the AJAX way, you tell the web page something you want and when you press Enter or click a button, only the relevant information is returned back.  From a visual standpoint, it is very efficient because you don’t have to go from one web-page to another.  You stay on the same web-page and “droplets” of information are presented when you need it, instead of one big package.  It’s also so transparent that you may not even know this is even happening as you are using the system.  This translates to sheer speed benefits, saves resources, and is  user-friendly to boot because the information is as if it was at your fingertips.

Most web-based EHR’s however, have not really kept up with the technology and when they incorporate AJAX, it is incomplete or a hodgepodge of usage here and there without any cohesiveness.

The design of NOSH ChartingSystem, with its simplistic, minimalistic user interface, was built with AJAX from the ground up.  The simple design is one of the reasons why it’s pleasant to use when I’m working with a patient.  Nothing is more distracting than a whole bunch of multi-colored boxes and information in seemingly random areas of the screen as if I’m playing “Where’s Waldo” – (I’d rather do that with my kids instead!).

Furthermore, nothing you press on the screen will seem to launch a nuclear weapon or just do nothing.  Because the information is natural to find, no tutorials are needed.  It’s very clear what you can do on the screen and poking around the system won’t cause thermonuclear war or crash the system.  The power of the system is in the live demonstration (ever wonder why most EHRs won’t let you demo it yourself?).  The great thing is that even if NOSH is not exactly the perfect system now, it can be with your input because of Commandment #4 and Commandment #3.  That is something that medical providers can feel assured about when they try out NOSH ChartingSystem.

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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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