NOSH ChartingSystem

A new open source health charting system for doctors.

Commandments #6, #7, and #8

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Thou shall have duplicate hardware systems

This speaks to the importance of a robust backup system.  Although this is outside the scope of what NOSH ChartingSystem can do, the fact that it is installed on a Linux web server that has proven to be rock-solid in reliability and coupled with robust backup scheme (you can backup using remote services such as a cloud server, for instance), you’ll have a professional-class system that is within reach for the solo practitioner in rural America, not just for a hospital with a top research facility.

Thou shall build and implement your system in a joint effort with real users in a real situation with real problems

This is where the power of open source software really lies.  NOSH ChartingSystem is an open source project that is meant to build a community of physician users coupled with software developers whose mission is to create a system that allows physicians to practice medicine again.  The real users are the physicians.  The real situation is providing medical care.  The real problems include how to deliver quality care in the most cost efficient manner possible.  Not cost efficient being cheap care, but cost efficient meaning being effective and meaningful care that prevents skyrocketing medical costs in the future.


Thou shall be concerned with realities of the cost and projected benefit of the computer system

This particular commandment is so important to me as one of the hallmarks of current health IT trends is that the costs of implementing an electronic health record is so astronomically high.  In my view, the cost-to-benefit ratio tilts more towards cost than the actual or even perceived benefits.  A glimpse at physician forums and blogs reveal a large level of dissatisfaction towards existing electronic health record systems…examples of de-implementations and buyers regret are frequently seen.  It should not have to be this way.  Why can’t a physician get the best of both worlds…a friendly user interface, but is affordable to maintain, and their data belongs to them and not locked to another vendor?  I think it can be done.  And it starts with the NOSH ChartingSystem.

Why is NOSH ChartingSystem a low-cost system to maintain?  Here are the reasons:

  • NOSH ChartingSystem is open-source, so there are no licensing fees to use the system.  The code is open to anyone who uses it or wants to modify it.  There are no yearly or monthly fees to use NOSH ChartingSystem.
  • NOSH ChartingSystem is recommended to be installed on other open-source systems, such as Ubuntu Linux.  This reduces costs for the medical provider and their business.  Examples of organizations and businesses that use open-source operating systems: Google, the White House, E-Trade Financial are some that come to mind.  There has been an increasing trend to move away from closed-source systems, like Microsoft, to save costs plus increased reliability, adaptability, and security.
  • For those who choose to implement NOSH ChartingSystem on a HIPAA compliant cloud-server, like Amazon EC2, the time and cost of hardware maintenance goes down as the economies of scale go up with cloud service providers.  This is an attractive option for those who do not want to hire or actively maintain server hardware, especially for large-scale implementations of NOSH ChartingSystem.
  • NOSH ChartingSystem gives you a variety of low-cost options for installation.  It’s free if you want to install it on your own.  You can absolutely do it and I’ve made it fairly easy to one to be able to do so.  However, I’m not going to assume that most physicians or medical offices will know or want to do it all on their own and so the real value for most organizations is successful implementation and transition to NOSH ChartingSystem.  That is the value that is missing since the focus of most other EHRs is the cost of the software itself; successful implementation is not really their goal once they have already received payment for their software.  That is where NOSH ChartingSystem Consulting comes in.  Who else knows more about how NOSH ChartingSystem works than the one who designed it in the first place?  If you are interested in seeing how I can help your practice with the NOSH ChartingSystem, please contact me!

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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