NOSH ChartingSystem

A new open source health charting system for doctors.

In a race to adopt expensive and poorly functioning EHR’s, no wonder we see this…


In today’s NY Times article, it is clear that the perceived health care cost benefits from using EHR’s, with the current options available at this time, were just smoke and mirrors.  This excerpt in this article is particularly telling…

Dr. David J. Brailer, who was the nation’s first health information czar under President George W. Bush, said he still believed tens of billions of dollars could eventually be squeezed out of the health care system through the use of electronic records. In his view, the “colossal strategic error” that occurred was a result of the Obama administration’s incentive program.

“The vast sum of stimulus money flowing into health information technology created a ‘race to adopt’ mentality — buy the systems today to get government handouts, but figure out how to make them work tomorrow,” Dr. Brailer said.

Although I get what Dr. Brailer is saying, I also believe there are several other factors here at work behind this mess…

1) EHR companies stand to gain by this incentive program by giving them “license” to sell their systems at whatever astronomical cost they can.

2) Health care providers, knowing that they will be financially penalized if they don’t adopt an EHR, jump to whatever EHR they can.  Sometimes, they just jump to whoever has the most presence in their community without any regard to cost.  Or worse, some feel that the cost is “necessary” to stay competitive even though it will drown the clinic/hospital financially.

3) Health care providers stand to lose revenue because of their transition to EHR’s and the expected decreased short-term productivity (some even long-term depending on how horrible the EHR is).

4) Some health care providers may jack up their own rates to make up for the loss of revenue, shifting the cost to the payors (insurance companies, Medicare, Medicaid, and yes, patients too).

All of this leads to…guess what?  Increased health care costs.  Even with the best of scenarios, the increased cost of purchasing and maintaining a poorly functioning EHR system negates the potential health care cost benefits.

With this sobering analysis of what NOT to do when trying to incentivize physicians to use EHR’s, it’s time that we look at alternative systems with open-source licensing that fosters collaboration, innovation, and increased user friendliness.


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.

2 thoughts on “In a race to adopt expensive and poorly functioning EHR’s, no wonder we see this…

  1. It says open source, is there a repository where we can see the source code (sourceforge, github etc) and/or contribute?

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