NOSH ChartingSystem

A new open source health charting system for doctors.

3 Big Myths – An excerpt from my Indiegogo Campaign

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I’m very excited to share that today is the day my Indiegogo crowd funding campaign begins.  
Below is an excerpt from my Indiegogo campaign:

Before going into more about my project, I’d like to debunk 3 big myths regarding the state of the U.S. health care system and health care information technology, because everyone has a role to play to make a difference to making things better.
Myth #1:  Most health care providers use an electronic health record system for documenting their encounters and are easily shared to other health care providers for my medical care.
Fact:  As of 2012, there’s a 50% chance you’ll come across a health care provider who is still using a paper chart.  That’s pretty bad, considering most other industries (finance, technology, hospitality) have already moved on.   Even worse, even if a health care provider is using an electronic health record system, most systems do not reliably “talk” to each other…even among systems that are the same!   Even though legisltation was passed in 2009 to increase adoption of electronic systems, the costs are so prohibitive, especially to independent practices and primary care physicians, that a good percentage have chosen not to adopt one.
Myth #2: Health care providers make a reasonable amount of money…they ought to be able to transition to electronic health record systems without difficulty.
Fact:  There is a wide spectrum of reimbursement rates between various health care providers.  Currently, we have a health care system that values more on procedures and specialist care than on primary and preventative care.  Generally, those that value spending more time with their patients are in independent practices, especially in primary care settings, because the only way for a hospital or group practice to survive when reimbursement rates are so low (compared to overhead) is to increase the number of patients seen which equals less time with patients.  It is this same group (independent practices) that is also struggling with acquiring a proprietary electronic health record system, because they are so expensive to purchase and maintain.  I know this from experience because I was an independent solo physician myself.  Furthermore, most of these expensive systems are poorly designed and not intuitive to use.  When you couple high cost with the unknown impacts to workflow and safety due to a poor interface, it is no wonder that health care providers are skeptical about the benefits of electronic health record systems.
Myth #3:  Giving physicians a nice, low cost electronic health record is nice…but it doesn’t affect me at all. 
Fact:  It is fact (unless you’ve been living under a rock) that health care costs in the United States are stratospherically high(compared to other industrialized nations) and are unsustainable for our economy.  There are multiple factors that I believe contribute to this (but for brevity sake, I’d like to refer you to Stephen Brill’s excellent article in Time Magazine, “A Bitter Pill” here).  However, one of the biggest elephants in the room is the misguided concept that health care dollars and resources are infinite, when in fact, the delivery systems for health care are structurally finite.  This is what I call the “money pit” mentality of health care dollars.  It is essentially a “black hole” that sucks and drags down anything that goes near it or when we even talk about health care.  We throw more and more money at procedures and health care related technologies with minimal regard for cost effectiveness and its impacts on the quality of life for the individual and society.  Conversely, we are not as effective at directing resources at prevention where cost savings have been demonstrated to work (in other countries’ health care systems, for example).  And this mentality goes for electronic health record systems too.  Why does it need to cost an arm and a leg for health care providers, when it is just a tool (like pen and paper) to help them help care for their patients?  Ultimately the high cost of buying and using a proprietary, closed system will be passed down to you, the patient (even doctors are patients too!).  So yes, this health care cost problem, including the exorbitant costs of electronic health record systems, does affect us all.  Therefore, this open source project (where physicians and patients have a say) is a small attempt to say “No!” to the temptation that we live in this health care “money pit” and change the dialog of how we can work together to improve access to quality health care for everyone without throwing our economy down the tubes.
So with these myths uncovered and explained, I’d like to introduce to you my open source electronic health record system, the New Open Source Health (NOSH) ChartingSystem.

So, come see and support my Indiegogo campaign by visiting  Tell your friends, colleagues, peers, and your family members.  Because even though NOSH is a electronic health record that appeals to medical providers of all spectrums, it has significant implications and ramifications for patients.  That is why this is such an important issue and one important step for medical providers to take back their data, allowing them to practice optimally for their patients, and saying “No!” to the health care money pit.


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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