NOSH ChartingSystem

A new open source health charting system for doctors.



These are the major features of NOSH ChartingSystem, out-of-the-box:

Standard databases incorporated into NOSH ChartingSystem:

  • SNOMED-CT database integration
  • CPT database integration
  • ICD-10 database integration
  • FDA drug database

Chart features:

  • Active issues list
  • Medication list
  • Supplements list
  • Allergy list
  • Past encounters
  • Organized document handling system
  • Automated task reminder and alert system
  • Ability to create personalized templates for the HPI (history of illness), ROS (review of systems), and PE (physical examination).
  • Ability to create personalized electronic patient forms for the patient portal.
  • Online scheduling with individualized visit types

Provider ordering features:

  • Computerized provider order entry (CPOE)
  • E-Prescribing (integration with rCopia Dr. First; enrollment is needed to use this service and the cost is separate from the NOSH ChartingSystem as a hosted service)
  • Checks for medication interactions whenever a new prescription is made
  • Patient instructions with Vivacare online patient instructions (enrollment is needed to use this service, which is free)

Practice management features:

  • Export claims to HCFA-1500 format as a PDF document
  • Export claims as a batch or single print image text file that can uploaded to a claims clearinghouse (such as Office Ally, which is free)
  • Ability to track remaining balances to a claim
  • Ability to track revenues month-to-month or year-to-year
  • Health supplements documentation and inventory tracking
  • Vaccine documentation and inventory tracking
  • Ability to create tags for encounters, messages, and documents
  • Ability to query your patients based on age, gender, issues, diagnoses, medications, supplements, and tags

Patient Portal features:

  • Secure messaging to the provider or the provider’s assistant(s)
  • Schedule appointments online with the provider
  • Automatic appointment reminders via email or SMS
  • Review lab results and other health-care related documents in the patient’s chart
  • Patients can fill out personalized electronic forms (registration forms, social history forms, anything else you like!) that directly integrate in the patient encounter with a click of a button

Communication features:

  • Electronic fax integration with MetroFax or Ring Central (enrollment is needed and the cost is separate from using NOSH ChartingSystem as a hosted service)
  • Generate clinical summaries via a Continuity of Care Record
  • Print a partial or entire chart into PDF format, or directly fax the document
  • Export health related information in a standardized format called the C-CDA (Consolidated Clinical Document Architecture), advocated by Blue Button Plus
  • Import documents via uploading PDF’s or faxing

Pediatric features:

  • Growth charts
  • Immunization tracking
  • Well child check documentation
  • Vaccine information Sheet printouts

Future features:

  • Remote scanning
  • Electronic lab interface with PeaceHealth Labs


NOSH is designed to be modular, so some features can be “turned off” if you don’t need it.  Examples of some features in NOSH that can be extended:

  • Medicare Medication Therapy Management module
  • rCopia ePrescribing

9 thoughts on “Features

  1. What about security? PHP and MySQL platform tend to be susceptible to cross site scripting, SQL injection, and user authentication vulnerabilities. Has the application undergone any pen testing?

    • NOSH ChartingSystem is based off of Laravel for all servicable routes and authentication. I chose Laravel due to its security-aware framework (preventing cross-site scripting for all AJAX calls, SQL injection prevention in all routes, and having no passwords stored in plain text in the database or public folders). User authentication is time-limited and this also applies to any future API calls going into/out of NOSH. I have performed my own penetration testing and verification of user authentication stability. However, I invite you to do your own. As an open-source project, I invite anyone to help make it better. There is always room for improvement, even though I believe, currently, NOSH is extremely secure for production use.

  2. Is there a way to integrate pediatric growth charts (CDC) into to a pre existing child tracking database. I currently work for an early childhood program with an in house database for tracking all medical and educational data. We are looking for a way to integrate the growth charts in our system. Thanks in advance for any assistance you can offer.

  3. Where are the pediatric growth charts? I created a dummy patient in the Demo and can’t figure out how to see the height and weight.

    • Make sure your test patient is under 21 years of age. There is a Jane Doe that is 3 years of age in the demo. When you open the patient’s chart, on the the left hand side menu, there is a drop-down menu labeled Growth Charts and pick which type to view.

  4. Hello, what are the hardware requirements of the software?

  5. I have 4 questions – hoping to be able to use for rural areas:
    1. Is there a way to use NOSH without internet connection and sync data later when available?
    2. Can you add your own template for registering new patients?
    3. Can the date of birth for new patient be optional (for example, to just add age #)
    4. what are the minimum computer (laptop ok?) requirements

    • 1. You could attempt to run NOSH without an internet connection only in these circumstances, NOSH is run on a laptop and the user is working on the same laptop. If there are multiple users on different devices, you will need to be in the same local area network. However, you may run into some errors specifically for medication and ICD10 lookups since they require an internet connection to work. Also, if you plan on using the patient portal features (patient notifications, online scheduling), you will need an internet connection for others to sign in from any location outside of your local area network.

      2. You can create your own form so that patients using the patient portal can fill out a form that you created for registering new patients. However, if you plan on not using an internet connection, that functionality will be lost.

      3. The date of birth field is mandatory for adding new patients. That is because many features for the rest of the chart require the date of birth for calculations and it’s a parameter to determine what view a clinician will see. It is not calculated by numerical age; it would be very difficult to rewrite this feature without disabling may aspects of NOSH to function. If you have to register a new patient, you can put in an approximate age based on the numerical age and you can change the DOB field later on once you know the exact value. I could put in a feature to place an age and then calculate the approximate DOB in that field if you wish.

      4. Any modern computer, desktop or laptop (as long as it is no more than 20 years old) can use NOSH as long as it has a web browser. The demo server is running on a 10+ year desktop. NOSH has very little overhead.

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