NOSH ChartingSystem

A new open source health charting system for doctors.

Live Demonstration

Click here for the live demonstration (https://demo.noshchartingsystem.com)

Provider User Level Login: demo_provider

Assistant User Level Login: demo_admin

Billing User Level Login: demo_billing

Patient Portal user: demo_patient

Password (for all accounts): demo

Disclaimer:  all printing functions will not work since the demonstration site is hosted on a non-secure server.  By default and for good reason, NOSH ChartingSystem requires installation on a secure server with the HTTPS protocol turned on for printing functions to work correctly.

109 thoughts on “Live Demonstration

  1. Nice start, well thought out.

  2. I cannot get the live demo to work. When I log in, the same screen shows up, but with login and password cleared. Is it still working for you?

  3. Hey that was pretty slick, made me want to use a tablet for quick slick box picks. ( say that fast)
    does it work on android tablet?

    • I haven’t tried it on an Android tablet, but theoretically, it should; I can use it to tap on the buttons on my Android smartphone; the obvious problem with that is the screen size and the code isn’t optimized for mobile; but that’s one of the upcoming features I’d like to do in the near future.

  4. And it was fairly quick and responsive, but I lost connection to your server once.
    But then i refreshed the page (running Win 7 & IE9) and could continue.
    If it was installed locally on my server, that would not be a problem.
    So if data is stored locally it can be backed to the cloud I assume.

    how do you view the entire encounter document – to send to consultant for example?

    • Yes, data is stored locally on the server that NOSH ChartingSystem is installed. If you have documents (in PDF), those are stored on a directory (separate from the database) that you designate when you install NOSH.

      NOSH is highly dependent on Javascript on the client side. I’ve had instances where IE doesn’t cooperate at random times; I suspect that may also be why you may have lost the connection during a command. On the login page, I’ve recommended that NOSH be used on a browser such as Firefox, Chrome, or Safari; only because their implementation of their Javascript engine is more consistent and standard than IE in my experience.

      To view the entire encounter (when it is not signed yet), there is a preview button on the top above the tabs. If the encounter is signed, you view the encounter by clicking on Encounters on the patient chart menu, and click on the encounter in the grid that appears. A window appears and will show you the entire encounter (you just can’t edit it anymore, for obvious reasons).

      To send the encounter to a consultant, you click on Print in the patient chart menu, and there you can print out one or multiple signed encounters along with any other ancillary documents if need be and you can either print it as a PDF or send it via fax.

  5. OK I tried demo on my Acer A500 tab. Problems with: tap and double tap zoom screen; screen size changing; pop up keyboard does not always rise when in typing field; pop up to create signature – draw field would not line up. But I was able to navigate thru demo

  6. Thank you for your feedback. NOSH ChartingSystem optimized for mobile and tablet user interfaces is in the works. NOSH was, from the beginning, designed for a desktop screen resolution. Obviously, some features (like hover overing and getting info) will never work in mobile or tablet format. This will be a chance to hear from others what they would like to see in the future in terms of user friendly design for mobile applications!

  7. ok i used my laptop with Ubuntu on it and firefox as the client for the demo and it worked very well.
    no financial data in the demo so we can’t really see how the billing, posting of payments and reconciliation will work.
    but it was very fast and smooth on this laptop ( a recent Dell Vostro , firefox browser)

    So, to run my office i would need a server running NOSH to hold all my pt data; and then desktop / laptop / tablet clients in my exam room and office. Any fairly modern server would do?
    thanks

    • The answer is, yes. In fact, what I’m using right now that you are seeing on the demo is on a server that has a Intel quad-core processor (it’s 5 years old!) So, even if you get a used server that was developed in the past decade, you are probably fine. The server should not be used in conjunction as a desktop or for client usage (just so that if something crashes by the user, it doesn’t bring down the whole server). The minimum amount of RAM on the server is 512 MB and for storage space, 500 GB is the minimum. Most systems from the past 5 years should meet these requirements. Once the server is up and running, it should not need frequent rebooting or having inexplicable crashes (unless there’s a hardware failure going on). Hope that answers your question.

  8. Hi,

    I am an Paediatric Orthopaedic & Spine Surgeon from India.

    Saw you demo. Great work. Its well thought out.

    Like you I was not satisfied with the existing EMR that multiplied my work.
    So I started a similar project, called AuShadha at http://dreaswar.github.com/AuShadha/
    Please let me know what you think. All criticisms are welcome.

    I have my web site at http://dreaswar.com where I speak about this and my other software implementations along with my medical stuff.

    Cheers

  9. Good job. Didn’t spend much time with it but it was easy to use.

  10. GOOD JOB BUT I COULD NOT FIND THE DOCUMENTS CAN YOU PLEASE DESCRIBE

    • Can you clarify your question? Documents about NOSH such as installation, help documents? If your looking for patient documents on the live demo, there is none but you can upload a dummy pdf file to see how the document features work.

  11. I am trying your demo, but how can I enter the names of the mother and father of a pediatric patient?

    • To enter the names of the mother and/or father, open the patient’s chart. Click on Demographics. Under the Guardian heading, you can enter the pediatric patient’s name(s).

  12. Trying with the login and pass and no luck, Are they the correct ones_

  13. someone changed the password again xD, plz can you reset it ?

    • Usernames and passwords have been confirmed to be correct.

      • i have tried to access the demo_billing but still cannot. Also, it seems the demo_provider sites’ language has changed.

      • The password to demo_billing is demo which I just verified. The language was changed back to English. If it gets changed again, you can click on the name on the right upper corner, the My Information, and change Locale field, then Save.

  14. hi shihjay,

    i was able to install this in an ubuntu desktop but a lot of errors keeps on coming like when your adding a patient.

    what is the best OS will this run best?

    thanks
    bong

    • Sorry Bong,
      There was a bug in a recent update that inadverdently disabled the documents directory field during the install. Your settings for the documents directory is incorrect. To fix this, log in as admin, click on Modify Practice Settings -> Practice Information -> Documents Directory
      The value of this should be: /noshdocuments/
      This is the default value if you kept everything unchanged during the initial install from Ubuntu. Make sure you keep the trailing slash at the end.
      Save and log out.
      If you have created new patients, you’ll be missing directories (that is where the errors are coming from).
      Go to your terminal where the server is and type in:
      cd /noshdocuments
      sudo mkdir 1
      sudo chown www-data:www-data 1
      sudo chmod 755 1

      1 refers to the PID of the patient (next to the patient name when you open the chart on NOSH) – make new ones (ie 2, 3, 4, etc) if you created more than one patient.
      That should fix it. Any new patients will work correctly once the documents directory is pointed in the correct directory as instructed.

      Michael

  15. curious if this is still an active project. i’m a tech-savvy pediatrician who has been nothing less than fed-up with virtually all of the commercial options out there (having tried several of them and wasted tens of thousands of dollars!). i’m duly impressed with your usability. common sense. flows like it was actually designed by a DOCTOR (hmm…imagine that concept!).
    if you’re still actively working on this, please reach out to me.

  16. Are you still developing this product ?

  17. extremely interested to know more but I couldnt watch the demo.. needed a password..

  18. I am using safari and experienced severely delayed loading of ICD 10 codes. Not sure if it’s a cache issue or incidental to it being a demo.

  19. Can the schedule be adjusted to show an entire week?

  20. Hi are we able to modify patient access rights? I logged in as patient portal and was able edit my own medical history and delete past encounters

    • I am not able to replicate the ability to delete an encounter or other items if you are indeed logged in as a patient (demo_patient as login). By design since this is also a patient-centered longitudinal health record, the patient can make proposed changes to their medication, allergy, problem list items but it is flagged as a request between the patient and the clinician that this needs to be discussed and reconciled in the record. The flagged item is indicated by a red background when there is an edit to the items.

  21. Doctor it is possible to change the system language

  22. Hello Doctor, I have been trying out your demo for a few days now, seems good. I’m an acupuncturist and need to play around a bit more to see if Nosh will work for me. Thank you for all your work and sharing.

  23. few questions: can schedule show whole month? Is it possible to split days into two shifts? As an acupuncturist will I be able to inventory Chinese herbs in supplement section and does it keep an inventory? Would I be able to remove or rename certain titles like “vaccinations”? and can I upload intake forms?

  24. Yes, other acupuncturists that use my system have been using the Office -> Supplements section to inventory Chinese herbs. Unfortunately, the titles for Vaccines can’t be changed since my EHR uses FHIR (an API standard) that requires that. However, I’m open to changing or allow the Supplements section to be changed. You can create forms on the fly and where patients can fill out when they access their patient portal in NOSH. This can be created under Configure -> My Forms. Due to limitations on desktop space and usability, the month view is pretty limited and so I left it out. You can get a weekly view when you click on “Week View” in the schedule.

    • Hi Dr. I really love your system well the demo have not been able to install it. I was wondering if mental/behavioral and speech therapy providers and home infusion provider would be able to use Nosh

  25. Bonjour Doc, Just did an initial run through of the system, very impressive. Please keep up the work . I guess my initial query is related to “certification”. Are there any certifications right now for NOSH (ie- stage I, II, etc, merit based ?) I am so frustrated with all of this “penalties, incentive based roll-outs, etc. They seem pretty nonsensical to me. Our group has been on some sort of EMR/EHR since 2003.

    Excellent work!

    • Unfortunately, NOSH does not have any specific certifications that I’m aware of. At least in the US market, NOSH was specifically designed NOT to follow certifications that I felt were heavy-handed in their user interface requirements that were both unnecessary and detrimental to clinical workflows. That is not to say that some clinics have been using NOSH, also in clinics outside the US, that may still meet certain certifications depending on their country of practice.

  26. Once I enter the demo, I cannot enter again with another function. For example, if I enter as a provider user, clicking on the live demo goes back to that page automatically. In addition, while I am doing this in English, the demo page shows up in Spanish. I can click to translate the page, but that’s annoying.
    I am part of an agency looking into using this for our therapy staff in Israel, so I am looking for something that is simple and straightforward.

    • Thanks for your interest in NOSH. Can you clarify by what you mean by “enter again with another function?”; do you mean as another user type (like an assistant or patient?) If you plan to do that, you will need to logout as the provider user first before you can login as a different user type. Click on the username on the right-hand corner and click on Logout to do so. Also, the language is set by the user (it might have been when you logged in the most recent demo user had set the locale to Spanish). To set the language, you click on the username, then My Information and change the Locale value and Save. If you use your own version of NOSH, your owner user account should not be changed by others so your language settings will not revert back to something else. Hope that makes sense.

  27. Trying to deploy Nosh in a box within an AWS instance, tried on a xenial image, debian strech and yes even a windows server. Get as far as installing Vbox, Vagrant, Git, and cmder for Windows. Run the “vagrant plugin install vagrant-vbguest” comand followed by the “vagrant up” command and that where it ends. Ubuntu Xenial, Debian Stretch give errors and doesn’t complete the final VBox install, Windows crashes. Similar results on Google cloud computing. Would love to deploy nosh on AWS preferably, Google 2nd option and Azure a last. I have/use OpenEMR on AWS now but would prefer Nosh on a dependable cloud environment instead of a local sever. I’m a Family Physician with reasonable computing skills (zero programing) I can follow/accomplish most install instructions (Linus, BSD, Win). Nt sure if this may make a difference “https://github.com/mitchellh/vagrant-aws”.
    David Maynoldi

  28. Hi, Can NOSH be used for RTL language such as hebrew, arabic?

  29. pl let me know, where I downloaded php files that I run on local systems.

  30. when I logged init was showing everything in spanish?

    • Retry again since I changed the locale back to English. You can set this after logging in by clicking on the username at the upper right hand corner and click My Information and change the Locale value and click Save.

  31. Can I send electronic prescription (regular and controlled) with NOSH? Is there a fee to do so?

    • Currently no. Several years ago, NOSH had that capability with a vendor (cannot say due to their licensing agreement) but because my code was open source, they would not allow NOSH to continue to interface with them even for one physician/practice unless I close-source the project (they didn’t want others to know how a piece of software code talks to their system even though there is a key/secret pair; it’s a way for software developers to make more money off of software partners). It was very important to me to have this project remain open-source out of principle rather than give into the demands of rent-seeking middlemen. This is one of the major reasons why NOSH is a part of the HIE of One project where we seek to gather current technological tools and standards where physicians can be self-sovereign and patients control and own their own personal health data, stripping away the power of these middlemen so that electronic forms of physician orders and signing of notes for documentation do not belong to these rent-seeking middlemen that exist only for profit. If you want to know more, you can visit http://hieofone.org and there are links to some YouTube videos with a demo of what we’re showcasing with NOSH being the patient-centered health record but physicians use it just like they would if they ran their own NOSH.

  32. Is Nosh HIPPA compliant?

    • Yes, the software itself is HIPAA compliant; however you have to ensure that you or your practice hosts NOSH in a HIPAA compliant fashion. Most US practices using NOSH run their own server (own hardware) and backups and have HIPAA compliance polices to maintain security of the healthcare data. Others who chose not to run their own hardware and server can choose to run NOSH in a cloud-based server (like Amazon Web Services) for ease of maintenance and backups. However, you will need to set up an account with that service provider to ensure that the service they are providing you is HIPAA compliant and the service provider provides you a HIPAA business associates agreement. Typically, this will significantly increase the monthly cost of running the server in the cloud so that is why most are hosting NOSH on their own.

  33. umm, hello… how to order supplement for patient and that supplements stock could be reduced?
    sorry for bad english

  34. The menus are all in Spanish now. Please change them back to English asap! Thank you.

    • Looking at the demo site, they were all changed back to English. The way to set this is after you login, click on your user name on the upper right hand corner, click My Information (first one from the top if it’s in a language you cannot read, and set Locale to English.

  35. demo_billing user account password looks to have been changed. Please reset.

  36. I can’t login to the demo_billing user account

  37. I love that live demo is a thing. However, making an appointment is too difficult. The only avenue I could figure this out from was through the schedule. The “day view” seems to be a requirement for this as well and there is some kind of glitch where when selected nothing happens and the text on the button disappears. Making an appointment should be easy from any screen. Even when on the patient view there are so many options except to make an appointment. Please consider making this an option. I have been exploring many EHR, EMR and practice management soft wares and yours is the only one that makes this feature so limited.

  38. Dear Dr Shihjay.
    I will not need many of the modules that are part of your software.
    Can some of these modules be turned off during the installation.
    What do you charge to install the software on a web server, such as Amazon?
    What do you charge to help select and deselect the modules.
    Thank you.
    Bill Brown MD

  39. Hi, I’m not able to login with the credentials demo_provider and pwd demo. We are healthcare provider here in Bahrain.

  40. hello Doctor can i have the system like on a local pc server is it possible to install it locally and use without the internet…

    • You can install NOSH locally for testing. However, if you install the system locally without internet access, many features of NOSH will not work properly (ie ICD10/medication search, additional user/patient access if they are using different devices outside of the local area network, email and appointment notifications, care opportunities features).

      • great application point to note some of the php extensions you use are depreciated somehow so for any contributer to install the code locally is a bit hectic but good project so far.

      • Doc thanks and the demo looks nice. Any possibility of inpatient management? Also patient identity card and picture on patient page? Lastly do you mean if I install locally and anytime there is no internet access during normal usage, I will lose access to some functionality?….like is it cloud dependent?

      • Yes you are going to lose functionality with ICD10 and medication list searching as it uses online APIs for these. Other functions lost will be email/text notifications.

  41. Hi Dr shihjay from colombia, I want to ask if there is any possibilitie of making a translated version to spanish language, or if we can talk to make it work. by the way… congrats for the hard work

    • Since this project is open source and is based on Laravel, anyone who is willing to do a little coding can contribute with adding translation files. On my GitHub site (https://github.com/shihjay2/nosh2) where the source code is residing, you can see under the directories ..\resources\lang you can see the specific existing language files. More details here.

  42. My demo shows up in Spanish. What gives?

  43. demo_billing wrong pw !!!

  44. hi! great app! how can i host it on AWS?

  45. is there an admin portal?

    • Yes there is but the credentials are not provided in the live demonstration for system integrity. If you install NOSH in an AWS instance the administrator role would be the first superuser to get established and you’ll need it to register new provider and support staff users first.

      • do you have a visual tuto for the AWS installation please?

      • I don’t have a visual tutorial for the AWS installation, but here is a link to get started on creating a AWS instance. You should choose the latest Ubuntu Linux server image to start. After you complete the first set of instructions, you just need to log into your console and type in the following commands to finish the installation process.

        wget https://raw.githubusercontent.com/shihjay2/nosh2/master/droplet-nosh-install.sh
        chmod +x droplet-nosh-install.sh
        sudo ./droplet-nosh-install.sh

  46. when I tried to run the script, i got this error “” and the installation didn’t start

    when I removed “set -e” from the script, i still get the error “” bubt it started performing the script actions

    sudo sh droplet-nosh-install.sh
    droplet-nosh-install.sh: 41: droplet-nosh-install.sh: [[: not found
    droplet-nosh-install.sh: 51: read: Illegal option -e

  47. here is the error
    sudo sh droplet-nosh-install.sh
    droplet-nosh-install.sh: 41: droplet-nosh-install.sh: [[: not found
    droplet-nosh-install.sh: 51: read: Illegal option -e
    you should check the script please

  48. i dont understand…
    when should i use this command
    can you summarize from start please?

  49. ok i got it
    thanks

  50. It says

    You can now complete your new installation of NOSH ChartingSystem by browsing to :
    https:///nosh

    but nothing happen when i go to https:///nosh

    • Your domain name is not valid (https:///nosh). It must be a domain name that is registered and routed to the IP address of your AWS instance. To find out the IP address of your instance, type in ifconfig or it may be on your AWS console window (usually xxx.xxx.xx.xxx). If you don’t have a domain name registered yet, you can also just type in http://xxx.xxx.xx.xxx/nosh from your web browser to access the service and complete the install.

  51. hi!
    how do i proceed from here please
    Certbot can obtain and install HTTPS/TLS/SSL certificates. By default,
    it will attempt to use a webserver both for obtaining and installing the
    certificate.
    certbot: error: argument -d/–domains/–domain: expected one argument

    • It looks like in the install script you left the answer to the question “Enter your registered URL: ” blank when you ran the droplet-nosh-install.sh script. If you see this and if you don’t have a domain name registered with your AWS instance, then follow my reply above on how to reach your nosh via IP address. If you do have a domain name registered with your AWS instance after you installed NOSH, go to the root directory for NOSH:
      cd /noshdocuments/nosh2
      sudo ./ssl-install.sh and follow the questions and response to add the LetsEncrypt SSL certificate to your web server.

  52. none of the options are working
    ~$ cd /noshdocuments/nosh2
    ubuntu@ip-:/noshdocuments/nosh2$
    ubuntu@ip-:/noshdocuments/nosh2$ sudo ./ssl-install.sh
    ./ssl-install.sh: 12: ./ssl-install.sh: [[: not found
    ./ssl-install.sh: 17: read: Illegal option -e

    can we please have a call?
    https://hangouts.google.com/call/YryB1QxpLpzMM2xfZ9cnAEEI

  53. SSL Certificate for http://ehr.ekhealthcare.com/ set
    [ ok ] Restarting apache2 (via systemctl): apache2.service.
    Restarting Apache service.

    I think is working now

  54. Still not working
    Ce site est inaccessibleehr.ekhealthcare.com a mis trop de temps à répondre.

  55. Hi I get the following error when running ppa install:
    [RuntimeException]
    require.Chumper/Zipper is invalid, it should not contain uppercase characters. Please use chumper/zipper instead.

  56. Installed composer.phar.
    The NOSH ChartingSystem documents directory has been created.
    The NOSH ChartingSystem scan and fax directories are secured.
    The NOSH ChartingSystem documents directory is secured.
    Do not run Composer as root/super user! See https://getcomposer.org/root for details
    Creating a “nosh-cs/nosh-cs” project at “./nosh-cs”
    Installing nosh-cs/nosh-cs (dev-master 4bc190e281805bf1cc520595a5954ecf6042ed2d)
    – Downloading nosh-cs/nosh-cs (dev-master 4bc190e)
    – Installing nosh-cs/nosh-cs (dev-master 4bc190e): Extracting archive
    Created project in /noshdocuments/nosh-cs

    [RuntimeException]
    require.Chumper/Zipper is invalid, it should not contain uppercase characters. Please use chumper/zipper instead.

    create-project [-s|–stability STABILITY] [–prefer-source] [–prefer-dist] [–repository REPOSITORY] [–repository-url REPOSITORY-URL] [–add-repository] [–dev] [–no-dev] [–no-custom-installers] [–no-scripts] [–no-progress] [–no-secure-http] [–keep-vcs] [–remove-vcs] [–no-install] [–ignore-platform-req IGNORE-PLATFORM-REQ] [–ignore-platform-reqs] [–ask] [–] [] [] []

    dpkg: error processing package nosh-cs (–configure):
    subprocess installed post-installation script returned error exit status 1
    Setting up php-auth-sasl (1.0.6-1) …
    Setting up php-mail-mime (1.8.8-1) …
    Processing triggers for libc-bin (2.19-0ubuntu6.15) …
    Processing triggers for libgdk-pixbuf2.0-0:amd64 (2.30.7-0ubuntu1.8) …
    Errors were encountered while processing:
    nosh-cs
    E: Sub-process /usr/bin/dpkg returned an error code (1)

  57. New to Nosh… Does it require a static IP address for installation and use?

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