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HIS stands for Hospital Information System which is integrated solution designed to manage all the hospital's operations including medical operations, clinical workflow , financial , administrative, human resources, documents, legal and inventory. HIS is basically built to manage everything in the hospital and built for every user with active role in hospital operations as managers, doctors, staff nurses, accountants, pharmacists, lab technicians.

The main aim is to ease the workflow of the connected and  intersected processes that involve different parties. However it's not just about managing but it's about reporting.

Free Open source ( FOSS ) or Proprietary commercial solutions?

One of the most active roamers about open source solutions and software that it comes without support, however that is not accurate as many open source project/ software are packed by developers and powerful community of advanced users. Another misconception about open source it's not totally free, well revenue models of open source solution is quite different than the commercial ones, some of open source provide the solution/ software for free but there is always extra fee for implementation, custom development, configuration and so on. However the user can get those services from the community, or buying a developers to customize it's modules on top of the free open source code.

Basic features required  in HIS

  • Patient admissions
  • Appointment management
  • Patient records management
  • Inpatient management
  • Laboratory management
  • Pharmacy management
  • Accounting and Financial management
  • Ward management
  • Human resources management

What Hospital Information System should has?

  • Powerful security layers

There are different user groups will access the system as doctors, nurses, employee, managers , laboratory  technicians , accountants, secretary  every group has it's own rules and modules to work on Users permissions should be granted by the system admins. Most of the HIS solutions are build as Server/ Client based solution to give the opportunity to access from multiple different devices by multiple users, departments and locations. The central server should be maintained and secured from access from unauthorised personal as well as protected from illegal activities and access.

  • Logging system

System admins should have access to all events log in their system including user activities, login events, data access etc.

  • Reporting

Reporting is a necessity in HIS, Usable HIS should has a reporting tools supported by visual presentations in down-able usable formats

  • Import/ Export tools for data

Importing and exporting data is very important tool any HIS should has to allow importing data from CSV/ excel files into the system as well as exporting them for backup purposes as well as to be used or viewed in other software as MS Excel.

  • Backup

"System without backup is unusable system", It takes few seconds  with computer glitch or human errors to lose all of the data, HIS should provide the necessary tools to backup and maintain the data. Especially patients records  and lab records in secure form.

Challenges and concerns in open source HIS

  • Implementation

Implementation is not easy even for Proprietary commercial solutions, however as the commercial ones has team to implement, the most successful open source HIS solution has powerful community world wide to implement with the help of rich powerful documentation provided by the core developers, any developer with primary  knowledge of the development stack and production environment can install  it easily.

Example of successful implementations :

- Bhamni , Open hospital, Hospital OS

  • Support

Open source solutions are often packed by powerful community of developers and advanced users as we mention before, so they provide active feedback for the core developers usually to improve the system with new feature and maintain it. However local support from local developers are much appreciated which is hard to find.

  • Upgrades

Upgrades in open source are necessity not a luxury also mainly they are free not commercial as many commercial enterprise solutions do, as the feedback cycle is active from the supported  community and as there is active users there are upgrades  released to empower the solution.

Why  open source ERPs " Enterprise resource planning " solutions are the perfect fit for build hospital solutions on top of them?

  • Modularity : They built to be modular and to extend the features based on the customer requirements. As  long the ERP is extendable and flexible it's successful.
  • Basic module exists and battle tested : They  already has the basic modules required battle tested and ready :  accounting, inventory and human resources along side with reporting
  • Support : Open source ERPs  are often backed by huge community of developers, users and implementers.
  • Battle tested  with enterprise customers. Many open source ERP already has enterprise  customers though mainly are not in healthcare but they provide enough  feedback to empower and strengthen up the ERP basic modules as accounting,  and inventory

Examples of Open source ERP with huge impact in healthcare industry :

  • Odoo ERP/ CRM has many modules built by community developers as HIS solution begin, mainly they are commercial extensions as they begin sold and the Odoo marketplace, but thats prove Odoo is the a perfect candidiate for ERP based HIS.
  • ERPNext :
  • DoliMed EMR :

Top  open source  HIS - Hospital Information System solutions

1- Bahmni

We place Bahmni on top of the list because of it's active development cycle and successful implementations in several countries.  Bahmni has been powered by powerful community including the implementers and several companies providing enterprise grade implementation  and development services over it.

Bahmni Open source HIS

Platforms : Server is based on CentosOS Linux distro. Clients run on Windows, Linux and Mac OSX so as iPhone and Android phones.

  • PACS integration ready
  • Integrating well with other open source solutions as Odoo ERP, OpenELIS for Laboratory management , OpenMRS EMR.
  • Read more about Bahmni in here.

Development status : Active

Bahmni Website

2- Open Hospital

Open Hospital is an open source HIS " Hospital Information system " from Italy to the world, it has been implemented first in St. Luke's Hospital in Uganda. Its has multi-lingual support , Open Hospital HIS has been installed on 23 hospitals in 13 countries so far, It has been installed in several countries at Africa, Afghanistan, India, Myanmar, Nepal, Italy and Greece.    

OpenHospital New Patient registration 

Open Hospital HIS is easy to install and use which will cut the training, implementation time.

Features of Open Hospital

  • Multi-lingual support
  • Multi user groups and permissions
  • EMR
  • PACS integration ready
  • DICOM viewer
  • Inpatient and ward management
  • Outpatient management
  • Laboratory management
  • Rich reporting tools
  • Accounting and Bill management
  • Pharmacy management
  • Specific modules for pregnancy, vaccination, Therapy followup and Malnutrition control management
  • Internal chat  module for the system users
  • SMS patient's reminder

Platforms : Linux, Windows and MacOSX

Development status : Active

Website , Open Hospital Download

3- HospitalRun

Open source HIS solution built to serve rural and poor areas, HospitalRun has been built over offline first concept to allow the system to run while there is no connection utilising new web development concept which is not seen yet in most of the open source HIS. HospitalRun has been in active development since its first release. It provides a rich developer documentation for developer and implementers to install it, use it and start developing over it. For more information we have wrote an quick review about HospitalRun few months back here.

HospitalRun Patient Management 

Features of HospitalRun

  • Battle tested clinical workflow
  • Patient record management
  • Pharmacy management
  • Laboratory management
  • Medical Imagining management and integration with the existing systems
  • Medication management
  • Billing management

Development status : Active

Website , HospitalRun download and installation , code

4- GNU Health

GNU Health has been released years ago, as full featured EHR, with focus on more than the clinical workflow as it holds diseases database, Genetic library,  Socio-economics parameters as ( housing conditions, substance abuse, education ), Diseases and Medical procedures standards (ICD-10 / ICD-10-PCS).

Features  of GNU Health

  • Patient records management
  • Patient administration management
  • Laboratory management
  • Doctor and Staff management
  • Stock management
  • Accounting and finance management

Development status : Active

GNU Health website

5- Care2x

Care2x is PHP based Hospital Information system, It features complete clinical flow management, laboratory management, patient records, multi-user support with permissions, stock management and accounting and billing management, PACS  integration and DICOM viewer. Though Care2x has not been updated since 2015, it's still begin download and used world wide. Care2x provides some other features as CCTV integration which has not been seen in other open source HIS.

Care2x has been built to solve problem of real-life actual large hospital that has different laboratories and serving thouthands of patients with dozen of departments. Care2x as been using outdated technologies ( for me at least ) and It has not been updated for years but it's still very large project and worth mention in this list.

Care2x 

Care2x development stack is PHP which require Apache installation of Ngnix server to be used as a server

Development status : No update since 2015

Care2x website , Care2x download page,

6 - HospitalOS

HospitalOS is an open source hospital information system from Thailand, It was built to be installed in the small hospitals in the rural area in Thailand. It uses Java and PostgreSQL. HospitalOS has been around for years, It's full featured HIS Hospital Information system yet it has not been supported or extended beyond Thailand. which is unfortunate for open source community so far.

  • Platforms :Preferred Server  : Linux.  Clients Running on Windows, Linux and MacOSX.
  • Development Status : Active

Website ,Hospital OS Download

7- ERPNext based HIS

ERPNext is the next generation open source enterprise grade ERP, It features financial management, HR management, communication tools including chat, emails, accounting and billing management, inventory management. ERPNext lead team has an eye on the healthcare industry as it joined the active modules of it's child SmarteHIS into the parent project which includes Patient management, clinical flow management, Laboratory management, Pharmacy management, Inpatient/ ward management  fully integrated with the current basic ERP modules of ERPNext.

SmarteCare : ERPNext based HIS now as ERPNext Health 

Though ERPNext does not have full marketplace now for community developed modules yet, but it's quite easy to install and use it as HIS. It's also developer friendly as it has production ready development tool to build apps and modules over it with ease for experienced developer. You may want to read our full review on it.

Platforms : Server Linux, Client : browser, mobile apps.

Development status : Active

ERPNext Website

8 - ElixirAid HIS

ElixirAid is an easy to install web based HIS, It has been built to manage hospitals with different building blocks and many departments. It focuses on easing the workflow for hospitals, with patient management modules for inpatient/ outpatient, Laboratory management, Pharmacy management, Medical staff management, and full patient portal module allowing the patient to access his records, take an appointment, Though the patient portal is very good idea yet I believe it's incomplete.

ElixirAid HIS has very easy to use user-interface, and functional modules to handle the appointments, patients registration and staff management however it seems to add more management tools to add hospital blocks/ buildings and floor for easy management.

ElixirAid HIS

ElixirAid is providing a premium version which seems to be different than the open source one. There is no use-case for the open source version

ElixirAid is written in PHP using YII Framework, It has not been updated since 2016, however it's usable as I see for small hospitals. Even though it lakes the developers documentation and the new PHP versions upgrades. There is no notes about if the current version which is release at 2016 will be compatible with the new release of YII framework and the new PHP version, but we are planning to try it out soon and update this post so keep tuned.

  • Platforms : Server : Preferred Linux Server, Clients : web browser, Mobile browsers as ElixirAid is providing responsive design
  • Development status : Last update was at September 2016, Current status Unknown
  • ElixirAID Website , Download

9- OpenEMR

OpenEMR is full featured and quite old EMR " Electronic Medical Record " open source solution, Some may see it has not to be on this list, but i believe otherwise as It has full control managing the patient flow as well as accounting and finance. It has Patient portal, DICOM viewer, Multi-users group and permissions, Reporting tools, and Database management module.

OpenEMR is backed by powerful community of experienced developers and users, and It has developer documentation about the database structure, file structure for developers to extend and integrate their apps or other open source solutions into it. Currently OpenEMR API is in development.  

We have reviewed OpenEMR covering most of it's features here.

  • Platform : Server, Client: browser, mobile browsers
  • Development status : active
  • OpenEMR website .

10 - Odoo ERP and HIS modules

Odoo is open source enterprise grade ERP " Enterprise resource planning " solution. It has many modules production ready and well tested with enterprise clients/ customers world wide. As accounting module, PoS services, Inventory management. Odoo has powerful community of developers and It's preferred by hundreds of companies around the world to develop their apps/ modules on top of it.

The last couple of years Odoo apps marketplace has received dozens of medical/ healthcare apps including EMR " Electronic Medical Records ", LIMS " Laboratory Information Management Systems" and HIS. We have written review about some of those modules and Odoo ERP impact in healthcare industry. You may read it here.

Note: Almost all of the HIS modules for Odoo are commercial sold in the Odoo Marketplace

  • Platform : Server Linux, Client : Browser, Mobile Browser and Mobile apps
  • Development Status : Active

Odoo website. Odoo Healthcare and HIS Modules.

Note : Don't hesitate to share your experience with open source HIS.


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