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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.
Some open source ERPs (Enterprise resource planning ) started to target hospitals with customized modular applications, but not all of them are equal, you may read about that in our review: 7 Most hospital ready open-source ERP solutions.
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
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.
System admins should have access to all events log in their system including user activities, login events, data access etc.
Reporting is a necessity in HIS, Usable HIS should has a reporting tools supported by visual presentations in down-able usable formats
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.
"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.
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
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 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.
Examples of Open source ERP with huge impact in healthcare industry :
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.
Platforms : Server is based on CentosOS Linux distro. Clients run on Windows, Linux and Mac OSX so as iPhone and Android phones.
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.
Open Hospital HIS is easy to install and use which will cut the training, implementation time.
Features of Open Hospital
Platforms : Linux, Windows and MacOSX
Development status : Active
HospitalRun is an 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.
Features of HospitalRun
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
Development status : Active
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 development stack is PHP which require Apache installation of Ngnix server to be used as a server
Development status : No update since 2015
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.
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.
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.
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 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.
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.
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
Ispirithalaya is a PHP-MySQL based hospital information system, Its released as an open source project.
Note : Don't hesitate to share your experience with open source HIS.
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A physician with programming skills, Linux user since late 1990s, Open source supporter. Coding with Python, NodeJS (Meteor, VueJS, Express, D3, PhantomJS), SmallTalk & R language.