Jun 252012

As the open source community continues to grow and thrive through the popularity of such enterprise ready platforms as Red Hat, the number of open source medical applications also grows with it. The truth is, medical software is expensive. Most health care providers – doctors, hospitals, dentists, independent clinics – have been under a lot of pressure to maintain or reduce run costs while at the same time continuing to provide the quality patient care and customer service expected of the medical care industry. In an effort to control these costs, many health care organizations are looking toward open source software to help them manage their complex billing and electronic medical records. This is an especially hot topic with the United States government mandating that health care providers move from a paper based system to a primary electronic medical record system over the next two years, complete with short term financial incentives in the form of government refunds for early compliance and hefty fines for late adopters.

With that said, here is a list of some of the top open source billing and EMR software available right now.


With its long history of providing free open source electronic medical record software, FreeMED is one of the most advanced and mature EMR tools available in the industry today. A really nice feature is the ability to purchase commercial support licenses for FreeMED. In some ways, it seems like a nice middle ground for users who want to utilize open source tools, but do not have the ability to provide all of the technical support on their own that is inherent in open source products.

Features include:

  • Web based interface
  • Stores and represents its medical data as a group of “modules”, which consist of a database model and a user interfaces
  • Uses external billing software called REMITT (REMITT Electronic Medical Record Information Translation and Transmission)
  • Printing system
  • Patient scheduling
  • PDF form templating
  • HL7 interface
  • XML-RPC web services
  • Extensible, modular architecture
  • Health Insurance Portability and Accountability Act (HIPAA) compliant
  • Translations includig French, German and Japanese


OpenEMR is another solid open source electronic medical record application. It is developed and maintained by the not for profit OEMR group. It features billing, scheduling and practice management functionality along with fully integrated electronic medical records management. Like FreeMED, OpenEMR also provides the option to purchase commercial support licensing through the OEMR group.

Major features of OpenEMR

  • Multilanguage Support
  • Electronic Billing (includes Medicare)
  • Document management
  • Integrated practice management
  • E-Prescribing
  • Insurance tracking (3 insurances)
  • Easy to customize
  • Easy Installation
  • Voice recognition ready (MS Windows Operating Systems)
  • Web based (Secure access with SSL certificates)
  • Integration with external general accounting program SQL-Ledger
  • Built in Scheduler
  • Multi-facility capable
  • Prescriptions by printed script, fax or email

OpenEMR Virtual Appliance

The OpenEMR Virtual Appliance is a subset of the OpenEMR suite, and provides medical record management, scheduling, insurance billing, prescription management, accounting and several other features. This virtual appliance can run on any operating system, as long as it supports the Free VMware Player.

There is a Demo available online to see what it can do.

This is a fully functional demo, which allows you to play around with all the software packages in the appliance. Some simple configuration has been added for clearer demonstration of OpenEMR, medical billing, accounting, and access controls.


The FreeB medical billing product has been around for several years, and seems to be in a state of flux right now. It is a Perl based tool that enjoyed some popularity some years back and may see a resurgence in popularity with the new EMR mandates from the government


SmartCare is an internationally distributed electronic medical records tool that was developed by the government of Zambia. It is currently widely used in Zambia, Ethiopia and South Africa. This system was built to support clinics that need to interface internationally, but also have co-existing paper based systems. It is also built around the assumption that many of the clinics may not have ubiquitous access to telecom systems or even reliable electrical power.

Smartcare Features:

Distributed database system: Given resource constraints in developing countries such as Zambia where electricity is still not available in some parts of the nation, having Internet access throughout the nation will take many more year. SmartCare data is held at each facility in a distributed design; unlike centralized designs of most systems. Internet is not essential, merely an added benefit.

Smart Card: SmartCare uses client carried smart cards or staff carried flash drives for a lower-tech connectivity solution that works today. An individual’s health information is stored on a very compressed, secure smart card to maintain continuity of care between visits, health services and health facilities. The individual’s health record is also stored on the health facility installation database for backup and generation of facility level and health management information system reports.

Touchscreen: Making the data capture task bearable can be the most challenging part of EHR design. SmartCare extends a successful Malawi idea, where touchscreen data entry by existing staff lowers this barrier. The software works well with a touch screen monitor enabling the clinician to view and record patient data.

GIS data visualization: Aggregate health data stored at health facilities can be visualized in GIS maps. This includes live patient data as well as static data from health surveys.


XChart is an XML based open source electronic medical record management developed and maintained by the Open HealthCare Group.

The Open Healthcare Group wants to create a community of people who share the goal of improving clinical care. This community will be able to freely use our health record, X-Chart. This maximizes everyone’s access to the Open Healthcare Group technology.

The stated purpose of the software is to create an electronic system that is easier to use than paper based systems, which they admit are extremely ubiquitous because of the ease of use over most electronic systems.


OpenDental is another electronic medical records application, but with a specific focus on dental care providers.
Current versions of the software require Microsoft Windows. Earlier versions of the software had supported other operating systems, but Linux support has been dropped and the full function version is only available under the commercial license because it includes royalty bearing, licensed materials from the American Dental Association (ADA), the Code on Dental Procedures and Nomenclature (CDT).

The software has many features, and for a complete list you can check its wikipedia page.


ClearHealth is a very popular open source electronic medical record application, used by a number of large institutions, including the Primary Care Coalition network out of Maryland, USA.

Written in the PHP language and capable of running on most server configurations, Windows, Linux or Mac OS X, under Apache and MySQL (LAMP), ClearHealth is compliant with the expectations of most Open Source web-based systems.

ClearHealth is a comprehensive practice management and EMR system incorporating the key categories of functionality for scheduling, patient registration, electronic medical records and CPOE, electronic and paper billing, and SQL reporting. As an open source reference implementation of several interoperability protocols, ClearHealth has support for working with data in HL7 and Continuity of Care Record (CCR) formats.

Author Byline

Jason Phillips is author of this post; he is self acclaimed linux specialist and gadget freak.check it out his site to gain insights on medical software.

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  7 Responses to “Top Open Source Medical Billing and EMR Software”

  1. In Canada you are forgetting Oscar – http://oscarmcmaster.org

  2. Check some of the many other open source health IT solutions identified on the non-profit COSI Open Health IT web site at http://health.cositech.net Also, check out Open Health News at http://www.openhealthnews.com There are now so many high quality open health solutions for EHR, PHR, HIE, Imaging, mHealth Apps and more. Once you go ‘open health’, you’ll never go back.

  3. Those look great – my only concern is security. Will they protect patient data as well as other programs?

  4. Take a look at GNU Health – http://health.gnu.org/

  5. Hi! I know biolinux project http://www.biolinux.fac.org.ar/ and OpenVista http://sourceforge.net/projects/openvista/?source=directory by Medsphere Systems Corporation… Greats!

  6. There are customized version of OpenEMR in the market. BlueEHS from ZH healthcare is the only EHR software with customizable clinical workflows and treatment plans, making it one of the best electronic health record systems. This medical billing software enables management of all the patients and routine effectively.

  7. I think OpenEMR is the best one!!

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