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Open-source EHR Systems for Ambulatory Care:
A Market Assessment

Sujansky & Associates conducted an assessment of open-source EHR systems to determine their suitability for use in the ambulatory setting in the United States. The assessment identified five EHR systems that were strong candidates and performed a detailed analysis of each. These analyses covered the history of the project, the features and functions of the software, the available installation options and support resources, and the open-source licensing terms.

The project also conducted brief reviews of four additional systems that were noteworthy but not as well suited for ambulatory use in the U.S. In addition to these product assessments, the project researched the various models for open-source development in health care and analyzed the general benefits and limitations of procuring open-source EHRs for ambulatory practices. The California HealthCare Foundation published this work as an iHealthBeat Report in January 2008.

In-Depth Analyses:

  • ClearHealth
  • FreeMed
  • OpenEMR (Commercial)
  • OpenEMR (Community)
  • WorldVista EHR

Brief Reviews:
  • Indivo
  • MedSphere
  • Tolven
  • Ultimate EMR

Relevant documents:

Open-Source EHR Systems for Ambulatory Care: A Market Assessment
(link to iHealthBeat reports)
(Web site)

An Evaluation of VistA-Office EHR in the Small Practice Setting: Functional Performance, Economic Costs, and Implementation/Support Processes (Final Report)



The project assessed a total of 13 open-source systems spanning a variety of business models, technical architectures, and target markets.

The minimal criteria for inclusion in the assessment were (a) at least some clinical information-management functionality and (b) availability of some or all of the source code under an
open-source license

Sujansky & Associates researched the systems via review of publicly available documents and via interviews with the open-source project participants and clinician users of the EHRs

The project was delivered on time and on budget