Comparison and Analysis of Open Source EHR Systems Project Documentation

Comparison and Analysis
of Open Source EHR

Systems Project
By Group 7
12345-
Dr. Mohab Maysara Abd Alwahab

Dr. Alia Hassan Tarek Abaza
Dr. Caroline Galal George
Dr. Maha Mohamed Abd Elkhalek
Dr. Remon Gameel Ebed
Supervised by
Dr. Rada Hussein
Dr. Aly Khalifa
Egyptian Health informatics Fellowship

May 2012
Comparison &Analysis Of Open Source EHR Systems
Acknowledgements
Apart from the efforts of me, the success of any project depends largely on the
encouragement and guidelines of many others. We take this opportunity to express
our gratitude to the people who have been instrumental in the successful completion
of this project.
We would like to show our greatest appreciation to Prof. Rada Hussein and
Dr. Aly Khalifa. We cant say thank you enough for their tremendous support and
help. We feel motivated and encouraged every time we got their feedbacks. We
thank Eng. Basma Maysara who designed our project logo. We finally thank our
colleagues who attend our open EHR workshop and shared this experience with us.
Table of Contents
Project Name:-
Project Team:-
Project supervision:
Project Documentation:
Project Initiation:
I. The Team Work Rules
II.
The team leader responsibilities
Phase 1: Preparation
Tasks and the team responsibilities
Phase 2: Analytic comparison of EHRs
12
12
Phase 3: The real field implementation
14
14
Stage 4: Set Final Recommendations For Phyaura EHR System

Customization
16
16
Phase 5: The implementation plan
18
18
Phase 6: The training plan
18
18
The project closure:
19
19
Appendices
19
Appendix 1: The project charter
21
Appendices 2 :The project plan

Appendix 2.1: The project plan document
22
22
Appendix 2.2: The MS project plan
23
Appendix 3 :The project team meeting archiving
24
Appendix 4 :The project progress reports
25
Appendices 5: The project plan updates

Appendix 5.1: The project schedule plan update at 19-2-2012
26
26
26
26
Appendix 6 :The project final presentation
27
Appendix 7: EHRs Comparison criteria list
28
Appendices 8: Comparison Result and determining the best open EHR to

be chosen and its review
29
Appendix 8.1 : EHRs Comparison Result
29
Appendix 8.2 : Determining the best open EHR rational
30
Appendix 8.3 : EHRs Comparison Result review
31
Appendix 8.4 : Determining the best open EHR rational review
32
Appendix 9 :Evaluation list to be applied on the selected EHR
33
Appendices 10: Training program manual of the selected EHR

Appendix 10.1 :The training presentation
34
34
Appendix 10.2 :Phyaura EHR user guide
35
Appendix 10.3 : The workshop scenario
36
Appendix 11 :User recommendations
37
Appendix 12 :The full recommendations for system customization
38
Appendix 13 :The legal and financial requirements for system

implementation
39
Appendix 14: Phyaura EHR implementation plan
40
Appendix 15: Phyaura EHR Detailed training plan
41
Project Name:Comparison and Analysis of Open Source EHR Systems
Project Team:1. Dr. Mohab Maysara Abd Alwahab (the team leader)
2. Dr. Alia Hassan Tarek Abaza
3. Dr. Caroline Galal George
4. Dr. Maha Mohamed Abd Elkhalek
5. Dr. Remon Gameel Ebed
Project supervision:
1. Dr. Rada Hussein
Pro.Dr PhD
2. Dr. Aly Khalifa
PharmD, BMI Cert.
Project Documentation:
1. The project charter (
)
2. The project plan (Error! Reference source not found..1 and 2.2)
3. The project documentation (this document)
4. The project team meeting archiving (Appendix 3)
5. The project progress reports (Appendix 4)
6. The project plan updates (Appendices 5.1,5.2 and 5.3)
7. The project final presentation (Appendix )
8. The project deliverables
a. The project plan (Error! Reference source not found..1 and 2.2)
b. Comparison criteria list (Appendix 7)
c. Comparison Result and determining the best open EHR to be chosen and
its review (Error! Reference source not found..1,8.2,8.3 and 8.4)
d. Evaluation list to be applied on the selected EHR (Appendix )
a. Training program manual of the selected EHR
(Appendices 10.1, 10.2 and 10.3)
e. User recommendations (Appendix )
f. The full recommendations for system customization (Appendix )
g. The legal and financial requirements for system implementation
(Appendix )
h. Phyaura EHR implementation plan (Appendix 14)
i. Phyaura EHR Detailed training plan (Appendix 15)
Project Initiation:
We start to plan to our project on 22 ND of January 2012 by meeting with ITI staff
Prof.DR. Rada Hussein and Dr. Aly Khalifa
Then, we held a team workshop resulting in:
I. The Team Work Rules:
A weekly meeting is held every Saturday at 10:30 am
An additional meeting is held on Thursday at 5 pm if its required
Meeting with the project supervisor at the ITI as needed
The tasks are assigned according to the project plan schedule in the start of
each phase and meeting
The main tool for communication: E-mail.
All documents have been shared on Google Docs for e-collaboration.
Each task done by one member reviewed by another one to assure the quality
of the deliverables
In case of any difficulty that may face any of team members to do the task assigned to him/her, he/she should feedback to the team leader for corrective actions.
II.
The team leader responsibilities:
Assign tasks
Coordinate work among team members
Communication with project supervisors
Send the deliverables to supervisors to be approved
Prepare and send weekly project progress report
7
The project composed of 6 phases which executed as the following:
Phase 1: Preparation
Start date: 22/1/2012
End date: 19/2/2012
Outcomes:
a. The approved project charter (
)
b. The project plan (Error! Reference source not found..1 and 2.2)
c. Five open source EHR for comparison
Task
Done by
Reviewed by
1. Downloading the provided EHRs (5 EHRs)
Table 1
Table 1
2. Install the provided EHRs by the project charter
Table 1
Table 1
3. Searching for other working Open EHR for the

project(44 EHR)
Remon
Mohab
Table 2
Table 2
4. Downloading and trying other investigated open

HER
Remon
5. Collect reviews and learned lessons about the usAlia
ing the open source EHRs
Mohab
Remon
6. Prepare the project plan
Caroline
Maha
Caroline
Maha
Alia
Mohab
The 1st and 2nd task: Provided open EHR has been assigned for download and installation as the following:
Table 1
EHR System
Assigned member
Reviewed by
Freemed
Maha
Mohab
Open MRS
Mohab
Maha
Open EMR
Alia
Remon
OscarMcMaster
Remon
Alia
Caroline
PatientOS
Maha
rd
The 3 task was to search the web for other available open source EHR systems and
we come to these results
The 4th task: downloading and analysis of the open EHRs was assigned as
Table 2
Assigned
member
Reviewed by
Alia
Remon
Caroline
Mohab
Application
Result
Freemed
FreeB
MedClipse
FreePM
Liferecord
Tolven
Indivohealth PHR
Open Dental Software
HOSxP
MirrorMed
openEMed
CAISI
ClearHealth
ZertisMD
tkFP is tk Family Practice software
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
need payment
10
Maha
Caroline
Mohab
Maha
Remon
Alia
OpenEMR Virtual Appliance

GNUmed
ZEPRS
Vista Office
VistA
WorldVista
Cottage med
Zudha
XChart
Hospital OS
Endoclinic
Natural EMR
Sourcio EMR
Medsphere Open Vista
OpenEMR Current
ClearHealth
THIRRA (EHR)
openMRS
OpenEMR
OscarMcMaster
patient os
Elexis
Ultimate EMR
Zms
Care2x
SmartCare
GNU Health
MedinTux
Phyaura
11
Pass
Fail
Fail
Fail
Pass
Pass
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Pass
Fail
Fail
Fail
Pass
Pass
Pass
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Fail
Pass
So we have 8 successful applications

openMRS
VistA
OpenEMR
WorldVista
OscarMcMaster
Medsphere Open Vista
Phyaura
So we decide to choose the best 5 EHR (according to its demo availability)

Open VistA
OpenMRS
OscarMcMaster
Phyaura
12
Phase 2: Analytic comparison of EHRs

End date: 13/3/2012
Outcomes:
a.
Comparison criteria list (Appendix )
b.
Comparison Result and determining the best open EHR to be

chosen (Error! Reference source not found..1 and 8.2)
c.
Reviewed Comparison Result and determining the best open EHR

to be chosen (Error! Reference source not found..3 and 8.4)
Task
Done by
Reviewed by
1. Set the comparison criteria
All members
All members
2. Compare the selected EHRs
Table 3
Table 3
The 1st task: Creation of comparison criteria to compare 5 EHR systems

It was all the team task
We search the web for available evaluation criteria of EHR systems.
Our comparison list was made based on the meaningful use criteria provided
by HEALTH RESOURCES AND SERVICES ADMINISTRATION.ELECTRONIC
HEALTH RECORDS: SELECTION GUIDELINES FOR HEALTH CENTERS. As its
considered a powerful approved tool.
13
The comparison list had been created to fit the Egyptian environment requirements to the list to set the final comparison criteria.
The 2nd task: comparing the five selected Open EHRs
Each team member was assigned to study and analyze one of the Open EHR systems in respect to the Comparison list, as the following
Table 3
System
Phyaura
Open VistA
OpenMRS
OscarMcMaster
Assigned member
Remon Gameel
Mohab Maysara
Maha Mohamed
Caroline Galal
Alia Abaza
Reviewed by
Alia
Caroline
Mohab
Maha
Remon
A scoring system has been applied for each in on the list as:
0 not found
1 partially found
2 found.
Then a cross review has been made to remove the bias by allowing the system to be
reevaluated by different team member. The Final result of the comparison has been
approved in March 18, 2012
The final results recommended Phyaura as the best one
14
Phase 3: The real field implementation

End date: 18/4/2012
Outcomes:
a. Evaluation list to be applied on the selected EHR (Appendix )
b. Training program manual of the selected EHR
(Appendices 10.1, 10.2 and 10.3)
c. User recommendations (Appendix )
Task
1. Creation of the evaluation Criteria

for the application
Done by
Remon
Caroline
Maha
2. Preparing the Training program
Mohab
Alia
3. Gathering and analysis of user

feedback
Alia
Caroline
Reviewed by
Mohab
Alia
Remon
Caroline
Maha
Maha
Remon
Mohab
The 1st task: Creation Phyaura evaluation criteria

The 2nd Task: Preparation of training program for users to evaluate the system
15
Training materials:
Phyaura EHR user manual.
A presentation to introduce open source approach, EHR capabilities and
Phyaura features.
A demonstration on Phyaura EHR using patient visit workflow to show capabilities of Phyaura EHR.
The EHR Workshop was attended by 6 doctors on April 7, 2012 at ITI
The following was done
Provide presentation about open source approach, EHR capabilities and
Phyaura features.
provide demonstration of Phyaura EHR system
Test Phyaura by the workshop attendees physicians
Evaluate Phyaura using evaluation Questionnaire
The 3rd task: Gathering and analysis of user feedback
The recommended features were gathered using the evaluation questionnaire of all
users
A final user recommendations list was made on April 14, 2012
By finalizing the user recommendations list we finished the real field implementation phase and its time to move to the next phase
16
Phase 4: Set Final Recommendations for Phyaura

EHR System Customization
End date: 30/4/2012
Outcomes:
a. The full recommendations for system customization (Appendix )
b. The legal and financial requirements for system implementation
(Appendix )
Task
1. Create the recommendations for system customization.
2. setting the legal
and financial requirements for system implementation
Done by
Reviewed by
Alia
Remon
Caroline
Mohab
Maha
Alia
Remon
This phase objective is to set full recommendations list to customize Phyaura EHR
to comply with Egyptian healthcare environment and needs
17
The 1st Task: Create the recommendations for system customization

The task was done through
Collecting the other features of meaningful use criteria which are not met by
Phyaura but applicable in Egyptian healthcare environment
Collecting the team members recommendations which made through using

Phyaura
The task assigned to all team members.
The 2nd Task: setting the legal and financial requirements for system implementation
The task objective is to gather the legal and financial requirements for system implementation to be considered in implementation plan
The task was done by holding meeting with legal affairs and financial affairs to set
the needed requirements
18
Phase 5: The implementation plan

End date: 14/5/2012
Outcomes:
a. Phyaura EHR implementation plan (Appendix 14)
Task
1. Set the EHR implementation plan.
Done by
Reviewed by
Alia
Remon
Caroline
Mohab
Maha
Caroline
Phase 6: The training plan

End date: 14/5/2012
Outcomes:
a. Phyaura EHR Detailed training plan (Appendix 15)
Task
Done by
Reviewed by
Alia
Mohab
Maha
1. Set detailed training Remon

plan
Caroline
19
The project closure:

Closure date: 14/5/2012
Task
Done by
Reviewed by
Alia
1. Prepare The project
Remon
documentation
Caroline
Mohab
Maha
2. Prepare the project

presentation.
Alia
Remon
Maha
Mohab
Caroline
20
21
Appendix 1: The project charter
22
Appendices 2: The project plan

Appendix 2.1: The project plan document
23
Appendix 2.2: The MS project plan
24
Appendix 3: The project team meeting archiving
25
Appendix 4: The project progress reports
26
Appendices 5: The project plan updates

Appendix 5. 1
Project plan update at 02-1
Appendix 5. 2
Appendix 5. 3
27
Appendix 6: The project final presentation
28
Appendix 7: EHRs Comparison criteria list
29
Appendices 8: Comparison Result and determining the best

open EHR to be chosen and its review
Appendix 8.1: EHRs Comparison Result
30
Appendix 8.2: Determining the best open EHR rational
31
Appendix 8.3: EHRs Comparison Result review
32
Appendix 8.4: Determining the best open EHR rational review
33
Appendix 9: Evaluation list to be applied on the selected EHR
34
Appendices 10: Training program manual of the selected

EHR
Appendix 10.1: The training presentation
35
Appendix 10.2: Phyaura EHR user guide
36
Appendix 10.3: The workshop scenario
37
Appendix 11: User recommendations
38
Appendix 12: The full recommendations for system customization
39
Appendix 13: The legal and financial requirements for system

implementation
40
Appendix 14: Phyaura EHR implementation plan
41
Appendix 15: Phyaura EHR Detailed training plan
42

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Comparison and Analysis

of Open Source EHR

Dr. Mohab Maysara Abd Alwahab

Egyptian Health informatics Fellowship

Comparison &Analysis Of Open Source EHR Systems

Comparison &Analysis Of Open Source EHR Systems

I. The Team Work Rules

The team leader responsibilities

Tasks and the team responsibilities

Phase 2: Analytic comparison of EHRs

Tasks and the team responsibilities

Phase 3: The real field implementation

Tasks and the team responsibilities

Stage 4: Set Final Recommendations For Phyaura EHR System

Phase 5: The implementation plan

Tasks and the team responsibilities

Phase 6: The training plan

Tasks and the team responsibilities

The project closure:

Tasks and the team responsibilities

Appendix 1: The project charter

Appendices 2 :The project plan

Comparison &Analysis Of Open Source EHR Systems

Appendix 2.2: The MS project plan

Appendix 3 :The project team meeting archiving

Appendix 4 :The project progress reports

Appendices 5: The project plan updates

Appendix 5.2: The project schedule plan update at 17-3-2012

Appendix 5.3: The project schedule plan update at 23-4-2012

Appendix 6 :The project final presentation

Appendix 7: EHRs Comparison criteria list

Appendices 8: Comparison Result and determining the best open EHR to

Appendix 8.3 : EHRs Comparison Result review

Appendix 8.4 : Determining the best open EHR rational review

Appendix 9 :Evaluation list to be applied on the selected EHR

Appendices 10: Training program manual of the selected EHR

Appendix 10.2 :Phyaura EHR user guide

Appendix 10.3 : The workshop scenario

Appendix 11 :User recommendations

Appendix 12 :The full recommendations for system customization

Appendix 13 :The legal and financial requirements for system

Appendix 14: Phyaura EHR implementation plan

Appendix 15: Phyaura EHR Detailed training plan

Comparison &Analysis Of Open Source EHR Systems

Project Name:Comparison and Analysis of Open Source EHR Systems

Comparison &Analysis Of Open Source EHR Systems

Comparison &Analysis Of Open Source EHR Systems

The team leader responsibilities:

Comparison &Analysis Of Open Source EHR Systems

The project composed of 6 phases which executed as the following:

Comparison &Analysis Of Open Source EHR Systems

1. Downloading the provided EHRs (5 EHRs)

2. Install the provided EHRs by the project charter

3. Searching for other working Open EHR for the

4. Downloading and trying other investigated open

Comparison &Analysis Of Open Source EHR Systems

Comparison &Analysis Of Open Source EHR Systems

OpenEMR Virtual Appliance

Comparison &Analysis Of Open Source EHR Systems

So we have 8 successful applications

Medsphere Open Vista

So we decide to choose the best 5 EHR (according to its demo availability)

Comparison &Analysis Of Open Source EHR Systems

Phase 2: Analytic comparison of EHRs