Re: [Gnumed-devel] Option to make Open-source EMRs billing-independent

[Karsten Hilbert]

For the record: OpenEMR already does certified US billing (HFCA)
via FreeB. So does TORCH, I believe.

Yes, IMO this is the way to go for now:

Use an ShinyNewOSS_EMR for the medical stuff (that's easier to
achieve). Use LegacyBillingApp to handle billing for now.
Interface LegacyBillingApp to FreeB for bill *processing* if
possible. Interface ShinyNewOSS_EMR to FreeB and move over
billing gradually. This will take time. And it will always be
serviced by paid staff for the majority of people. Perhaps
interface ShinyNewOSS_EMR to OSS_ledger at the API or database
level for financial data handling.

> - target FreeB for "process", SQL Ledger for data warehousing & admin?
Yep.

IF you want to go billing with a ShinyNewOSS_EMR I would
suggest going with OSCAR or OpenEMR for now.

> record is found in OSCAR and the info is merely updated. I believe 
> that providing billing in OSCAR is a needless waste of resources that 
> could be better used to improve or extend OSCAR provincially or 
> nationally.
Agree.

> As a program that would be billing agnostic, it would be 
> an attractive approach to other billing systems that do not have an 
> EMR.
The likely course GnuMed will effectively (though not
necessarily) take in the medium-term future.

> There is no need for billing systems to be open sourced. Indeed 
> where support is always urgent, you could argue that for urgent 
> support it does not matter how slice it, you need to pay for support. 
Nonsense. The Open Source in a billing system is not at all
about support costs. It is about being able to *switch support
providers* should I be dissatisfied with the service or
strangled by outrageous fees.

> As you do for OSCAR. Do you really as a user want an open source 
> program which you could manipulate, break and then not get paid 
> because the data getting to Medical Services Plan is screwed up?
Where's the difference to Closed Source ? At least with open
source I can hijack the next developer that happens to come by
and make him fix it.

> Additionally, most people are viscerally opposed to changing billing 
> systems so staying with your billing system and extending it via this 
> approach makes sense to me.
Ack.

Karsten
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