EHRs Going Global

Open source healthcare has global reach.

Creating, updating, and reconciling medical records is one of the most visible areas where technology has shaped healthcare. While most electronic health record (EHR) systems remain proprietary, over 30 countries now use open source EHRs in some capacity.1 Founded in a rich legacy of global initiative to meet shared, human needs, successful open source healthcare IT initiatives are not only taking a hold in the United States,2 but also spreading to Mexico,3 Thailand,4 France,5 Uganda,6 Zambia,7 Kenya,8 9 Canada,10 11 Germany,12 the UK,13 Australia,13 Haiti,14 and many other societies.

OSCAR McMaster

OSCAR is maintained at McMaster University in Canada and used by over 1,500 physician offices with a 12% market share in the Canadian province of Ontario.10 It is also in use in Argentina, Ecuador, Kenya, Zimbabwe, Uganda and Jamaica. https://oscar-emr.com

Medic Mobile

Medic Mobile is an open source mHealth non-profit that trains community health workers (CHWs) to have impact on rural populations. Over 20,000 CHWs use Android-based phones and open source software to track immunizations, disease, antenatal care, and basic health in over 23 countries as of 2018 such as Kenya, Nepal, Uganda, India, and now in the Americas. https://medicmobile.or


The SIGA Saúde Health Information System in Sao Paulo (Brazil) is serving over 14 million patients yearly in over 700 health facilities, and stores records from 20 million patient contacts annually.3 Sigasaude.go.gov.br


Supported by the Regenstrief Institute at the Indiana University School of Medicine, OpenMRS has a broad global appeal and is used in South Africa, Kenya, Rwanda, Lesotho, Zimbabwe, Mozambique, Uganda, Tanzania, Haiti, India, China, United States, Pakistan, and the Philippines. https://openmrs.org


The openEHR was jointly conceived by University College London and Ocean Informatics Pty Ltd. Australia. Since its formal acceptance by the European Union and the International Organization for Standardization as CEN 13606.15 openEHR is promoted by the openEHR Foundation comprised of 1500 members from 87 countries.13 openEHR has been deployed in Australia, Brazil, the Netherlands, Norway, the Philippines, Portugal, Russia, Slovenia, Sweden, and the UK.16

Hospital OS

Sponsored by the Thailand Research Fund, Hospital OS has been deployed at 95 small rural hospitals and 402 health centers serving at least 5 million patients in Thailand and Nepal as of 2011. www.hospital-os.com

AMPATH Medical Record System

Based on OpenMRS, the Academic Model Providing Access to Healthcare (AMPATH) Medical Record System (AMRS) was first deployed at the AMPATH center in Eldoret, a regional capital in Western Kenya, and then expanded to eight other AMPATH sites in Western Kenya.8 The AMRS has recorded over 100 million discrete clinical observations from 2.8 million AMPATH visits made by 300,000 enrolled patients, from an eligible population of 2 million patients in the catchment area. www.ampathkenya.org


Developed by Informatici Senza Frontiere in Italy, Open Hospital was first used at St. Luke's Hospital in Uganda and has since expanded to 23 sites in 13 countries serving over 425,000 patients.6 www.open-hospital.org/en/


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  2. Frequently Asked Questions. Medsphere. 2018. Accessed 3 Jan 2018: http://www.medsphere.com/company/frequently-asked-questions
  3. P. Webster. The rise of open-source electronic health records. The Lancet. vol. 377, no. 9778, pp. 1641-1642. 2011.
  4. BMS-HOSxP. Bangkok Medical Software. 2018. Accessed: 3 Jan 2018.: http://hosxp.net/joomla25/index.php/2013-03-25-08-44-08/2013-03-25-10-39-58/2015-01-06-03-54-39/bms-hosxp
  5. À PROPOS. MedinTux. 2018. Accessed 3 Jan 2018.: https://medintux.org/about/
  6. Non-profit software for the healthcare management in developing countries. Open Hospital. 2018. Accessed 3 Jan 2018.: http://www.open-hospital.org/en/
  7. C. Kelley. ZEPRS EMR. GitHub. 2018. Accessed 3 Jan 2018.: https://github.com/chrisekelley/zeprs
  8. Medical Informatics. Research & Informatics, AMPATH-Kenya. AMPATH Kenya. 2018. Accessed 3 Jan 2018.: http://www.ampathkenya.org/our-programs/research-informatics/medical-informatics/
  9. About. OpenMRS. 2018. Accessed 3 Jan 2018.: http://openmrs.org/about/
  10. EMR Vendor Market Share. OntarioMD Inc. 2017. Accessed 3 Jan 2018.: https://www.ontariomd.ca/emr-certification/certified-emr-offerings/market-share
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  13. G. Ulriksen, R. Pedersen, G. Ellingsen. Infrastructuring in Healthcare through the OpenEHR Architecture, Computer Supported Cooperative Work. vol. 26, no. 1-2, pp. 33-69. 2017.
  14. Health Information Systems in Haiti. International Training and Education Center for Health. 2018. Accessed 3 Jan 2018.: https://www.go2itech.org/2017/05/health-information-systems-in-haiti/
  15. T. Beale, S. Heard. Foundation. openEHR. 2018. Accessed 3 Jan 2018.: https://www.openehr.org/about/foundation
  16. T. Beale, S. Heard. Deployed Solutions. openEHR. 2018. Accessed 3 Jan 2018.: http://www.openehr.org/who_is_using_openehr/healthcare_providers_and_authorities