OSCAR Reflections
At the Family Medicine Forum this year, I attended the OSCAR User Group Meeting. This is their second annual meeting and the first time I have reconnected with the group in a number of years.
The user group has come a long way in a few years.
OSCAR has made some advances as well. The big change is the replacement of the running text blob to track visits to discrete visits. It’s called “eChart”. It is tracking date (both actual and intended), changes per visit note are tracked and there is a form of digital signature. This also allows for locking / signing / verifying individual notes. Issues can be assigned to notes- these are coded in ICD 9. Visits have types now. The note is still text based. There are still additional, parallel “forms” and “e-forms” that can be filled out. These three streams seem to store similar data in different places inside OSCAR – I couldn’t confirm it, but it looks that way.
Part of the afternoon consisted of a presentation by an outside group recommending changes in structure to take OSCAR to the “next level” – more organization, road map, etc. This is the third time I have personally seen this type of presentation formally made to the OSCAR group. OSCAR has an active community and active development, but still does not have explicit architectural documentation, road maps, etc. The recommendations were sound, from the level that they were at. The language might have been off and the group seemed to be an “outsider” group so I do not know how much the recommendations resonated as opposed to something more “corporate takeover” (despite being presented by two University Department Chairs).
I would very much like to see an academically driven and open EMR being supported more broadly in Canada. It could allow for some amazing work – both EMR and clinical if we had a structured backbone across our campuses with consistent data models that allowed for easy recruitment of patients into studies, sharing of best practice research and guidelines, etc. I hope that one day OSCAR could grow into that — there are certainly many very intelligent people getting involved and if they could be rallied… who knows where things would go.
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Interesting observations. Here is one of mine: the people with the expertise to build a useful,open EMR that could potentially form a structured backbone for research across Canada. . . these people are too busy with other pursuits (PhDs, jobs, life, etc). And if they did have time, who is to say that they would have the courage?
In my opinion OSCAR has the courage. It was founded by doers. It started on the principle that something is better than nothing, so let’s build something … even if it isn’t perfect. For this I commend the group. They’ve hung in there for several years now as the only game in Canada for an open source EMR. The support from the community continues to grow. They understand the software is not without limitations (as VP described) but want to continue to its improvement.
However, I firmly believe there are a set of principles that should exist at the very foundation of a clinical information system. These should be present in an open EMR for a research backbone. Can they be retrofitted into an existing product or does this mean a re-write? I don’t know. In any case OSCAR is a great community start moving this idea forward . . . damn the torpedoes!
mcglen
1 Dec 08 at 8:15 am
thanks for the comment
Yes – they have courageously stepped out and pushed forward. The BC users in particular have made great strides since the last time I was involved with them.
OSCAR has done a lot, despite the torpedos (and I know I accidentally volleyed a few in the past when sorting out their license) and I hope they move forward towards your principles. It would be very exciting if the design community could be rallied in the same way as the user community.
priceless
1 Dec 08 at 8:53 am