Wednesday, July 22, 2009

Multi-language OSCAR

Trying out the multi-language features of OSCAR has never been easier.

Although the number of language packs included in the new OSCAR 9.06 base distribution is still small, the mechanism to perform basic language translation is reasonably easy, and trying it out is as simple as telling your web browser (easiest if you are running Firefox), that you would like to see OSCAR in another language.

Would you like to try OSCAR in French? If you are running OSCAR 9.06, all you need to do is open your Firefox preferences, go to the Content tab and under Languages, choose "French [Fr]". Now, restart your browser, point it at OSCAR and voilà!

Please let us know if you would like to volunteer to translate OSCAR to a new language. It is as simple as editing a single file and swapping out the English words for the dialect of your choice.

Thursday, July 9, 2009

OSCAR vs. Practice Solutions

OSCAR and Practice Solutions have become the two must-have EMR finalists on your shortlist evaluation when making a decision on which EMR to choose in Ontario.

click to view larger


Practice Solutions and OSCAR are both government certified, standards supporting and based on modern architectural and user interface paradigms. Furthermore, both OSCAR and Practice Solutions will support either hosted or local deployment models.

From a user's perspective, the Graphical User Interface is the most important, make-it-or-break-it function within an EMR. Put simply, without a modern, freeform based data input model, your EMR will slow you down and frustrate you on a daily basis.

Luckily, both OSCAR and Practice Solutions have implemented very similar user experiences.

And so, considering both have similar certifications, support similar standards, offer equivalent functionality, and are both based on modern, user friendly interfaces, how does one decide on which EMR to deploy?

If you want to go with the EMR with the largest market share, the one owned by the Canadian Medical Association, then your choice is clear - Practice Solutions is your choice. It is not a bad choice. Practice Solutions EMR is a reasonably architected, user friendly software application. The CMA is a very large organization with many resources and significant assets.

OSCAR, on the other hand, continues to beat Practice Solutions in numerous head to head competitions. OSCAR has become the EMR of choice for practitioners that care about ease of use, cost, choice of supplier, platform flexibility, and data stewardship.

The OSCAR advantage is significant and hard to ignore.

  • OSCAR costs significantly less. OSCAR is the least expensive, full featured and fully certified EMR to deploy and operate. There are no license fees. You do not have to pay annual support fees forever.

  • OSCAR is open source. You own your data. No one has the right to take that data away from you.

  • OSCAR is free of software bombs. You can not be locked out of your system by your vendor because you did not pay your annual maintenance fee, or whatever other reason your vendor may dream up. There are no back-doors in OSCAR. There are no super user passwords that change everyday without your knowledge or consent. Your OSCAR EMR is your EMR.

  • OSCAR runs on commodity hardware. Any computer workstation that has a web browser is capable of running OSCAR. You do not need to purchase all new top of the line workstations. In most cases, your existing workstations will be just fine.

  • OSCAR is open to end user modifications and enhancements. You are free to change OSCAR to meet your specific needs. You do not have to ask for permission.

  • OSCAR is available from multiple sources. Whether you support your own OSCAR installation or choose from one of many OSCAR support companies, you are free to pick the supplier that satisfies your specific requirements.


OSCAR versus Practice Solutions. OSCAR gives you more of what you want and less of what you didn't know you were about to get.

Monday, July 6, 2009

Latest OSCAR Installation Instructions

For the OSCAR do-it-yourself-ers out there, we have updated the OSCAR installation guide to cover off the OSCAR v9.06 release.

The new install guide can be found here.

Monday, June 15, 2009

Of Hospitals, Health and Private Information

Much has been made in the media recently concerning the waste of taxpayers money related to the move towards Electronic Medical Records. Couple the potential for a fiscal boondoggle with the threat of a large scale privacy invasion by the government and we have much to be concerned about.

OSCAR users believe that we have the solution - freely licensed, government certified, standards based, and highly secure open source.

Vancouver Sun June 15, 2009 2:06 AM

Many doctors have grave concerns about the privacy implications of large centralized government databases containing people's detailed personal health information. Many doctors are also excited about the potential for improved patient care with the use of electronic medical records.

The United Kingdom has spent more than £13 billion centralizing patient records in government databases. It has been an acknowledged fiasco.

In a 2008 British Medical Association poll, nine out of 10 doctors said they don't trust the government with patient data security.

What can we do, instead, to gain the benefits of technology without spiralling costs and privacy violations?

In Canada, huge savings to taxpayers could be achieved with the use of the free open-source medical-record software developed at McMaster University, known as OSCAR.

In collaboration with Harvard and MIT, OSCAR has also developed MyOSCAR, an open-source personally controlled health record (PHR) that lets doctors securely "push" information like lab reports and clinical summaries from their electronic office records to a patient's PHR. The patient can log into his or her PHR from home or when seeing a specialist.

With PHRs, patients become the custodians of their key cradle-to-grave medical information.

Why are we spending millions of tax dollars on proprietary software when there is open- source software that does as much, or more? Why aren't we looking at alternatives like PHRs for the long-term storage of personal health information?

The good news is that more and more doctors have asked these questions and decided that OSCAR makes more sense.

David Chan, MD

Associate professor of family medicine and director of information technology, McMaster University, Hamilton, Ont.

Tuesday, June 9, 2009

Why Not Just Use OSCAR?

Today on CBC's Metro Morning radio show, Andy Barrie and Jesse Hirsh discussed the current crisis in Ontario's eHealth organization and asked the obvious question - why is the Ontario government wasting money trying to implement expensive closed proprietary systems instead of doing more to promote the free & open source OSCAR EMR.

A very good question, indeed.

Thursday, June 4, 2009

OSCAR - blog en español

The international OSCAR users have become a wonderful source of pride to the OSCAR community, and so it is with great joy that we can introduce you to the blog that's been created by Dr. Santiago Dejo, a family physician in Argentina.

Please visit his blog at http://oscarcanadaes.blogspot.com and say hello.


Una gran bienvenida a nuestro nuevo OSCAR amigos y colegas en la Argentina.

Tuesday, June 2, 2009

New User Manual, New User Experience

OSCAR's latest user manual has gone online and has become much more interactive.


One benefit of an online manual is that Google Translate works on it.

If you would like to see the manual in Spanish for example, it is easy to make the switch:

Or perhaps OSCAR in French is more suitable for you:


We are looking for volunteers to contribute to the manual to make it even better.

If you would like to volunteer, please contact David Chan (dchan@mcmaster.ca) to get write access to the document.

Tuesday, May 19, 2009

OSCAR Installers from 35 Countries

In the past month, people from 35 countries have taken a look at installing OSCAR.

Below is an ordered list identifying the top ten countries from where the interest has come from:



OSCAR continues to enhance support for international users by delivering support for Internationalization in the upcoming release.

If you rummage through the source, you will see that English, French, and Portuguese modules have already been crafted. Based on the number of global users downloading and installing OSCAR, we can only guess that support for additional languages is just a matter of time.

OSCAR Grows 275% in British Columbia

We've been counting OSCAR users in British Columbia and what we've found was so exceptional that we had to check our math.

Over the last six months, the total number of known OSCAR users in British Columbia alone has jumped to 270!


This represents a 275% growth in the OSCAR user base so far this year.

OSCAR Certifies OntarioMD CMS Spec 3.0

OSCAR Canada is very happy to announce that the OSCAR EMR is now OntarioMD CMS Spec 3.0 (conditionally) certified.

OSCAR is the only open source EMR in Canada that is certified by OntarioMD. Furthermore, no other OntarioMD certified EMR solution gives you complete and unfettered access to your data, the database that it is stored in, and the source code for the solution - now and forever.

As we've discussed before, CMS Spec 3.0 certification is a major achievement in the life of the OSCAR project.

OSCAR users can be very confident that their chosen EMR continues to advance technically and in conjunction with important public standards such as those being defined by OntarioMD.

Tuesday, May 5, 2009

Preview: OSCAR 9.04


New Encounter window (click on it to see a larger image).

The upcoming OSCAR 9.04 has a number of new features, including time saving one-click-direct-billing-from-the-chart, and additional new CPP boxes.

Data Portability Is A Big Deal

Vendor lock-in. Dirty, despicable words. Vendor lock-down. Even worse words.

Let's say that you are writing your Master's thesis and right before you have to hand it in, your support agreement with Microsoft expires and you no longer have access to your work.

That would be bad. Very bad. So bad in fact that it doesn't happen. When you license Microsoft Office, the Microsoft Corporation can't lock you out of your stuff. After all, your work is your work.

Years after you've left university, you are practicing medicine and using the latest tools. Fantastic tools like the modern EMR.

Things in life change and perhaps you decide that you want to move to a new practice or adopt some new technology. Perhaps you are not moving, but your vendor has expired or is no longer responsive to your needs and you need move your medical records to a new system.

A lot of physicians are in this exact position today. Unfortunately, many of these physicians are having a crash course in the nuances of being, for the lack of a better word, screwed.

Before spending once minute inputing a single piece of valuable information into your EMR, ask yourself this:
Is my relationship with this vendor going to last FOREVER?


Then, look in the system for the data export feature.


This is the data export window in OSCAR.

Click a couple buttons and take your information with you.

It is that easy.

Friday, May 1, 2009

Has OSCAR Become the #2 EMR in Ontario?

We know that OSCAR is the #1 open source EMR in Canada, but how does it compare to the proprietary vendors as far as market share?

Most proprietary EMR solutions are extraordinarily expensive to operate. To encourage EMR usage, provincial governments across Canada have developed programs to fund doctors as they transition to electronic records. Because the governments are paying the bills, they have a pretty good idea of EMR market share.

Recently the Ontario government published EMR market share statistics, current for March 2009, in Ontario.


The unfortunate part of these statistics is that OntarioMD only counts the doctors that have been funded by the government, and not the actual number of doctors using an EMR.

OSCAR users have recently been counting themselves to get a sense of how large our community is. Our current understanding is that there are 438 physicians using OSCAR in Ontario.

Further analysis of the data leads to an interesting conclusion - OSCAR may now be the EMR in Ontario with the 2nd largest market share, when measured by the actual number of physicians using an EMR.


By updating the OntarioMD statistics, and swapping out funded physicians with just physicians, we find that OSCAR is catapulted into 2nd position, when measuring market share.

Thursday, April 23, 2009

OSCAR Fundraising Update

From the every tireless Dr. Colleen Kirkham, an update on the current OSCAR Canada Users Society fundraising effort:
The OSCARCanada first ever fundraising campaign was launched in early March and has raised $17,500 to date. Donations have come from BC, Ontario and Quebec. A huge thank you to all those in the OSCAR community that have made a donation so far!

There is a new page on the OCUS website where donors are acknowledged. (Note-if you have made a donation and don’t see your name there, please let me know. You are likely in the group of 20 anonymous donors as I didn’t want to post anyone’s name without explicit permission to do so!)

For those of you who have been meaning to make you donation, you can find the form here. Keep those cheques coming in!

What we will do with the funds raised? David Daley has created a new roadmap page which outlines the top items we are targeting for the October release. You can also see what has been completed on the April release. Some programming we hope to accomplish includes:

  • We have a programmer lined up this spring to revamp billing module and the WCB module

  • Dr. Karen Cunnningham has collated a wish list for changes to the prescription module

  • At the national usergroup meeting we agreed on changes we want to the encounter page

  • We also have plans for a new INR module


  • What to do if you don’t see your most desired programming item at the top of the list?:

  • Start by making sure your item is on the wishlist

  • Be vocal, participate, show up at the meetings, teleconferences etc and make sure you are part of the ongoing discussion

  • Volunteer-the more people we have helping to move this project forward, the more we can get done –there is a job for everyone!

  • Don’t forget to make your donation –we can’t do anything without funds for programming

  • Don’t panic, be patient –those of us that have been using OSCAR for a few years can tell you that most things seem to get done eventually and the speed of development is actually very fast

  • If you really can’t wait –hire a programmer (or your kid) and get started (but don’t forget to talk to Jay Gallagher or David Chan about what you want to build!)


  • The OSCARCanada board of directors will be discussing the ongoing management of the wish list and the setting of priorities and how to do this in the most efficient and fair way. If you have any ideas about this, please pass them onto the board. Your board of directors are listed online and all of them read the list serv!

    Thanks again to Dr. Carole White, our treasurer, who is processing all the donations.

    I will keep the group posted regarding how our fund raising campaign is going.

    Colleen

    Wednesday, April 22, 2009

    OSCAR EMR Roadmap

    OSCAR Roadmap
    (last update, April 15, 2009)

    The OSCAR Roadmap strategy is to target two formal releases each year - in April and October. We've adopted a new numbering strategy consistent with other significant open source projects, specifically following the format Year.Month. The next release will be version 9.04.

    Source code will continue to be available for interim and development releases.

    OSCAR is based on a community based development model. Current contributors to the OSCAR project include:
    - Large institutions (e.g. McMaster, McGill & City of Toronto)
    - Independent companies (e.g. OSCAR support companies)
    - User Groups (e.g. OSCAR Canada Users Society)
    - Independent clinics and individual doctors

    We encourage all users and organizations that are working on significant new features to inform us of what they are doing so that we can support and publicize their efforts.

    Whenever possible, our intention is to be transparent about what features are currently committed (ie funded and scheduled), and which are currently planned (ie prioritized, but funding/scheduling is still being organized).


    Spring Release - April, 2009 - OSCAR v9.04 (committed)

    - OntarioMD CMS Spec v3.0 conformance, including improved data portability, chronic disease management, and diabetes reporting
    - French OSCAR & improved internationalization
    - OSCAR Measurements extensions to enable easier end user customization
    - Improvements to the encounter page (additional CPP input boxes)
    - Customizable CDM flow sheets and new CDM flow sheets for other diseases
    - ICL lab interface
    - support for OntarioMD web portal
    - enhanced support for MyOSCAR, including
    -> create patient myoscar account from the demographic screen
    -> direct pasting of the myoscar message into eChart roll
    - enhanced support for MyDrugRef, including
    -> display/hide MyDrugRef messages while prescribing
    -> show how many untrusted postings



    Fall Release - October, 2009 - OSCAR v9.10 (planned, unless noted otherwise)

    - (committed) Billing subsystem improvements and extensions, including BC specific improvements, multi-jurisdictional support allowing easier regional localizations
    - Prescription subsystem improvements (workflow and functionality)
    - Document handling and workflow routing enhancements, including scans delivered to inbox, improved document tagging
    - Improvements to the allergy module (improved interactions)
    - Reworked INR flow sheet
    - Code maintenance, UI cleanup, improved documentation

    Saturday, April 18, 2009

    Access OSCAR Anywhere

    Walk outside.

    Pull your iPhone out of your pocket.

    Open up Safari and navigate to your OSCAR EMR server.

    Accept your certificates & enter your passwords.

    Enjoy reviewing your latest lab results while sipping a coffee, on your patio, in the summer sun.

    Saturday, April 4, 2009

    OSCAR EMR Security

    "Will my medical records be safe?" This is what is all reduces to. This is what patients are concerned about. This is what practitioners are concerned about.

    Before the deployment of your EMR, you may have your medical records in locked cabinets, within a locked room, within a locked office, and within a locked building. Most, however, have their files on open shelves in a locked office, within a locked building.

    In the world of paper charts, the concept of offsite access and offsite backup is usually a function of the files that you've taken home with you at the end of the day.

    By computerizing your infrastructure, you will clearly gain new functionality (e.g. reviewing lab results from the Bahamas), but how does this affect the security of your medical information?

    Unfortunately, all EMRs are different and thus the security of your medical records are a factor of the EMR you select and the architectural decisions made during its construction.

    The good news for OSCAR users and the patients they care for is that you are in safe hands. You don't have to take our word for it. OSCAR is an open source project and as such, the security model is plainly available for anyone to look at, review, evaluate, and improve.

    When you select an EMR, you should insist on reviewing or performing an independent third party security audit of their system before your entrust your records in their package. It is not acceptable to "just trust them". It is not acceptable to believe that the mechanism used to implement the security of your medical records is "a secret".

    Within the security community, it is a known truism that publicly available, tested, peer-reviewed and improved security mechanisms are significantly more secure than those mechanisms that are based on the cleverness of a hidden algorithm. It is important to realize that no reputable scientist disputes this fact.

    In the security world, it is what you don't know that kills you. For an example, review how Researchers Crack Medeco High-Security Locks With Plastic Keys.

    It is no secret that some consumer operating systems are inherently insecure. OSCAR starts on a secure foundation. OSCAR was designed to run on the open source UNIX operating system. UNIX is a very old operating system. It was first designed in 1969 by a group of very clever folks at Bell Labs. In the 40 year history of UNIX, it has become the industrial operating system of choice due to it's flexibility, efficiency, and robust security.

    OSCAR uses a number of significant open source packages, including the Apache-Tomcat web applications framework, the MySQL, PostgreSQL relational databases, SSL & PGP encryption technologies, and the JAVA programming language. Each of these open source projects were designed with security in mind, have been deployed and tested on hundreds of millions of servers around the world, and have been challenged and enhanced repeatedly over the years.

    OSCAR users don't access the infrastructure directly. OSCAR runs as an unprivileged application within an overall secure environment. OSCAR users access the application, the application accesses the needed infrastructure as required.

    Clearly OSCAR is based on a secure, robust and tested platform, but what about the OSCAR application itself?

    Let's start with the login and take if from there.


    Before you connect to the server, your web browser will encrypt the data stream between you and OSCAR. If you try to access OSCAR via an unencrypted channel, your server can be configured to reject your connection, or redirect you to the encrypted one. OSCAR can be configured to force users to supply secondary passwords to gain access from any computer, or from just those machines not physically connected to your local office network. OSCAR can be configured to allow connections only from specific computers, machines that have been authorized by OSCAR administrators in advance, whether these computers are local or remote.

    Once OSCAR users log in, the security doesn't stop. What you actually see as a user is dependent on what role you've been assigned.


    OSCAR comes pre-configured with specific security roles for a number of typical users:

  • Admin
  • Doctor
  • ER_clerk
  • External
  • Locum
  • Nurse
  • Receptionist
  • Remote_access
  • Vaccine Provider

    And these roles are easily expandable to meet your specific needs.

    The access rights of your users are then configurable at the object level:


    This gives you incredible control over who gets to see and do what, and under which circumstances.

    OSCAR has a legally relevant audit trail. What this means is that everything that anyone does in OSCAR is tracked and timestamped. If a user writes a prescription, it is tracked. If a user views a chart, it is logged.


    If information is accessed and modified, not only is it logged, but the modifications are tracked so that you can view both the "before" & "after" records.



    OSCAR security has been designed throughout the system, and the system was designed with security in mind.

    However the best security in the world is useless if users will turn it off because it gets in the way of ease of use and simplicity of operation. Once again, OSCAR has taken this challenge up.

    OSCAR users typically find that a correct balance has been achieved. Layers of security prevent unauthorized access to the system, but authorized users have full and easy access to the platform, making the day to day use of the system a joy to work with.

    It is nice to know that you can count on an electronic medical record system that has been designed to give you the security that you need today and into the future.
  • Wednesday, April 1, 2009

    McMaster Family Health Team Wins Award

    The Ontario College of Family Physicians recently announced the 2008 Family Practices of the Year. Along with The Centre for Family Medicine Family Health Team, Kitchener, and the Victoria Family Medical Centre, London, McMaster Family Health Team, Hamilton was recognized.

    The McMaster Family Health Team is one of the most advanced family practices in the country and their facility is truly an amazing operation to visit.

    The McMaster Family Health Team provides care to 27,400 patients with two large primary care teams consisting of 28 physicians, 15 nurses, 6 social workers, 2 dieticians, 1 lactation consultant and numerous support staff. They also educate 64 Family Medicine residents at the two teaching sites.

    Congratulations to Dr. David Chan, Dr. David Price, and the rest of the McMaster Family Health Team.

    Friday, March 20, 2009

    OSCAR & OntarioMD CMS v3.0

    The OSCAR team has spent this last week going through OntarioMD's CMS Specification v3.0 conformance testing.

    CMS Specification v3.0 introduces requirements to provide better functionality to support chronic disease management, to enhance querying and reporting capabilities within CMSs, and to connect CMSs to the comprehensive knowledge resources available on the OntarioMD.ca physician website. It also includes refinements to existing requirements to better serve the needs of the healthcare community.

    The CMS Specification also prepares certified Offerings for e-Health initiatives such as the Ontario Laboratory Information System (OLIS) and the provincial Diabetes Registry.

    Official results are pending, but our team is very confident about the outcome.

    Once achieved, the certification as a CMS v3.0 compliant application will mark another major milestone in the life of the OSCAR open source project.

    Wednesday, March 18, 2009

    OSCAR - The #1 Open Source EMR in Canada

    OSCAR users may believe it to be an obvious statement, considering the large number of clinics and doctors that rely on OSCAR everyday in support of their delivery of world class patient care, but OSCAR is the #1 open source EMR in Canada.

    OSCAR powered clinics can be found across this great, multicultural land, from Prince Edward Island on the Atlantic Ocean, across 6,000 kilometers of lands and lakes to Vancouver Island on the Pacific.

    There is a French version of OSCAR being developed in Quebec, and there is a Portuguese version of OSCAR that was developed in Brazil.

    OSCAR EMR is spreading everyday! Recently, OSCAR has been gaining a global footprint.

    To illustrate, the map below shows the global downloads of the OSCAR installation tutorial in the last couple weeks.



    What this graphic shows is that on average, every day, someone in the US is reading about installing OSCAR. Every second day, someone in India and someone else Mexico is doing the same. Once a week, someone in Argentina and Austria is giving it a go.