
Bahmni – Open-source Electronic Medical Records and Hospital System - aj_jaswanth
http://www.bahmni.org/
======
moyta
Epic and the other big medical software providers have this market on
lockdown. I do not see a path to this seriously challenging the major players
any time soon in the US, even though it could be done.

Additionally, the software dependencies (CentOS v6.7 & Java 7) that say
breakage occurs with newer versions is very sketchy IMO, ignoring the HIPPA &
PCI compliance work that needs to be done (the latter costs $40k a year to
maintain).

~~~
dismantlethesun
I am curious why so much needs to be done for HIPPA compliance anytime
something is held in electronic form.

What if you have a computer, unconnected to the internet, simply sitting in a
doctors office with billing information on it.... does this system need more
'protection' and regulation than the one it replaced of paper files, and
sticky notes?

~~~
ryanbertrand
There are many layers of HIPAA outside of of just electronic data security.
You must train your staff on security protocols (e.g not sniffing for
celebrity records, etc).

I am pretty sure even if your office is all paper charts you still fall under
certain HIPAA guidelines such as notifying patients if there was a breach (e.g
physically stealing records from the office). This happened in Rocklin, CA a
few years ago.

[http://www.cda.org/news-events/burglary-leads-to-lengthy-
hip...](http://www.cda.org/news-events/burglary-leads-to-lengthy-hipaa-
investigation-for-cda-dentist)

------
jcrawfordor
One of the major EHR systems used in the United States, VISTa, was developed
by the Veteran's Administration and is open source. It's sufficiently
successful that it's been adopted not just by other government agencies but a
number of private hospitals. Most instances still seem to be based on a
commercial M implementation, but some use the fully free GT.M stack

It's M based and in general not on the cutting edge of technology, but it's
long service life has shown that it fits the need. I've worked with it once at
the Indian Health Service and while not exactly Web 2.0 it is quite powerful
and familiar to the staff there.

~~~
SEJeff
M / Mumps is a terrible language / datastore to deal with however.

~~~
cordite
As a language user, it is really just a semi-structured assembly-style
everything-is-string and global-memory as a hierarchical tree map.

The language comes with transaction support, though one can use mutexes
instead for performance reasons.

------
kakoni
Earlier this year I made an list of interesting/active open health software
projects. Available here [https://github.com/kakoni/awesome-
health](https://github.com/kakoni/awesome-health)

------
bansheehash
How does this compare with HospitalRun
([http://hospitalrun.io](http://hospitalrun.io)), which also targets the
developing world/resource-constrained market?

------
um304
Getting US hospitals to use your software is super hard. Majority of them are
using Epic, and won't entertain you much if you don't provide Epic
integration. And Epic is almost a closed system, they've done their best to
make sure that integration with them is almost impossible for small companies.

------
ryanbertrand
The thing that pisses me off about HIPAA and startups is the cost of being
HIPAA compliant! You must run on dedicated instances. So your AWS bill is
minimal thousands of dollars and that's just the start!

Sure there are starts doing HIPAA compliant IaaS but Paying $99 for 1 GB
container is still pricey.

~~~
angersock
Pull on your big kid pants and maybe admin your own servers?

~~~
raverbashing
So much this

Get the actual machine and plug it. It will be much cheaper than AWS

And no you don't need 5 machines to run hundreds of "microservices" on a
handful of VMs

------
kn9
[http://hospitalrun.io/](http://hospitalrun.io/)

------
patja
Naming matters. I can't see this without instantly thinking it is about
delicious sandwiches.

~~~
sudhakarrayav
Why the name Bahmni?

The first implementation of Bahmni took place at Jan Swasthya Sahyog (JSS), a
hospital that has been instrumental in pioneering this open source work.
Bahmni is named after a village 70km north of the small town of Bilaspur,
India where one of three village health centers of JSS hospital is located.
The work being done by JSS at Bahmni village is very inspirational to us and
hence the name was chosen.

Ref: [http://www.bahmni.org/faq/](http://www.bahmni.org/faq/)

~~~
healthenclave
As a Medical Doc and a health tech entrepreneur current living in Bilaspur. I
find this fascinating. But I think the village where JSS is located is called
as Ganiyari ??

~~~
gsluthra
Yes, JSS is in Ganiyari. About 15 kms from Bilaspur.

------
sidcool
This is one of the great products I have friends working on. ThoughtWorks has
a big team working on this product. It's amazing to see it working well in so
many countries.

~~~
shivaodin
Please give examples of how this is working well in other countries with case
studies. It does not appear to be a technically innovative product, just
bundling of some open-source products together.

------
45h34jh53k4j
Very proud of this product. The target is not the US domestic market, but
developing areas that have no resources for electronic health records. I have
seen this being implemented places where the traditional software would be
cost prohibitive. Good for humanity. Please contribute patches!

~~~
h3llow0rld
Why did you rip off Epic's UI? This is only going to make them more paranoid
going forward.

~~~
gsluthra
Which screens in Bahmni made you feel like they look similar to Epic? Here are
the Bahmni screenshots:
[http://www.bahmni.org/screenshots/](http://www.bahmni.org/screenshots/)

It would be pretty amazing if anything looks similar to Epic. Maybe the login
screen? ;)

------
h3llow0rld
There is no way this will be successful in the US specifically because it's
based in India which hospitals in the US are extremely resistant to. Also, it
looks exactly like Epic and now I understand why they are so careful with
their Intellectual Property.

~~~
Roboprog
Thanks for that bit. We are working on an integration project with Epic, but
I've never really even seen it.

(Epic throws some SOAP data at us, then we pop up a sub-view of a web app with
a form to complete which Epic puts in a frame or something like a frame)

------
contingencies
Did anyone else read this and think of _bánh mì_ (Vietnamese baguette?)...
[https://en.wikipedia.org/wiki/B%C3%A1nh_m%C3%AC](https://en.wikipedia.org/wiki/B%C3%A1nh_m%C3%AC)

------
amree
I wonder if a hospital can really use an open source hospital information
system for several years without the need to change much of the workflow to
the point where modifying it will make it impossible to update from the its
original source.

~~~
gsluthra
One of the key things about Bahmni that differentiates it is that most of the
EMR screens / fields in Bahmni are configurable via JSON / Administrator UI.
You don't need to fork / code / branch to make these changes. In some places
you can also change the order in which screens get rendered via configuration.
So, your Bahmni config stays separate from the "product", which allows you to
upgrade and get new features without having to manage your own version of
Bahmni. All you need to manage is the metadata.

The plan is to integrate with OCL in the future, so that even metadata
management can happen via a github like terminology system:
[https://talk.openmrs.org/t/introducing-open-concept-lab-
for-...](https://talk.openmrs.org/t/introducing-open-concept-lab-for-
distributions/4842)

------
raverbashing
Reminds me of Indivo. Too much promises too little results

~~~
sidcool
Bahmni has got good response from some developing countries. I didn't get your
'Little Results' jibe.

