Wilder, writing in Advance for Health Information Executives, notes that current Electronic Health Record (EHR) systems can cost $44,000 to install, and $8,500/year to maintain, per doctor. But his argument for open source goes well beyond cost.
Universal implementation of proprietary EHR systems has the potential to wrest control of the doctor-patient relationship from doctors and their patients. Unfortunately, most doctors and their patients don't have a clue that this could happen — and already is happening — right under their noses.
Wilder says insurers who subsidize the purchase of EHR systems also wind up controlling the proprietary systems' architecture. He also says proprietary systems make reform more difficult, because they lock-in the system of multiple payers and employee-paid insurance through software.
Wilder adds that if insurers are able to control EHR architecture privacy will never be protected, as it's not in their interest to protect it.
Reading Wilder's piece, critics will argue that he is supporting a vendor, namely WorldVistA, the open source project based on the Veteran Administration's VistA code. But in the end it's the transparency of the code, not its cost and not who it comes from, which matters most to him.
So, today's question. Does open source protect the interests of doctors and patients, and do proprietary solutions mainly serve insurers and other stakeholders?