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Thinking of installing OpenEMR yourself?
OpenEMR is an open-source project maintained by an independent community. You can download and run it yourself, and for some clinics that is the right call. This page is written to help you make that judgement, not to talk you out of it.
Published
Availability is not the same as operation
The software costs nothing to obtain. What costs something is keeping it running, patched, backed up and correctly configured for a clinic that sees patients every day. Those are two different questions, and only the first one has a free answer.
What you are actually choosing between
Both routes start from the same software. OpenEMR is the same code whether you install it yourself or someone installs it for you, and nobody owns it or can take it away from you.
What differs is who carries the work listed on the rest of this page. Self-hosting keeps all of it with you, and you pay for it in staff time rather than in fees. A supported implementation moves most of it to whoever you engage, and you pay for that in fees rather than in staff time. There is no version where the work does not happen.
Neither answer is right in general. A clinic with someone technical who already keeps other systems running is in a genuinely different position from one where the practice manager would become that person by default.
Hosting
- Decide whether the server sits in your clinic or with a hosting provider, and who is accountable for it either way.
- A machine under the reception desk has no redundancy and usually no monitoring.
- Whoever holds the server also holds the responsibility for its operating system, its certificates and its access rules.
Installation and configuration
- Installing the software is the short part. Configuring it for how your clinic actually works is the long part.
- Facilities, users, fee schedules, appointment types, document categories and code sets all have to be set up before anyone can be asked to use it.
- Budget for a second pass. Nobody gets this right the first time.
Updates and patches
- Someone has to watch for new releases and decide when to apply them.
- An update that goes wrong on a Monday morning is a clinical problem, not an IT problem.
- Test an update somewhere that is not your live system, and know how to go back.
Accounts and roles
- Give every person their own login. Shared logins destroy the value of any access record you might later need.
- Decide what each role may see before you create the first account, not after.
- Write down who removes an account when someone leaves, and how quickly.
Forms and templates
- The forms your clinicians use are configuration, and configuration is work.
- Decide who owns them, and what happens when a clinician asks for a change.
Backups and restore testing
- A backup nobody has restored is a hypothesis, not a backup.
- Decide the schedule, where copies are kept, and who can reach them.
- Put a date in the calendar to test a restore, and keep it.
Migrating your existing records
- Look at the data before planning the move. What you find usually changes the plan.
- Decide in advance what will not come across, and who signs that off.
- Check a sample of records by hand after the move. Counts matching is not the same as content matching.
Training and day-to-day support
- Someone in the clinic becomes the person others ask. Decide who, and give them the time.
- Plan for the staff you hire next year, not only the ones in the room today.
What the free option costs
The cost of running it yourself is not a licence fee. It is a standing claim on someone's attention, and it does not end after the first month.
- Someone has to notice that a release came out, and decide whether it is safe to apply this week.
- Someone has to own the configuration when a clinician asks for a form to change, and say no when it should not.
- Someone has to be reachable on the morning it will not start, and that morning will come.
- Someone has to test a restore, in advance, when nothing is wrong and there is no urgency to do it.
- That person is usually the same person the clinic already relies on for something else. Ask what they will stop doing.
What to ask an implementer
- Which of the responsibilities above are theirs, and which remain yours?
- What is included in the fee, and what is charged when it happens?
- What do they do the day your system will not start?
- How do you leave, and what do you take with you?
Where to go from here
Every SkyEagle product line can be seen in a walkthrough, with its scope and any configuration or integration requirements explained.