CottageMed

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CottageMed
Developer(s) Caring in Community 501(c)3 & Stefan Topolski
Stable release 2.7 / February 12, 2013; 2 years ago (2013-02-12)
Operating system Linux, Cross-platform
Type Electronic Health Record
License GPL v2
Website www.cottagemed.org/cottage-med/

Cottage Med is electronic medical record (EMR) software based on FileMaker, created by Caring in Community 501(c)3,[1] a Massachusetts hill town nonprofit organization. Cottage Med is free and open-source subject to the terms of the GPL v2.

CottageMed began development in 1999 as a newly minted physician, Stefan Topolski, opened a house call practice in Johnstown, Pennsylvania. It shares a software heritage with Dr. Howard Zwerling's early EMR experiments and began with a similar Apple hypercard programming environment. Unlike Dr. Alexander Caldwell's TkFP, the VA's VISTA and other early purely open source EMR projects which suffered poor user acceptance due to highly technical installations, CottageMed chose a hybrid path employing a proprietary database engine for easy installation and wider physician acceptance. In the succeeding years a dozen physicians and Filemaker community programmers have participated directly in the development of this early EMR project.

In 2002 CottageMed became the first publicly distributed free EMR to be both open source and cross-platform for PC, Mac & Linux in the world. It remains cross-platform with support for all internet browsers conforming to open standards including Chrome, Safari, Internet Explorer, Opera, and more. Filemaker, the invisible backend, is a popular Apple / Clarisworks database engine acknowledged for its advanced user interface design features which supports complex systems design through rapid development cycles. CottageMed was developed live through continuous reiterative quality improvement. Clinicians programmed it while seeing patients simultaneously.

CottageMed is the one EMR reportedly developed through constant testing and instant revision by clinicians in the field. It remains popular with clinicians in small and medium-sized practices requiring easy, instant drag and drop installation, a quick learning curve, and seamless integration with prior paper chart records and patient care workflow. It promotes itself as a nonprofit EMR not marketed to business leaders profiting from sick patients and overworked clinicians. CottageMed is distributed directly to clinicians at no cost as an EMR alternative. It is described as a pure clinical tool which supports billing but not a business tool for charge capture in the business-centric North American medical culture.

The project reports and SourceForge statistics support over 10,000 downloads[2] and 240 installations since 2003 including young physician practices in developed and developing countries, mental health clinics, correctional facilities, and projects by United Nations headquarters in Ventiane, Laos as well as USAID in Africa. It received the Filemaker Community Service Award in 2007.[3] Physicians manage most installations and make unlimited modifications to the program. The Filemaker programming interface is noted for its extensive point-and-click customizing and ease of use characteristic of early Xerox' Palo Alto and Apple human interface ideals.

CottageMed is in active development with international versions in Spanish along with beta releases in Italian, Hebrew and other languages. Since 2010 the health care reform movement in the United States of America provided federal government meaningful use standards to regulate EMR design and enforce EMR use upon physicians. This has markedly altered Caring in Community's marketing of CottageMed and its installed user base. The inordinate cost of meaningful use maintenance of certification for nonprofit free EMR's has driven this project's installed base towards developing nations. CottageMed remains a popular and appropriate technology transfer in many countries and development projects where CottageMed's simple design and ease of use complement low resource environments with limited infrastructure.

Components[edit]

CottageMed consists of a fairly flat documented series of 22 database files with one custom layout and one custom database file which is interchangeable depending on a practice's specialty or preference. Filemaker provides the database engine to operate these 22 database files as one cohesive EMR program. Filemaker Server can distribute CottageMed to over 200 simultaneous users. Filemaker Corporation documents that it is scalable to much larger network sizes.

Features[edit]

  • Basic accounting functions
  • Full and flexible access to all data fields
  • Powerful search functions on any and all fields
  • Fast, flexible report generation
  • ASP option
  • Wireless and PDA support
  • All hardware supported from 1997 to present using Filemaker v.5-13+
  • Automated prescription writing
  • Epidemiologic data mining extensively supported
  • Scalable to separate offices and 200+ simultaneous users
  • Handwritten notes supported
  • Dictation of notes directly into chart with Dragon© Naturally Speaking
  • Photo, video, radiologic and ultrasound imaging support for all open formats viewed directly in charts

References[edit]

Further reading[edit]

  • Purchasing an Affordable Electronic Record. Spikol, Louis. Fam Pract Manag. 2005 Feb; 12(2):31-4
  • Improving the Medical Home through an Understanding of Complex Systems. Topolski, S. PrimaryCare. 2010; 10(19):371-374