Health insurance agencies demand correct supply of data which have to be compliant with the law of their particular countries. In the case of erroneous submitted data the user might run into big trouble. Therefore, accurate accounting is an absolute must for practice management systems. Only providers able to provide accurate data will stay at the market. This is true for both kinds of systems: Open and Closed Source.
As such, certifications for practice management software are needed. The German BMfGS (Ministry of Health and Social Care) has indicated that this should also be possible for Open Source software.
There is also a precedent where Open Source software was certified: Deutsche Teleckm only lets certified software access the firmware of ISDN-cards. So the drivers in the Linux kernel for those ISDN cards need certification. This will be done by defining a MD5 checksum which the code has to match.
Technically this is realized by registering the checksum of the certified source code. The verification of this checksum ensures that the actual code is identical with the code which was certified.
Sometimes the guidelines fixed by law may change with very short deadlines. This means the practice management software has to be changed very quickly and the user depends on timely changes. Often users have doubts that Open Source software developers could afford this because it is common sense that Open Source software is developed by some funny geeks hacking around on their keyboards far from daylight. But this prejudice is very outdated.
Production systems for practice management software definitely require commercial support. Users have to learn that Free Software does not mean free like free beer. Well the code is free of charge but if users want commercial support they have to pay for it. They have to pay for it as they would have to for any other piece of software they use in their practice. This is no different. The advantage is that the availability of the source code makes support easier and users are safe for the future. So in the longterm run Open Source software will be cheaper but you do not get it for nothing.
Moreover analyses show that free availability of the source code makes the work of service providers more easy, provides insurance for continuous independence from producer and thus it is less expensive in the long term run. Using the change of legal guidelines as an example it should made clear that Free Software is not identical to free of charge usage. Of course greater institutions like hospitals are able to hire specialists who might replace external service providers but also these specialists cost money.
Commercial support requires the expert knowhow of bioinformaticists who have knowledge in both fields: software engineering and medicine. This leads to a business model for companies that sell support for medical Free Software
regarding meaningful usage of Free Software or the choice between different Free Software projects solving the same problem. This implies a detailed knowledge of the Free Software market. Debian-Med will give a good overview about different solutions.
of the software in customers office. The ideal situation would be if all necessary programs would be included in Debian to enable trouble-free installation.
by adapting the software to special requirements can be done by a support company. However, it is in the interest of the support company to forward these changes to the upstream authors to get those new features included in future versions. For this purpose the Debian Bug Tracking System might be used to supply patches.
of the installed software in case of security issues or new versions. Debian shows its strength here because this is solved by powerful tools which are of really great help for a support company.