Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS

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Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS

This is a review Zaidan, Ziadan, Al-Haiqi, Hussain, and Mohamed (2015) articles, Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS. [1]

Research Question

The purpose of this study is to evaluate open-source Electronic Medical Record (EMR) software and select the top performing packages on a multi-criteria evaluation.


It is challenging to select software that meets organizational requirements. Evaluating and selecting software packages that meet the requirements of an organization are difficult. A poor choice in EMR software can be costly and have many adverse effects on the functionality of the organization. This study uses a hands-on approach to examine open-source EMR software through the use of virtual machines and several evaluation measures. The Integrated Analytic Hierarchy Process (APH) and TOPSIS were used as outcome metrics. GNUmed and OpenEMR software received superior overall rankings on these metrics.


Eight open-source system underwent a preliminary investigation prior to installation. Next, hands on evaluation was used to compare systems on the process of instillation, usability, and other variables. Systems were compared using Integrated AHP and TOPSIS to evaluate the merits and limitations of each system. The programs were evaluated based on the following quality characteristics: technical details, usability, functionality and features, security, user support, developer support, customization, and ease of installation.


Total scores on each of the eight cores are combine for a true value score. The scores are normalized. The following systems received the following composite score (system score/total possible score: OpenEMR (19/25, GNU-Health (16/25), GNUmed (14/25), WorldVista (14/25), OSCAR (14/25), FreeMED (13/25), HOSxP (10/25), HospitalOS (9/25), MedinTux (9/25), OpenMRS (8/25), ClearHealth (7/25), THIRRA (7/25) and ZEPRS (5/25). OpenEMR and GNU-Health had the highest total score on the 8 quality measures.


Few studies have analyzed the available open-source EMR software options beyond status and profile. The studies limitations includes lab versus real world implementations, the sample of open-source software is limited, and quality measures are subjective rather than objective. AHP-TOPSIS analysis revealed that GNUmed and OpenEMR software have the best overall ranking scores compared to the other open-source software in the study. The features that demonstrated the most significant deficiencies are security, interoperability, and support from developers.


As research continues to investigate open-source EMR software options, users will be better able to select the best available option to meet organizational needs. Additionally, the results of the software evaluation will guide future improvements in open-source systems. Without determining where open-source software performs poorly, it is not possible to make significant improvements with minimal investments. Based on this study, the development of open-source software should be directed towards increasing current system performance in the areas of security, interoperability, and support from developers.

Related Links

  1. Leveraging of Open EMR Architecture for Clinical Trial Accrual
  2. Open_source_EMR_software:_Profiling,_insights,_and_hands-on_analysis
  3. The OpenMRS System: Collaborating Toward an Open Source EMR for Developing Countries
  4. Cooking_up_an_open_source_EMR_for_developing_countries:_OpenMRS_–_a_recipe_for_successful_collaboration
  5. Open-source_health_information_technology:_A_case_study_of_electronic_medical_records


  1. Zaidan, A., Zaidan, B., Al-Haiqi, A., Hussain, M., & Mohamed, A. (2015). Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS. Journal of Biomedical Informatics, 53, 390-404.