Today with the vast development of technology in the world responding to the variable and complex needs for interchanging clinical information among healthcare providers to improve the quality of health-care services seems more practical than any time before. Effi cacy of healthcare services and medical interventions are highly dependent on a trust worthy and integrated history of individual medical and health status. Electronic health record (EHR) is one such response that covers the need of all engaged parties including patients, doctors, clinical staff , insurance companies, health care providers and policy makers. It provides a platform on which individual health information is stored and accessed only by authorized people.

EHR is a new way of storing and processing health information. A wide range of terms and phrases have been used to describe health and medical records. Health Insurance Portability and Accountability Act (HIPAA ) defi nes EHR as “an electronic record of health-related information on an individual that is created, gathered, managed and consulted by authorized health-care clinicians and staff . The terms “Electronic Medical Record,” ( EMR) Computer-based Patient Record (CPR), Electronic Patient Record (EPR), Personal Health Record (PHR), Computerized Medical Record (CMR) may also be treated synonymously with EHR.

OPEN SOURCE SOFTWARE (OSS) In terms of software development and licensing, OSS and proprietary software are two main categories of software. “The promise of open source is better quality, higher reliability, more flexibility, lower cost and an end to predatory vendor lock-in. OSS encourages having access to the source code — the code computer programmers write-with the freedom of usage, modification and redistribution. On the contrary, he source code in proprietary software is confidential. The end user of such products can access and execute only the machine code.

The source code of proprietary software is closed and belongs only to the developer. The intention of developing this kind of software is to make a profit from licensing, rental or sale of the software and maintain full control of the product. Although OSS and “free software” describe almost the same category of software, they stand for views based on different values. Free software respects freedom to run the software to study and change it and also to redistribute copies with or without changes. The free software movement begins in 1983. In 1984, the free operating system GNU was developed. GNU General Public License (GPL) is a free, copy leF license for software, which is intended to guarantee the freedom to share and change all versions of software to make sure it remains free for all its users. As some of the users and developers of free software were not agreed with the goals of the free software movement, a part of the free software community separated in 1998 and began to campaign in the name of “open source” afterward. Open source is based only on practical values, such as making or having powerful and reliable software. Open Source Software (OSS), Free and Open Source Software (FOSS) and Free, Libre and Open Source Software (FLOSS)- although are not exactly the same- are alternative terms for free software. In the health sector, open source products have been designed to improve health-care while reducing the cost of similar proprietary products.

According to Reynolds CJ,  Wyatt , it creates “a key opportunity for the promotion of effective systems by enhancing clinical engagement in software development, fostering innovation, improving system usability and reducing costs and should therefore be central to a rational HIS [Healthcare Information System] procurement strategy. A handful of projects on developing EHR systems have been carried out in many countries.