Use and characteristics of free/libre and open source electronic health records: an overview of reviews.

Authors

Arthur Thives Mello, Daniel Henrique Scandolara, Júlia Meller Dias De Oliveira, Vanessa Pereira Corrêa, João Paulo Lucchetta Pompermaier, Francisco Martins Hoffmann, Miliane Dos Santos Fontanelli, Ianka Cristina Celuppi, Jades Fernando Hammes, Célio Luiz Cunha, Raul Sidnei Wazlawick, Eduardo Monguilhott Dalmarco

Published in

JAMIA open. Volume 9. Issue 3. Pages ooag100. Epub Jun 22, 2026.

Abstract

To synthesize and consolidate the existing evidence on the use and characteristics of Free/Libre and Open Source Software (FLOSS)-based electronic health records (EHRs) in global healthcare settings.
We conducted an overview of reviews, systematically searching 14 information sources using a peer-reviewed strategy. Pairs of reviewers independently and in duplicate screened studies, extracted predefined data items, and assessed methodological quality. Findings were synthesized thematically and categorized by use and system characteristics.
Nine systematic reviews (2012-2024) met the inclusion criteria. Methodological quality was generally low. We identified 26 themes related to use and 19 related to system characteristics. FLOSS-based EHRs were predominantly implemented in low- and middle-income countries, driven by cost advantages, adaptability, and community support. Reported challenges included organizational barriers, uncertainties about the capacity of volunteer-led development communities, limited comparative evidence with proprietary systems, and concerns over set-up, customization and training costs. System characteristics varied, especially regarding interoperability, security, and governance.
The implementation of FLOSS-based EHRs appears to be influenced more by institutional and organizational factors than by technical features. Their adaptability supports use in resource-limited settings, but persistent challenges may raise concerns about long-term sustainability.
To realize the potential of FLOSS-based EHRs, stakeholders must strengthen institutional readiness and governance structures, while the research community must improve the methodological quality of supporting evidence.

PMID:
42339166
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.