Open Core Ventures (OCV) is proud to announce the launch of OpenCoreEMR, a platform to modernize healthcare technology infrastructure built on the world’s leading open source electronic medical records system, OpenEMR. OpenCoreEMR helps medical practices manage records, scheduling, prescriptions, health information exchange, and billing so providers can focus on outstanding care. It addresses the critical infrastructure gap between small clinical practices and enterprise hospital systems by providing extensive customization capabilities while delivering enterprise-grade security, compliance, and scalability. OpenCoreEMR is positioned to revolutionize this space by using AI to transform every facet of the EMR platform, creating a truly intelligent and predictive healthcare ecosystem.
Founding Head of Engineering Matt Summers brings decades of experience in healthcare technology, DevOps, and open source software to OpenCoreEMR. His background includes building data systems for federal grants, leading infrastructure development at a cancer genomics startup, and leading the technical design and implementation of a hybrid edge/cloud metagenomics and infectious disease surveillance platform for the Department of Defense. A former board member of the Gentoo Foundation, Matt has a long history in open source. He’s joined the OpenEMR security advisory team to triage and fix security vulnerabilities in the core product.
The flexibility crisis in healthcare IT
Healthcare technology is dominated by inflexible commercial systems requiring expensive customizations that fail to meet the unique needs of growing medical practices. Many growing practices are caught in a difficult middle ground—too large for simple solutions and too specialized for rigid systems like Epic. Commercial EMRs like Epic are designed for massive hospital systems with enormous IT budgets and dedicated staff, leaving mid-sized practices with solutions that are simultaneously overpowered and underperforming for their specific workflows.
There are an estimated 5,000+ OpenEMR installations within physician offices and smaller healthcare facilities in the U.S., collectively supporting the care of over 30 million patients.
"OpenEMR as a project has existed for roughly 25 years, and throughout the project's lifetime, it has provided an accessible open source health record system that smaller clinics could easily get up and running with a minimal investment in terms of licensing costs or otherwise," said Matt. "OpenEMR gives clinics the freedom, flexibility, and control that you definitely do not have with an EPIC or Oracle Health.”
Customization is critical for clinical practices with specialized workflows and unique operational models. Growing practices typically operate with lean IT teams who need solutions they can adapt without extensive resources. "There are just so many different implementation models that you can fairly easily customize OpenEMR to do what you want," said Matt, highlighting deployments for mental health clinics, vision centers, and other specialty practices that benefit from this flexibility. While commercial systems force providers to adapt their workflow to software limitations, OpenEMR allows the opposite: adapting software to clinical needs.
Growing clinics face limited options
While OpenEMR provides the flexibility and control small clinics need, growing medical practices require more support. “The OpenEMR foundation has made tremendous strides in advancing health equity globally, focusing on creating accessible healthcare technology for underserved communities,” said Matt. “But medium-sized clinical systems in the US market need more robust commercial support than a volunteer-driven foundation can provide.”
As a clinical system with one or two providers expands to 10-15 locations with 50-60 doctors, they have to support OpenEMR with their own dedicated IT staff or work with another small IT company. This infrastructure gap creates critical data management challenges. As practices grow, they accumulate massive amounts of sensitive patient information that they are responsible for protecting. Without the enterprise-grade security and compliance infrastructure, many practices face significant compliance risks that threaten both patient privacy and business continuity. "A HIPAA breach is expensive. It can completely end a company," said Matt.
For mid-sized practices caught between simplistic small-clinic solutions and overwhelming enterprise platforms, there's a desperate need for technology that bridges this gap, offering the customization benefits of open source with the reliability and compliance of commercial systems, all while keeping data management secure and streamlined.
NextGen healthcare IT
OpenCoreEMR aims to bridge this gap by modernizing the OpenEMR codebase and providing a managed service platform that abstracts away the complexity of running a secure, compliant healthcare system without losing system flexibility. "There's a pretty significant maintenance burden and observability burden with running this yourself, and we can do it better, faster, and cheaper," said Matt. “The open core approach allows us to stay committed to contributing improvements back to the core project while building value-added services on top for those who need them.”
Modernizing the technology foundations to support current deployment models and security requirements includes integrating contemporary technologies like AI, increasing the scaling capabilities of the core project itself, leveraging newer deployment models like Kubernetes or containerization, and possibly embracing serverless, according to Matt. “Our approach is iterative. We’re chopping off little pieces and building a more contemporary or modern service approach that lends itself to containerization and makes it easier to maintain in terms of security patches and vulnerability management."
The team has already begun rebuilding critical components with modern technologies. "We just rewrote the calendar module using Python," said Matt. They also plan to develop a comprehensive workflow customization engine to take this flexibility to the next level. "Custom workflow engine is a big one. There isn't much of a workflow engine now,” said Matt. A workflow engine would allow practices to design their clinical processes exactly as needed, supporting everything from general practice to specialty-specific workflows for mental health, vision care, surgical centers, and other disciplines.
Long-term, OpenCoreEMR hopes to bring customization, flexibility, and control to bigger medical systems. "As we are able to accelerate the modernization of the code base itself and improve its capacity to scale to larger systems, we'll move up the chain from the smaller and medium-sized clinical systems into hospitals and hospital systems,” said Matt. This approach offers an alternative path to the expensive and inflexible solutions that dominate healthcare today.
Beyond operational efficiencies, OpenCoreEMR is a champion of true patient data portability. In an era of increasing regulatory momentum towards patient-centric data access, the platform will empower patients by providing seamless and secure control over their health information. This enhances the patient experience by reducing friction and enabling continuity of care across different providers, and has a profound impact on outcomes by ensuring that critical health data is available when and where it's needed most. By leveraging modern, interoperable standards, OpenCoreEMR will break down the data silos that currently hinder patient care and pave the way for a more collaborative and informed healthcare journey for every human being.
Open core opens doors
Open Core Ventures started OpenCoreEMR to transform a critical piece of open source healthcare infrastructure. After extensive conversations with the OpenEMR foundation, it was clear there was a market need for a commercial entity around the project. Matt’s experience in healthcare technology, infrastructure at scale, and open source governance made him the ideal choice for technical leadership at the company.
Matt shares enthusiasm for the opportunity ahead: "The foundation folks at OpenEMR are dedicated to progressing global health equity, and I think that's excellent. I want to support that personally and professionally," said Matt. “Starting a commercial company with OCV supports the goals of the foundation by taking on and serving the commercial needs. Everybody benefits from a more secure, more robust, more interoperable open source electronic medical record system.”
By focusing on the infrastructure layer of healthcare technology, OpenCoreEMR is building the future of healthcare by embedding intelligent AI at every touchpoint of the electronic medical record. “We envision a system that doesn't just store data but actively partners with providers to unlock efficiencies, elevate patient care, and dramatically reduce administrative burdens. From ensuring precise coding and billing for seamless payer approval to optimizing scheduling, streamlining patient intake, and empowering clinicians with intelligent scribing,” said Matt. “This is not just EMR modernization; it's the dawn of the intelligent EMR.”