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The production-ready, open-source EHR.

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Ottehr

This monorepo contains code for Ottehr telehealth.

Ottehr is a modern, modular EHR that began as a reference implementation for ZapEHR. It quickly outgrew "sample EHR" status and became the foundation for large-scale production EHR installations. Ottehr uses ZapEHR for back-end service endpoints, and requires a free ZapEHR account to run as-is, but you are welcome to modify and use a third-party service vendor or build your own service architecture. Ottehr is designed for developers, hopefully making it easy to fork, white-label, and build entire new classes of EHRs and health-tech products with a fraction of the effort of starting from scratch.

Setup

Ottehr currently has a few components. Two, Ottehr Scheduled In-Person Intake and Ottehr Unscheduled Telemedicine Intake, are for patients to make appointments. Another is Ottehr EHR, for staff to work with appointments. Ottehr Elements includes components for building health software.

  • Ottehr Scheduled In-Person Intake: A patient-facing registration website for creating appointments, with features including rescheduling, checking in, sending text messages and emails, and listing appointments for an account
  • Ottehr Unscheduled Telemedicine Intake: Another registration website for patients made for telemedicine to help patients join calls with providers
  • Ottehr EHR: A staff-facing EHR for managing appointments created through the In-Person or Telemedicine intake websites, with features including checking appointments, managing patient queues, texting patients, updating a location's slots, setting a location's schedule, joining telemedicine calls, HPI and medical history, exam charting, eRx and Assessment, patient plan, coming soon: RCM and claims submission
  • Ottehr Elements: A components React library for creating healthcare applications

First Time Setup

To run Ottehr for the first time, you need to set up the project.

Node Installation

To manage Node.js versions efficiently, we recommend using Node Version Manager (nvm).

  1. Install nvm by following the instructions provided here.

  2. Use nvm to install Node.js version 18 with the following commands:

    nvm install 18
  3. Set Node.js version 18 as the default with:

    nvm alias default 18

After successful installation, verify the setup by executing:

node -v

This command should display the installed Node.js version.

Installing pnpm

To manage Node.js packages, we recommend using pnpm.

Using Homebrew or NPM (macOS/Linux):

The easiest way to get started is to use the brew or npm command:

brew install pnpm

OR

npm install -g pnpm

Manual Installation

Alternatively, you can install pnpm using the official documentation.

Joining ZapEHR

You'll need a free ZapEHR account to run Ottehr. Register for access at zapehr.com. Follow these simple steps:

  1. Visit zapehr.com.
  2. Click on Free Access to initiate your early access request.

Once your request is received, the ZapEHR team will promptly reach out to you via email, providing the credentials you need to kickstart your ZapEHR journey.

For comprehensive guidance on getting started with ZapEHR, explore our technical documentation available at https://docs.zapehr.com/docs/welcome.

Setup Procedure

To proceed with this setup guide, it is assumed that you have access to a ZapEHR project. If you have done so, please follow these steps:

  1. Fork Ottehr: Visit https://github.com/masslight/ottehr/fork and fork the repository.

  2. Clone Your Fork: Copy the SSH clone link of your fork and execute the following command in your preferred folder:

    git clone [email protected]:{your_profile}/ottehr.git
  3. (Optional) Add Ottehr as Upstream: If desired, add the original Ottehr repository as an upstream remote:

    git remote add upstream [email protected]:masslight/ottehr.git
  4. Open Repository in Your Editor: Open the repository in your chosen editor; for example, in VSCode:

    code .vscode/Ottehr.code-workspace

Before proceeding, ensure that you have Node.js v18.x and pnpm installed on your machine.

Once these dependencies are in place, enter the following command from the root directory.

sh scripts/telemed-setup.sh

For a sample guide of setting up Ottehr Telemedicine, please check getting started with ottehr.

The script will prompt you for the following information:

  • Your access token: Log in to your ZapEHR project, and copy the access token from the dashboard.
  • Your project ID: Find this on the ZapEHR project details page.
  • Your first provider email: This can be your email address.

Once the program finishes running,

  1. The Intake and EHR websites will open.
  2. To log in to the EHR, enter the email you input during the setup program. Click Forgot password? and set a password then log in.

The URL for a test location is http://localhost:3015/location/testing/prebook.

Scripts

pnpm <script name>

If a script is environment specific, use:

pnpm <script name>:<env>

build

Builds all packages using the build script.

lint

Lints all packages using ESLint.

start

Environment specific: local, dev, dev2, testing, staging.

Starts all packages. If the env is excluded, defaults to local.

update

Interactively updates all dependencies to their latest versions, respecting ranges specified in package.json.

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Modular, Production-Ready EHR

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