ClearHealth and it's affiliated companies were acquired in 2017. ClearHealth the EMR stopped open source releases in 2017/2018. You can kind of hair split what is and isn't an "EMR" but if you want a system most providers would call an EMR it is extremely difficult to have it be any sort of open source anymore. Basic fundamentals like procedure codes, diagnosis codes, eprescribing, billing, drug databases, interoperability, mandatory reporting and certifications all involve large fees, licensing and other ongoing costs. At ClearHealth our main business was healthcare management. We spent about ~2 million a year on those things, we released what was not encumbered otherwise under the GPL. The EMR is still used and maintained internally by some larger institutional users.
Good points, but diagnosis codes don't generally require any licensing fees. Depending on the use case those are usually either ICD-10-CM or SNOMED CT, both of which code systems are free to use.
