By any chance have you used GNU Health[0] at all? I'm guessing no since it's uncommon in the US/NZ, but figured I'd ask just in case. Curious what your impression of it would be as an MD.
Does anyone in high-income countries use something like that? It is worth nothing that the software product itself is only a tiny part of implementing most enterprise software projects.
Maybe not, but if the EHR systems used in high-income countries are as universally awful as I've heard from doctors, and if GNU Health is at all better... I'd ask why not then!
Billing and marketing is likely the reason. There is no one responding to RFPs advocating for GNU Health, and it likely is not up to scratch for medical billing/automated overbilling of insurance providers.
EHRs in the USA, Germany and other countries with numerous health insurance providers are primarily there to ensure every service and tools used is billed fully (or overbilled).
Because the EHR system is not itself an independent system, but part of a broader complex that also includes handling of financial transactions, and financial transactions are what moves money.
GNU Health’s support for the whole set of pre-authorization, billing, payment, and related transactions seems to be...generating manual invoices.
[0] https://en.wikibooks.org/wiki/GNU_Health