CareCode Open HMIS: An Open-Source Hospital Management System Built in Production, Not in Theory
Most open-source hospital management systems start as academic projects. CareCode Open HMIS started in a doctor's clinic in 2004, and it hasn't left production since.
Over the past two decades, this system has grown from a simple Electronic Medical Record into a comprehensive Hospital Management Information System serving over 40 healthcare institutions. It handles real patients, real billing, real pharmacy stock, and real lab results — every day, across hospitals, clinics, pharmacies, laboratories, and channelling centres.
Here's what makes it different, and where it fits.
The Numbers
- 20+ years of continuous development (since 2004)
- 45,000+ commits from 125 contributors
- 890,000 lines of Java code
- 1,699 Java files and 3,587 XHTML pages
- 40+ healthcare institutions in production since 2015
- Open source under AGPL license
What It Covers
CareCode Open HMIS is not a single-module tool. It covers the full breadth of hospital operations:
- OPD — Patient registration, billing, queue management
- Inpatient — Admissions, ward management, interim billing, discharge
- Pharmacy — Procurement, batch-level stock tracking, dispensing, inter-department transfers, wholesale
- Laboratory — Investigations, specimen tracking, analyzer interfacing (ASTM), report approval, collecting centres
- Channelling — Doctor appointment booking, session management, SMS notifications
- EMR — Clinical notes, diagnoses, prescriptions
- HR & Payroll — Staff management, attendance, shifts, salary processing
- Accounting — Cashier shifts, cashbook, credit companies, revenue reports
- Theatre, Store, Membership, Optician — And more
Institutions adopt the modules they need. A standalone pharmacy doesn't need the inpatient module. A lab doesn't need HR. The system adapts.
The Key Differentiator: Configuration, Not Code Changes
The most important architectural decision in CareCode Open HMIS is its three-level configuration system:
- Application Options — Hundreds of system-wide settings (mandatory fields, payment methods, bill formats, SMS triggers, shift enforcement, report columns...)
- Institution Settings — Per-branch overrides for multi-location deployments
- Department Preferences — Per-department customization (bill footers, pricing strategies, print formats...)
This means two hospitals with completely different workflows — one enforcing cashier shifts with POS receipts, another using A4 template bills without shift management — run the same code. No forks. No branches. Just configuration.
This is what has kept a single codebase serving 40+ diverse institutions for over a decade.
Who Is It For?
CareCode Open HMIS is built for healthcare institutions in resource-constrained settings that need a working system without commercial licensing fees. It has been deployed across:
- Private hospitals with multiple departments
- Outpatient clinics and medical centres
- Standalone pharmacies
- Clinical and medical laboratories
- Doctor channelling centres
- Multi-branch healthcare groups
The Honest Limitations
- Not a SaaS product — You need Java EE and database administration skills to deploy it, or commercial support
- Desktop-first — The primary interface targets workstation browsers, not mobile
- FHIR interoperability is evolving — RESTful APIs and HAPI FHIR libraries are present, but full standards-based interoperability is still developing
- Primarily deployed in Sri Lanka — While globally applicable, most production experience is from Sri Lankan healthcare institutions
The Technology
For the technically curious:
- Stack: Java EE, JSF, JPA (EclipseLink), PrimeFaces, MySQL/MariaDB
- Server: Payara / GlassFish
- Architecture: Three-tier web application
- APIs: JAX-RS RESTful services
- Lab middleware: C# based ASTM protocol interfacing
- Data model: Pharmaceutical classification based on NHS dm+d and WHO ATC standards
- Deployment: On-premises or cloud (Google Cloud Platform tested)
History
| Year | Milestone |
|---|---|
| 2004 | EMR for a single general practice (VB6 + MS Access) |
| 2008 | Adoption by hospitals and laboratories |
| 2011 | Published in Sri Lanka Journal of Bio-Medical Informatics |
| 2012 | Java EE rewrite, open-sourced on GitHub |
| 2015 | Continuous production use across multiple institutions |
| 2024 | 40+ institutions, 45,000+ commits, active development |
Get Started
- Clone: https://github.com/hmislk/hmis
- Configure a MySQL/MariaDB database
- Deploy to Payara or GlassFish
- Run — the system guides you through initial setup
- Explore the wiki for user guides and configuration references
Bottom Line
CareCode Open HMIS is not the flashiest open-source healthcare project. It doesn't have a marketing team or a venture-backed roadmap. What it has is two decades of production use, a codebase shaped by real healthcare workers, and a configuration architecture that lets diverse institutions run the same system their own way.
If you're evaluating open-source HMIS options for a healthcare institution in a developing country, it deserves a serious look.
CareCode Open HMIS is available under the AGPL license at github.com/hmislk/hmis.
Originally developed by Dr. M. H. B. Ariyaratne. Actively maintained by the CareCode team and community.
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