The ACA mandated and funded the adoption of EMR in large part by providing funding to physicians' offices which they could use largely as they wanted as long as

The ACA mandated and funded the adoption of EMR in large part by providing funding to physicians' offices which they could use largely as they wanted as long as they ended up with a certified EMR. Unfortunately the certification process is "not free" to tune of at least tens of thousands of dollars in testing costs to outside certification authorities, plus whatever work needs to be done as prep or to remediate issues. OpenEMR also used to have a very unpolished interface in a "frame-driven late 90s web form" kind of way, and that probably hurt its adoption some when practices were looking at it and comparing it to more polished offerings from the commercial vendors. There have been multiple open source EMR packages over time, many of them derived from failed commercial attempts that were then open-sourced. I believe that OpenEMR is one of those, but I think that most of the rest have fallen by the wayside or are used in situations where certifications and Meaningful Use attestation are not so relevant. Others on the thread (e.g. brady) are core members of the OpenEMR team so they're probably better able to answer questions.