// the find
masslight/ottehr
Modular, Production-Ready, Open-Source EHR
Ottehr is a full-stack EHR system built in TypeScript covering patient intake, provider-facing clinical workflows, billing/RCM, telemedicine, and lab ordering. It's aimed at health-tech teams who want a working starting point rather than building from scratch, though it requires a paid/free Oystehr account as its backend infrastructure. The fork count (364) exceeding stars (311) suggests teams are actively white-labeling it rather than just bookmarking it.
- Feature breadth is genuine: scheduling, intake chatbot, telemedicine, eRx, in-house and external lab orders, immunizations, RCM/claims, patient merging — this is not a toy. Looking at the directory tree confirms the implementation depth isn't just README promises.
- FHIR-native data model via Oystehr means the clinical data layer is standards-based rather than a bespoke schema you'll regret later when you need interoperability.
- Playwright e2e test suite with CI workflows and a dedicated E2E_README is a real differentiator from most open-source health projects that ship with zero tests.
- Theming is actually separated from app logic (THEME_PATH env var pointing to swappable theme folders), making white-labeling more than a find-and-replace exercise.
- Hard dependency on Oystehr (a commercial platform by the same company) for auth, FHIR storage, Zambda FaaS, and messaging means you're not self-hostable — 'open source' here means the frontend and business logic, not the full stack. If Oystehr changes pricing or terms, your fork is stranded.
- The Terraform setup and Oystehr account provisioning add significant onboarding friction; the README essentially suggests using an LLM to help you get started, which is a red flag for operational complexity rather than a feature.
- No evidence of a self-hosted or alternative backend path — there's no adapter layer, no mock server for local dev without Oystehr credentials, making it difficult to evaluate or contribute without signing up first.
- 311 stars for a project claimed to be production-ready with this much scope is low, suggesting limited external adoption and community validation outside the company's own customers. The contributor graph is likely dominated by Masslight employees.