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Introduction

OpenEMR is an open source electronic health records and medical practice management tool. It is used by physicians and healthcare facilities to manage electronic medical records, prescriptions, patient demographic tracking, scheduling, reports, and electronic billing. At the time of this publication, OpenEMR supports more than 30 languages.

In this tutorial, you will install OpenEMR on an Ubuntu 20.04 server running a LAMP environment (Linux, Apache, MySQL, PHP).

- An Ubuntu 20.04 server with a non-root sudo-enabled user account and a basic firewall. This can be configured using our initial server setup guide for Ubuntu 20.04.
- A fully installed LAMP stack, including Apache, MySQL, and PHP, with firewall settings adjusted to allow HTTP traffic. Instructions for installing a LAMP stack can be found in Steps 1 through 3 in our guide How To Install Linux, Apache, MySQL, PHP (LAMP) stack on Ubuntu 20.04. Note that Steps 4 through 6 of the LAMP guide are optional as they are for testing purposes and unnecessary for this tutorial.

Step 1 — Installing Additional PHP Extensions

When setting up our LAMP stack, a minimal set of extensions were required to get PHP to communicate with MySQL. OpenEMR requires two additional PHP extensions that you will need to install for it to work correctly. Use apt to update your server’s package list and install the php-xml and php-mbstring extensions:

 $ sudo apt update

 $sudo apt install php-xml php-mbstring

After both extensions have been installed, you’ll need to reload the Apache web server for changes to take effect:

 $ sudo systemctl reload apache2

When your webserver has reloaded, you should be ready to proceed to the next step.

Step 2 — Create a MySQL Database for OpenEMR
You will now create a database in MySQL for OpenEMR. First, log in to MySQL as the database root user:

 $ sudo mysql

Once you are logged into MySQL as the database root user, create a database named openemr with the following command:

mysql> CREATE DATABASE openemr;
Next, create a new user and assign them a password by replacing PASSWORD below with a strong password of your choosing:
mysql>CREATE USER 'openemr_user'@'localhost' IDENTIFIED BY 'PASSWORD';
Next, grant the new user permission to the openemr database:
mysql> GRANT ALL PRIVILEGES ON openemr.* TO 'openemr_user'@'localhost';
To enable these changes, enter the following command:
mysql> FLUSH PRIVILEGES;
Once you have flushed the privileges, you can now exit MySQL:
mysql> exit

You are now ready to proceed to the next step.

Step 3 — Configuring PHP for OpenEMR

In this step, you’ll make some changes to the php.ini file as recommended by OpenEMR documentation. If you followed all prerequisites within a fresh Ubuntu 20.04 server, the php.ini that applies to your Apache web server should be located at /etc/php/7.4/apache2/php.ini. In case you have a different PHP version, this path may be slightly different. Adjust as necessary and open the file with a text editor of your choice. Here, we’ll use nano:

 $ sudo nano /etc/php/7.4/apache2/php.ini

Once you are in the php.ini file, you will change the values of several options as recommended by OpenEMR. If you are using nano, you can search for these options using CTRL + W. If there is a semicolon ; in front of the option you are adjusting, make sure to delete it as a semicolon is used to comment out an option.

Values for the following options should be changed:

max_ input_vars
This option limits the number of variables your server can use in a single function. OpenEMR requires this option to have the value 3000:

/etc/php/7.4/apache2/php.ini
max_input_vars = 3000
max_execution_time
This option limits the amount of time (in seconds) a script is allowed to run before being terminated. OpenEMR requires this option to have the value 60: