OpenMedCheck: the AI prescribing assistant for the emergency room, reading what doctors don't have time to

Hacktoberfest Open-Source AI Challenge Week 2: Side Hustle Submission 💸

This is a submission for the Hacktoberfest Open-Source AI Challenge Week 2: Side Hustle

Not for clinical use — synthetic patients. Not a medical device. OpenMedCheck is a concept demonstrator. Every patient in this post is invented.

OpenMedCheck is an open-source prescribing check for emergency-department doctors. One proposed medication order goes in, together with the patient's record. One decision card comes out: NO_ISSUE, WARNING or BLOCKED, with the reason, the doctor's own words as evidence and, where the rule table allows one, a re-checked alternative. When nothing conflicts it says one line, "No issue found by these checks", and gets out of the way.

The problem it solves. In the ED, orders are written under time pressure, and the fact that makes a drug a bad idea is often only in free text:

Prescribing modules mostly check drug pairs against coded data. They don't read the note. And the alerts they do raise are often overridden: a 2025 systematic review of drug-drug interaction alerts found no significant improvement in patient-important outcomes. We think the problem isn't too many alerts in general. It's alerts without the patient's context.

Who would pay. Not the ED doctor. The buyer is whoever owns medication safety in a hospital: pharmacy and medication-safety teams and clinical-informatics teams. They carry the cost of medication errors and of alerts that don't help, and they can't extend the checks inside their vendor's prescribing module. EHR and decision-support vendors could also embed it as an open, inspectable component.

The model is open core. The engine stays open source. A hospital would pay for:

This is a hypothesis I haven't tested with buyers yet.

Open-source prescribing check for emergency-department doctors. Flags a medication order that conflicts with the patient's labs, diagnoses, past medical history or free-text note — and stays silent when nothing conflicts. Deterministic rules decide; Gemma 4, running fully locally, can only escalate.

Quick start · How it works · Configuration · Architecture · Contributing

Not for clinical use — synthetic patients. Not a medical device. OpenMedCheck is a concept demonstrator built for the DEV Hacktoberfest Open-Source AI Challenge. It works on synthetic patients only, gives no medical advice, and must not be used for any real patient.