Featured

EMR: can it be feng shui?

In a recent article by the Washington Post dated 10/25/09 it highlighted some of the darker sides of EMR. In particular, it underscored physician dissatisfaction with the user unfriendly nature of many programs. It also pointed out that some products took longer than their paper replacements and weren’t completely error free. Design issues were at the heart of the problem.

The Power of Choice

“Be the change that you want to see in the world.”

                                                         Mahatma Gandhi Read more

To Dare Success

It never occurs to me to shy away from a challenge. Maybe I’m foolish or possibly just wired that way. Read more

The Downside of EMR as a Service

Software as a service has firmly planted itself into the very fabric of the internet and daily computing.  EMRs are beginning to venture into this new territory. Read more

EMR: Is it worth the investment without the stimulus package?

This is an important question for me. I believe that EMR products should be able to stand on their own from an investment perspective. Read more

Breach Penalties: has Armageddon arrived?

Has the government gone too far?   The newly enacted laws related to violations of privacy and security has reached unprecedented levels. Read more

EMR Customization: is it important?

So far in my experience as an EMR developer, I’ve found that every customer has some unique wants and needs. Read more

Time is Money!

Although this seems self evident, many physicians struggle with time management. I see many doctors who say they will just do some of the office tasks to “save money.”  I recently read a blog from a psychiatrist in solo practice who had no support staff!  That means he is doing all of the office duties himself! Go ahead and do the math. If his employees made $20/hr, he would likely be losing on the order of $150-250/hr in lost revenue by virtue of missed patient billable time. Any physician who is doing any office work is leaving money on the table. Beyond just the financial loss, he or she didn’t go into medicine to be a bookkeeper! Besides, health care providers have enough on their plates trying to keep up with their clinical responsibilities.

Now that I have established the need for the physician to just practice medicine and leave the details to the low wage staff, what else would help keep the physician’s time efficient?  This is where quality practice management software comes into play. The next area of savings is to have a program that captures as much of the human workflow as possible. The biggest expense in a medical practice is payroll. Though there will likely always be a need for some humans in the office to do reception and call backs, the software program can take over many of the mundane human steps and processes. This then would save considerable overhead costs.

Lastly, the EMR should speed up the clinician’s practice, allowing an increase in productivity and satisfaction. This may be one of the harder challenges as many programmers do not understand the intricacies of a physician’s workflow. Only another physician can really understand that. A user driven development process is critical and takes a considerable amount of time and testing to pull off. In my experience doing this, it requires a lot of patience and give and take with the existing users. At the end of the day, it is rewarding to see how fast and efficiently the clinicians can use the program and enjoy practicing again.

Psychiatrists- a breed unto themselves

There is a subset of psychiatrists that are sort of like cats; they resist herding. Read more

Is there a dark side to cloud computing?

The other side of cloud computing

Cloud computing is all the buzz these days!  Various entities are jumping on the bandwagon, touting its virtues. It is the next great thing. Well, in attempting to understand cloud computing, I discovered it still is in the process of being defined and comes in many forms and varieties.  If there is still a lot of vagueness to a concept, what is one jumping to?

In terms of healthcare, rapid adoption of cloud computing is a mine field waiting to happen. If EMRs were to go in this direction, I have the following questions:

1.   Who actually owns the records?

2.   Where is the physical location of the records, since by definition they exist in a virtual space?

3.   If EMR is a service, what happens if the service ends? Does the clinician lose those records?

4.   What happens if the service cost becomes prohibitive, does the clinician get the records back?

5.   Who is responsible for breaches in the cloud computing environment, the clinician or the service provider?

6.   How can the clinician be sure of the integrity, security and privacy of the cloud computing service?

7.   Who regulates cloud computing?

8.   With such a vast network, how can a cloud computing provider prevent a hacker from breaches?

9.   How fast can cloud computing handle bulk scanning of medical records?

10.                  What happens when the internet connection fails? How does a clinician access his/her records and chart then?

These are just a few of the important questions that still need to be answered. I certainly won’t be the first to venture into this arena, until some serious bugs are worked out on the design and implementation. With federal breach penalties and fines approaching  $1.5 million and prison time, I’m going to let someone else be the guinea pig.

Call me old fashion, but I still like to have the records in my possession, albeit in server form. By owning the server and the data therein, no one can take away my records (provided it is backed up). If the internet goes down (which it has), I can keep on charting via the direct connection to the local server. I can also perform high speed scanning directly to the local server at high capacity. Even when power has gone out in the building, I could keep on charting due to the backup batteries. There is nothing worse than having no charts when one is seeing lots of patients or having your business support staff grind to a halt.

Don’t get me wrong, I’m all in favor of technology and progress. I do think that we need to act cautiously as technology advances to make sure it doesn’t compromise healthcare’s integrity and security. Patients and providers get very nervous if this is eroded in any way. I will be the first to embrace advances in technologies when they have a proven track record of user friendliness, security, privacy and well defined ownership. These were high on my list when designing and implementing ChartShare.

Next Page »