AS GOOD AS IT GETS:

Most physicians are waiting for the best of breed EMR to arrive, which is inexpensive, user friendly and has high performance with a built in interface screens for simple clicking to generates notes fast as well as integrated to the appointments and billing Software.

Physicians need to begin the transition to EMR someday. It is going to take some time to integrate into a complete paperless office. It is like learning bike riding or car driving. Vendors keep making better versions with updates so you can always transfer your data to better software later if you need to. However the transformation is less painful if you use the right EMR that has an RDBMS database like Microsoft SQL Server 7.0.

A journey of thousand miles has to start with a few single steps!!!

Practice makes a man perfect!!!

TIME:            

Most Physicians feel that it is time consuming to use an EMR. Initially you might need to spend some time to gain acquaintance with the system, which depends on how fast you will learn exciting things; thereafter it is just a mouse click for you and you can spend most of your time with patients or social commitments.

They could use all normal physical examinations initially and then go to a less cumbersome symptom related progress notes like a routine follow up for Hypertension or Diabetes or a URI later. They could also use the nurse assistant or a medical assistant to enter routine data like patient(s) particulars, past medical & surgical history, allergies, social history, medications etc. This can eliminate a lot of burden off the physician’s shoulders and save time.

A physician can also save time by totally eliminating the need for an assistant’s input of routine history of the patient each time, during dictation to transcribe. Documents can be made longer with EMR in a few seconds that justify those comprehensive visits.

PRICE:                     

The cost of EMR software varies from few hundred dollars to more than a few tens of thousands of dollars. The less expensive EMRs may not be ideal and comprehensive and the more expensive ones may not be money’s worth. So, choosing the right EMR needs a lot of caution and careful judgment. EMRs can improve the quality of work of the employees and save their time as well. It also saves paper cost and filing expenses. It helps generate more revenue and lost billing. Transcription expenses can be avoided as well. 

PARADIGM SHIFT: (INFORMATION REVOLUTION)

A shift is occurring from an industrial to an informational economy. The electronic revolution, which had changed the way the things were, from space stations to daycare centers and dry cleaners, has yet to embrace the health industry.

With more managed care and Medicare scrutiny and audits, penalties are being implemented thoroughly in reviewing medical records for justification of charges billed. MDs without EMR software are exposed to risk of audit and penalty.

PARADISE OF TECHNOLOGY:

In the years to come one would wonder how did the physicians do without pagers, cell phones, fax machine, computers and above all EMRs. What a paradise of technology!

EVIDENCE BASED MEDICINE & PREVENTIVE CARE:

Preventive screening can never be complete without proper documentation and reminders. Statistics and reports cannot be generated without EMR software. Patients on a particular drug cannot be recalled when that drug is withdrawn from the market for a post marketing reaction.

POINT OF CARE:

It is very important for the hospital and all the treating physicians at the point of care to have access to the past history and other details of a patient. It is also very helpful to have all the available medical information so the best of health care can be delivered. All this can only be achieved with EMR software.

TOO MUCH OR TOO LITTLE:

Most of the notes generated by the available EMRs are too much or too little. But it is possible to modify the notes to one's taste very easily with a customizable EMR.

INTERFACE: Graphic Palettes with new technology

Not all templates are same. They vary from a simple macros like a sentence to a paragraph to a page which is just copied into your note like a Broiler plate and they the user edits some words or a few sentences to make it look like a custom note. With this kind of template based software it is time consuming to customize and adjust to one’s requirements. These are very low end EMR programs which are developed overnight by programmers with only  a little idea of what the doctors do.

The other concept based EMR programs bring in as much text as possible but the user still needs to chase those changes. Again such notes have to be typed initially and it is really very time consuming to make at least 50 commonly used templates.

In Graphic Interface the user can input data much faster with just a few clicks and selections. However, this feature could be time consuming if the user has to click and scroll a number of times and move between several screens. A lot of time could be saved if all these clicks and selections are saved and recalled with just one click when the user encounters such a scenario. This feature is only available with a Graphic Palette. The Graphic palettes are easily customizable with only clicks instead of writing large paragraphs of text and are adjustable for any scenario encountered in the medical practice.

MOBILITY:

It’s hard to stay close to or find a computer during the patient care scenario. True, proximity to the hardware is a practical issue. Thanks to the improved technology, it can be achieved simply with a network (wireless preferably-which is faster now) LAN or WAN to keep connected to the main database on a server. However if you are a solo physician you may use a compact low weight laptop or sub notebook (preferably a Sony or Fujitsu or Acer).

PDA is other alternative to take smaller notes or prescriptions or rounding information. It is cumbersome to generate detailed notes with PDA due to its smaller size. Some of the Intern residents have mastered skills on these and are able to generate SOAP Notes quickly. Hats off to them.

SQUISHED BY TEMPLATES:

Most EMRs have templates that give you the “Jack in the box” feeling and slow you down, if you were to change any of the text or disrupt the established functionality of the EMR. However there are some EMRs, which are not purely template based like the innovative WriteMD that is also introducing palette based examinations giving you free text generation capability from a Graphical User Interface or GUI, rather than editing a Boilerplate template that gives you “more response than you bargained for”.

HOW TO CHOOSE AN EMR SOFTWARE:

Following are few important features you should consider:

Ä     Does it have ease of use GUI and support for Templates? Is it customizable?

Ä     Database: Is it a Relational Database?

Ä     Network: Is the Application network ready?

Ä     Security: Password and proper encryption?

Ä     Price: Is it affordable? 

Ä     Scalability: Is it possible to shift from a single office to multi Office and single user to multi User?

Ä     Accessibility from Home: Through Internet or Modem?

Ä     Access on Internet: Is it possible to host records on Internet?

Ä   Other features:  Look for features like Memo and lecture notes, CME tracker, Formulary, referral, Medical calculator etc.

HOW TO CHOOSE A HARDWARE:

Hardware: 

Network:

Wireless: Bid good-bye to those ugly cables. This gives you so much freedom. You can move your machines freely with out the hassle of untangling all those wires.

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