To users of EMRs and vendors:
1) Please go through the step-by-step process of scanning a patient's paper chart into your software.
2) Is the entire chart just one bulk scan? Or can one divide it up into various created headers: Demographics, Insurance, Radiology, Labs, Visits, etc ?
3) If documents can be stored into various headers, while in the process of doing the scan, can the PDF go directly into the appropriate headers
as done with FileCenter and Twain compatable scanner ? http://www.lucion.com/filecenter-screens.html Or does one actually have
to take additional time to drag and drop into the appropriate header?
4) Can one visualize a PDF without completley launching it? Like this.... http://www.lucion.com/images/screenshot-previewer-enlarged.gif
DescriptMED Scanning Tour
DescriptMED Multi-page Tiff scanning
R Terry Ellis
DescriptMED, LLC
Get Done, Go Home!
Tour The Chart!
1. Scan the chart, instantly it is in Medscribbler on the clerical desktop, clerk selects one or multiple scans for either same categorization as multi page or seperate pieces for particular categories and/or sub categories. we use jpgs generally but if a multipage PDF is scanned or accepted (ie some labs etc send results by PDFs) it is accepted as multi page and can be viewed page by page. Mutliple scans for the same patient can be chosen - the clerk sees each page instantly when selected and can use control to select multiple pages for the same category, sub category and patient. Once a patient to whom the scans belong is chosen then they are filed immediately into the patient chart and additionally can be marked as unsigned meaning they are sorted and qued on the doctors desktop from where they can be written on with Tablet ink, and attached to to an internal message and/or emailed or faxed (with correct management and tracking). Then there is the regular error checking and fixing for when things like filing in a wrong chart etc Also HIPPA compliant with logging of who filed etc.
2 and 3. You can scan anyway you want. If you divide the chart into "headers" ie Demographics, Insurance, Radiology, Labs, Visits etc that means you have sorted the paper first and then maybe added a category piece of paper to divide "headers" This would work with Medscribbler and is the way most non-medical document management systems work. But with Medscribbler we feel it is faster and more effecient - which it is - to sort by mouse clicks rather than by moving paper. Categories and sub-categories can be defined. In your example we would suggest a category of "old chart" be made for demographic, insurance etc because Medscribbler would now actively mange those and but the rest (labs, radiology, encounter forms) into the regular categories and subcategories so they can remain an active component of care.
4 . We use our own jpg and PDF viewer so it is instanteous, and you can see scans and pages as quickly as you can click the mouse.
The example "Filecenter" is nice but it is somewhat rudimentary compared to the document management of Medscribbler, several docs have bought Medscribbler mainly for the document management only. IFilecenter is only a $99 program, and while it may be a quality program for general filing it is very limited to a use in a busy medical office.
Because Medscribbler is built for medical office scanning (among other things) it can be far better than a generic document management program.
Call for a demo - the Medscribbler document management is the most robust I have ever seen - but then again I'm bias
Medscribbler Getting you there sooner!
Scriptnetics
866-350-6337
FP my man,
I lie awake at night knowing you don't have an EMR yet. Do you think you might be ready for one ? Can you start a new thread and detail what are your electronic plans (or lack thereof) ? or email me ? It's possible full EMR doesn't suit you yet. I get a bit worried you don't have a PLAN. If you are at a "Just Looking" stage that is no problem.
If you are pretty serious about making some IT/EMR investments ... I'd sleep better if I knew you were on the right path. As you know, the right path is elusive
My best advice is in the "ad hoc" EMR sphere where you are looking for low financial outlay and you want a flexible system.
As for my fee for this EMR advice, I am too expensive, you can't afford me ! In that case, I'll do it for free
I will give the multitude of ways we handle this. By now everyone knows this is our area and we have a multitude of tools to work with and handle images.
The real question really is more importantly,
How much clicks does it take to view records after scan?
How does it flow with other data sources?
Given the need to see Lab Data for example from a Fax from the Hospital, then in data format, and then from a PDF document, how is this desparate data retrieved by the physician? Do they simply click one button and navigate freely back and forth between EMR Data or are they pointing and clicking and opening and closing windows to gain a understanding of the patient.
Is the viewer in a location of the program and the program itself designed to properly handle images, for example, does it require scrolling or maximizing and minimizing to see information?
Can it be made full screen?
Is the design such that it is viewed in the EMR and the EMR has taken advantage of Microsoft Technology in a way that the GUI does not steal valuable screen space from the physicians viewer work area, thus making the document unuseable?
I have a large presenttion tommorow, but I will show you unequivably why we are king in this area.
We have to stand at what we do best. And given our software is one of the only ones that I know of that started out as a Enterprise Document Management solution and ported over to EMR I think we have at the very least, after 18 years, some understanding of Document Management?
Medscribbler,
Et. All, lets screen shots with step by step presentation would better show suitability to task. We will put ours up on this weekend.
See for example Descriptmed.
I can't wait, I am sure your product is cool as hell, be nice to see its flow for common office problems like DM.
While we were one of the first to post screen shots etc, (remember when no-one had listed prices or screen shots) In this case we want to do only demos to qualified physicians. With that said there are some screenshots posted with an early design to give the idea. Our design is EMR unique but can be copied, we think it is better because we had no pre-concieved ideas as to how it should work only that it had to work for what everyone told us they wanted. There are several EMRs now that seem to have added document management after ours but very similar to Medscribbler - I am not accusing anyone of copying but some things which were somewhat unique in Medscribbler (simply because we didn't know any better) and in our early versions now look vaguely familiar in other EMRs. While there were several EMRs that addressed the paper scan issue early and even came out of the document management area most did not. Many, even several well known ones here and one hundreds of docs have purchased, have added a scanning function more recently but because it was never addressed early basically save the documents to a file folder becuase they are tied to an Access DB or no longer have the programming staff to make robust changes. Am I paranoid, only if they really are not out to get me. I am beginning to sound like Nextgen - please hang me
Great to know.
But there is no one with a EMR that looks or feels like ours. It is a specific design based strictly on the concepts of Content Management, the real Document Management on Steroids.
I just wanted to see how the differen tEMR's transition.
I will let you know we are looking into full Inkable Forms Support Integrated into our data model.
Rest assured the driver for this use of technology, yet another module inside of eMedRec, will be innovation for our user base and by demand only.
Wiht that being said, without screen shots, you really our only talking about and conceptualizing, not providing any meaningful detail.
You can view our screen shots forever if you like, replace the 18 years of code at your own peril and with your own headaches. If a product is so simple to develop that anyone can alter there program to steel from it, then it is not a very complex product.
Some of the simplist concepts, like eMedRec, are the hardest to steal. The ability to transition seemlessly is more a concept that has to be adhered to from the ground up of develoment.
See most EMRs are written in modules that are all over the place, as user requests come in. Failure to adhere to a strict requirement on GUI gets projects done quickly, but overtime produces crap for a product.
CEOMike: While we were one of the first to post screen shots etc, (remember when no-one had listed prices or screen shots)
While we were one of the first to post screen shots etc, (remember when no-one had listed prices or screen shots)
And these are where? I don't see them on your web site.
CEOMike: With that said there are some screenshots posted with an early design to give the idea. Our design is EMR unique but can be copied, we think it is better because we had no pre-concieved ideas as to how it should work only that it had to work for what everyone told us they wanted. There are several EMRs now that seem to have added document management after ours but very similar to Medscribbler - I am not accusing anyone of copying but some things which were somewhat unique in Medscribbler (simply because we didn't know any better) and in our early versions now look vaguely familiar in other EMRs.
With that said there are some screenshots posted with an early design to give the idea. Our design is EMR unique but can be copied, we think it is better because we had no pre-concieved ideas as to how it should work only that it had to work for what everyone told us they wanted. There are several EMRs now that seem to have added document management after ours but very similar to Medscribbler - I am not accusing anyone of copying but some things which were somewhat unique in Medscribbler (simply because we didn't know any better) and in our early versions now look vaguely familiar in other EMRs.
Do you spend a lot of time looking at other EMRs? Or is this based on what you see posted here? CEOMike, you seem to imply that you had the original idea and others just hijacked that originality. In this - scanning - is there not but a limited number of ways to actually present a scan, source and document controls on a form? Or are you speaking of something else.
CEOMike: While there were several EMRs that addressed the paper scan issue early and even came out of the document management area most did not. Many, even several well known ones here and one hundreds of docs have purchased, have added a scanning function more recently but because it was never addressed early basically save the documents to a file folder becuase they are tied to an Access DB or no longer have the programming staff to make robust changes. Am I paranoid, only if they really are not out to get me. I am beginning to sound like Nextgen - please hang me
While there were several EMRs that addressed the paper scan issue early and even came out of the document management area most did not. Many, even several well known ones here and one hundreds of docs have purchased, have added a scanning function more recently but because it was never addressed early basically save the documents to a file folder becuase they are tied to an Access DB or no longer have the programming staff to make robust changes. Am I paranoid, only if they really are not out to get me. I am beginning to sound like Nextgen - please hang me
Scanning is a necessity. There are true document management systems like eMedRec that, by design and intent, truly manage documents and offer EMR functionality at the same time. Others, say DescriptMED, offer a method to tie old records and new images to the program, without trying to present themselves as document management systems. I personnally think there is a difference between an EMR and an EDMS. Neither alone fully offer both capabilities. An EMR that pulls in old & new files thru a rudimentary scanning/flie structure meets some needs. Even DescriptMED, which allows markup of images, can meet some practice needs.
One thing I have learned is that not all data stuctures must lie within a database and not all database stuctures need handle all data. Some of these things we talk about are internal to development and matter little to the doctor using the program. And, I'll wager some of the things said touting a system as "better", is it really not better but "how we developed it" therefore we call it better? And you know, some people will choose MedScribbler over NextGen because MedScribbler design & price meets their practice needs better than NextGen.
I second the thoughts of Terry. We didn't "steal" our design from another EMR. Our document management sprang from the same basis from which many things come to a vendor-- the customers' needs and input.
I think "scanning paper into a chart", by the title alone, shows an inherent deficit in this threads presumptions. We are really talking about importing. Importing takes many forms, including file-based and scanner-based. Not only are there images, such as TIF, JPG, and BMP, but also data (DOC, RTF, TXT, CCR, HL7), or even the combination (PDF).
All of these document types carrry medical information and all of them must be categorized and filed appropriately in the chart. Some categories are labs, images, pathology, hospitalization, consultations, registration, procedure note, vaccinations, and others. These categories should be built into the EMR due to their frequent use. There are other categories used by different specialties, some being unknown to the vendor and thus require user-defined categories. Medtuity has 20 user-defined categories. A cardiologist may want categories for echoes, ECGs, Holters, stress testing, and caths, for example. The echo may come directly from the echo machine without a scanner ever involved. All of these processes require some common elements in assigning the data. For the user, having 10 different processes for 10 different filetypes would be learning nightmare. Thus, there should be a process for "importing".
Markup of images and metadata (data about the data) are important too. Their importance was discovered long before EMRs.
There are few original ideas. Seldom does a user ask for a new feature where no other user requests the same feature. And seldom is there an EMR user who has never used another EMR. All EMR users are exposed to all sorts of software with all sorts of features. It would take a detective to track down the real origin of any feature and still there would be arguments.
All EMRs copy each other.
That's a fact.
I must have touched a nerve on the copying issue,
here's the link to screenshots etc http://www.medscribbler.com/electronic_medical_records_demos.html
and http://www.medscribbler.com/electronic_medical_records_comparison.html
Emrupdate has become sort of an addiction for me, I generally follow what info is posted here or I follow the info other CEOs that I meet at the CMEs give me. I don't have time for much more.
My feeling is that writing on a scan without the added management features to make it useful (ie messaging) is useless and scans that can't be annotated are equally useless (and probably means an inadequate messaging system among other things.) Using a folder to store scans that is called from the app is rudementary as it means that the manipulation of those scans will probably slow the application as the folder size grows over the years. The doc wants to see the last 10 blood labs and the physio reports done in 2005 - three years of scans for one doc is a folder size of maybe 4GB - if it isn't instantaneous in loading and view - click, click, click, click - it is useless. Add, say three docs on a wireless network and you better have the design right in the first place - an Access DB or simple folder storage won't cut it. There are other issues like HIPPA tracking of annotaions on a scan etc etc. Medscribbler addressed these issues first thing in the design, now 5 years ago - it seems some who have also been around for a decade or more have not. So?
Ok, guys, I got my helmet on.
Brendon, I hope your video will demonstrate how existing paper charts are scanned into your EMR - existing notes that have not yet been barcoded.
Matt, what is the process of scanning existing paper charts into Medtuity? Do you have a video showing how to add a PDF to the various categories and then viewing them while in an appointment?
DrMurdoch: All EMRs copy each other. That's a fact.
DrM I think that may be a little strong. Some ideas may very well be copied, but speaking for myself I have gone out of my way to avoid copying someone elses idea.
Funny thing Matt & I met together at the BIG EMR conference in California that time and both had independently come up with the sam idea... at least I don't think he copied the same EMR.... Seriously, no copying here.
CEOMike: Am I paranoid, only if they really are not out to get me. I am beginning to sound like Nextgen - please hang me
Am I paranoid, only if they really are not out to get me. I am beginning to sound like Nextgen - please hang me
Mike,
First as famously noted by Yossarian in Catch 22 - just because you think everyone is out to get you, doesn't mean that they're not.
Second, in almost every sales situation we find ourselves, the other vendors usually feel that if they can beat us, they will probably win the business - so by definition they are all generally out to get us!
Third, I would presume that if sounding like us could include you reporting similar success, similar longetivty, similar financial stability, etc., you would probably be happy to sound like NextGen!
Back to the thread, we have a high speed scanning solution that we developed in-house, which is part and parcel of our single DB solution. The scanning process in obviously full intergrated into the application and meets the criteria and functionality discussed in Matt's post. I don't know about the copy thing, but we have had high-speed scanning as part of NextGen for years. We first integrated a third party application into our EMR in the late 80s and then when Allscripts bought them, we wrote our own. You can see the full functionality - including screenshots - by going to the website www.nextgen.com and clicking on the products tab and then clicking on Image-Control System.
Have a good weekend everyone!