Although I have seen the term used by programmers referring to themselves, the term is considered to be mildly insulting .. see http://en.wikipedia.org/wiki/Code_monkey
Of course the use of the term in the Bay area may differ from elsewhere in the world.
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
Dr. Osler,
Do you use an EMR?
Are you happy with it?
What is the name of your product?
Help other physicains. Provide more concrete information rather than these sweeping rants to beat up on all EMR vendors.
By the way, it is not Mr. Chase, it is Dr. Chase. I have a gift for programming (at least my wife tells me so) and I practiced Emergency Medicine for 15 years before I embarked on writing an EMR. I am not out to fleece physicians, to offer up poor software, to unnecesarily bloat my code, among your other wide ranging accusations. As you will find among the pages of EMRUpdate, we have very satisfied users.
Please do tell us about yourself.
mchasemd: Dr. Osler, Do you use an EMR? Are you happy with it? What is the name of your product? Help other physicains. Provide more concrete information rather than these sweeping rants to beat up on all EMR vendors. By the way, it is not Mr. Chase, it is Dr. Chase. I have a gift for programming (at least my wife tells me so) and I practiced Emergency Medicine for 15 years before I embarked on writing an EMR. I am not out to fleece physicians, to offer up poor software, to unnecesarily bloat my code, among your other wide ranging accusations. As you will find among the pages of EMRUpdate, we have very satisfied users. Please do tell us about yourself.
Please forgive the error in title, mchasemd. You sound more like a vendor than a colleague, so I assumed the former. I have not "accused" you of personally doing anything that you claim I have, by the way.
Yes I use an EMR and have used several dating back to the Dark Ages over 15 years ago. Does this fact give me street cred here? Maybe I'll add it to my signature, along with "Highest rated by patients". (Well, two patients once rated me higher than a couple of other colleagues in a clinic, so technically I was "highest rated", right?
No, I don't make "sweeping rants, I make honest observations based on what I have learned over the years. Isn't it strange how the most experienced and knowledgeable EMR users that I've met over the years have almost all been disappointed by the overall state of EMRs? Yet if you listen to EMR vendors you would come away believing that these glorified database applications are a panacea for all the ills of medical practice. Why do you think there is such a is such a difference in opinion between physicians and vendors? Hmmmm?
Earlier in this thread, I replied the following to you:
"I would suggest that you tell us why it is you "have over a million lines of C++ code making up Medtuity". How much of that code could be trimmed? Are there simpler ways to do what you're doing? Are you CCHIT certified? If so, why and how much of the "over a million lines of C++ code making up Medtuity" is involved with adding CCHIT-mandated features that most physicians likely have no interest in paying for? Please enlighten us.
I'm also sorry to hear that my "bellyaching" displeases you but I'm going to keep on "bellyaching" until the vendors cut out the B.S. and the hype. Pick the 100 most commonly used EMRs on the US market and look at them objectively. What percent of them have been designed intelligently? 50%? 25%? 10%? 5%? What percent of them have been coded well? 50%? 25%? 10%? 5%? Sorry, Mr. Chase, but if you're going to try to charge filet mignon prices for your EMR, you can't be serving up the third rate, maggot-infested ground beef that most vendors are offering up to unsuspecting physicians."
I'm sure that many physicians would be interested in hearing your answers to those questions, mchasemd. On the other hand, me posting demographic information, my favorite color and turn ons/turn offs adds little to the discussion here. Gleaning personal information might help if one was attempting to profile or marginalize a poster though...
This website's mission statement is supposedly "unbiased independent EMR discussions and resources". Perhaps we should stick to doing that.
Take care.
Dr. Osler
(EMR user for over 15 years.)
Dr. Osler - highest rated by patients.
Osler - I like your posts as they are entertaining and while you could tone down the rhetoric I get your points.
I am one of those guys who is less than satisfied but I blame myself. I was thinking I would get more out of my EMR and it was a case of buyer beware. It's one of the leading EMR's and in my opinion it has accomplished much but not what i was ex[pecting. For the way I practice medicine i think I need an EMR not only for chronic care management but to effectively run an office. Perhaps they should be advertised for the latter more than for the former.
Anyway, it's an expensive endeavor with regards to time and money and in hindsight I needed to get a hybrid EMR that allows for easy use of paper in a way that allows me to manage chronic care for my patients. Not sure that even exists.
Lowell Kleinman, MD www.drkleinman.com www.old-fashionedhousecalls.com
"This website's mission statement is supposedly "unbiased independent EMR discussions and resources". Perhaps we should stick to doing that."
Dr Osler, aren't you the same dr osler who has your ownEMR that you have been flogging somewhat unsucessfully in British Columbia Canada. Maybe the largest in a Canadian province that provides subsidies but a mere blip in the US market ( and not even a major player Canada wide)
You say an EMR user for 15 years, which one is yours as most making these claims identify themselves to be clear where they stand - you have no bio, no friends and no country - how do we know your bias?
You will be forgiven if you come clean - many of us made the same mistake when we joined the board - it takes more than 30 posts and 3 weeks to figure out what goes on here.
Medscribbler Getting you there sooner!
Scriptnetics
866-350-6337
DrK: Osler - I like your posts as they are entertaining and while you could tone down the rhetoric I get your points. I am one of those guys who is less than satisfied but I blame myself. I was thinking I would get more out of my EMR and it was a case of buyer beware. It's one of the leading EMR's and in my opinion it has accomplished much but not what i was ex[pecting. For the way I practice medicine i think I need an EMR not only for chronic care management but to effectively run an office. Perhaps they should be advertised for the latter more than for the former. Anyway, it's an expensive endeavor with regards to time and money and in hindsight I needed to get a hybrid EMR that allows for easy use of paper in a way that allows me to manage chronic care for my patients. Not sure that even exists.
Since people like to quote Wikipedia (a dangerous game, by the way)
http://en.wikipedia.org/wiki/Rhetoric
I attempt to include rhetoric, logic and grammar in all of my posts, thank you.
To solve your inability to achieve the (often unrealistic) goal of going COMPLETELY paperless, I would suggest looking into this:
http://www.amazon.com/gp/product/B0014IUVCE
CEOMike: "This website's mission statement is supposedly "unbiased independent EMR discussions and resources". Perhaps we should stick to doing that." Dr Osler, aren't you the same dr osler who has your ownEMR that you have been flogging somewhat unsucessfully in British Columbia Canada. Maybe the largest in a Canadian province that provides subsidies but a mere blip in the US market ( and not even a major player Canada wide) You say an EMR user for 15 years, which one is yours as most making these claims identify themselves to be clear where they stand - you have no bio, no friends and no country - how do we know your bias? You will be forgiven if you come clean - many of us made the same mistake when we joined the board - it takes more than 30 posts and 3 weeks to figure out what goes on here.
My, my, my. Aren't you vendors so eager to profile posters here.
I'd be interested in hearing what gave you the bizarre notion that I was an EMR vendor from British Columbia. I am not.
Is it okay with you and the other vendors if I don't "come clean" and identify my current EMR, bio, friends, country, favorite color, sexual preference, etc., etc.? Most reasonably intelligent adults should be able to easily discern my "bias" without the personal details you vendors appear to be so anxious to glean. Try to judge the merit of what is said in my posts and don't be so concerned with who I am or where I live. Is that a difficult concept for vendors to grasp?
If you want, I'll add the phrase "Not an EMR vendor" to my signature...
Sir William (if I may address you by your first name)
We probably agree on more than we disagree, but to really know, it might be better to talk features and functionality which represent bloat, for example.
For those of us who have posted on EMR update several thousand times, we sometimes too easily assume that other members know us better than they do. I've written about many issues on EMRUpdate, often at length including granularity, documentation by exception, documentation by findings, health maintenance guidelines, user interface issues, CCHIT, EMR pricing, CCR, and more.
I do believe that I have taken the high road with Medtuity. Our pricing model is per encounter and Medtuity takes as much risk as the customer. If a group decides to drop Medtuity, it pays us nothing further. We have no contracts for customers to sign. We do not charge extra for training or technical support. We train on weekends, on weeknights, and all times in between-- all at no additional charge to the customer. We've never charged for interfaces and have even convinced some PMS companies to drop their interface charge as well. This week we are testing our LabCorp bidirectional interface with a group.....no charge.
We do not chase the CCHIT guidelines of the moment, but we are interested in providing functionality that our customers need and want. While no one ever asked for an audit trail function, we have one. Why? If there is ever an issue with the veracity of a record, we know that an audit trail will benefit our physicians. So we have one. It's invisible to them.....at least until they moment they need to review it.
We wrote import/export functions for the entire CCR standard. Is it bloat? I suppose so. Nobody uses it. Should we remove it? No, of course not. If all EMRs never provided the ability to read and write the CCR, the CCR would die. We are hoping, by our and many other vendor's participation, that the CCR thrives as a means of trading information.
We put in a SQL Server backend for stability and speed. Could we have used Access? Yes, but I was not happy with its file server roots. We wanted client-server. Many of our customers initially use the free version (SQL Express) to keep costs low while still enjoying the benefits.
This hardly touches the issues of code bloat, features and functionality. I invite you to take the time to get a demo of Medtuity and then pick it apart on this forum. Describe what you feel is "maggot-infested meat" or code bloat and I will offer my opinion as well. It will be enlightening to the readers as the issues go from generalizations to specifics.
Well said, Margalit.
mchasemd: This week we are testing our LabCorp bidirectional interface with a group.....no charge.
That sounds like a neat trick Matt.
Did you find the password to the labcorp db files? Or is the version you're using not password protected ?
Regardless of whether one agrees with Dr Osler's opinions about glorified databases and code monkeys, I am happy to see new debate here .. this place was getting way too boring!
Vendors - defend yourselves!
CEOMike: aren't you the same dr osler who has your ownEMR that you have been flogging somewhat unsucessfully in British Columbia Canada.
aren't you the same dr osler who has your ownEMR that you have been flogging somewhat unsucessfully in British Columbia Canada.
Mike - just because the original Osler was from Canada does not mean this one is from the same place :)
From Osler himself, "Medicine electronic medical records is a noble heritage. You enter a noble heritage, made so by no efforts of your own, but by the generations of men who have unselfishly sought to do the best they could for suffering mankind. Much has been done, much remains to do".
In this quote Osler is telling us that we are in the early stages of emr and that many vendors are doing the best they can (ie Medtuity).
Graham,
I don't understand your question. You sign an agreement with LabCorp, you get the HL7 interface specifications, you decide on the level of the interface (we decided full spectrum of labs test), and whether it will be unidirectional or bidirectional. You create the interface first to send messages to LabCorp, and then the interface to receive their messages back. Then you go through testing, first as Medtuity to LabCorp and LabCorp to Medtuity. Once it passes the vendor-to-vendor testing, it is retested with a dual LabCorp/Medtuity customer. Once it passes testing in this environment, you go live. There are many steps in the process and LabCorp is a delight to work with.
Again, I don't understand your question.
Osler: To solve your inability to achieve the (often unrealistic) goal of going COMPLETELY paperless, I would suggest looking into this: http://www.amazon.com/gp/product/B0014IUVCE Dr. Osler
http://www.amazon.com/gp/product/B0014IUVCE Dr. Osler
The guy loves ScanSnaps ! Now that is good taste !
mchasemd:Again, I don't understand your question.
My user didn't want to pay $5000 for the HL7 interface from labcorp ... we wanted to access the data directly, but it's password protected and labcorp won't reveal the password.