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This is my first post and I want to thank you for allowing me in your forum. I am about to attempt to stir your interest in a free (okay, not so free) electronic medical record system that is both portable and universal.
I am not the author of the concept, but I have been asked to promote the idea and see what doctors and patients think. Please, note that neither the author nor myself have or will have any direct or indirect profit from this idea,
The system is free to the patient and nearly free to the doctor. Total hardware and software investment is that of a regular PC and a word processing program (like Word), which all doctors will have in their office regardless of what EMR they're going to use. The only extra expense would be $25-50 dollars for the KEY piece of software that will make it universal.
The patient will make it portable by carrying it in a USB drive wherever he/she goes, including other doctor's offices. Each doctor office will then update the local copy of the records and the USB drive records. And when the patient finds him/herself in an emergency situation, moving or in another doctor's office, he/she will hand the USB drive (or it will be found in his pocket in an emergency situation) and the information will all be there, including the contact information for doctors that have previously seen him/her.All systems, including the info in the USB drive could and would be password-protected.
Of course, the patient may have to sign a release ("hold harmless" document) in exchange for the benefit of a universal, free, portable medical record. Similar documents are signed when paper or digital records are signed or when medical info is stored online, so this is not unheard of.
Appreciate your input. If you play the devil's advocate (gentle language please!) and think this idea is impossible, your opinion is also appreciated. We can only fix what we know is wrong.
See the idea at: http://www.vascularneuro.us/wp.htm
Hey...it's a thought!~
thank you!!! :)
Thrombolyser
Free EMR, frankly I am surprised with the Governments dedicaton to healthcare IT they have not provided a good one yet.
Do you really think the Government could not buy out or develop a great free EMR/EHR. Given the tech savvy new administration I would not be surprised if this does not come down the pike.
In any case good luck with your concept. I believe the challenges of EMR sales/marketing extend way beyond that of price alone.
Brendon,
The problem is, it takes years to develop a good EMR, an EMR which is relevant to some physicians. To develop an EMR which is relevant to most practicing physicians, wow that's a monumental task.
The most important question is: What is the goal? Develop an EMR which is relevant and usable by most specialties and general practices, or develop and EMR which can increase efficiencies (and be relevant)? Without really changing the efficiencies of the medical system, the feds are just throwing a bunch of money at the system where the software will be irrelevant in almost immediately. Sure, docs now have an EMR, but so what.
Regarding developing the software, look to the eMDs example. Their new product was discussed with great fanfare on EMRUpdate.....what....maybe a 1 1/2 years ago. Twenty some developers, huge investment, the most intuitive, easiest, most relevant EMR in the world, "wonderful" in its earliest sightings......and it would soon be out there is the market place.....yada yada yada. The message was clear. Hold onto your wallet. Relief would arrive. Every physician could use it.
As I wrote back then, you cannot simply throw money and programmers at the problem. Sure, it helps, but there is no one smart enough, at least in our business, to figure all of this out. For example, the specialists do very well with point-and-click because they are dealing with fairly circumscribed problems (urinary incontinence, gallstones, intestinal polyp, etc). The family physician is dealing with a train wreck-- 7 problems of which only 2 can be totally ignored during this visit-- where point-and-click loses its effciency. What works well for one does not work as well for the other.
It appears likely that eMDs hit a wall, possibly this one of relevance. Of course, to make it relevant, they made it "Lite", so forget the efficiencies that are so badly needed.
So add efficiency to the goal. Having an EMR which works does not guarantee improved efficiency for the practice as a whole. We have incredibly efficient practices but they have as their leader a physician owner, or coroporate entity, who searches and finds efficiencies in the software. When they drive to work or daydream on the golf course, they think about this problem. An EMR can only grease the skids for efficiency. Efficiency also requires change in the practice.
Using our incredibly efficient practices (not all of our practices!), these are some of the ingredients needed in such a system:
Putting the Feds in charge of this is a risky proposition. The Feds cannot possibly develop and provide software to these masses which will make a dime's worth of efficiency improvement in the system if physicians have no interest in really creating efficiencies. There is one item driving efficiency and which will continue to drive efficiency- decreasing reimbursements. Now that gets the attention of physicians and some physicians are doing something about it.
Well said, Matt.
I don't understand this fixation with a government developed EMR that will be the the ultimate solution for everybody. I am not aware of any precedent where the Feds picked an industry and developed a universal software solution. People often compare the EMR industry to the financial industry. The financial software and its interoperability evolved from private companies competing and innovating. The government did not develop Quicken or Turbo Tax. Or look at the CRM industry; SAP and Siebel and Sugar CRM and even salesforce.com are all products of a free market. There is no one product that fits all, and in our industry, as Matt says, it is impossible to have such animal. We shouldn't even try. There is nothing wrong with having multiple products competing on price, functionality and quality. All they need to do is adhere to some well defined standards of communications. We are more like the auto industry. It's all user preference, but every car\truck\SUV\compact must be able to share the highways with all others.
Margalit
Margalit Gur-Arie
My brand new Blog: On Healthcare Technology
The difference is that the banking industry needs to interoperate to function and survive.
For EMR companies, for far too long they have dismissed interoperability as not being relevant to their own survival.
Graham http://www.synapse-ehr.com/ Synapse - the EMR for the superior physician
gchiu: The difference is that the banking industry needs to interoperate to function and survive. For EMR companies, for far too long they have dismissed interoperability as not being relevant to their own survival.
Well...... it is becoming more and more relevant by the minute..... so I guess, we'll see what happens now
Well, each doctor can have his/her own template for notes, adjusted to the particular needs of his/her specialty. All the info can be done in something as simple as Word, and then tranformed into a PDF.
Each doctor that later sees the patient can add his/her note in PDF to the main PDF document in the USB driver.The first page of that main document would be identifying iformation about the patient's medications (updatable) and allergies/sensitivities, The complete record follows.
What is cheaper than a 25-50 dollar PDF converting program.......and a free Adobe Acrobat reader...and a little USB driver (probably the price for the doc, since he/she buys in large quantities, would be about 5-6 dollars at most)...
If the doc does not have the note written the same day, he can email it to the patient or the other docs as a PDF attachment...and that document can then be integrated into the main file in theUSB driver. A copy is then left in each doctor's office or hospital.
What is more universal than PDF?
Really......the free EMR is out there.......don't know why not do it this way. I'm sure the patient will sign a release; after all...carrying all your medical info everywhere you go is invaluable.
It should also have a "Clinical Summary" screen which displays - Active Alerts, Relevant Family History, Relevant Social History, Active Medical / Surgical Problem List, Active Medication List, Significant Lab Reports, Patient Preferences etc.
First off thanks for posting your idea and having your idea ! The world needs practical digital medical solutions and surprisingly there are few.
You've asked for a Devil's Advocate, and that would be me.
We have talked about this before. I really really dont like this idea of medical information on USB drives.
http://www.emrupdate.com/forums/t/7972.aspx
http://www.emrupdate.com/forums/t/17564.aspx
I think you outline a scenario where an almost free EMR could develop. My main issue is that it will accomplish nothing - what's the use of an EMR that won't allow for things like alerts, drug interactions, etc? To accomplish these things the Medical Record needs structure that a PDF will never provide.
My other main beefs are: lack of health information security, USBs are terribly wonky, PDF isn't actually a standard, doctors are going to need an EMR (What you call templates) anyway, essentially the list goes on. If you want to argue point by point I'd be happy to.
I did rant on this topic, even more so than my usual. Because I think this USB Medical Record idea is so bad, I felt it appropriate to give it an analogy ( in a previous thread, I'll repost it here).
Selling the idea of Medical Information on USB drives during the age of the internet is like selling paper editions of Encyclopedia Britannica during the age of Wikipedia. Dr. J. Murdoch, MD, 2008
Do you *REALLY* want to be an Encyclopedia Britannica salesman ?
No you dont.
I will give you a simple example, which will hopefully convince you that this USB idea is antiquated already.
Make a Windows Live Sync account (aka Foldershare)
https://sync.live.com/foldersharetolivesync.aspx
Make your Word / PDF Health documents. Save them to the folder you are sharing.
Install Foldershare at your work.
Now you have essentially instantly synched documents at home and at work.
Now get your doctor to install it.... now you are all on board.
This setup is VAAASTTTLY superior to your USB idea, not even comparable.
Of course FolderShare is free.
Hmmmm .... a FolderShare EMR .... the technology really could be a major part of the document sharing needs of Medicine. Anyone with lots of Venture Capital need me to expand here ? I'm available for free as usual.
email:
thrombolyser:The system is free to the patient and nearly free to the doctor. Total hardware and software investment is that of a regular PC and a word processing program (like Word), which all doctors will have in their office regardless of what EMR they're going to use. The only extra expense would be $25-50 dollars for the KEY piece of software that will make it universal.
Something that might interest you is TSMR.
It's is a Word Based Medical Records System that easily runs of a USB key.
I really like it.
I think we are mixing terms here.
The term EMR as it is used today, refers to a software application used in the doctor's office to record patient data, but also to manage workflows, provide decision support and alerts, connect to labs and pharmacies, manage schedules and intra-office communications and so forth. You cannot put that on a USB drive. It is a tool not a piece of information.
The Electronical Medical Record that the initiator of this thread is referring to is pretty much any given patient's electronic chart. That can be uploaded to another storage device, be it USB, magnetic card or whatever. As Dr. Murdoch points out, this poses many security issues and its practicality has been discussed here before.
By the way, you don't really need an EMR to export charts to PDF. Just scan the paper notes to the desktop and copy the files to the USB drive.
I read somewhere that the president wants each American to have an EMR by 2014. The president is also misusing the term. Maybe they are all referring to PHRs. In any case I think that PHRs should be nothing more than a view of the electronic chart created by the EMR. If PHRs are to become some health website maintained by the patient, their clinical value will plummet. But that's a different discussion altogether.....
Thinking of this problem of developing a "free EMR", the Feds should consider buying and releasing the sourcecode to some of the best designed EMRs already on the market. It will cost the Feds much less than, could be done relatively quickly (versus a significant amount of time to create a new one), provide for competition, and promote improvements in the current architectures. Users would have a choice and could acquire an excellent EMR for nothing, if they wish to use the open-source package, or pay more from an established company.
Hello to all of you i found " Iasis Free EMR-ERM Practice Management " is really free does not cover all our needs yet but is fully customizable and is updated almost daily, the really good news are that they developing on practician requests and ideas !!!!!! for free i do not know if i can post links here so if you want more info about it mail me or google it.Hope this will help all.
http://www.google.ca/search?hl=en&q=Iasis+Free+EMR-ERM&btnG=Google+Search&meta=
Likely quite rudimentary.
hello first with respect to all of you i cant take this personally in any way,
but i think that you might look at it better or try to use it is huge app and by the time of your response is not possible to even take a fast snap to all the procedures the software provides, i m using it about 3 months and 1st grouths rapidly (means people trust it), 2nd people there really doing a hard job(i can tell from the updates) and 3rd if you know something better and free REALY FREE not just funcy words please advice, ex. i try to download Synapse express but "path not found returned" for all components.
After all comparing the both Iasis Free EMR-ERM Practice Management is far far far far better than the "not found" Synapse Express.
Iasis Free EMR provides free backup and restore , free files maintanance,free REAL Support no just contact us
you can install it where ever you like i try it on my flash disk (even not adviced from authors) and worked!!!! i work it on to places one is my notebook and i syc the data easy with the FREE inbuild backup tool, i'm using the free intramessaging system with my front office, reminders and appointments are great, i've build my OWN Iasis Custom Work scheme with my OWN Test Groups and OWN Tests, reports are not so good for now at least not for me and they are not provide a lot prebuild Iasis Workink Schemes for now .Graphs on numeric data types are great, also i'm using cheap equipment(web cam and scanner) to import depiction control in my records i'm writting all these and not even cover the 1/2 of Iasis Free EMR, what to metion first? inbuild editor for my documents,access to medical news ,access to to support forums(step by step videos) and and and.... if you find these "quite rudimentary" :) what can i say ..... i like this software i like the idea i like the way it works and as i say if you know something better and NO TRICKY FREE please advice to follow.....also notice that Iasis is plag and play i did n't have to be a computer genius to run and use it.
with respect to all...