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Mike, what are you currently working on to improve your EMR?
Any headway on what we talked about before ?
digital-doc: FPdoctor: Very common in my practice to see a patient for two separate types of visits on the same day. 1) Pain from an auto accident - auto insurance 2) Med refill for diabetes - health insurance I currently maintain separate charts for auto accidents (date of injury), workman's comp (date of injury) and health insurance. Attorney's or insurances want copies of my records, and they don't want things unrelated. Hence, separate charts. MedScribbler has come up with a process that will assist in this. When patient checks in, the note is tied to a specific insurance or injury. When it comes time for searching for notes, the incident type (MVA, health, etc) is searched to find the correlated chart notes. Makes sense. I do similar, in that I have different chart headings with a unique set of parsed fields and corresponding data. I can manipulate the fields for each reader.
FPdoctor: Very common in my practice to see a patient for two separate types of visits on the same day. 1) Pain from an auto accident - auto insurance 2) Med refill for diabetes - health insurance I currently maintain separate charts for auto accidents (date of injury), workman's comp (date of injury) and health insurance. Attorney's or insurances want copies of my records, and they don't want things unrelated. Hence, separate charts. MedScribbler has come up with a process that will assist in this. When patient checks in, the note is tied to a specific insurance or injury. When it comes time for searching for notes, the incident type (MVA, health, etc) is searched to find the correlated chart notes.
Very common in my practice to see a patient for two separate types of visits on the same day.
1) Pain from an auto accident - auto insurance
2) Med refill for diabetes - health insurance
I currently maintain separate charts for auto accidents (date of injury), workman's comp (date of injury) and health insurance. Attorney's or insurances want copies of my records, and they don't want things unrelated. Hence, separate charts. MedScribbler has come up with a process that will assist in this. When patient checks in, the note is tied to a specific insurance or injury. When it comes time for searching for notes, the incident type (MVA, health, etc) is searched to find the correlated chart notes.
Makes sense. I do similar, in that I have different chart headings with a unique set of parsed fields and corresponding data. I can manipulate the fields for each reader.
Glad to hear that others share my need.
So far there has been no updates from Medscribber as to the above needs.
Sorry, I have to go in "fits and starts" posting here - have to actually do some work as well, I guess you saw me posting again!!!
FPdoctor:Basically all we really need to do is pin a searchable “incident “ field to a visit. These “incidents” would be indexed by patient and selected from a drop down list when the patient either books an appointment or checks in. If a patient happens to visit you two or three times in one day then so be it. The “incident” field selected for each visit will keep them separate.
This is a good idea but not something we have on our priority list. We are likely to do a rudimentary indexing to allow for this in the minor upgrade path to our next major version (6) due in October.
This is a good example of why doctors should not design EMRs and why many EMRs never really get finished. There are at least a half dozen "frustrations" that you would have if we implemented this the way you describe. To us, Medscribbler, the competition is the paper you use now. You could use Medscribbler now in this scenario exactly as you do paper charts now with a separate chart or by noting the 'incident" in the progress note. For reporting it would mean a simple compile and save to PDF or print or email for the separate chart method. For the incident note marking method it would require an individual sort and save to pdf, print, or email that would be comparable to a sort and scan function with paper.
Is this better than paper, maybe only slightly. But there are hundreds of other functions that Medscribbler is better than paper now.
I suggest your reluctance to go with Medscribbler has nothing to do with this function.
Right now there is 1800 pages of unsorted "suggestions" from doctors, government and others sitting on my desk. Your comments here on the "incidents" problem is one of them. After the next version of Medscribbler is released I take those 1800 pages, categorize them into maybe 50 piles. The piles are then evaluated to complexity and "marketability" A few, between 5 and 10 will be chosen as minor upgrades and then between 5 and 20 will be chosen to release in another major version in 18 months.
Does this mean you should wait 2 years to buy Medscribbler, NO, because Medscribbler wil ease the paper crunch in your office NOW and will give you tools to improve care OVER PAPER now. Was the first Microsoft Office perfect, no, but it reduced mundane paper use and added extra tools OVER PAPER. Are you still waiting for for them to perfect Microsoft Office? Did others use Office while you were still using paper, and why did you finally "give in?"
The problem with EMRs is Microsoft Office is a toy in comparison to the functions required. Medscribbler is the best EMR compared TO PAPER, which is still king. We are going to dispose the king with a revolution!!!
Medscribbler Getting you there sooner!
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FPDoctor I believe you are wise to not make a move until you feel right. First, I believe you will need to make sure your solution meets all your needs and the needs of the ever changing medical industry.
I have always appreciated your constructive criticism, and taken it with a grain of salt. Without constructive criticism we are all doomed. As to your request, this is often handled with Different Tabs in our solution. Different visit types can be configured and different notes and data can go to different tabs.
Further, based on the login you can be allowed or disallowed access to content, like a tab. This is handy in multi-specialty practice.
As to automating paper, obviously this is at the core of Medscribbler, eMedRec and SRS Software. It is also a part of Allscripts they bastardized call AIC ImpactMd, the original leader in this space.
Nice to see your posts, keep it up.
This doesn't sound terribly different than those companies who offer a healthcare facility for their employees and dependents. If there is an injury at work, they want that encounter segregated from the patient's non-injury visits That is, they want no bleedover from one group of encounters to the other.
I am wondering where all the vendors have gone (and other posters)???
Brendon, you have no clue what Medscribbler does, if I have said this once I have said it a thousand times Medscribbler is not a document management system - Document management in Medscribbler is a feature just like in every other credible EMR - maybe yours doesn't have one!!!!
The Medscribbler difference is you can also annotate on those documents and create documents to annotate on, a feature no other EMR has.
Medscribbler does all those other things EMRs do that document management systems like you mentioned don't - like manage history lists, scheduling, messaging, billing, drug management, vital tracking, patient tracking etc etc
I can understand you wanting FP to wait, maybe you have to catch up! Medscribbler beats paper NOW and because it beats paper it beats every other EMR out there. Why you keep bringing up the document management systems is they also beat paper so they also beat every other EMR out there. There will be a few docs who will change the way they work, spend gobs of time on learning new tech and maintaining that tech, for EMRs that is 4% of solo docs.
So the only reason to lump Medscribbler in with doc management systems is they also beat paper. Watch out, I do consider them to be my competition because eventually they are going to figure out how to add scheduling, messaging, histories etc etc. The only other competition I consider is GE, Cerner and other "big boys" because they can out out spend me in dozens of dangerous ways!!
Matt, you are right, and it is one of the complications making it more than an simple add. Medscribbler is designed so that every doc whatever specialty, can pick it up and use it almost immediately. This requires design that is comprehensive in the first instance, simply adding features as a potential sale asks for it is a sure way to become an unuseable CCHIT monstrosity.
Mike I will not get into a tit for tat. We not only have a full fledged EMR and Note System, we also have Active Ink for Inkable Forms linked directly to the EMR Data.
I am taking care not to try on this forum to state that we are a Inkable Solution, because we are, just this is one feature of our solution.
We include Elements for Drop Down and Dragon Enabled Active Ink Forms linked to the EMR with real data. Again just one small Module.
For more on Active Ink.
http://www.activeinksoftware.com
But I am aware your software is amongst the best in the world. We for one are stuck with the huge task of getting CCHIT certified to not lose our customer base. I am sure you are also buried in making this happen without sacrificing useability. If you are not, I feel sorry for your end users, the direction is clear and the writing is on the wall.
Brendon:We not only have a full fledged EMR and Note System, we also have Active Ink for Inkable Forms linked directly to the EMR Data.
And was it worth it? There is a concensus that pen based platforms are fading into well deserved obscurity http://activeink.typepad.com/ and will be replaced by touch based technologies.
I myself have bought two tablets .. the first one lasted a week in my possession before I gave it to my daughter to use. The one I use now ... well, let's say that the pen is still stuck inside its little slot.
Graham http://www.synapse-ehr.com/ Synapse - the EMR for the superior physician
I guess it is my lot in life to educate. Active Ink is a short-cut for those that can't develop an application themselves. It is a very good shortcut. Using Active Ink for forms is an interfaced function using someone else's code rather than an integrated one. Its like the same question of integrated vs interfaced billing. This does not make your EMR pen enabled, it makes yours forms ink capable. I don't know if you have taken the Active component to the next step of also building it into the progress note - but hey then you would be Medscribbler.
Actually, I'm flattered that you have added this penable forms function, Active Ink is making a very good living providing this add-on for EMRs that lack what I think is an essential feature for an EMR.
As for the the "concensus that pen based platforms are fading" it is exactly the opposite!!! Did you know that with Vista the Tablet abilities are now built into every operating system and they have been upgraded. Windows 7 is a significant upgrade in pen abilities, probably the biggest technical improvements in 7. Also the ink developers at Microsoft are already working on 8, leading the way there. Microsoft has also invested heavily in new Tablet hardware. Every major computer reseller now has several models of Tablets.
The problem with penable computers is software manufacturers haven't clued in yet so there is very little in the way of enterprise software. Medscribbler is the most robust penable application, bar none. It is our opinion Medscribbler is the only hope to move the 96% of solo docs onto an EMR, it is as revolutionary as Apple's i-phone. It is not CHITT or any other foolishness that will get the 96% to move, it is technology - and Medscribbler is on the cool edge of it, like the i-phone.
One thing you inferred is correct "touch technologies" are coming to the fore. Medscribbler, with the new release due in October, will introduce dual touch and pen application design. Unfortunately, there is little hardware that can maximize its use, but this will change soon.
Great question Graham. Actually I would have to say that of all my dealings Active Ink is a great product, but our user demand is low, as they can use a Tablet with our conventional Dragon Note System and are happy with that. There has not been much demand for the actual Tablet, most use them as Laptops.
I know that Mike will feel differently, but I for one don't necessarily think the investment is out weighed by the demand. i thought demand would be high, not the actual result to this point, I will let you know if this changes.
Actually Mike that is exactly what we have done, thanks for the promotion, nice to know we have Medscribbler incorporated in our product. Jeez just think I thought it was a module. Actually I put a developer with 20 years programming experience on the Active Ink module for over 4 months. We believed then we can:
All that being said, I agree that Pen will be here for a while as well as touch screen. These are technologies to enable in your product, not the basis of your product. Once the input device is taken out of the equation, you still in the end have to have a product that meets the end users needs.
Those needs right now include CCHIT. Over 80% of all our calls now are related to ARRA payment to get a EMR. I would say this is a driving force. Get with the program mate, don't fight the tide.
As to Touch Screen, this is a different technology. It currently is no where near as accurate as Active Digitizer with a Pen. It needs to be implemented with completely different interfaces, think Apple IPHONE.
Regards and good luck,
Brendon
Ditto. I see our users wanting more granularity, not less. The tools we put in our product to promote this granular data collection are being used in ways I never anticipated. This in turn has prompted us to increase the functionality of health maintenance guidelines, per-patient longitudinal data tracking, and reporting features.
In contrast, nobody asks for ink.
CEOMike: Did you know that with Vista the Tablet abilities are now built into every operating system and they have been upgraded. Windows 7 is a significant upgrade in pen abilities, probably the biggest technical improvements in 7.
I am using Windows 7 RC1 on my tablet ... I don't see any way I can "pen" a reply here. And when I have tried it, the handwriting recognition was terrible.
>>I am using Windows 7 RC1 on my tablet ... I don't see any way I can "pen" a reply here. And when I have tried it, the handwriting recognition was terrible.<<
Are you referring to a failure to convert your handwriting to text, via the Tablet Input Panel, or failure to ink into this dialog box?
Chris Wilkerson, D.C. Carson Doctors Group TabletPCs in Medicine Editor-in-Chief www.MedicalTabletPC.com Home: www.Digital-Doc.com