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Newbies Introduction to EMR Acquisition !!!

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NYFP Posted: 11-16-2005 11:11 AM

The purpose of this thread is to; simplify, consolidate, and help provide physicians with the steps that are required for EMR/EPM Acquisition & EMR/EPM Implementation, as well as the following:

1) The Benefits of EMR's/EPM's
2) EMR Terminolgy & EMR Functionality
3) The proper questions to ask, while researching EMR's
4) Interfaced EMR/EPM vs. Integrated EMR/EPM vs. Bridged EMR/EPM
5) How to Demo an EMR/EPM
6) ASP Model (web based) vs. Client Server (office based) vs. Hybrid Model
7) EMR Training & EMR Implementation
8) Prices of EMR's
9) Scanning & e-Faxing & Document Management
10) Data Backup & Server Backup
11) Hardware Requirements; Server, Tablets, Workstations, Scanners, Printers
12) Hardware Prices
13) Wireless Networking vs. Hardwire Networking
14) DSL vs. Cable
15) Physician Portals & Patient Portals
16) EMR Reviews & EMR Comparisons
17) Templates
18) Tablet PC vs. Desktop Workflow
19) How to better utilize this website
20) "The emrupdate Hall of Fame" containing,"The Best of the Best Threads & Posts"

Another Goal of this thread, is to focus primarily on "Educational Information," and less on sentiment.

Please feel free to Post new information, as well as Post Links to other threads that you feel would be Valuable with regards to the above recommendations.

Kindly refer new viewers of emrupdate to this thread, by providing them with the link.

"New members," please note that you can find, any additional information that you require, on your own, by utilizing the "Search Feature" on the upper right hand corner of emrupdate.

Furthermore, Please check out the "Other Forums" on emrupdate including; Medical Voice Recognition, Billing, General IT, Hardware & Non-EMR Software.

"Please don't forget to register."
If you don't feel comfortable posting new information, than you may just post a question.

"Others, please continue to elaborate on topics of the linked threads, so that this one will continue to grow exponentially."

Please Pick a Topic and Kindly Help Educate Us About it.


Thank You Everyone for your Contribution to this Thread!



Rich Family Practice New York:
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Reprinted from Medical Economics Sept.16, 2005:

"50 Reasons to get an EMR"

http://www.emrupdate.com/forums/thread/31715.aspx


Rich Family Practice New York:
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"How to Select an Electronic Health Record System"

Article from AAFP website:

http://www.aafp.org/fpm/20050200/55howt.html


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Prices of Hardware with Specifications:


http://www.emrupdate.com/forums/thread/44963.aspx

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Wireless Networking:

http://www.emrupdate.com/forums/thread/41994.aspx


Wireless Security: 

http://www.emrupdate.com/forums/thread/42616.aspx

Rich Family Practice New York:
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ASP vs. Hybrid EMR

http://www.emrupdate.com/forums/thread/20976.aspx

The Hybrid Model is supposed to be the best of both worlds; a combination of Client/Server and ASP Server combined. You will have a local Client/Server in your office that runs the EMR application; therefore all medical records are housed in your office which will provide you with better control of your medical charts as well as some additional piece of mind. You will also have increased speed over your local area network (LAN) which will afford you quicker access to your charts, and you will not be dependent on an internet connection to access your data.

In the Hybrid Model, you will also receive benefits of the best of ASP; like central administration of the EMR; including ASP offsite backups and database synching from your Client/Server to the ASP Server, downloaded updates and upgrades from the ASP Server to the Client/Server, and access to all of your data from any internet connection in the world to the ASP Server. In the event that your Client/Server goes down you will still be able to access your records on the ASP Server as long as you still have one internet connection.


ASP vs. Client Server:

http://www.emrupdate.com/forums/thread/13700.aspx

http://www.emrupdate.com/forums/thread/32818.aspx

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408 Family Physicians EHR user Satisfaction Study:

http://www.aafp.org/fpm/20051000/29aneh.html


http://www.aafp.org/fpm/20051000/ehrsurveyappendix.pdf 

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DSL vs Cable:

http://www.emrupdate.com/forums/thread/42635.aspx

Rich Family Practice New York:
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Electronic Health Records: Just around the Corner? Or Over the Cliff? 


http://www.annals.org/cgi/content/full/143/3/222#R7-8


Rich Family Practice New York:
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Medical Economics: Exclusive Survey Doctors and EHR's:


http://www.memag.com/memag/article/articleDetail.jsp?id=143144&pageID=1&sk=&date

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Your top 5 EMR Choices:

http://www.emrupdate.com/forums/thread/31761.aspx

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Ways to Reduce Training Costs: 

http://www.emrupdate.com/forums/thread/30789.aspx

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How to Demo an EMR:

Any good presenter worth their salt can make a demo look good. It can often be like an infomercial.

I would suggest that you demo your top choices (EMR's) at least twice, if you’re considering buying it. The first time you should let the presenter show you as much as they can during your 2 hour session and certainly ask questions. Then, the second time you demo the EMR, you should try and direct the demo just like you would by treating your own patients.

For instance, you can start off with an existing or new patient. Have them show you how the EMR handles the patient from beginning to end (no PUN intended).

1) Start off with Patient Demographics Entry, then move along to the Appointment Scheduler, next is patient arrival into the Waiting Room, you may then track the patient into the Treatment Room, see how the Vital Signs are documeted, Chief Complaints, Progress Note, Prescriptions, Test Orders, Follow Up, Bill Generation and Patient Recall. Don't get too bogged down on each step. Your goal is to track the patient through the EMR, not to see every miniscule feature during each step.

In my case, I'm a family practitioner so lets say the patient has a 9:30 AM appt most of the good EMR's will track the patient from the waiting room through bill generation. Let’s say a patient comes into my office for a sinus infection and I list the chief complaint in the EMR and then prescribe the appropriate antibiotics. So, let them show you how easy it is to generate a progress note, order prescriptions and lets say I want to order a CT of the sinuses, and then ask them to set a reminder, so later you can see if the patient went for their procedure.

2) Then when the note is complete, let them show you how easy or difficult it is to add additional chief complaints or amend the chart. For example, in my practice, as the patient is walking out the door, they say that they need refills of everything, and they also have a toe nail fungus that they want me to take a look at. Then see how easy it is to document those things that will actually affect the way “you” practice medicine, as oppose to how the demoer (Is demoer a word?) practices medicine, and hopefully with time you will find an EMR that does it better than the rest. Try to stick with the same multi faceted patient scenario when comparing the different EMR's.

3) Then you should ask them to show you, how routine; Health Maintenance and Disease Management is documented and tracked as well as, Incoming Interfaced Lab Results, Scanned Documents, Intra-Office Messaging, and To Do Lists.


Rich
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This Post:
Originally posted by digital-doc:

A free trial or ability to use the product online at one's leisure is the ideal way to learn and demo. Anyone who has spent an hour or two with a demo, knows that they could and should spend a day........or two!

Other Tools Needed for a demo:

1. Patience: The demoer has a routine he wants to present, no doubt with an existing patient. This is necessary because of time constraints.
2. No patience: If you let him run the show you will only know what he wants you to know.
3. Digital camera to take pics of screen
4. Ability to cut and paste screen shots into mspaint...fast.
5. Take prolific notes or have a tape recorder.
6. Have your own questions pre-written.
7. Most important, have the demoer chart a new patient from the beginning, from Matriculation to chart note. (just like you would do with a new EMR).
8. Tell the vendor in advance, in writing what you want to see. (example chart sciatica on the right side and Brachial radiculitis on the left, chest pain). There is never enough time.
9. Always see how multiple complaints are handled.
10. How does the program handle custom reports? Can an end user insert fields in a document making their own custom reports? What fields are available?
11. Show me an example of digital ink? Draw a picture in the chart note. Will it pass forward to the next visit, if desired?
12. Show how the EMR is shared by different users. Example nurse vitals, para-professional demographics and history, ROS etc.
13. Templates: How, what, when and where...





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