Concept began in the late 1960 s s by Lawrence Weed M.D. Vermont hospital in 1970.

Transcription

1 Brief History Benefits of an EMR Barriers to adoption Deciding on options Practical implementation aspects and strategies Concept began in the late 1960 s s by Lawrence Weed M.D. Vermont hospital in Mayo Clinic also began EMR development around the same time Alcon s Ivy EMR developed in the late 80 s Acquired 1400 users for it s s DOS based product which became outdated HIPPA (1996) Portability was a key portion of this legislation In 2004 the Bush administration proposed a 10 year initiative to implement interoperable EHR s 2009 HITECH Act used to incentivize clinicians to convert to EMR s Reimbursements first penalties later

2 Improved patient care 1. Legibility 2. Organizing data for longitudinal care 3. E prescribing to reduce errors and reconcile medications and allergies 4. Interoperability and communication of data 5. Implementing best care practices Access to patient data You don t t have to be at the office. (Web based systems especially) Multiple users Improved coding, billing, and administrative flow Mining of structured data Paper charts have been estimated at $1 in materials and labor to make and approximately $1 to maintain (per year). Finding and filing (including misfiling) Office space cleared for more profitable use Data lost, stolen, or destroyed. No back up! People change when they... Hurt enough that they have to Learn enough that they want to, and Receive enough that they are able to. John Maxwell Costs Reduced productivity and workflow Dynamic of patient care Current data migration Data security Interfacing w/ diagnostic equipment Processing speed (Moore s s Law) every mo s Storage hard drive space/capacity doubles about every year Bandwidth doubles every 9mo s s (amount of data through a fiber optic cable per Chris Anderson in Free) Price is driven down The price decreases by half at the same speed of the doubling!

3 Usability THE key factor Consider step wise process and best of breed Certification taking advantage of incentives Costs go for greatest value (Total Cost of Ownership) Platform what makes the most sense Traditional Client Server Remote Client Server or Application Service Provider (ASP) Web based based User purchases a software product license which is placed on a server (central computer with large storage and processing power) Workstations or clients are networked to the server Download Software Internal Network Requires retrieval process Access to the server outside of the network requires a virtual private network (VPN) Additional software which allows access to the office server. (Extra costs) Possible performance lag Server must stay up and running full time for you to access it Firewall HIPPA Internal Network

4 Most recommended that you engage an IT professional Microsoft certified Ongoing maintenance service fees annual Internet connection for e prescribing, e submitting claims, etc Servers Great variability in data storage needs. Data size and number of users IT work from these to maintain your network Workstations Clinical users 4 GB of RAM, a 17 monitor, 40 GB hard drive, Windows Professional versions (7, Vista, or XP) MaximEyes Compulink OfficeMate ExamWriter Crystal Practice Management Practice Director

5 Same client server product except the vendor houses and manages server May reduce some of the network management Some companies may use this to offer a web application Data storage off site Generally charged a monthly fee per user No software to download or purchase Less hardware requirements Cross platform Mac, Windows (PC), Linux No server and network management You own the data Cloud based More efficient storage system using multiple servers Redundancy and security are improved Instant updates no software downloads Ready access to data Amazon, Google, and Rackspace Benefits: self service, scalability, speed Internet connection broken!

6 Never fear technology is here! Failover routers like this Cradlepoint router automatically switch over to a 3 /4G back up. Cool. Cyclops Revolution EHR Integrity EMR for Eyes Ophthalmology Focused imedicware MDIntellysis Traditional tower and monitor Relatively inexpensive $ Interchangeable parts

7 Laptops Portable and small footprint Built in battery back up Inexpensive May have limited performance Good back up All in in One Systems Relatively small footprint w/ nice monitors Some have touch screen capabilities Simple set up and clean look Great mobility but smaller viewing area Could be good for drawing and showing a patient images Some will not be compatible with certain systems New Android tablets are coming Dial up up Yeah right! Satellite slower but possible in rural areas WiMax and Mobile Broadband (MiFi) DSL Cable T1 Fiber optic Network connections in all the rooms with workstations Printers Dual sided high speed scanners Back up system Battery back ups Determination and a little patience.

8 Cell: