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Google Plus for EMR and Helathcare IT

Posted on July 31, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Considering the amazing adoption of Google Plus, I imagine that many readers of this site are using it. I must admit that I got a little bit of a slow start to Google Plus since I was traveling for 2 weeks. However, I’ve started to dive in head first and see what it’s about. I’m still not sure exactly how this will be used in the future. Although, I’ve already seen some potential for amazing discussions to happen on Google Plus.

You can find me on Google Plus if you’d like to add me to your circle. I’d of course be happy to add any of you to my EMR and Healthcare IT circle.

I’m not really sure where Google Plus is going to lead, but I do know that the more people I connect with on it the more I like it. So, I’m interested in connecting with a lot more EMR and healthcare IT people.

I’d also love to hear what others like or dislike about Google Plus. How are you using it? How do you think it will fit in with other social media sites like Facebook, Twitter and LinkedIn? I’d love to hear your thoughts.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 91-95

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time for the second entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

95. Background check the vendor’s support team
This is such great advice. You’re guaranteed to have to call your EHR’s support number. You want to know what kind of answer you get. Certainly this can be learned by asking current clients of the EHR vendor. Although, don’t just ask the clients the EHR vendor gives you. Also, be sure to call other users of that EHR system to understand what kind of support they get when they have an issue.

Online forums are also a great place to learn about support. Just be aware that online you’re likely only going to read about the best and worst experiences that people have had with an EHR vendor. Of course, you can also always just give their support number a call and see what happens. Cold calling their support could teach you a lot about the type of service they provide.

94. Ask how the vendor ensures disaster recovery and business continuity
This is particularly important when you’re dealing with a SaaS EHR vendor. Don’t be shy asking them for details of how they’re doing this. In fact, if I were an EHR vendor I’d have a nice detailed explanation of how we’re doing it. If they’re doing it right, they’ll be happy to talk through the details.

If you’re considering a client server based EHR software, then some of this will fall to you and your IT team. However, your IT team can often only implement certain disaster recovery and business continuity features if your EHR vendor supports those features. So, be sure to have a competent IT person look over the EHR vendors capabilities. Plus, you might want to put these capabilities in your EHR contract since they often say one thing about disaster recovery and then deliver another.

93. TRY to use a vendor that actually has standards in their system I find this point from Shawn interesting. My first problem with it is that unfortunately we don’t have great standards in healthcare IT (yet?). However, a few that are easily recognized are HL7 and CCR/CCD. I honestly can’t say I’ve seen any vendor that doesn’t support HL7 though. So, since they all do it, that won’t help you much.

The other side of this coin is the various systems that an EHR vendor uses. Do they use a standard SQL database and a common programming language or do they use a proprietary database and programming language? I’m not sure this should be a complete deal killer, but there is some benefit to choosing an EMR system that uses a standard SQL database. Particularly if we’re talking about a client server EMR system. However, for most people this won’t likely have much impact on them. The only exception being that the language and/or database they use might be an indication of how “legacy” their EHR software is.

92. Google “product name + support forum”
There’s some real value for an EHR vendor to have an online support forum. In some cases, EHR vendors have support forums that are run by a third party. I think we can all see the value in sharing experiences using a specific EHR software with someone else who uses that same software. A lot of learning can happen that way. You’ll be amazed at how creative some people are and how vastly different they might use the same software.

My only problem with some of these third party online forums is that it can often mean that the support from that EHR vendor isn’t very good. Why do I say this? Because if the EHR vendor support was better, people wouldn’t have had to turn to these third party forums to get support. You can usually see if this is the case by browsing the threads of the forum and see how many complain about not getting support from the vendor and so that’s why they found the online forum.

I wouldn’t say an online forum is absolutely essential for an EHR company, but if they have one you should know about it and see what it’s like before you buy.

91. Google “product name + Twitter / Facebook / etc…
It seems that I wouldn’t knock an EHR company as much as Shawn does when it comes to an EHR vendor’s presence on things like Twitter and Facebook. Shawn says that it could be a sign that they’re stuck in the past. While this could be true, it could also just mean that they’ve chosen other forms of marketing that fit their skills and abilities.

While I don’t necessarily count lack of social media presence as a huge minus, it can be a huge plus. Twitter has become a great way for me to get support. For some reason companies like to listen more when I broadcast my need in a public forum. So, EHR companies that listen on the likes of Twitter might be a benefit for you when you’re not getting the support you need. Plus, an EHR vendor’s Twitter, Facebook and blog can tell you a lot about the personality of an EHR company. Something that can be really important in your assessment of the company.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.

Shoutout to Amazing Charts!

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

This is long overdue since they have been sponsoring my blog site for some time now, but I wanted to show appreciation for the generous support of my blog site by Amazing Charts.  Seriously though, their offer to allow users a trial period of using their EMR system is, in my humble opinion, a great feature.  What’s more, their price is one of the most competitive I have seen so far and I think very reasonable considering the much higher average price of EMR systems out there.  Please check out their site.  Thank you Amazing Charts!

If you’re interested in advertising on Happy EMR Doctor, check out the Happy EMR Doctor advertising page.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.  Computo ergo sum.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 96-101

Posted on July 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Shawn Riley on HealthTechnica has collected a great list called 101 Tips to Make your EMR and EHR More Useful. I find lists like this really interesting and provide a great point of conversation. So, I’m planning to take the 101 ways, and over 10 or so blog posts, I’m going to cover each suggestion and where appropriate provide some commentary on the tip. I expect it will drive some really interesting conversation.

101. Trust, but verify
This is a fine suggestion. It’s a tough balance to achieve, because you want and need to have the trust of your EHR vendor, because once you’re ready to implement that EHR you’re likely going to ask them for help. Some of the help will be rather easy for them to support, but more often than not you might want to ask them for some pretty custom work to make the EHR work the way you want it to work for your clinic. So, you want to make sure that you have a good relationship with your EHR vendor.

However, that doesn’t mean there’s anything wrong with verifying what the EHR vendor and their salespeople are telling you. In fact, it would be a huge mistake not to verify. There are lots of open forums like this website where you can ask and verify a lot of what the EHR representatives are telling you. Also, visit other hospitals, healthcare centers, doctors etc. who have implemented an EHR from the same vendor.

100. Ask about the learning curve
Great suggestion! Although, I don’t think there’s much value asking the EHR vendor about the learning curve. Ok, maybe you can find a little value if you ask them on average how much training their users require to implement their EHR. However, the learning curve of an EHR goes far beyond the initial training. So, you should ask your EHR vendors existing users about the learning curve. Also, try to ask those doctors who have implemented in the last 3-6 months. It’s easy to forget how hard (or easy) it was to learn something when you did it a few years ago.

99. Ask what platforms are supported
Yes, most EMR software is very specific. You can actually find much of the breakout of which platforms various EHR companies support on this EHR and EMR Operating System Compatibility wiki page. Obviously, if you love your Apple products, then you’re going to need to be sure that your EHR platform supports it. Not to mention, the platforms an EHR vendor supports (or more likely doesn’t support) might be a sign of how well the EHR is at keeping up with the latest technological trends.

98. Look for long life and long term support
Switching EMRs is worse than implementing one in the first place. Sure, they usually go better than the initial implementation, but there’s nothing fun about switching EMR software. So, do what you can to ensure that the EHR that you choose is going to be around into the future. Otherwise, even if you don’t want to switch EHR software, you may be forced to do so. It’s not fun redesigning clinical processes for a new EHR.

97. How will your teams be educated on the EMR / EHR?
Yes, your whole team will need to be educated. Even if you have one person that’s educated on all the components and then trains the rest of your staff, each staff member is going to need training. There are even many EHR companies that offer unlimited training. It’s part of their sales pitch. Basically, they offer unlimited training as a way to show that they have to make the EHR really easy to use so that they don’t spend all their time training you.

Personally, I also like to do some up front training for the EHR implementation and then budget for some training a few weeks or a month down the road. You’ll be amazed how much more you learn and how much better questions you ask after having used the EHR for a few weeks or month.

96. Ensure audit logs are easy to get to and are comprehensive
I like to do this best by imagining 5 legal scenarios that you might need the EMR audit logs. Then, ask the EHR vendor to provide you the audit logs for those 5 scenarios so that you can see how it would look if you happen to need that information. This is even better if you can test drive the EHR software and try running the logs yourself.

There you have it. My commentary on the first 5 of 101 EMR and EHR tips. 10 more posts to go. If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other 95.

Hand scan gadget allows fast, convenient patient check-ins

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Short post today.  Here’s a cool article on hand scans for electronic medical visit check-ins.  It’s a few days old, so I’m sure I’ve been beaten to the punch by my fellow Tweeters and Bloggers, but I have to say a big “Wow!”   Now if anyone can figure out how much it costs, I would be grateful to know.  Surprisingly, Googling it doesn’t turn up the cost anywhere that I can find.  That might be foreboding sign, but I like to hope for pleasant surprises.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.  Computo ergo sum.

Happy EMR Doctor statistics of the week – July 25, 2011

Posted on July 27, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

In her July 18 article in US News & World report, The Era of Electronic Medical Records”, Angela Haupt quotes a Health Affairs study published in March, stating that:

“Researchers put the first-year expense of installing an EMR package and training staff at more than $230,000 for a five-physician office…  Each doctor, according to the Health Affairs study, will need about 134 hours to learn how to properly use the system.”

Ugh!  Are they even aware that that’s 3.35 forty-hour work weeks, plus an additional $46,000 per doctor?  How many doctors in private practice can afford to take a month off for training and then give up $46K on top of that even?  Where to find the time and money!?  Are they completely insane!?

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.  Computo ergo sum.

Reasons Your EHR Will Go Down

Posted on July 26, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My previous post about the cost of EHR down time prompted me to think of all the ways that your EHR can go down. This might not be an exhaustive list, but hopefully it gives you an idea of the many many ways that your EMR can go down. With that knowledge hopefully you’ll be inspired to plan for EMR down time.

Reasons Your EMR Could Go Down:
Power Outage – Very few EMRs are setup to be able to handle a power outage. Sure, maybe you have a UPS attached to your server and some battery life in your laptop, but that’s only going to last so long. Plus, I bet your router/network switch isn’t on a UPS. What about your printer? You get the idea. EMR and power are friends.

Hard Drive Failure – At some point I asked someone why it was so common for hard drives to crash. They then described that hard drives are moving parts and anytime something is moving, there’s a higher chance that something will go wrong. Of course, now they have solid state hard drives that you can get. Either way, I’ve seen a lot of hard drives fail in my time. Of course, if you have a nice RAID setup for your hard drives, then you often won’t notice. Until they have to replace the failed hard drive with a new one. This could be the hard drive of your server or your computer. Most computers don’t have a RAID configuration.

Power Supply Failure – Most servers have redundant power supply. Why? Because they’ve been known to fail. If your server doesn’t have a redundant power supply, then be ready for down time. Most desktops don’t have redundant power supply and so they could easily fail too.

Network Cable – I don’t think I’ve ever seen a network cable go bad. However, I’ve certainly seen plenty of cables to servers bumped, moved, ripped out of the server. Everyone wonders why the server went down. Takes far too long to see that the network cable just got pulled out a little too much.

Switch/Router – Switches and Routers are what’s used in most offices to connect all your computers to the internet. Certainly these can go down if the power goes out. However, they can have other issues too. It’s not that common, but can sometimes cause down time for your office. Of course, wirelesss routers in particular can cause clinics lots of headaches when they go down.

Motherboard Failure – Might as well cover another common hardware failure: the motherboard. No motherboard and you can’t use your EMR.

EHR Software Issue – I’ve seen where a poorly tested and implemented EMR system would slowly use up all the memory on a server. Once it used up all the memory on the server, the EMR would take forever to do the simplest task. While not technically down since the server is up, it’s still a form of down time since users start refusing to use it in this state.

Internet Outage – This is particularly applicable to a SaaS EHR. Unless you have spent a lot of money to get redundant internet lines to your office (which in some locations is impossible), your internet will go down sooner or later. I don’t know how many times I’ve heard of some construction guy digging up the internet lines and causing outages for doctors offices. Happens all the time.

Much of the above can be applied to servers, desktops or laptops. Sometimes it causes a partial outage (ie. one laptop dies). Other times it takes down your whole EMR system (server dies). Either way, you should consider all these possibilities. Then, you see how you can minimize them (likely with the help of your IT support). Then, you think about what you’re going to do when the EMR down time happens.

Speaking from first hand experience, having a plan for EMR down time made all the difference when the event occurred.

Templating notes improved my healthcare delivery: an anecdote

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Recently, I sat down with my trusty practice manager Ken and we went through our monthly profit and loss — P&L — statement, as we do every month about this time.  Excellent business person that he is, Ken noticed an interesting trend.  Lately, my Pneumovax vaccines have been flying off the shelves since I moved to templating my notes on a full-time basis back around April.

Nowadays, all of my new diabetes patients are asked, with nearly 100% precision, when is the last time they had a Pneumococcal vaccine (Pneumovax 23, made by Merck) to prevent bad outcomes in case of pneumonia.  If they cannot recall or find out from a previous doctor, then they are a candidate for this vaccine.  If their sugar patterns are under reasonable control to render the vaccine effective, then I offer to give it to them on the spot.  If not, then I write it into my plans for future visits to rediscuss this when they do reach a reasonable level of control.  I used to give out maybe around 5-6 vaccine doses each month, but for the last three months, the count is up to about 13-15 doses monthly.  Since diabetes patients are pretty much the only people I give this vaccine to, I have to conclude that healthcare delivery is improved for my diabetic population.  Interesting, no?

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Why Should Doctors Trust the Government?

Posted on I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

This article is published at Townhall Finance and was written for a Docs4PatientCare.   This is much more politics than Health IT but still a good read.

MK

Find the article here