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Serverless freedom in the world of EHRs: glorious!

Posted on July 13, 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.

After reading John Lynn’s great Fourth of July freedom post, I recently had a conversation with him behind the scenes about my office’s IT meltdown this week and how my poor — but highly talented and amazingly dedicated — practice manager Ken has been pioneering the way for our office to resurrect itself from the IT ashes.  Those of you who have read my blogs know that when I first opened my practice in December 2009 we initally bought a server-hosted EHR system that was housed in our office.  In retrospect, I would never do that again.

It turns out that we dumped our first EHR company three months into the horror of having something new broken on it basically every day and went the way of a web-hosted EHR company (Practice Fusion — LOVE THEM!).  However, we made another mistake in continuing to use our server, which was networked with WYSE thin clients throughout the office.  For the past six months or more, we have endured slower and slower page loading speeds, never knowing if it was the EHR company’s problem — it wasn’t – or our network’s.  After discussing with several people, we came to the conclusion that it was most likely those darned thin clients hooked up to our server.  These, it seems, don’t have much computing power of their own, but instead rely upon the server to run software and connect to the web.

Okay, now for the royal IT screw-over.  At the same time we selected our first EHR vendor, we went with an IT consultant who, in retrospect, was probably pretty small potatoes, albeit pretty smart and capable.  Ken would often remark to me that the phone calls would be answered by the CEO from a grocery store where his kids would be heard shouting in the background.  A big Achilles heel for this first IT company was that on a day about two months ago when our server went down, the company refused to help us because they “weren’t within their normal operating hours of 9-5 pm.  Hence, when our printer wasn’t functioning at 8 AM one day, we were pretty much screwed for our first business hour.  Bye-bye company #1; we needed reliability.  The second IT company we hired promised to be open for our working hours of 8 AM to 6 PM but never fulfilled requested work tickets each time until we had to practically scream at them.   They sent out an incompetent individual who we later found out was “only a level-1 tech” and who “didn’t get the internal communication they should have received” before coming out to our office.  As a result, it took the technician over three hours to network an office scanner while she cluelessly stood on hold with the scanner’s tech support line while we watched the clock tick away.  Come on now … even I can call a tech support line by myself and have someone walk me through a setup.

And so, at long last, we have realized our latest goal as an electronic practice:  to fly free of our server cage and avoid doing anything with an IT consulting company from now on if we can avoid it.  As a medical clinic providing healthcare, we’d much rather spend time elsewhere.

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.

Digital phone reminders for patient visits

Posted on June 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.

Just a quick blurb about a great service I found out about recently. There was a technology future talk over on a post that I can’t seem to find again.  In it, the speaker says a lot of stuff that honestly left me a bit confused.  Whenever technobabble starts mimicking metaphors and you can’t tell if they are talking about something real or symbolic, I tend to glaze over.  But one thing he did convince me of was that if I could imagine something I’d like to automate in 2011, I could probably find it on a free (or nearly free) web app somewhere.

And so it went.  I googled free phone reminders — or something like that — and found a new site I’m in love with… Phonevite.com.  For the low cost of 5 cents a call, this site lets you plug in anyone’s phone number — as many as you like at a time — and they will get a pre-recorded audio message that you speak into your phone.   So I looked over the past month of my patient visits and found that on average I had about 2-4 no-shows or cancellations weekly.  In my quest for a high-efficiency medical practice, eliminating any of those per week would translate into practice revenue enhancements and thus enhance the likelihood of keeping our team going.

There are two versions of Phonevite.com’s services.  A free version that let’s you call up to 25 numbers twice a month — doesn’t really apply to us since my phone number lists will be different every day and time we use it.  On the other hand, their “premium” option is to pay 5 cents per successful call — and YES it actually gives the added service of a success log that lets you know if a number is out of service!  So for the low investment of around a dollar or less daily, I can now add to my “electronic” medical practice’s services a digital phone call reminder feature.  Incidentally, they are endorsed by the Better Business Bureau and they have a stated policy of confidentiality and not selling or sharing any phone numbers with third parties.

This will come in very handy for patients that forget to check their email or those who do not have email accounts.  Very handy indeed!

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.