Simple question for Mac OS using medical people
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From: Mark Conrad on 8 Jan 2010 22:11 Hi Tim, thanks for the detailed response about EMRs and EHRs, regarding their problems, and why they are not presently universally adopted by medical practitioners. I am strictly a layman, so I will include two brief and slightly confusing Wikipedia definitions: EMR definition (Wikipedia) ******************** An electronic medical record is usually a computerized legal medical record created in an organization that delivers care, such as a hospital and doctor's surgery. Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and manipulation of records. Heh heh, I like that, the word "usually" - - - I see Wikipedia does not know what an EMR is, either. Perhaps the definition of EHR will be a bit clearer. EHR definition (Wikipedia) ******************* An electronic health record (EHR) (also electronic patient record or computerised patient record ) Such records may included a whole range of data in comprehensive or summary form, including demographics , medical history, medication and allergies, immunization status, laboratory test results, radiology images, and billing information. It is important to note that an EHR is generated and maintained within an institution, such as a hospital, integrated delivery network, clinic, or physician office. Its purpose can be understood as a complete record patient encounters that allows to automate and streamline workflow in health care settings and to increase safety through evidence-based decision support, quality management, and outcomes reporting. - - - end of definition - - - > EMRs are supposed to save money overall but my experience is > that they drastically show down the process of getting access to > information about my patients. That's what I wanted to find out, thanks. > In my experience, using a paper chart makes access to the important > information much, much faster than a computer. Flip a page, there's > the new info. On a computer, click a button and wait while the system > queues the request, finds the file, displays it on the screen- I can be > almost halfway through a printed page by the time this finishes in many > cases. Yeah, especially if you are using a slow Citrix in-house network, instead of a dedicated computer. I do not know what the answer is for cleaning up the present EMR/EHR record-keeping mess is. One oncologist posted that he spent 30k for an Altos EMR and 1.6k for the Dragon speech recognition app to fill in the Altos EMR by voice. Did not work. He had a service contract with Altos, but Altos claimed they never said that their EMR would work with Dragon... EVEN THOUGH Altos admitted they had been "certified" by Dragon. Poor guy contacted Dragon, sure enough the Altos EMR was on their "approved" list. Doctor bounced back and forth between Altos and Dragon, even pleaded with the owner of Altos, their head bird, to get the damn thing working. Neither outfit would, they both stopped answering his emails. By stirring up this kettle of s***, the guy eventually "got a tip" (probably from Dragon) - that he had to turn off "HTML Support" in the Tools menu of Dragon. He did, and his $32k investment was saved, everything worked fine, he could quickly speech dictate data into the Altos EMR form. Whole harrowing account is at this website: <http://www.knowbrainer.com/PubForum/index.cfm?page=viewForumTopic&topic Id=8466> I am amazed that the owner of Altos did not personally help the guy, because the guy had a service contract with Altos EMR. No word whether the initial problem was with Altos code, or with Dragon code. BTW, an international company named "Nuance" presently owns Dragon NaturallySpeaking, I think their head office is in Belgium. Mark-
From: Mark Conrad on 8 Jan 2010 22:43 In article <timmcn-0FE1C0.19492708012010(a)news-2.mpls.iphouse.net>, Tim McNamara <timmcn(a)bitstream.net> wrote: > > EMR makes sense when it is interconnected (or centralised) because in > > systems where you have a choice of doctor/hospital (not restricted to > > one insurance company's hospitals), when you go to another hospital, > > they can access the records created at the other places in seconds > > instead of hours/days to have the stuff faxed to them. > > Those things are true, but at this point because those hospital systems > tend to be competitive rather than cooperative (and since AFAIK there is > no standardized data format for interchanging information between > different EMR systems) that is mostly a theoretical rather than > practical benefit. Plus I question if it is even possible to create a standardized EMR "catch all" version to cover all the different medical specialties, labs, etc. If such a standard EMR were possible, surely someone would have done it by now? Maybe there is some technical reason it can't be designed. Too costly, perhaps, when one considers that even _one_ EMR like "Altos EMR" runs $30,000 Mark-
From: JF Mezei on 9 Jan 2010 06:52 Mark Conrad wrote: > Plus I question if it is even possible to create a standardized EMR > "catch all" version to cover all the different medical specialties, > labs, etc. I sometimes think Google might be the answer. Ok, perhaps not Google Inc, but some similar system that can index free form text in many different formats. There could be a central indexing site (lets call it Giggle). Giggle would access every hospital database and index the data. You're looking for a person ? Giggle will give you all references to that person from all hospitals where that person has been. this would allow one to index all sorts of different medical record format, xrays etc.
From: Wes Groleau on 9 Jan 2010 10:13 JF Mezei wrote: > There could be a central indexing site (lets call it Giggle). Giggle > would access every hospital database and index the data. Probably with a user interface that requires nitrous oxide to tolerate. > You're looking for a person ? Giggle will give you all references to > that person from all hospitals where that person has been. And when all the HIPAA lawsuits start, the developers will want NO2. I think you named it well. -- Wes Groleau Armchair Activism: http://www.breakthechain.org/armchair.html
From: Tim McNamara on 9 Jan 2010 11:15
In article <080120101911474836%aeiou(a)mostly.invalid>, Mark Conrad <aeiou(a)mostly.invalid> wrote: > I am amazed that the owner of Altos did not personally help the guy, > because the guy had a service contract with Altos EMR. They probably didn't know why it didn't work and didn't want to admit it. -- "I wear the cheese, it does not wear me." |