Essential Insights On Electronic Medical Records

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Bruce Werber, DPM, FACFAS

   Go see the product in use at a local practice. Send your staff to talk with that practice’s staff. Usually you will find out from staff if there are any problems, which the doctors may not share as easily.

   Go to a Web site such as to see a listing of most EMR systems available. There are several hundred of these systems.

   Personally, I like the idea of going with a market leader. For example, a podiatry specific system is Dox EMR (Dox Podiatry). More generic systems are Medisoft and Medinotes, just to name a couple. For specialty non-specific programs, look at Centricity (General Electric Healthcare), eClinicalWorks and MedInformatix (DavLong Business Solutions), Noteworthy and/or Greenway. These are just a few well-known market leaders. Additionally, there are several low cost systems available such as Amazing Charts or even free systems.

   The process I have used to make my decision is first to ask for references. I then ask the hospital medical staff office if the hospital system is sponsoring any EMR systems as they may be offering a large group discount. Check with your state medical society or state tech consult as they also may have one or two systems that they are sponsoring or offering at a lower cost.

   Then draw up a list of eight systems that you have heard about that the hospital or state tech council has offered you. Review one or two products every week and have each staff member write down the pros and cons of each system.

   After reviewing all eight systems, narrow it down to the best three systems and have a demo day for the three remaining systems. Again write down the pros and cons of each system. Call each vendor and ask about your concerns. Talk to more references and ask for a final quote with the bells and whistles that you will use — the ones you really need. Make sure the vendor provides all of the costs of training, setup conversion and implementation schedule.

   Review the essential features and features that would be on your wish list. Do not accept any features that may be coming in a few months. Consider those to be “vaporware” (nonexistent until implemented).

   Now make the decision based on budget, the service provided, a demonstration of systems, reviewing the references and an impression of the onsite visit. Check the company’s financials. Is the company solvent? Will it be in business in five to 10 years? How many installations does the company have? Check that the company is really certified. Talk with your staff and make sure they are comfortable with your decision. Most importantly, take your time as it is a big investment so make sure you are going to be happy with this system for at least five years.

Keys To Implementing The New System

   When implementing the system, should you attempt to convert present systems into new system? I do not advise this. It is costly and it is better to run the old system down and start the new system from scratch as there is less chance of errors or picking up corrupt data.

   If you know when your patient flow is the slowest, that is the time I recommend implementing the new system. I have found the best way to keep up production and minimize disruption is to take your schedule one day at a time. Hire data entry people and have them enter all the data for the next day’s work. If the system does have OCR, tell patients to come in 20 minutes earlier so you can gather their information. If the system has an online portal and it allows the patients to enter their own data, invite the patients to enter their information into your new high-tech system.

   It is possible that your production may be off by 20 to 30 percent in the first few weeks but the price will be worthwhile in the long run of increased efficiency and hopefully improved cash collections and lower accounts receivable.

Dr. Werber is in private practice in Mesa, Ariz. He is the Director of Clinical Education at Midwestern University in Glendale, Ariz. Dr. Werber is a Fellow and Past President of the American College of Foot and Ankle Surgeons.

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