Monday, May 21, 2007

Your favorite headache: EMR

Choosing and buying an EMR is difficult, since an EMR always means a lot of work and turmoil in the office and a lot of expenses. EMR companies usually fill pages and pages with "benefits" of using their products instead of listing what specifically their software can do and, very importantly, what it cannot do! That essential piece of information is never mentioned in the glossy ads. EMR prices and functionality vary dramatically from zero to hundreds of thousands of dollars.

Therefore, the first thing to do is to get good info, objective and marketing-free by visiting the website "". This is a neutral site published by a colleague that was and is looking for a good EMR. The site does not promote any particular product, but rather reviews most available ones and gives very helpful hints.

I am presently using GE Logician, now called "Centricity Physician Office" and I was disappointed. I had been waiting and hoping for an EMR for 14 years and when I finally started using it, it was not I had expected.

1. I need more time than before to finish my charts. Most actions require just too many clicks.

2. It was like having a whole new set of paper forms that you have to get used to.

3. Your EMR is not like your paperchart. It was designed by someone else that does not work and think like you do.

4. You often cannot adapt the EMR to the way you think and work adn you can olny adapt it a little. Your boss will tell you: "We try to keep it standardized", which is another way of saying "The programming or consulting time to adapt this program to your needs is too expensive. Suck it up already and get used to what we give you!" One of the advantages of corporate medicine, by the way - you have to adapt to what they give you instead of you adapting things to your likings as it happens in private practice

5. The advantages such as having "access to patient records everywhere including at home" turn out not to be as amazing as you thought. The added work everyday more than outweighs the advantages.

6. My most important issue as a specialist was that I wanted a super-easy way to send a letter or fax or email to the referring doctors. I want to have the report of the visit to be on the desk of the referring doctor as soon as the patient leaves the office. This happens to be very difficult in Centricity with multipe clicks. A consultant has to create the templates you request, every time a change is necessary, a consultant has to do it and so on. You cannot even enter a new pharmacy address because stupid you could mess up the sytem.

7. Centricity does not have a space for email address, for primary care doctor, for cell phone etc. The system was created 20 years ago and it shows.

If I was in private practice I probably would get "Amazing charts", a system that give you the ost value. It was developed by a family practitioner in Rhode Island to avoid being taken advantage of by the IT industry (just my line of thinking). Costs only $1000 for the first physician, $250 for each next one. And it does not matter how many staff members use the program.

Amazing Charts: You can download it and try it for free for three months, and the three months do not begin to count until you have 10 or more patients in the system. Meaning, you can play around with 9 patients as long as you want. Use it with a standard off-the-shelf wireless network, desktop and tablet computers. You can almost do all the installation yourself. Keeps the office frugal. Amazing charts also offers to do your billing for a very good price, which makes sense. Google it and see.

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