More about a commercial install

I'm amazed. Its been since November since I wrote here and yet nothing has really changed.

My clinic bought a premiere medical office system complete with a vast EMR and EHR, all the bells and whistles, and then some. We spent three months getting some hardware changes in but somehow we've never migrated from using this as a billing system to working into the parts of the medical record. The original implementation date (full) was June. As of this writing we are no further along than my last posting in November. We cannot send out electronic billing which means that we are fined for each non-electronic transaction which we send out. There are no derivative statistics available (zip code, referrals, numbers of patients) and the scheduling system continues to be a miasma.

In one of my earliest posts here I spoke about the need for a physician champion. That's someone from the group of physicians who both has an interest in IT and has the ability to help lead fellow physicians into this brave new world. There are many reasons for temerity. Some of us come from no electronic systems at all, some with minimal backgrounds, some who cannot type. The organization is using a top-down approach to implementing the system, by committee without the involvement of the major input source, the physicians.

One of our major slowdowns has been over server use. There are three working floors and there have been some major movements of staff from floor to floor, changing the distributions and loads on the servers. Often there are unacceptable wait times for screen clears (this without any load from the medical record). Several suggestions about round robin DNS serving have fallen on deaf ears.

Another annoyance in the system is not being able to retrieve dates of injury. These are apparently stored in the EMR side which we can't access. Any 800-900 ICD code requires a date of injury. If lucky enough to have a paper chart that date can be found, else, lots of luck.

I've read alot about this system we have and have worked (and continue to use FreeMED) as my EHR/EMR system.Although I recognize that someday I'll have to switch out of FreeMED I've found it far more reliable for these tasks than the current Electronic System. I've produced some ebills (not sent of course) but as a product concept. I find the 0.9.x-dev series even easier to work in.