Posted: Thu Dec 26, 2002 4:16 pm Post subject: Thanks Chris
Guess I'll be the first to post on the Doc SIG.
I've replaced my NEC MobilePro 880 with the Acer tablet. The Acer is identical in form-factor and wt as the 880. Though the Pinax Group has taken over the defunct Vadem/Sharp business (original WinCE 2.11 Pro full screen handhelds), i've been concerned about the survivability of wince machines that have very limited utility outside of a special niche. I've been satisfied with the Acer which fits in perfectly with my paperless office (though scanning incoming paper is a full time job) and appreciated being able to network win xp pro to win xp pro at home and not have a crippled MIPS processor and IE 3.0 while kids take over the upgraded MM desktop in the basement.
As I'm paperless, also needed to network at home so that at 2am i don't have to go downstairs and log into the office. Only problem with capabilities of tablet superset is that though i don't have to worry about hipaa security issues or wireless pirating thanks to Windows NT Terminal Server Edition and Citrix Metaframe, speech and RDP don't mix. This is apparently a Citrix issue from what I've gathered from MS' site. It would be nice to occasionally dictate text entry when database template clicking won't work - such as when detailing family conferences etc.
though several posters here have used Naturally Speaking for their apps, I haven't had the need for anything that sophisticated or expensive. I've trained the ms engine and have copied my letterhead template onto the tablet so waiting to try dictation on it. for documentation purposes, though, i've relied on letter writing with the actual EMR (E-med Records, formerly CompuKID) by opening up a new note. this way don't have to scan letter back into "file cabinet" that now has over 10,000 pages in it. though seems daunting, i made the decision when i opened my solo practice 4 yrs ago, to start paperless from the get-go.
Thanks for your post. You are much farther along in your in your understanding and implimentation of an EMR than myself and probably a lot of other docs I bet. Being your own boss probably has a lot of advantages (and responsibilities). I'm glad you have found a system that works to make you efficient and paperless. I have theTablet PC now, which will be my first step into getting technology into the office besides using a Pocket PC. I hope to be able to use Word as a simple means of documenting using the template function and possibly shorthand for windows. If I can get out of the loop of waiting to get dictations back to edit and sign that would be a big accomplishment. Some simple solutions are documented in this article:
I have read and demoed some of the low cost EMRs such as SOAPnotes and Amazing Charts that are out there, but I am a little fish in a big pond (work for a hospital network) and the HIPPA concerns are big issues. For now I want to document as much as I can at the point of care and hopefully my two brothers that work with computers and programing can devise a software solution to help me document quickly and and code accurately. I hope the revised E/M guidelines that are supposed to be out this spring make it easier for everyone to code and document easily. Those will be my first baby steps then I will try to work with IT guys at the hospital and hopefully to get more intergrated and more features added. Thanks for letting others hear your experience!
SOAPnotes... do you mean SOAPware? If not, could you tell me a bit about SOAPnotes?
I'd "noodled around" with SOAPware a few years ago and found it was pretty decent. I've exchanged a few e-mails with DOCS, Inc. which produces SOAPware. They are excited about tablet pc's and are indeed developing an "ink friendly" version of SOAPware. ETA 6 to 12 mos., I think.
Interestingly, their CEO, a physician, is using an Acer tablet.
Posted: Fri Dec 27, 2002 3:58 am Post subject: EMR's
CompuKID is very friendly, and they are able to do things by an ASP set-up. their front page mentions and $895 special. an an FP, you know that kids grow into adults, need more work to get better etc. So, using an initially pediatric-based EMR matures nicely into an adult EMR, whereas adult EMR's that they try to customize for peds never works. One of the reasons company changed from Pediatric Software International to E-med Records is because it is no longer strictly for peds. but, if you're doing peds, too, there are many significant perks, including immunizations (which wouldn't hurt with adult vaccine tracking - ie, do you track how many pts get their DT shots every 10 ys???)
I will try to check out the CompuKID sometime. If my understanding is correct however of ASP models (?uploading files to an internet server for central storage?) I'm not sure I am as interested. I have seen this demoed and have seen it work well with another EMR program but I am always worried about not being able to connect or having a server down and malfunction. I realize problems can occur with any EMR or system used. I guess since I am not so technical I want a system that is as bulletproof as possible. That's why I was interested in your use of CE devices. On other forums I have read about and discussed with other physicians about Smart Displays which theoretically should work well but as you have said the voice recognition shortcomings may make it less attractive. Although one doc is going to try it with the the work around of using a wireless mike with the main computer. Interesting things people are trying out there! I try my best to understand all the concepts and technologies and I find them fascinating and a lot of times very expensive to impliment. Thanks for your tips, I'll keep trying to get up to speed!
Posted: Fri Dec 27, 2002 2:53 pm Post subject: emrs
instead of responding to this thread, i've started a new topic called emrs. (same for anyone else. title of thanks chris was directed towards chris for setting up a DOC SIG based on the three of our answers that we'd be interested.
though i've used win ce, thats been strictly as a thin client for my citrix setup. though may sound confusing, when i opened up my practice, danny didn't have asp facility so i have my own server. as you said, any server can go down. the beauty of his new capabilities is that i would no longer have to worry about daily back ups. only reason i haven't gone with him is the 15K i spent for hardware/software 4 years ago.
i think anything that is worthwhile would require a server with an EMR rather than a home-grown solution unless you're a great relational database builder.
danny will be more than willing to go over things with you if you'd like - Sparta NJ, 1-973-726-4444.
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