Comments on: eWal-Mart?

By: pookiemd

pookiemd — Mon, 13 Apr 2009 20:32:26 +0000

Would love you to do a guest post on the strengths and weaknesses of various EMRS (basically similar to what you just wrote!) Are you up for it?
What’s funny is that I use EPIC in the hospital, and grump about how complicated it is. I also use meditech and prefer it.

By: cs

cs — Sat, 11 Apr 2009 18:42:12 +0000

maybe it’s not the same b/c I am a surgical specialist, but I loooove EMR. Started out with EPIC in my residency, group practice with hospital also had EPIC and I just started solo practice. EPIC is for big hospitals and about $50K. Tried Amazing Charts (free for 90 days then $1000) but it isn’t very oriented to procedures and xrays (I’m ortho) so I’m going to end up going with Medtuity which is a mere $750. The hardware won’t be cheap (I want the fancy stuff – a tablet touchscreen, a waiting room kiosk and a real server with redundancy so we’re talking $5K) but can be used for years and the same hardware can also be used if I end up having to get a super fancy expensive CCHIT system to get my $44K from the government in 2 years. Anyway, right now I am using my home laptop and a $350 netbook from Walmart so I need real computer equipemtn anyway.
Also looked at eClinical works (didn’t like it), Chart Logic (like this but haven’t got $18K to spare), iMedica (really liked it and local BC/BS insurer will pay 50% of cost but that still adds up to $15.5K), NexGen (sucks and grossly expensive), Logician (a piece of sxxx and expensive).
Did I say again how much I love EMR? I was paperless from day 1 and love to access charts, xray images, labs from home. I share a space the size of a bedroom so have no room for paper charts and since I am micropractice, I would be probably making those file labels myself rather than being in the OR. If I need to share info, I just fax or email a hardcopy from the system. Electronic interconnection is an expensive waste of time – just print it out if you aren’t on the same system and they will scan it in. I just scan in outside op reports/referrals etc.
Oh, and I live on a small tropical island so yeah, electric and internet go down daily but a UPS is $99 from Costco and don’t do ASP, get your own server so you own your own data.
It’s been interesting doing this research but the key is, if you are technical at all, you will never be able to live without an EMR once you’ve had one (kind of like why would you not have a cell phone as a doc – carrying your beeper then stopping the car to find a pay phone and all that other irritation that no one ever remembers now that there’s a better solution?)

By: pookiemd

pookiemd — Sun, 15 Mar 2009 13:51:24 +0000

Well said. I have two issues with the “lets-all-get-EMRs” mandate: 1) too expensive, especially for solo practice/small groups 2) lack of universality–how will the health care community share information if we all have a different emr?

By: IcedLatte

IcedLatte — Sat, 14 Mar 2009 01:26:27 +0000

Nice, but still. My avg reimbursement per patient is generally $78 give or take a couple of bucks (NON-medicare patients, that is). I bill a high level of service, generally. I’ve passed all my internal and 3d party audits handily with PAPER. For moi, solo doc, to spend another $25,000, I’d need to see 320 plus more patients a year. I don’t think I’d bill at a higher level of service, really, so I don’t think the system would pay for itself. While I’m really not arguing about the objective beauty of having a patient information available electronically, in my office we rarely lose paper. Hospitals have UPS. Offices don’t. Paper charts never go down. My electricity, computers, and internet connections do. EHR is going to come, and I’ll love it, but not for $25,000.