A good day at the office

For those of you who may not know me I spend 50% of my time in clinical practice and 50% of my time as Director of Medical Informatics for an IPA called Brown & Toland Physicians. Brown & Toland is a comprehensive, multi-specialty independent practice association (IPA) serving the residents of San Francisco and the Bay Area. The member physicians practice in offices throughout the city of San Francisco and at the prestigious University of California at San Francisco.

About 4 years ago B&T embarked on a massive project to roll out an EHR to all its physicians. We have approximatley 150 providers on the system and hope to enroll at least another 200. It has been an intresting and challenging ride – to say the least. The functionality used includes note creation, electronic prescribing, electronic messaging and soon full CPOE. We also have in place 7 interfaces built with local lab,radiology, hospital and ER reports etc.

I would be very interested to hear your story regardarding implementation, functionality used etc. If you have worked in an IPA setup I would also love to hear from you.  Until next time…….

Netbooks in HealthCare……

You may have heard about NetBook computers. Only this morning they were featured on NPR. They are essentially very small laptops that run Linux or Windows operating systems and are very inexpensive, with prices ranging from $300 to $600.  Early on, they were considered second computers, best for e-mail and Web surfing—thus the netbook moniker. The market is very competitive right now and prices have plumeted. We are comnsidering the use of these devices in accessing our EHR. 

It would seem that they would appeal to a wide audience, from businesspeople who travel frequently, to kids and home users looking for a small laptop to carry from room to room, to book-laden students who spend long hours on campus.  Are you using a Netbook in your healthcare environment?  Please let me know. Does it function adequately in the hosptital or in your office? 

It’s easy enough to tell a netbook from other laptops, but the differences between one netbook and the next are getting fewer and fewer. They generally have 8-to-10-inch widescreens and lack built-in optical drives. They do not have full-size keyboards—they usually range from 89 percent to 93 percent of full size—so expect a more cramped typing experience than with a mainstream laptop. You will find an abundance of USB ports, a webcam, a card reader, and built-in Wi-Fi. Some even have bonus features like ExpressCard slots, Bluetooth, and options for cellular modems. Most every netbook has adopted the Intel Atom platform, made up of the Atom processor, integrated graphics, and 512MB to 1GB of RAM.

They’re not just limited to Web surfing, compiling spreadsheets, or word processing. You can  dump your photos from a digital camera and edit them using a program like Adobe Photoshop Elements 7. With some patience, you can transcode video to another format using Windows Media Encoder 9 or edit video footage using Adobe Premiere Elements 7, or run your entire music library with iTunes. A netbook can play video from sites like YouTube or a movie from an external USB drive, unmarred by distortions and lag. Businesses are considering these pint-size laptops because you can run various e-mail clients on them, put them on a network, install a VPN client, and secure them with antivirus and antispyware suites.

Here is a link to the NPR article – http://www.npr.org/templates/story/story.php?storyId=104527832 

And a recent article in the New York Times - http://www.nytimes.com/2009/04/02/technology/02netbooks.html?_r=1

Please may I get your feedback….

I am taking a closer look at how physicians enter data into their electronic medical records system. It seems as though there is a great diversity in the way the electronic notes are created. Some practitioners simply type into the electronic system , whereas others will use templates or voice recognition  systems. To see a simple video of the Dragon voice recognition system simply look to the lower right of my home page.

I will be grateful if you could take a look at this poll and let me know which option you normally prefer for entering information into your electronic medical records system.

An update on SureScripts….

SureScripts, operator of the nation’s largest electronic prescribing network, reported on April 22 that more than 100,000 prescribers are now routing prescriptions electronically in the United States.

SureScripts made the announcement in conjunction with the release of the company’s “National Progress Report on E-prescribing.” The report, based on the operations of the Surescripts network, details the status of e-prescribing adoption and use in the U.S. from 2006 through 2008.

I have added a copy of the full report in the files section at the top left of this page. Feel free to download it here.

A cute video about Cloud Computing – for the newbie

The Center for American Progress

In the library of files to the left of this homepage I have posted a a very interesting PDF. It’s entitled the “Center for American Progress’. Its an excellent article by Todd Park and Peter Basch MD. I urge you to read it. Of particluar interest to me is the discsssion about replacing/revamping the current E&M Coding guidelines- this is long overdue.  I congratulate the authors on a well written article that serves as a good discussion document. We need to communicate this type of information to EHR vendors as I think it will help to advance the cause of a more powerful and useful EHR in the future.

Twitter from the O.R.

this seems to be a new trend.  I was reading this morning about a hospital in Dallas that provided live Twitter updates from the operating room.  Apparently a father donated his kidney to his son and the surgical procedure was reported via Twitter.  It sounds like it could be a very powerful marketing tool for the hospital and also provides the general public with specific information.  The hospital in question also maintains a FaceBook account, a blog and also has a channel on You Tube.  I think I will investigate further about the use of these social networking tools in medicine. I will post further on this topic in the near future.  Watch this space.

Increase in certified EHRs

I was reading an article today about the increase in electronic medical record products. 64 companies recently applied for certification of their electronic medical record systems. This is one third more than had applied by the same time last year. 40% of the new applications were for  new EMR products rather than renewals. The biggest category, with 26 applications, was for EMR products for children.Oother applications covered cardiovascular medicine,  emergency departments, and inpatient records. So far, 25 of the products have been certified.

I guess everybody is trying to jump on the band wagon!

A disturbing story from the Washington Post……..

http://voices.washingtonpost.com/securityfix/2009/05/hackers_break_into_virginia_he.html

Thank you WordPress!

WordPress just added a cool new feature that allows me to write blog entries and submit them via email on my Blackberry. Very cool.