Eliminate Print Servers: go LANless?
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@Dashrender said:
I know you think all US health care is out to screw you,
Your descriptions of your office processes in patient care, security, common sense, etc. don't do anything to discourage my impressions of the health care. Yes, I firmly question the motives of many in the health care system... but I don't react to that when you describe what is happening in the health care practice that you describe. The concerns are based off of what they are actually doing there.
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@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?
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@scottalanmiller said:
@johnhooks said:
@Dashrender said:
You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.
I'm confused why this can't be done with a query to the other system? Why do they have to dig around?
And how they get distracted by the digital form of the data.
I don't think ita about distraction. It about just finding things.
Most charting systems show just a list of office visits, if you are looking for something done at some previous visit, you have to open each one until you find what you want. Hell you might not even know what you want, you just want to skim than all. That is a pain... Is it in reality more of a pain in EHR than old paper chart, probably not... Bit its definitely not easier.
I'm not making excuses for them.
I'm trying to make things better within the realm that I can. I can't put a gun to their head and demand they atop being lazy and find their own shit. They choose to spend their money on having staff look it up for them so they can go directly to the data they was as is possible. -
@scottalanmiller said:
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?
Ask uncle Sam... It's current a federal requirement
Though the fed is working to solve it, so they say.
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@Dashrender said:
@scottalanmiller said:
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I know you think all US health care is out to screw you, but we get paid in my office by the visit, not amount of time spent with the patient.
You can convince me that they care when they do things like take the "time" to keep patient data safe and don't handwrite. You cant defend their intents after describing their processes and what they prioritize.
They only hand write narcotics today... Everything else is digital.
That's good. Why is the one special? Does it have a problem that they need to bypass the normal security measures?
Ask uncle Sam... It's current a federal requirement
Though the fed is working to solve it, so they say.
I do agree, I don't understand why the current electronic med system wasn't considered secure enough for narcotics... I'm guessing it was just political.
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@Dashrender said:
In EHR you find it in a huge list, requiring scrolling... Etc.
See this is nuts. Everything I've built, I've been able to use autocomplete in a selection like this. So if I want Ibuprofin, I just type until it's the right one. If the field is just to select something (and not create a record), don't allow anything other than items that are already in a record. This removes misspelling errors.
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@Dashrender said:
@scottalanmiller said:
@johnhooks said:
@Dashrender said:
You'd like to think that, the info is in another system. Bit that requires digging around in that system to find it... So they pay the staff to spend mins digging instead of themselves. Then once they find it... There is no way to keep it front and center while moving onto those next task without printing or something similar.
I'm confused why this can't be done with a query to the other system? Why do they have to dig around?
And how they get distracted by the digital form of the data.
I don't think ita about distraction. It about just finding things.
Most charting systems show just a list of office visits, if you are looking for something done at some previous visit, you have to open each one until you find what you want. Hell you might not even know what you want, you just want to skim than all. That is a pain... Is it in reality more of a pain in EHR than old paper chart, probably not... Bit its definitely not easier.
I'm not making excuses for them.
I'm trying to make things better within the realm that I can. I can't put a gun to their head and demand they atop being lazy and find their own shit. They choose to spend their money on having staff look it up for them so they can go directly to the data they was as is possible.Why does your EHR not support searching?
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I do not know about all of you, but when he repeatedly stated other system, that implied that it is not their primary system.
I would wager a solid guess that it is a legacy system.
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@JaredBusch said:
I do not know about all of you, but when he repeatedly stated other system, that implied that it is not their primary system.
I would wager a solid guess that it is a legacy system.
Ah I didn't think of that case. The Doctor's offices I have worked with had their in house EMR, and then the EMR that the Hospital uses. However the hospital will be switching over to the system that the Doctors use so it should help a lot.
It would help if we knew what the back end for the secondary software is.
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I can say legacy or not...
There are three EHRs in play here.
Athenanet - ours
Epic - three of the major hospitals around here use it
Cerner - used by the other hospital system -
@Dashrender said:
I can say legacy or not...
There are three EHRs in play here.
Athenanet - ours
Epic - three of the major hospitals around here use it
Cerner - used by the other hospital systemYa that makes it tough, you probably can't get database access to pull info from the two others.
Too bad with iOS you can't view network shares. You could just create a folder for each doctor as a document repo for that day and just set it to sort by creation date. Then have it wipe the folder every night.
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Most of the Healthcare providers around here use GE Centricity which provides a lot of the things you're asking for.
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The offices I deal with use Medent. I haven't heard of any issues like this either. Insurance cards are OCR scanned and then everything after that is digital.
They provided (the doctors bought) Fujitsu touch screen laptops from Medent and then use those to carry to the rooms. They're like the old school HP laptops where the screen swivels 180 and lays down over the keyboard.
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Our pediatrician uses the same system. When Bentley gets shots or anything, they hand us the digitized pen and we sign directly on the Fujitsu laptop.
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@johnhooks said:
@Dashrender said:
I can say legacy or not...
There are three EHRs in play here.
Athenanet - ours
Epic - three of the major hospitals around here use it
Cerner - used by the other hospital systemYa that makes it tough, you probably can't get database access to pull info from the two others.
I can't get DB access to any, athenaNet is a cloud service.
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@Jason said:
Most of the Healthcare providers around here use GE Centricity which provides a lot of the things you're asking for.
While we have one doctor who demands that everything be printed out, the rest are mostly willing to read what documentation is available in our own EHR. The biggest issue the other systems. In the past, before remote access other other records we had to have everything faxed to us. Today we have to go and get that information ourselves, but the only way we can get it is via printing (saving as a PDF), there is no way to electronically send it to our system for integration.
Direct messaging is working to solve this problem, but that seems to be slow going.
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@johnhooks - how do your doctor's office/clients deal with getting information from other offices?
We are a specialty clinic, we only see patients when they are having problems relating to that specialty. This means we need to get outside records all the time from sources all over the city, and more.
As I mentioned, we have one doc that just prints everything - why? Not entirely sure, thus far I haven't been allowed to ask that.
A piece of information I was given recently was the constant need to reference data from a previous visit (either in my clinic or somewhere else). This flipping is difficult at best, a huge pain in the ass at worst.
One thought was to give them a second computer/tablet where they can look at old chart data, while using the first for documenting.
A constant complaint I'm hearing is that the docs don't want to be typing in documentation while talking to the patients, it seems rude and impersonal.
What is your proposal to solving that?
Looking previous paper based methods, Doc walked out of a room, barked orders at a nurse, dictated into a dictaphone about orders, past medical history, etc. Those would take an average of 2 days to get transcribed. Now one of the trackable measures for Meaningful use is making available the office visit notes to the patient when they leave.
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@Dashrender said:
@johnhooks - how do your doctor's office/clients deal with getting information from other offices?
We are a specialty clinic, we only see patients when they are having problems relating to that specialty. This means we need to get outside records all the time from sources all over the city, and more.
As I mentioned, we have one doc that just prints everything - why? Not entirely sure, thus far I haven't been allowed to ask that.
A piece of information I was given recently was the constant need to reference data from a previous visit (either in my clinic or somewhere else). This flipping is difficult at best, a huge pain in the ass at worst.
One thought was to give them a second computer/tablet where they can look at old chart data, while using the first for documenting.
A constant complaint I'm hearing is that the docs don't want to be typing in documentation while talking to the patients, it seems rude and impersonal.
What is your proposal to solving that?
Looking previous paper based methods, Doc walked out of a room, barked orders at a nurse, dictated into a dictaphone about orders, past medical history, etc. Those would take an average of 2 days to get transcribed. Now one of the trackable measures for Meaningful use is making available the office visit notes to the patient when they leave.
Both offices I deal with are just PCP's. No specialists. Billing is outsourced (but I do know the billing department prints something whether that's PDF or paper I don't know). I don't see any paper flowing around, however I'm not there like you are. I'm only there if something is wrong. Your office size might be a factor also, I know you're bigger than we are.
As for the typing while talking with patients. The pediatrician we go to does that. I would be kind of concerned they wouldn't remember everything if they weren't. I don't find it rude at all.
All three doctors use Dragon and that crazy remote mouse/microphone for dictation after seeing the patient.
As for the previous visit data. If you're on Windows 10, can't you just use a virtual desktop or whatever Microsoft named it? If not on 10, can't you just do a side by side of two instances of the software? Is this on a laptop or at their desk?
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We have about half that use Dragon, most of them don't dictate while in front of the patient.
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@Dashrender said:
We have about half that use Dragon, most of them don't dictate while in front of the patient.
Ours don't dictate in front of patients but they will take notes.
