If you are considering buying an EMR, or are just checking out the options, I would recommend having a good, hard look at open-source EMR’s.  This resource at Health IT is a good place to start.

It is definitely time we started developing a consensus of what these abbreviations mean.  The National Alliance for Health Information Technology is forming a work group to do just that.  They are taking applications for volunteers if anyone is interested in participating.

I was pretty sure it was just a matter of time before we saw the advent of medical applications on social networking sites.  Medgadget reports the launch of ReliefInSite on Facebook.  No doubt this is the beginning of an interesting trend.  What’s next, a Facebook Personal Health Record?  Could be!

This article at iHealthBeat reveals that only 4% of small physician’s practices have an electronic health record.  The other statistics relating physician use of EHR’s in hospitals are sobering as well.  The bottom line is that while electronic records store and retrieve data efficiently, they remain expensive, labor intensive, and inefficient.  As I’ve said before, I am very glad my office has an EHR, but I doubt I would implement one at this time if I was in private practice.  Someday maybe, but not yet.

I was pretty sure we would be hearing from Google rather quickly in response to Microsoft’s PHR initiative.  The details are sketchy, but Computerworld.com posted this story just yesterday and InformationWeek reported on the announcement at the Health 2.0 summit in San Francisco.  I wonder if Google will offer the platform approach that Microsoft is taking, or if their product will be something quite different.  Either way, it’s going to be an interesting battle.

Our outpatient clinic has just finished the conversion from using mobile devices (laptops and motions) to providing desktop computers in every patient examination room.  The decision to switch was difficult, but for us it was the right one.  We found that our wireless network was simply not up to the task of providing a stable working platform for our physicians.  It was slow and unreliable causing a negative impact on efficiency and productivity.  We decided this just wasn’t going to work over the long run.  As you’ll see, however, I am very glad the wireless network remains intact.

Most of our providers are much happier with the desktop workstations, but I’ve found the limitations are significant.  It’s not as easy to share on-screen information with my patients as with a mobile device.  It’s also awkward locking and unlocking the desktop between patients.  The desktops, however, are faster, more reliable, and the bigger screens are much easier to navigate. 

It’s interesting that while the majority of our physicians prefer the desktops, there are still a few (myself included) who continue to use the mobile devices.  The decision one way or another seems to be related to preference in work style.  For example one of the biggest challenges in outpatient medicine is staying on time.  No one likes waiting and a person’s time is important to them.  I’ve developed a paper-chart work pattern over the years that helps maximize my efficiency and I’ve found that a laptop closely mirrors this.  For example it allows me to to quickly review a patient’s record before I enter the room.  I can also leave a patient partway through the visit (while waiting for an immunization, ECG, etc.), see the next person to completion, then finish the first visit.  A laptop allows me to do this with no disruption of workflow (no locking and unlocking a computer).  But what about the problems of slow screen loading and dropped connectivity?  I’ve happily discovered that these difficulties have virtually disappeared because of the reduced number of clients on the wireless network.  Yes!

I was recently elected to chair my hospital’s EMR committee.  There are several challenges the IT department faces, not the least of which is getting physicians on board with changes that have to be made.  The Scobleizer interviews Dr. Christopher Longhurst where he presents a nice summary of the issues involved.  The short version (just over 4 minutes) of the interview is here.

Let the games begin.  Google recently announced its intention to enter the EMR market.  Not to be outdone, Microsoft has launched HealthVault and it has created quite a buzz in blog-dom.  Vince Kuraitis at e-CareManagement gives a nice summary of what HealthVault is and what it isn’t. 

It’s too early to say who will bring the expertise and vision needed to consolidate our fractured EMR market, but Microsoft brings serious muscle into the fray.

My brother Jame Healy passed along a heads up regarding Microsoft’s Inkseine.  It ranks way up there on the cool scale.  Maybe it’s just me, but I’m having trouble seeing a clinical application.  I do admire its intuitive feel, speed, and ease of use.  It would be helpful in quickly pulling together treatment plans and Internet resources for interested patients.  Any thoughts? 

I’ve posted on this before, but I’m wondering if  the iPhone might point toward a huge step forward over current PDA capabilities.  I’m not sure that continually updated medical reference material (as discussed at MedGadget) is very helpful, but what about in-patient vital signs, point-of-care glucose levels, labs, etc.  Take Diabetic Ketoacidosis for example.  Like most doc’s I find treatment of DKA fairly straightforward, but it’s stressful, time consuming, and fraught with medico-legal pitfalls.  This is a partly because of the large volume of data required to follow the patient’s progress.  In order to see the latest results I currently have to either log into a desktop computer or find a sync portal for my PDA (it’s a bit awkward I suppose, but it sure beats the days of paper charts).  I would like to have a PDA/iPhone, or whatever, that continually updates in real time every parameter I need.  Now that would be something to get excited about.