Electronic Medical Record Systems and other Myths 1Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission

2 There is no “best” system. Know your requirements. You must chose the best from what is available.

Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission4 Electronic Medical Records (EMRs) Used by VIM Clinics PercentAvg. Annual Cost Practice Fusion26% $0 MedServices15% $2,296 Amazing Charts13% $1,388 eMDs11% $7,894 Allscripts4% $4,300 Centricity4% $21,000 Other30% $3,203 Practice Fusion is the most common (popular?) Probably due to cost. The “other” category may be a more important clue.

Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission5 Top Seven Free Electronic Health Records  Practice Fusion  Kareo EHR  Hello Health  Open EMR  Open MRS  VistA  FreeMED

Practice Fusion  Truly the gorilla in the room  17,000 customers  100,000 users  Web based  Quick responsive support (usually)  Certified for Meaningful Use  Many good templates  Will integrate with tablets but… Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission6  Weekly scheduled maintenance disruptive  Ad supported (relevant but annoying at times  (Ad free for $100 per month)  Tries to be one size fits all  Little customization  Difficult to interface to some labs  No recurring appointments  Hard to extract administrative data  Lack of Adobe Flash may cause frustrations on mobile devices

Kareo EHR  Modern cloud based interface  Easy to use  Good with tablets (native Apple app) and SmartPhones Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission7  Limited functionality unless you pay $299/month

Hello Health  Clean interface  Online scheduling  Communication between Patient and Doc  Virtual visits  Certified for Meaningful Use  Offers patients access for a fee  Portion of fee returned to clinic Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission8  Charging patients for access may alienate some.

Open EMR  Most popular open source EHR  3 to 5k downloads per month  Will run on Mac, Linux and Windows  Active support from user community  Fully customizable  Many add-ons available Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission9  Not cloud based  Not certified for Meaningful Use  Requires tech skills or consultant to customize

OpenMRS EHR platform rather that developed system Easily customizable Intended as a global EHR tool Lots of add-on modules Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission10  Requires up front investment in time to configure.  May require consultant to properly design

VistA  Developed by VA  Being extended by others  Largest EHR on the Earth Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission11  Targeted for hospitals and large organizations  Daily updates  Not user friendly

FreeMD  Oldest open source EHR  Works well with large and small clinics  Active support community Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission12  No longer developing product  Requires local tech support to modernize

Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission13 There is no best EHR. There is only the best of what is available. Know what you need first. There is a difference between Requirements and Desirements It is good to get user buy in before you select a vendor, but there are drawbacks too. When you look at a lot of systems, it is easy to comingle features Be ambitious in your implementation scheduleWatch out for feature creep Before you implement an EHR make sure you have access to some local IT talent. If you work with a local hospital, get someone to volunteer! You will have problems, but they are manageable if you have the right kind of help.

Questions? Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission14

The 7 Phases of Implementation 1. Wild enthusiasm 2. Disillusionment 3. Confusion 4. Panic 5. Search for the guilty 6. Punishment of the innocent 7. Promotion of non-participants This should not be funny!!! Sadly, most IT projects are never finished. Most are over budget and delivered late. Gary Smith, VIMO Clinic Port Angeles Photos by Ross Hamilton used with permission15