| You may be surprised that we haven't told you | | | | ability to create, modify and design powerful |
| which electronic medical records (EMR) software | | | | graphically-based EMR templates with normalized |
| you should implement at your practice. At our | | | | data (not text). |
| practice, the plan was to first establish a | | | | 3. We wanted a robust ACID-compliant relational |
| foundation and infrastructure in order to later | | | | database for several key reasons: a) we wanted |
| implement an EMR product of our choosing. | | | | the data to be protected and able to recover fully |
| Now we'll outline the considerations to make to | | | | from failure, not just restore from backup; b) we |
| select an EMR system vendor. These guidelines | | | | wanted a database back end that would scale well |
| are what we used to select a particular vendor | | | | as we grew; c) we wanted something with an |
| and arrive at the solution which fit the needs of | | | | open interface that we could report on. By the |
| our medical practice. I should stress that other | | | | way, ACID-compliant means that the database |
| large and small practices currently contemplating | | | | has the desired features of atomicity, |
| EMR may have completely different needs, and | | | | consistency, isolation and durability. |
| should make their own choices with these needs | | | | 4. We wanted a product and company with a |
| in mind. | | | | strong practice management product that |
| Our practice used an electronic practice | | | | integrated with EMR. We did not want to install a |
| management application, Fiscal, until the late 1990s. | | | | system with duplicate data entry, or one in which |
| In 2000 we made a choice to go to a | | | | patient information isn't accessible from both the |
| hospital-based system, meanwhile ceasing to | | | | EMR and EPM. |
| service practice-based systems. The Fiscal version | | | | After we reviewed the products of over a dozen |
| we were using wasn't ready for Y2K. At that | | | | EMR vendors that fit the parameters, we |
| time there weren't plans to move to EMR from | | | | trimmed the list down to just four. We then |
| paper records, although we knew that Medical | | | | invited these vendors to make presentations to |
| Manager was developing their own EMR system. | | | | our committee. After we analyzed their abilities |
| Many doctors tend to be interested in new toys | | | | and checked their references, we went with |
| and gadgets. Ophthalmologists often must resist | | | | NextGen Healthcare Information Systems, from |
| the temptation to bring a flashy EMR product | | | | Quality Systems, Inc. |
| home after learning of it at the latest Academy | | | | Reasoning and Choices |
| meeting. When we remind ourselves of the actual | | | | NextGen not only had an award-winning product, |
| plan, we give this sort of information over to the | | | | but a better EMR interface as well. We found that |
| electronic medical records committee. This | | | | NextGen met our need for EMR template |
| committee is comprised of both administrators | | | | customization, as well as a solid database and |
| and members of the technical, business, and IT | | | | total support for both fat and thin clients. |
| departments. The primary goal of the committee | | | | Today, NextGen doesn't use an interface. Instead, |
| is to select the main criteria for the EMR system | | | | both the EPM and EMR share a common |
| with suitability to the practice in mind. | | | | database. Rather than send patient data between |
| Selection Criteria | | | | products, it's native to the application because of |
| To begin, our committee established some | | | | the database. As a bonus, the application claims |
| guidelines for what they needed from an EMR | | | | engine is HIPAA ANSI X12N-compliant. This |
| system vendor. The short list only mentioned | | | | facilitates direct electronic data interchanges with |
| businesses with at least mid-level market | | | | complete HIPAA compliance. |
| presence. The vendors for consideration also had | | | | We chose to drop our clearing house, which |
| some existing EMR program, as well as | | | | saved $11,000 each year. Meanwhile, we saved |
| experience working in the field of ophthalmology. | | | | time on our accounts receivable by removing the |
| The committee selected four main criteria on | | | | middle man. NextGen has been easy to work |
| which to base our ultimate decision: | | | | with, even growing into a positive element in the |
| 1. We wanted a system that could be fully | | | | success of the project. The company is receptive |
| supported on both thin and fat clients, to | | | | to suggestions and has a helpful user group which |
| accommodate the low bandwidth of our satellite | | | | practices throughout the country, meeting |
| offices. | | | | occasionally for training and discussion. |
| 2. We wanted a system which would give us the | | | | |