| Our practice was able to find a provider who met | | | | wanted a database back end that would scale well |
| our individual needs. | | | | as we grew, and we wanted something with an |
| We've waited until now to discuss the actual | | | | open interface that we could report on. By the |
| process of how we determined our electronic | | | | way, ACID-compliant means that the database |
| medical records (EMR) software provider. The | | | | has the desired features of atomicity, |
| plan, which started over two years ago, originally | | | | consistency, isolation and durability. |
| was to establish an infrastructure and foundation | | | | 2. We wanted a system which would give us the |
| to make a successful transition over to whatever | | | | ability to create, modify and design powerful |
| product we would eventually choose to use. | | | | graphically based EMR templates with normalized |
| Here we will outline the particular criterion which | | | | data (not text). |
| you should use to select an EMR vendor. We'll | | | | 3. We wanted a product and company with a |
| even discuss the exact reasons for determining | | | | strong practice management product that |
| and selecting the appropriate vendor for our five | | | | integrated with EMR. We did not want to install a |
| location, 140-person practice. | | | | system with duplicate data entry and where all |
| I'd like to stress the fact that other practices, | | | | patient information isn't accessible from both the |
| both large and small, may be currently | | | | EMR and EPM. |
| contemplating this same choice, but also probably | | | | After reviewing the products of about a dozen or |
| have different needs. They should make the | | | | so EMR vendors that had some experience with |
| choice of vendor with these needs in mind - this | | | | ophthalmology, we narrowed these down to a |
| article presents the overall process, offering | | | | short list of about four. These vendors were then |
| examples of the things that should be considered | | | | invited to make a presentation to our EMR |
| when matching your practice to a vendor. | | | | committee. After analyzing their capabilities and |
| A medical practice, Ocala Eye, has used an | | | | checking references from not only ophthalmology |
| application called 'Fiscal' for its electronic medical | | | | practices but also practices of other specialties, |
| practice (EMR) solution up until the late 1990's. The | | | | our choice was NextGen Healthcare Information |
| practice later made the choice to concentrate on | | | | Systems from Quality Systems, Inc. |
| hospital-based systems, choosing to no longer | | | | 4. We wanted a system that could be fully |
| service practice-based systems (beginning in | | | | supported on both thin and fat clients (remote |
| 2000). The Fiscal version wasn't ready for the | | | | control and direct control, respectively) to |
| year Y2K, and at that time there weren't plans to | | | | accommodate the low bandwidth of our satellite |
| switch from paper records to EMR. | | | | offices. |
| Most physicians, and ophthalmologists in particular, | | | | Reasoning and Choices: |
| tend to become highly-interested in new kinds of | | | | In addition to a solid database and total support |
| toys and gadgets. Often we must resist the | | | | on both thin and fat clients, we discovered |
| temptation to bring a hot new product back to | | | | NextGen meet our need to customize EMR |
| the office after discovering it at the recent | | | | templates. In addition to an award-winning |
| Academy meeting. When we do remember the | | | | product, NextGen had a superior EMR interface. |
| true plan about new technology, we simply turn | | | | Today, NextGen doesn't even use an interface; |
| the relevant info over to the electronic medical | | | | instead both the EMR and EPM share a common |
| records committee, which is comprised of certain | | | | database. So, instead of sending patients' data |
| administrators and specific members of the IT | | | | between the two different products, the |
| and business departments. One primary goal of | | | | information is already native in the application |
| the committee is to set up the criteria for | | | | because of the database. |
| selecting an EMR system that is specifically suited | | | | With this application, the added bonus of having a |
| to our practice. | | | | fully HIPAA ANSI X12N-compliant EPM claims |
| Criteria Selection: | | | | engine is included. This facilitates a direct electronic |
| The committee first established some general | | | | data interchange (EDI) with complete |
| guidelines of their expectations from an EMR | | | | HIPAA-compliance. We were then able to drop |
| system vendor. The committee decided that they | | | | our clearing-house, meanwhile saving $11K annually |
| would only consider vendors with at least a | | | | while providing ourselves with the ability to save |
| medium-sized presence in the market, expected | | | | time on accounts receivable and eliminating the |
| to survive into the foreseeable future. Vendors | | | | middle-man. |
| would also have an EMR system in use in some | | | | NextGen has been excellent to work with as a |
| other area of ophthalmology. | | | | company, even developing into a positive element |
| Next we agreed upon the primary criteria upon | | | | in the success of this large-scope project; they |
| which to form our final decision: | | | | are receptive to suggestion and have a user |
| 1. We wanted a robust ACID- compliant relational | | | | group that forms into practices throughout the |
| database for several key reasons: we wanted the | | | | country, meeting occasionally for helpful training |
| data to be protected and able to recover fully | | | | and discussion. |
| from failure, not just restore from backup; we | | | | |