Bert,

I hear you about the over thinking part....but before we make the leap to an EMR, my Med Director wants to know how AC works with incoming faxes, and how labs that come in can be sent back and forth through the system, how that works when we sign off on a lab, and more importantly, how it works when we put a message on the lab and then the M.A. has to read it, and possibly reply to our question. An example of what I am talking about is this: Say there is confusion about exactly what dose of a statin a pt. was on when his lipids were done; as it is now, we jot a note on the lab (which is paper clipped to the front of the chart), the M.A. takes it, calls the pt., makes her note as to what the pt. says, and it comes back around to us again. We have lots of circulating labs this way. It is not efficient in the least, but there you have it. My MD wanted to know how all of this would be accomplished within AC.

In addition, there is the issue of how to manage the paper reports our in-house lab generates. We have the ability to do CBC (w/diff), chem, lipid panels, TSH, PSA....and all of these results are reported on separate sheets of paper. Again - really poor efficiency, because one lab may come in on one day - it goes in our stack of charts for that day, we sign it off. Then, in another 1- 2 days, etc. another lab comes in - and the cycle gets repeated. So the chart recirculates in our stacks for a few days. So, I am also REALLY hoping to reduce wasted time and increase the efficiency of this whole process - and am hoping that we can develop a system within the EMR that will make this easier. Granted, it probably won't be any faster. The "cycling" will still occur unless we change how we do the labs (not likely, because tests that are run less often get run in batches) - but at the very least, we won't have the paper issue, and the time it takes for the staff to find and pull the chart and attach the lab will be erased.

Having labs scanned in is certainly doable, but with the volume we have, it sure would be nicer to have an LIS that would interface with all of our devices and send the results of all of our in-house tests into a patient's chart. My Lord, that would be faster and simpler! And - no paper, no scanning.

I think I have a vision of a setup that would work for us - if we use UpDox (or a similar program) to have our faxes and send them directly into the EMR, and a LIS to link our in-house labs to the EMR, then it is "simply" a matter of learning the logistics of how to send things back and forth to the M.A.s, and each other, etc. It seems to me that while that is certainly not the least expensive setup, it may be the most seamless we can get...

We have a very high-volume practice, and speed is essential to our flow. If we're gonna have an EMR, it needs to be as easy as possible to use. That's one reason we have developed templates for our ROS and PE areas of the chart. Yeah, I probably am overthinking it, but it is going to be hard enough to make the switch without having an EMR drag us down to a near halt. The more I can make a roadmap of how things will fit together, how we will do what when, then the transition should be somewhat easier (I hope!) None of us wants to be there till midnight each night finishing off lab results, messages, etc.

We have looked at demos from Greenway, Practice Fusion, Unicharts, Meditouch, AdvancedMD, Dr. Chrono...everything has it plusses and minuses, some more than others. The cost issue is a factor, and the integration with Dragon is super-important, since we will be dictating. Some EMRs say that they "work with Dragon", but in practice, it's just not as smooth as they sat it is!

AC works extremely well with Dragon, is affordable, has been around long enough that we don't have to worry if it's going to disappear in another year, and - one of the most important things - has the terrific support from other users, like yourself. Now, if ONLY I can find a way to make our template work within the body of an AC note, we may have a winner...!

Melanie