Home Forums Discussions General Discussion any problems with AC if several satellite clinics?

Good day to everybody. This discussion board is very informative.

I will be evaluating amazing charts for our use (8 physicians in 6 different satellite clinics). Our database will be stored in our community hospital - we will use VPN. We will probably be using only DSL to connect to internet. 1) Do you think amazing charts can do the job? 2) Scanned documents will also be stored in the hospital's computer, right? If so, will clicking on the scanned labs/papers going to be slow? (again, 8 doctors accessing at the same time). 3)I will be comparing AC to an EMR that is ASP (that has monthly payments - can I say the company name here? Well, it's MISYS). Is there really a difference between AC and an ASP if 8 doctors in different clinics will be using the EMR?

Thank you very much!
- christian

Christian,

There are a lot of variables in your question. Certainly, Microsoft Access can handle eight users simultaneously. I assume you are talking about XP Pro?

It also depends if you are using Citrix or not? Citrix can be a lot faster due to the need for only mouse clicks, keyboard and screens, etc.

How fast is your DSL? I don't think eight doctors connecting from six clinics is any different than from one office.

Is this your own server at the hospital or theirs? How fast is the server, i.e. processor and RAM, etc.

I only have one suggestion: Since there are quite a few ways to set this up and some are faster and some are less expensive than others and others are more secure than others, I would hire a very good networking IT to consult. If you are all doctors doing IT on the side, you will never know if the situation is doable.

Hope this helps.

Cheers!

Bert,

Thanks for your reply. Our hospital IT person will handle the technical stuff. I guess my question should be: is there an advantage of using an ASP emr (like MISYS) over client-server emr (AC) if there are 8 doctors in the group (in different clinics, but with an IT to do the networking)? Our practice administrator heard from a physician using amazing charts that AC is okay for 1-2 doctors but not for a group as big as ours.

Thanks again,
christian

I think they both have their advantages. With an ASP model, since the information is hosted on the Internet server, it is rather accessible, but at the same time you want to be able to download your data daily in case the company goes under and takes your data with it, i.e. Logician Internet, aka Medscape Encounter.

I took a quick gland at MISYS. My guess is this is a subscription based model which would depend on the number of providers. It probably costs a bit more than what AC costs. It looks like a "drill down" EMR, which has its advantages with formatting and automatic coding, but this is offset by the fact that AC would be significantly faster. You would have to take all of these things into consideration.

There is almost no IT work involved since if you have DSL, you will be able to access it instantly, and the number of doctors accessing it will not affect speed or performance.

Hope this helps.

Chris,
If you are willing to use the search function and dig a little Roy and I had a passionate conversation on this one. Both of us agree that we would never touch an ASP vendor. Imagine having your Excel spreedsheets, Word documents, or Quickbooks in an ASP version. Always on their taxi meter or you can not access your own data that you created it in, what bullchitt.

That is yours and your patients' intellectual property and you need to be able to access at any time for a number of reasons including because Medicare crashes your office in three years from now and tries to take away your money for services you already rendered and fine you for supposed fraud. If I can't own the software that it is created in then I am not using it. Even here in AC we have had a back and forth debate as to whether or not this is an annual subscription now or a software we the users own a legal copy of to have and to hold. Really read the EULA carefully, not just here, but everywhere and search that topic too.... some of us are still waiting on an answer here on this one

But as far as I'm concerned ASP model softwares should just about be illegal and considered not meeting HIPAA standards. Don't believe honeymoon promises of easy conversion of your data, it garbage! When the divorce starts just wait and see how nice and cooperative your vendor is about assisting you with some conversion and access to your charts. More BullCHITT. Ask yourself this simple question: Tomorrow the company I go with goes belly up...Where are my charts or my PM data? Need I say more???
Have a great night.
Paul

Paul,

I agree with a lot of what you say, but I don't think we should paint all ASPs with a broad brush. There are many good features to them. The key is to learn from the Medscape Encounters of the world. I wouldn't use an ASP where I couldn't download my data every night into a decent format that would be easy to import into another program. Personally, and I know many on here do not agree, but I feel strongly that all of our patient data belongs on the Internet, and the data should be easily shared with other providers. Digitally faxing or printing and faxing patient records which are illegible is ridiculous. Sending records and then waiting three to five weeks to receive a consult letter is more than inefficient. There should be fines for consultants who take longer than five business days to use his or her read/write properties to send a consult note that is now instantly part of the chart.

I know, people will say they don't want their patient's data up there on the Internet. It could be stolen, hacked, etc. And, although, it may be more likely to happen; people rob banks, and we don't stop using them. It is just an accepted risk.

When Martians finally do make it here (if not already), when they return to Mars, they will report back that mankind does have some neat inventions such as Plama TV and iPhones, but they will laugh uncontrollably by the fact that the fax machine has remain unchanged for the past twenty years except for the addition of a scanner and that medical providers still write out prescriptions and progress notes by hand.

HIPAA compliant? Of all the things which are used in medicine, ASPs are the most obvious targets for HIPAA. MISYS is HIPAA compliant.

Bert and Paul,

Thanks again for your help!

- christian

Glad we could help.