Posted by: notdeaddinosaur | October 11, 2010

Button Up Those Overcoats; Hell is Freezing Over

The dinosaur is adopting an electronic medical record.

That’s right. After going on and on for years and years about the shortcomings of EMRs, how superior my old-fashioned paper records still are, etc. ad nauseum, I have seen the light; well, the electrons, at any rate.

I found myself wanting to computerize my records the way they already were. The portability factor began looming larger. The idea of being able to access records when not in the office became more attractive. I actually looked into designing my very own EMR from scratch. Bought “Access for Dummies” to teach myself how to create a database; that went nowhere really fast. So what happened?

The blogosphere came through. Our very own WhiteCoat suggested a program that I went and looked at. I was impressed at how intuitive it seemed. (Then again, having just read about how databases work may have made it all the more impressive to me.) Still: I’ve said over and over that I don’t have that kind of money right now. Really; I don’t. So what happened?

It turns out that this EMR is free. And a damn good thing, too. I’ve confirmed that unless I bill Medicare at least $25,000 a year (I don’t), I’m not eligible for one thin dime from the well-hyped stimulus funds. So I’m definitely not doing this for the money. I’m doing it for myself.

We’ve already converted over to using the scheduling module exclusively. I’m trying to get my staff to send me electronic messages instead of sticky notes or phone message pads. Today I figured out how to send superbills to the front office. And I had a helluva lot of fun ePrescribing all day.

The main hassle is getting twenty years worth of information on paper converted into an electronic format. I’m looking at hardware option. I need a duplex scanner, one that can scan both sides of a page with one pass. I’ve already acquired a smaller notebook (but bigger than a netbook) computer to take into the exam room with me. Last week I was double-documenting which was truly ridiculous. Today I began charting primarily electronically, scanning in what I need as I see people. It made the day dreadfully long and somewhat tedious, not to mention having to leave a stack of labs uncalled (I’ll get to it tomorrow and remind everyone that today was a holiday; that’s my story and I’m sticking to it) and taking stuff home with me (which I never do). But once we’re fully up and running, I can see this being really cool.

Or maybe the coolness factor is indeed from hell freezing over. That’s right: I’m doing what I said I’d never do. Funny how things change.

The thing is, though, that while I’m in this transition phase, I’m finding myself just insanely busy. Which is to say, stuff like blogging and writing (Sorry, Janet; I promise I’ll get that novel to you yet!) are going to be taking a bit of a back seat for the time being. Unfortunately, I can’t manage to finagle any more than twenty-four hours in any given day, and things like eating (much less lately), sleeping (ditto, sadly), and personal hygiene do not lend themselves to skimping.

Except for baseball, of course. Go, Phillies!



  1. For low-volume duplex scanning, I’ve been happy with a Fujitsu Scansnap 1300. USB powered, small, holds 10-15 pages and does duplex scanning.

    If you’re looking to convert your old records, you should probably rent an office-level scanner/copier for a month or two, and hire a temp to feed records through it. We have such a unit at work and they’re VERY fast, but prohibitively expensive to purchase.

  2. ha..having read all your past posts about ‘hell freezing over before you go the emr way’, I am quite intrigued to see this. It does remind you that ‘change is the most constant thing’.
    If I had been near you, I would have offered you ‘8 free temping hours’ from suggestion above.
    Way to go, Doc.

  3. May I recommend that you think hard about scanning…My previous practice has EMR and quite frankly, we rarely looked at old records (but it was a GYN practice…unless the pap or ultrasound was abnl, old records aren’t that useful to us).

  4. Sounds like a great project for NinjaBaker over break to me!

  5. Our GI group adopted EMR last month. Now we are getting a sigmoid.

  6. Wow, this is a surprise! I hope you can give us brief updates on how the change-over goes. And I’d be very interested to get more details about what’s motivating you to take this step. The only reason you mention is having access to your records outside the office. That’s something that sounds good in theory, but has it ever really been a recurrent problem during your years in practice?Thanks.

  7. So, which EMR package did you choose, if one may ask?

  8. I hope it is okay I chime in – I work in a dental office that uses electronic charting. I’m an assistant for a dentist (disclaimer, also my older brother 😉 and he insists on writing all his chart notes, after which I enter them into the computer (he’s a terrible typist). Why the double charting? The other dentist won’t bother to read any note that’s not in the computer,
    but we lost every electronic note (and x-ray) from 1/1/09-2/18/09 after a server crash. Treatments were recoverable because they were billed out, but had to be re-entered into our system. My brother’s notes were the only ones recoverable, because his were hand-written – he didn’t have much faith in the system even then, and now certainly feels justified.

  9. nikkik,

    That is very unfortunate that you lost all your electronic medical data. May I ask, are you using computer-based software or a web-based software? Web-based EMRs should have your information stored on off-site back-ups to prevent such a loss of information.

  10. […] Button Up Those Overcoats; Hell is Freezing Over and Star Struck. […]

  11. I agree with PJ’s comment about the Fujitsu ScanSnap. It does duplex scanning with ease, and my model (the S510) holds at least 20 sheets at a time. Congrats on finding an EMR that you are happy with!

  12. Please share the name of your EMR freeware with us. Thank you.

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