Wiki Free EMR's and Downloading Medical Records

[medicalsec]

Our docs are going to go with a free EMR web based system. They think it apparently will be a breeze. Anway, they want all of the incoming faxes to come into the program. They will come in with a miscellaneous serial number and no recognition of what is being faxed to us. I would say that by the end of the week we will have about 1000 faxes or more sitting in an inbox all mixed together in no order. We have five surgeons. All of the referrals, operative reports, labs, correspondence from others will all be dumped into one big file. Apparently, all of the files have to be named and dispersed into other folders. It will take four steps to disperse one sheet of paper into a file, and most of the records will not even have a chart that has been created yet because our doctors are on call surgeons. We are a very busy office. I will not be able to respond to correspondence, and I have tried to tell them that I will miss many deadlines. They expect the front desk representatives who answer the phones, make appointments, do referrals and will have to prepare all of the charts electronically to disperse all of the faxes, organize, and create accounts. We see about 40 patients a day in the office, and many hospital patients I will not even be able to bill because I will have nothing tangible in front of me to work from in any order. Most of our patients require a referral before they can be seen, and so the front desk will not even know if they have a valid referral or where it is because it will probably be sitting in an incoming folder with thousands of pieces of correspondence that is unreadable. I was wondering how other offices do this? The doctors believe that we should not have to work with any papers in front of us. Do you have everything sent by paper fax and then decide what you want to put into the EMR, or do you have everything dump into one file and then disperse it electronically. All of us need different pieces of correspondence in order to do our jobs. Many pieces of paper will be sitting there because accounts have not yet been created, and it will be very confusing because you will not be able to organize anything in alphabetical order. Do EMR's that are not free work the same way? Also, the EMR only consists of a SOAP note, and so it will not prompt any areas needed to satisfy Medicare's E & M requirements. It allows the doctor to pick an E & M code but it is not based on any documentation that he did, and they will have no idea what they are picking because they will not be viewing the records from our other system. They will not know if it is a consult, new patient visit, of if they have been seen within the last three years, etc. The program does not give a suggested code. It all seems likes a horror to me.

Please help. I am desperate for suggestions from those that have had experience with these programs, especially a free EMR.

Thanks!

 

[jackson7591]

Emr

Our office has had an EMR system from day one. We still process incoming faxes, daily
Patient visit notes and correspondence. Paperwork is scanned into the system, labeled and then sent to the appropriate file and/or staff member or provider. Setting up patient files is very labor intensive. Does the free EMR provide on site staff support to guide you through the process of generating pt files? This would include setting up the necessary insurance data necessary for submitting a claim. It takes me maybe 20 minutes to set up a new patient and new insurance carrier.

With regard to SOAP reports, you should be able to get into the system from the administrative side and generate notes for your providers to see when writing a report. You can also generate pop ups which only appear with specifics diagnoses or charge sets.

Have you started an implementation plan? One step is to get your existing patient files into the system, which for many practices is a large task. Also need to get your IT people to generate a staged back up, generally on a separate server, as files are transfered in case problems arise.

Our system is able to receive faxes directly into the EMR. But we find it easier to receive paper faxes so we can sort them based on importance and direct them more efficiently to the correct person or file.

It is a very overwhelming process. But with assistance from your IT people and EMR support people? It can be managable. The "holes" in the system, i.e. Pt history prompts and report prompts are not really missing. They are usually left empty so you can generate notes and prompts most appropriate to your office. Which at the front end is more work, but in the end allows the EMR to be tailored to your needs.

What is your time frame for implementation. And is the EMR ready for upgrade to ICD10?

Also, while a paperless office may be the ultimate goal, we still have forms, documents, etc. Available in case if power/technical issues arise that prevent or seriously delay access to EMR data.

 

[medicalsec]

Thanks for the answer. The free program that they are going to use is Practice Fusion which is web based. They have online videos and email support, but we will not have any onsite technical support. It is supposed to meet all of the requirements to meet medical necessity for the Medicare requirements and should be updated for ICD10. It does not have billing with the program. You either have to use your current billing system that does not integrate with the EMR, which means that you have to input the demographics in each system, or you sign up with a web-based company that works with their company. You do not actually have a program in your office or any software, all of your information is on the company's server, and so you have no backup of your data in your office. My main concern was that it seemed so labor intensive to have hundreds and hundreds of faxes go into the system that would be sitting there until someone could go in and look at them and rename them because they will just come in with a serial number on them, and they will need to be directed to the party that needs to see the information. It would seem to me that you would need extra employees to do this. I guess I am trying to get an idea of how time consuming this would be, and I also feel that someone could send me information that I don't see until a week or more later. It just seemed easier to me to have the operative reports, correspondence, referrals etc. come in on paper and once it is organized direct it to the accounts in the EMR. Even if the info is delayed in getting into the accounts, the employees would still be able to get the info that they need in a timely manner in order to do their jobs. I guess our doctors think that "paperless" means not having any papers come into the office. I think of the EMR as more of a place to put the important information, but I did not think that it would eliminate all paper entirely. I was just wondering if most offices have eliminated the use of their fax machines for incoming and outgoing info. Also, you can just go in and sign up for the program. Their motto is that you are "alive in five minutes" so you do not need any extensive hardware installation. They would essentially just need to get notebook computers and login in to the system.

Also to Jackson7591. You mentioned scanning your visit notes. Do your doctors still write their notes (consults, follow-up, new patients etc.) and then you scan them into the computer. I was wondering because the systems that we have seen require the doctors to pick various prompts or type in the info. Frankly, I think it could almost be faster for some of the doctors to continue writing their notes and have them scanned in instead of trying to cut, paste, and edit the "canned" statements that are in the EMR, but I thought that they had to use the system prompts because they tracked the meaningful use info.


Thanks again for your reply!!!

 

[jackson7591]

Notes input

Our providers have a patient visit profile sheet for notes and information that medical assistants and providers make regarding a viit. Our provders use these notes and enter the data into a more formal report with bullet points and prompts entered into the computer directly. The written visit report is scanned into the system and is used for a paper trail and to double check coding for the visit. It us also helpful on busy days when it to completely chart every visit. If we relied on charting every visit as it occured, it is likely that charting detail would decrease as the daily workload increased.

Your concerns regarding multiple unidentifiable faxes showing up for distribution seems reasonable. Not saying it can't work, but would ask to see if there are any local facilities you could visit to observe the logistics.

 

[ksanthony]

Emr

Our practice also considered using Practice Fusion. I found it to be quite confusing but the price is right. I have since come across another free EMR with a practice manager that allows the physician to work on and IPad. If you have more than one practitioner there is a small monthly fee per provider. The name of it is drchrono. I don't know much about it yet but you may want to check it out.

 

[courtcadle]

Practice Fusion

Our practice uses Practice Fusion and there's still a lot of paper involved. Much of the paper is scanned and uploaded. While it is great, nothing out there (yet) is completely paperless with out having to duplicate the work through multiple systems.

 

[MSGreen]

EHR Practice Fusion is a very good web based program

Practice Fusion is an outstanding program. Its super user friendly certified, and has many training resources. Initially any practice converting to a new EHR system should keep current systems in place for a while until the new system is fully operational and all the staff have been trained.