What EMR & Medical Software Options are available for doctors who use an Apple Mac !

In the Health Care industry EMR’s, Practice Management Software’s and other Clinical Productivity Tools are primarily built for the ubiquitously available Windows platforms. A huge number are also available for Linux, most of these Open Source, and a very small number for the Macs.

In the United States, the EMR business is filled in with over 300 major vendors, however as per this report by from Software Advice there are 8 vendors offering EMR's natively built for the Mac's in the United States. 

Very few vendors actually support the Mac. Many doctors over the years have wanted a Mac, but would’nt get one due to the lack of Medical Softwares for it. Though lately there has been a surge in the number of vendors promising native Mac versions in the future.

In the interest of the majority of doctors reading this, lets ask the questions: “What does a vendor mean when they say that their EMR is natively supported on a Mac? What exactly does it take for an EMR to be supported on a Mac ? What is this native thing I’m talking about”

For an EMR to be natively supported on a Mac, The EMR program’s software code must be understood by the Mac ; In simpler terms, The program must speak the Mac’s language and follow the Mac’s set of rules. Windows has its own set of rules and they are different from a Mac. So a program made for Windows unfortunately may not run on a  Mac.  

Summarizing

The Mac and the Windows are inherently different, and a software program built for one may not run on the other as the other operating system might not understand what the program is trying to say/do

For an EMR to natively run on a Mac, its underlying code must be understood by the Mac, and it must be following the rules of the Mac.

Given this criteria and the fact that the number of Mac based software are few, what jugaad can be done to provide more choices to the Mac users?

Enter Virtualization
Enter Web based Applications

Virtualization:

Virtualization is based on the concept that if you have a software made for the Mac, and you can make Windows understand it, then it will run on Windows : And Vice Versa
 
A Virtual Machine is a type of software used to create a Virtual Environment, which is referred to as Virtualization. Virtualization may be used to run multiple operating systems at the same time on one Physical Machine. Through the help of a virtual machine, the user can operate software built for one Platform (Or Operating System) on another.

THUS A SOFTWARE NEED NOT BE NATIVELY SUPPORTED ON A PLATFORM TO BE USED BY IT ANY MORE, AS LONG AS YOU CAN USE A VIRTUAL MACHINE WHICH ALLOWS YOU TO USE IT ON THE INCOMPATIBLE PLATFORM.

The virtualization industry is a boon and it is booming because it allows people more choices

Here is a link to 2 fantastic Virtual Machines for the interested. As always, feel free to drop me a line at n.nihalani AT plus91.in for any help.

Virtualbox

VMWare Fusion

In recent times, whether it is due to Apple’s advertising or the Word of Mouth spread that works with Doctors, a Number of Indian Doctors have told us that they are buying a Mac; and if the Clinkare Physician EMR would be supported on it. Yes of Course! Both the desktop version and the SaaS version are supported on the Macs.

Web Based / SaaS Aplications:

The category of SaaS and Web Based EMR’s is exciting. THEY ARE USUALLY PLATFORM INDEPENDENT, UNLESS THERE IS A PC COMPONENT WHICH REQUIRES NATIVE SUPPORT: LIKE A SCREENSHOT PLUGIN, OR A VOIP COMPONENT, OR A DICTATION COMPONENT;

Web Based EMR's are EMR's which can be used directly via your browser, the same browser you are using to read this article. They are usually available on a remote internet connected server and thus free you as a user from worrying about the nitty gritties of configurations, operating systems and the administration issues which come with time due to these.

In this article on MAC EMR Software, the author states that “Web-based EMRs are the best long-term investment for doctors using Macs. Unlike their on-premise counterparts, vendors offering web-based software won’t have to support two versions of their software (i.e. one for Windows, one for Mac) in the long run ”

One can’t agree more. Every Web Based EMR vendor, knows that their EMR can be used using a Windows , a Mac, a Ubuntu; Users can even use the EMR’s on Tablet PC’s as well as Low Cost Netbooks.

There has been a surge in the adoption of the iPads in many health care institutions(pictures below), here in India, and as reported in the United States, United Kingdom and Singapore. iPads with their form factor well suited for use by On Round Doctors in In-Patient Wards, Nurses while taking down Vitals in Charts and even Assistants in OT’s for Managing Checklists are a hit. 

LabC: Pathology EMR on the iPad

The Clinkare EMR on the iPad

        
With Virtualization being available and Web Based EMR’s being the popular flavor with vendors, there are now choices available to Physicians and Clinics for Medical Software which can be used with their Mac’s.

If you are in the United States, you may want to use this comparison to help you select the Web based EMR which works best for you

If in India, you really should give the Clinkare Physician EMR  a try ...

Disclaimer:  This post is a modification of the post Why are there no Mac’s in the clinic? from Nrip's Personal blog Wirelysis

EMR'S: PROVIDING INDIAN DOCTORS WITH AN EDGE: VOL 2

APPOINTMENT MANAGERS FOR EFFICIENT TIME MANAGEMENT

Managing time is a major issue for all professionals in today’s fast paced world. This is even more so for many doctors, especially those who work at multiple locations: Clinics, Hospitals and Medical centers. Workshops on effective time management are regularly organized at different financial and IT firms to help hard working professionals. Gyan is imparted on setting Alerts for Reminders, and To Dos for Task management and the importance of diaries, blackberries and calendar reminders is emphasized here. 

Physicians have a slightly bigger problem. Their schedules are majorly dependent on set appointments with patients. While they do have other areas of concern, the majority of their daily schedules are built around patient appointments. What complicates this for a consulting doctor is that every day he may have different visiting hours at different locations. This makes Time management even more crucial for Physicians. 

Effective Appointment Scheduling for Physicians thus becomes an extremely important activity, and many firms are trying to make an industry out of it alone. It makes more sense though to ensure that Appointment Scheduling is not taken up stand alone, but is an integral part of an EMR system. Add an effective Appointment Management Process to an EMR, and you have added a strong case with Physicians on adoption. 

The Appointment Management Process can be divided into 3 parts:

1.    Appointment Scheduling
2.    Scheduled Appointment Tracking
3.    Patient Visit
 

Mandatory Requirements for an Appointment Management System:

• It should allow for different mediums of Appointment Scheduling
• E.g. Via a Website, Via A Phone Call, Via SMS
• It should permit Rescheduling
• It should be able to handle Walk-In Patients
• Besides the process, the screens should be simple – Non IT friendly users should be able to easily use it
• Color Coded Entries: Pending, Completed, No Show, Bill Pending
• Point And Click with Minimum Data Entry
• Should be rigid enough to prevent Scheduling Errors
• Should Support Multiple Doctors and Multiple Specialties
• Maintain 2 Daily Calendar Views
• Appointment View for Front Desk staff, Online Portal
• Scheduled Visits View for Physicians

Appointment Management Workflow

Useful Features in an Appointment Manager which add value to the Appointment Workflow
 

A Good Appointment Manager allows appointments and available spots to be displayed across multiple locations ensuring quick coordination.
 

It has a visit calendar that showcases the status of the patient’s appointment right from the initial booking stage to the consultation and finally to the bill payments post check-up.
 

It contains Smart Customization features that help the staff and doctors to configure the appropriate time slots, visit options and default visit duration.
 

It offers Multiple Calendar Screens to View the Appointment Schedules Daily, Weekly and Month wise.
 

Sometimes patients forget appointments, which adversely affects the practice’s cash flow as well as adds Delays in the patients’ treatment. A Good Appointment Manager will offer automated appointment reminders built into the Appointment manager. This will help reduce No Shows as well as Reduce Confusions over time of Scheduled Appointments. These Reminders can be

• Email Reminders
• SMS Reminders
• Automated Phone Calls Reminding the Patients of the Scheduled Appointment

The control center of a successful medical practice is an EMR with an efficient and user-friendly scheduling system. It will help your practice run smoothly with increased productivity and optimum patient satisfaction.  

by Nrip Nihalani

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

If you missed it here is a link to 


EMR'S: PROVIDING INDIAN DOCTORS WITH AN EDGE: Vol 1 

Information Technology Orientation For Starting Hospital Administrators

Information technology and computer science tools are definitely the most rapidly growing segment of the world ecosystem. The development in the sector permeates every human activity; social, economic, cultural, religious, political, professional, personal and healthcare. Information technology has radically altered the way many people work and think. Information Technology has made a significant difference to the Quality and Standards of Life. Learning some of the common IT application an individual can carry out any activity of your work life simpler and easier.

There is a rising awareness about the need for better healthcare in India. The demand for healthcare is growing with the increasing affordability of Indian middle class, a new breed of patients have emerged with enhanced expectations for better quality of healthcare, both patients and doctors exposed to international healthcare setting demand more, number of insurance players playing a key role, net savvy population, more number of independent hospitals have made the healthcare market more competent and complex.

Over the years, technology has touched a new zenith and now it is not constrained to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer disregard the application of information technology to healthcare because they are key elements for competing in complex healthcare competition.

The major component that can give an edge in terms of patient care and effective decision making is IT support. Today's corporate hospitals compete on the basis of the technology with investment in it being the major benchmark.

Technology in healthcare has brought better therapeutic & diagnostics delivery of services,  integration to various components of large healthcare providing entity, very similar to that of any other sector like manufacturing and banking sectors. Healthcare IT has huge potential in India as the hospital are emerging, growing up and healthcare workers want to upgrade.

When a fresh post graduate with medical and non medical background entering in the market searching for a job in the healthcare administration side with little or no knowledge on IT, he has to be a part of  following job codes

Job code 1 He joins an ongoing cooperate hospitals that has an established IT infrastructure, enterprise wide software and a well integrated system. The hospitals have already invested heavily on IT applications and using them successfully, the expectations from a fresher to perform in the new setting are high. To deal with this situation the fresher should be oriented with basic operational domain knowledge as well as trained by application specialist.

Job code 2  When a fresh post graduate joins a hospital from the scratch (for a new hospital which is in the inception/ setting up stage). The fresh post graduate has to plan, coordinate, budget, execute, install, and train the employees, built an entire IT system for a new hospital for which he should have a sound knowledge of IT application in his post graduation as a core subject.

Job code 3 When a fresh post graduate joins a consultancy and suppose the consultancy is working on an IT project for an established hospital or a new hospital. The fresh post graduate has to work with IT vendors and make a decision regarding the IT infrastructure. He has to plan, budget, execute, install, and train the employees built an entire IT plan for a new hospital and act as a facilitator, catalyst as a change agent

Job code 4 When a fresh post graduate has mobilized enough funds to start his own hospital as the owner he has to make a  tough decision regarding  IT infrastructure .He  should know his budget, requirement and growth prospect .He can plan the entire schedule by himself or take the help of  IT consultant

Job code 5 This is the toughest of all the jobs codes, you are working with existing software and reported some modifications either want to add new features or replace it you have been assigned this duty to select , administer , execute, train, budget the entire program( he has to act as a change agent, motivate the staff and convince the management ). It is very risky. The individual may have little or no knowledge of new technology and application. The success of the project depends up on you which involves time, money and efforts.

What Are The Software Options?

As a fresh post graduate who is in the future going to be an administrator should understand few basic principals about IT software either to go for (Build software vs. Buy software) or (Make decision vs. Buy decision). This is the most important and curtail of all the decision of IT infrastructure.

If it is Make decision then it is development of software in house which follows SDLC (System Development Life Cycle)

If it is Buy decision then checking out your hospital requirements, listing out various vendors who supply readymade software product on contract bases, evaluate their features, select the best from the available, install the software, train the employees with application specialist, have a backend support with vendor.

Basic Check List Elements

Check list 1    The first responsibility that the administrator has is to ensure is that the software which is being used has an End-User-Licensing-Agreement. It should not be pirated one

Check list 2 The administrator should instruct the IT manager to have all the detailed about hardware, software, number of computers, date of manufacturing, their warranty period, when was the annual maintenance contract renewal (AMC), when is it to be renewed and so on. This all should be maintained as a hard and soft copy.

Check list 3 The administrator should instruct the IT manager to have total control over the network, support your system with a good firewall which scans each piece of data that goes out or comes in, a good antivirus with daily updates with Malware and spam mail options, a sound multi-level authorisation to ensure what data is viewed only by authorised personal. Site-blocker software should be installed which blocks illegal browsing sites.

Check list 4 A sound backup and recovery program is very important. (Offsite backup is preferred).

Check list 5 Check the various insurance options for IT which include (Insurance for the entire hardware and software installed in the system and even the user is supposed to be insured. (If you are not aware of the insurance policy then hire an insurance broker)

Check list 6 Plan the IT– infrastructure by seeing the existing workload, technology up gradation etc. A definite amount of budget should be allocated to the IT- Manager. A maintenance budget and an operational budget

Check list 7 Regular training programs should be conducted for the new employees, as well as for the existing ones. Eemployee feedback should be taken about IT and evaluated by the administrator and IT manager.

Check list 8 An easy to navigate, light, perfect, interactive website or portal should be maintained by hospital IT-Department. This can be browsed on any browser.  All the employees should possess an Email for any form of internal communication.

Note: The document has not covered the technical details of various elements like firewall, backup, recovery, browser, portal, insurance broker etc

This is a Guest Post by:
Syed Murtuza Hussain Bakshi

Associate Professor

Department Of Hospital Management

Owaisi Hospital and Research Center

murtuza_in21@yahoo.com, murtuzain21@gmail.com

Mobile: - 09948662135

Improving Patient Care through EMRs

EMRs-Electronic Medical Records are a modern revolution in the field of healthcare improving the standards of quality in healthcare and raising it to a higher level. With all the numerous benefits of EMRs to doctors, it eventually signifies the benefits to patients and thereby improves patient care.

Using EMR in medical practice can improve patient care in the following ways:

Safe and secure medical records: Electronic medical records are safely and securely maintained in a PC in contrast to the paper-based records let out in open leading to forgery, loss of records or damage due to natural factors. Records inside the PC cannot be damaged or lost and thus a patient is tension-free with respect to the security of his records.    

Make better decisions: A patient history well maintained helps you make better decisions in your treatment. EMR is a tool to maintain such patient histories and take decisions accordingly increasing patient care.

Less time in management and more relief to patients: Paper-based records and registers pile up and become difficult to manage. Moreover, it takes a lot of time for the receptionist to search the record and hand it over to the patient. Instead through EMRs, the doctor searches the records in a single click and reduces the time spent in searching them inside the clinic. This eventually gives a relief to the patients as their waiting time is curbed.

Email the reports to non-local patients: Mailing the reports is a great way to showcase care for patients. If they are paper-based, it becomes a tedious task to deliver it to the patients who are not in the same city, state or country. However, if the doctor uses EMR and mails the reports it saves time and improves patient care. 

Reduction in chaos, happy patients: A messy clinic with cluttered papers, chaos and mismanagement gives a bad impression of the doctor and the clinic. Instead resorting to EMR with no papers lying around, a clean clinic and proper management smoothens the practice giving a good impression to the patients. 

Say no to Memory-based treatments: A memory based treatment proves dangerous for both patient and the doctor. So no more risk of giving bad treatment to your patients with EMR having records of the diagnosis and treatment available within seconds. EMR based treatments have proved safer in contrast to the memory-based treatments improving patient care.

A specialists’ and colleagues’ opinion: EMR stored inside a PC is easy to share with your fellow colleagues and specialists to discuss a rare clinical case. Paper-records require a lot of time to share as compared to an electronic record. With a handy device and a sharing access, medical record distribution is a cost-effective solution.

Handwritten Prescription Risk: A hand-written prescription can prove highly dangerous for the patient. Drugs which are spelt similarly or having a difference of few alphabets/structure are more liable to be misunderstood by the pharmacist and handing over wrong medications. Resorting to a PC-based prescription along with the record neutralize the perils of handing over some other drug increasing patient care.

Quick response to emergencies: Digitized records on a centralized server ensure quicker response to emergency situations for patients. Entire patient history can be referred by the doctor in a short time and proceed with the treatment unlike the paper-based records where it requires a lot of time to search and refer patient history.

 

Adverse Drug Reactions: Side effects of drugs if not informed to the patient can lead to a patient’s health in danger. EMR software which records ADR definitely makes you inform the patient while prescribing the drug. Patient safety and patient care ensured.             

                                             

Patient’s access to records: Giving another dimension to EMRs; from a doctor’s accessibility to patient’s accessibility of medical records, EMR is a boon to patients as well. Not only does it eases access of records in faster and simpler manner but is helpful when a patient is at different locations. A medical record integrated with a doctor’s portal is accessible worldwide limiting it only to the doctor and the corresponding patient providing patient care.

Patient Consent: Smart EMRs with consents help patients make decisions about the choices available in the treatment they are about to undergo. Issues related to patient consent are reduced with EMRs that give you options of the treatment and lets the patient beware of the risks and benefits associated.

An in-depth medical knowledge may care and cure the patient but added services like EMR will retain patient care.

 By Pooja Raval

Learnings from Japan: National Health IT Networks are required

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan's most powerful earthquake in 140 years struck the north-east coast on March 11^th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please;

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this.  Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS).  Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong. 

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model.  Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first.  A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.

One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early. 

Links of Interest

WHO Page on Environmental Health in Emergencies

WHO page on Myths and Realities in Disaster Situations

Technoclinics- Upcoming scenario in India

Medical industry in India is proud to have adopted the latest medical equipments in every specialization and has achieved tremendous results in terms of rapid and effective treatment. The benefits that the Indian IT sector has made in the global village the past 15 years, are now being extended to the Indian Healthcare industry too! 

Taking advantage of these  some clinics are transforming into “technoclinics” by smartly using technology and software in their practice. Dr. Ankit Khanna (MDS) at Pune, who uses a Blackberry to track his online appointments says, “Advances in technology have definitely changed today’s scenario in the dental practice. Earlier for root canal treatments, X-rays taken were on a thin film which gave information only about pathology and cavity. But with the Digital X-ray, it is now possible to know the bone density, height, thickness along with the conventional pathological details and cavity of the teeth.”

Moreover, the paper-based records are now shaping into Electronic Medical Records storing all the patient details along with the medical history and previous visits. Searching a patient record barely takes seconds and all the information is available at fingertips. Dr. Khanna cites out the benefits of EMR, “With EMR, the medical records are a proof which reduces the conflicts between doctor and patient. If a patient visits two dentists for treatment, with the software now it is easy to show the patient which treatment he came for to avoid the confusion.” Dr. Khanna confides in software stating that he can now provide warranty with the treatment as he successfully manages and tracks the patient records strengthening the patient-doctor relationship.

Most of the clinics are still maintaining the paper based records which eventually lead to frustration and chaos. There are some clinics where the doctors prescribe medicines on a follow up visit memorising the patient history which proves dangerous for the patient as well as the doctor! Imagine how much better it would be if the doctor knew the patient history and accordingly prescribed the medicines? That’s where the software plays the role and reduces the risks of memory-based treatment.

The doctors of “technoclinics” are enjoying their practice because they only have to concentrate on proper diagnosis and treatment whereas the entire clinic administration is managed by the software. Within the coming years, its predicted that the majority of clinics will resort to software, thus improving their practice,  benefit in terms of hassle-free practice, improved profits, time and money savings and also building stronger patient relationships. This revolution is what awaits the healthcare sector in India.

by Pooja Raval and Nrip Nihalani

Do EMRs increase clinic or hospital profits?

What is the most common question asked by Doctors and Hospital Administrators when they meet me? Safe to say it is quote unquote: How does implementing an EMR solution increase my clinic/hospital profit?

Now first let’s go into the economics of the whole thing.

Profit = Revenue – Cost

So to increase profit an EMR needs to either increase revenue or decrease cost, and also factor in its own development, implementation and training costs.
So let us look at revenue first:
A good EMR system can drive revenue up in following ways:

1. Cause: Better customer service
SMS alerts, Quick Generation of reports, No confusion in terms of appointments, neat printed prescriptions, Doctors more attuned to patients with their complete history available, Emailing of reports
Effect: Patients keep coming back to you due to their pleasant experience, they develop a fan following and also recommend relatives and friends thereby driving up revenue.

2. Cause: Better Management of Time
Quicker access to Patient History, More Accurate Appointment schedules, Quicker Generation of Reports, Easy one Click Generation of Management Reports and Statistics
Effect: Man Hours saved by Doctors, Nurses and Attendants can be effectively used to see more patients’ thereby increasing revenue.

3. Cause: Minimizing Errors
Accurate prescriptions, Better Access to History, Improved note taking, Auditing of stored information
Effect: Less time spent on un-doing errors, less chances of revenue loss and time wastage on medico legal cases.

4. Cause: Portability and Access
Online Appointments, Online availability of EMR, Online Access to reports by Doctors, SMS and Email Communications
Effect: Access over the Internet to Patients and Doctors increases work time, provides more avenues for patients to interact with the hospital or clinic thereby potentially increasing revenues. E.g. Charging Patients to access their records online, or Doctors giving reports in quicker due to online access.

5. Cause: Offering More Services
Online EMR, Patient History Printouts, Fast Insurance Clearances, Multiple Doctor Schedules
Effect: New Services offered can be charged increasing the revenue streams

6. Cause: Better Decisions
Unpaid Bills Reports, Daily Registers, Medical and Administration Statistics
Effect: Where is your largest revenue coming from, which service, what kind of patients, which days, answers to all these questions which are now at your fingertips lets you plan better to increase and maximize revenues?

Increasing revenue is just one end of the bargain. The other is saving costs! How?

1. Decrease Staff Size: A good EMR system lets you maximize your efficiency especially on the administrative end. This lets you streamline your staff activities and in some cases even reduce staff.

2. Generating Important Reports: Report on Unpaid bills let you call the requisite clients to follow up and recover the money, a time consuming affair on paper. Or important statistics on schedules lets you find the bottle necks in Doctor Timings and improve the scheduling, decreasing losses to the setup.

3. Save Paper: Less work is done on Paper leading to long term benefits and gains.

4. Save Space: Less paper means less storage space required. Use the clinic and hospitals to provide new services or better service.

5. Manage it all: A good EMR allows you to manage your practice as well, integrating basic accounts and inventory to prevent losses, theft and effective reminders when stocks or balances run low.

Now for the down side, what costs are attached to the EMR?

a. Development: For a customized solution or a product you will spend on developing vis-à-vis buying a ready product, this is the direct sunk cost.

b. Hardware: Choosing a good EMR can greatly reduce this cost, but this too is a sunk cost.

c. Training: Time and effort required in training the staff and migrating to the new system takes time and since time is equal to money there is a cost attached to this.

d. Upgrade and AMC: Support costs are also involved with any software, so is upgrading it to newer versions. But this is vital to pay, because in the long run, PC problems do crop up and its best to be protected.

In the long run however, the ROI on a good EMR system can be tremendous.

Our product case studies for our Clinic Management Software Clinkare showed that a doctor using all the features of Clinkare in a multi-user setup can save upto Rs 15000 per month directly and in man-hour estimates.

But nothing will increase your Profit as much as using all the features of an EMR in a proper manner and fully utilizing its potential. The real value comes when you are ready to work with the EMR and not against it, when you can understand where all it can help you, increased profit is then certain.

Improved Patient Safety Using Software

Patient Safety is a vital aspect of healthcare. With a fairly large number of indirect deaths and also potentially life threatening situations resulting directly from lack patient safety it becomes a vital cog in the healthcare machinery. Software products are introduced in any setup to increase efficiency and accuracy, both important factors when trying to improve safety. I am going to highlight some basic examples how inherently as well by actual design patient safety measures can be improved through normal Electronic Medical Records or Practice Management Software.

1. Prescriptions and Medications: The most common errors are seen when doctors write prescriptions on paper and the patient or the chemist misread the prescription. This is a common occurrence and a printed prescription generated from software with already present Drug Data is the safest bet against such a mishap. Other errors which can be prevented include, mistakes made by doctors in writing the dosage or strength, which in software can be fixed to prevent wrong entries, also a check on concomitant medications interfering the drug can be done. These features are already present in the Plus91 clinic package Clinkare. Ensures no errors happen due to differing writing styles or hand writing.
Another neat feature is sending reminders to the patients/nurses to take the appropriate medication at the correct time via SMS. This ensures no missed dosage which could have lead to problems. This feature is available in ClinION the hospital management solution from Plus91 Technologies.

2. Patient History: Doctors in a hurry, if patient comes without papers can prescribe the wrong treatment in case the data is not properly documented. It is vital to know previous visit experiences which can help the doctor make a better decision. Almost all softwares allow storing overall patient and current complaint history which helps doctors make better and more accurate decisions thus ensuring patient safety. This feature ensures that reliance on memory is less!
In the new age software patient history can also be coupled with Clinical Decision Support systems to help the doctor make his or her decisions in a better and more accurate manner.

3. Patient Data Entry: This is an exclusively software based point. Accurate entry in the system can be ensured by various validation measures and checks. This may slow down the process but a good process ensures the software protects the basic problems that can happen. Some key examples are: a. Validated fields which take only certain values and anything outside throws an error, b. Every time a new page is opened or traversed the patient name is popped up to double check the correct patient data is being filled in, c. Two person check entries at very vital and critical data entry points (used often in clinical trial data management), d. SMS or Email alerts in case of a vital sign going outside normal range at the ICU

4. Consent Checks: A patient must know what procedure they are undergoing, the risks and also most importantly dos and don’ts. A software can for all the procedures ensure that the consents are filled using a reminder / validation system to ensure the patients have been given the once over either by the doctor as a series of questions and answers which are entered in the system or using a video/presentation format with a consent thumbprint or electronic signature taken at the end. This is vital so that the patient does not make mistakes because of not knowing he or she had to come empty stomach for a procedure.
Plus91 softwares automatically allow you to link vital consent forms to various tests, procedures and consultations and remind you to get them filled.

5. Check lists: The Indian Born adviser to the American President on Healthcare issues is Dr. Gawande just released his new book “The Checklist Manifesto”. A checklist is the doctor and hospital staffs most trusted friend. Often negligence cases leading to patient safety mishaps happen because proper procedure was not followed. Many types of software come with check lists which need to be marked as complete before the next screen of tasks can be accessed. This ensures that all important steps are carried out and in order.
Checklists can be determinate that is fixed in nature like an inventory for a particular type of surgery. Some check lists can be flexible, like an in house patient prescription check list or schedule followed for an entire ward. Using software both can be checked and managed without a fuss.

6. Improved analysis: Software allow us to collate all sorts of medical data, this data can now also be analyzed to make future decisions better. Knowing what kind of patients react to which medication, or which months cause more complaints of a particular type of disease or maybe information on which doctors have better recuperation rates vis-à-vis their treatment methods all allow the healthcare system to better prepared for future patients.

Ten reasons why you should use a computer in your practice

As a doctor, you routinely have to capture a large amount of information about your patient in order to provide good medical care and to collect your fees . Medicine is a pen and paper intensive domain, where clinical history, examination findings, lab reports, scans, appointments , messages and bills - all happen on paper. Managing paper is always hard to do – and IT can help you to do so more efficiently !

What is the downside to all this paper work? After all, you’ve been doing it for donkey’s years and are happy with this , so why bother to change ?

Have you ever lost your temper because your patient has lost his medical records, and does not know what medications he is taking ? Are you fed up of having to write the same prescription again and again ? Aren’t you impressed by other doctors who give their patients crisp, professional word-processed medical summary sheets ? How are you going to compete with corporate hospitals who can access their patient’s medical records at the click of a button ? The good news is that the same technology is now easily and inexpensively available for you to use in your own clinic ! IT can help you improve your documentation and storage ; and actually increase your productivity and efficiency, by allowing you easy access instantly to all your patient’s medical records, no matter where you are !

Here are the top 10 reasons why you should use a computer in your practice !

1. Impress your patients by having all their information available at your finger tips. Your patient expects you to remember exactly what medicines you prescribed and what surgery you did when she comes to see you, no matter how busy you are. Unfortunately, many of us cannot even remember the patient’s name, forget about the medical details ! Having an EMR with the patient’s photo and clinical details means you are well-prepared to talk to your patient ! If you cannot do so because you cannot find the patient’s medical record, you are going to lose the patient’s confidence – and the patient as well ! If you store all this information on the PC, you can find it immediately, and this helps immensely in creating lifelong patient loyalty !

2. Impress your colleages and consultants : Communication is becoming the cornerstone of society today . Once you have all your patient records stored digitally, you can share them with your colleagues. The referring doctor or consultant will be very impressed when he gets an SMS and an email automatically from you, when you see his patient ! This will help you stand out from the rest of the crowd !

3. Save time: You can retrieve stored data much faster on your PC then from a filing cabinet. Why waste time and money hunting for records, when you can instantly find what you need on your PC !

4. Save on storage space. Real estate costs money while digital space is cheap ! You can store thousands of medical records on a hard disk – and as your practice grows, you need to think about the future.

5. Reduce chaos: A large clinic is often drowning in paper – and it’s very frustrating when you cannot find the record you need. With an electronic medical record, there’s no clutter – and much more work gets done efficiently when time is not being wasted in finding lab reports and scans.

6. Increase productivity: A faster records access, storage and retrieval system gives you and your staff more time. It increases efficiency , allowing you to spend more time with your patients. As patients are wowed by how efficient you can access their medical history, they will refer even more patients to you !

7. Improve your clinical skills and practice evidence based medicine: Even though Indian doctors are very busy, our research output is pathetic, because we do not bother to keep medical records properly. Documentation is poor, and most of a senior doctor’s wisdom is primarily anecdotal, since it is not based on a stringent analysis of stored clinical data. For example, most orthopedic surgeons don’t even know the exact number of hip replacements they have done ; or which type of artificial hip works best in their hands. They cannot analyse their complication rate reliably, and depend primarily on their selective clinical memory, which is often deeply flawed ! Digital information allows you to do much more with the patient data you have. You can easily analyse your clinical data and produce informative research reports based on your years of clinical experience. Analysing paper records is a painful chore. Why work so hard when your PC can do the work for you in seconds ?

8. Look cool: A computerized clinic which runs state of the art software creates a lot of confidence in your patients. They will be much more faithful to you, because they know you are well-organised , effective and efficient !

9.Improve your business processes by automating administrative tasks. Because all the data is stored electronically, it’s much easier for you to fill in all the forms and papers everyone else needs – your CA; the IT officer; the TPAs and insurance companies !

10. Empowering patients. Because you now have a state of the art digital office, you can communicate electronically with your patients. You can send them alerts and reminders through SMSes and emails – and this can create a Wow ! experience which will help you to leap ahead of the competition.

Software Features Most Appreciated by Doctors!

Plus91 is a team of very innovative people. Since the last 3 years we have tried to include, in most cases successfully and in some cases still trying to introduce game changing features into our softwares. These software products are specifically targeted at doctors and hospitals in the Indian Market. We have tried to keep a realistic outlook towards usability and need in developing these features, though some are for the pure thrill of it. Below I have listed some of the features we offer that are really being appreciated by the Doctors.

1. SMS and Email integration - Simple, yet effective in communicating with patients and doctors alike. Today India communicates on the Mobile so why not the doctors.

2. Data Protection - Online back up to save data and download it any time in case of a crash or back your entire PC onto a device provided by us. Keeping the data safe has always been a priority for doctors and hospitals, now you can.

3. Point and click interfaces - Simple Graphical User Interfaces makes life and learning simple for the doctor. Minimal learning curve ensures that the doctor and his staff are using the software within days to its maximum benefit

4. Online EMR - Offering doctors the expertise to offer patients their records online for easy access, especially patients from far away or constantly traveling. Takers for this are few and far, but those who understand the implications of this, really appreciate the scope of the progress that is being made.

5. Online Support and Updates - Now no more waiting for help to arrive is how I best pitch this service. But trust me, one actual live use of this service and the doctor is sold on it for life.

6. Structured Reporting - For every specialty in medicine we support, we appreciate that the potential outcomes are numerous. That these outcomes can be displayed in a structured way to quickly select, display and publish reports to make this a mundane and quick task is a vital feature in our PMS. Doctors increasingly appreciate this intelligence structure to help them quickly select report templates and publish reports.

7. Referrals - Referral management module has been a boon to those doctors which keep track of who is sending them how many patients and any monetary implications of the same.

8. Exporting Data - Export to Excel feature is very well appreciated by Doctors as it helps them to send data to CAs and other external sources without any headache. Soon to come, export to Tally.

9. Auto-Complete and Auto-Add Drop downs - A simple technical mechanism to help manage drop downs better. Increases data entry speed and also makes the software User Friendly. Doctors immediately recognize this and appreciate the capability.

10. Adding attachments - Scan or capture and attach videos, images and documents to the patient record. This feature proves worthwhile for a myriad of reasons. Doctors are happy to be able to be flexible in their approach and attach everything in a single location.