Wednesday, October 08, 2003

A Really Good EMR?

Yesterday someone posted an announcement on one of the email listservs I subscribe to reporting that AAFP, Medplexus and GE Medical Systems had some kind of agreement for discounts for their EMR (Electronic Medical Record) systems. This is sort of good timing for me since my goal is to go with completely electronic medical records, ie. no paper charts in my new solo practice.

However, this strikes me as falling short of AAFP's original goal of a low-cost, open-source, platform-independent EMR system. I suspect most EMR companies aren't interested in giving their product away, so maybe a discount is the best they can hope for.

A computerized medical record system is the goal of many physicians and medical offices, but has been fragmented in implementation. There are dozens of programs out there, some more polished than others. Most are incompatible with each other. Most cost thousands, some in the tens of thousands of dollars.

Dr. Gordon Moore, the family doctor who started this whole solo-solo doctor thing, went with the Alteer system, which combines electronic medical records with a scheduling and medical billing program. I've seen demos of it, and it looks very sharp. But it costs $20000! By the time I paid off the loan for it, I wonder if it will be obsolete, or if the company will still be in business. I decided that I would rather not spend that much on an EMR system. Since much of the success of this practice will depend on keeping my overhead expenses low, I am planning on going cheap --- er, I mean, frugal.

My EMR choices are limited not only by price, but by computer platform, too. I have used Macs ever since they came out almost 20 years ago. Not only are Macs easier to use, but they are much more stable and secure compared to Windows computers. But there are very few EMR programs for Macs, compared to Windows:

?ComChart, based on FileMaker, a database program.
?MediMac, which is supposed to be coming out with a version that runs on OS X.
?SpringCharts, which is a Java-based program. This last one looks the most promising to me, mainly because it is "Priced far less than published industry norms" ($500). And it works on my Mac! (At least, the demo did.)

I also have the option of running Virtual PC ($250) on my Mac, and getting AmazingCharts, an inexpensive Windows-based EMR which also goes for $500. But then I'd have to deal with all the bugs, viruses and patches to maintain the Windows system. Is it worth the aggravation and wasted time?

So bottom line, unless the discounts for Medplexus and GE's Logician are really substantial, I think I'll be going with SpringCharts or AmazingCharts and save up my money for a really good EMR.

Ironically, we've been hearing for the past 10 years at Kaiser that an EMR is coming. It's always been "a few years" away. Now it looks like I will be getting my EMR first.

Countdown: 89 days until target start date