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EMR for Rheumatology Rheum Aid

11/13/07. EMR for Rheumatology. 2. Contents. Introduction and BackgoundAbout Electronic Medical RecordsAbout Medic AidSoftware for Rheumatologists. 11/13/07. EMR for Rheumatology. 3. The need and philosophy. Healthcare IT projects a graveyardIT usage for patient care dismalMost apps restricted

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EMR for Rheumatology Rheum Aid

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    1. EMR for Rheumatology Rheum Aid S B Gogia President, Indian Association of Medical Informatics

    2. 11/13/07 EMR for Rheumatology 2 Contents Introduction and Backgound About Electronic Medical Records About Medic Aid Software for Rheumatologists

    3. 11/13/07 EMR for Rheumatology 3 The need and philosophy Healthcare IT projects a graveyard IT usage for patient care dismal Most apps restricted to billing /inventory Medical Care and needs complex Specialists have focused needs Unsurpassable learning curve A software which is not used is useless Users make the best applications

    4. 11/13/07 EMR for Rheumatology 4 What we have done Made software in collaboration with specialist Featuring Patient Demography Detailed history, examinations and investigations in a freeform style Multiple diagnoses (ICD10) Detailed prescription and progress notes Reporting at each level Completely Research ready Built in Change management

    5. 11/13/07 EMR for Rheumatology 5 Why computerization?

    6. 11/13/07 EMR for Rheumatology 6 And where would it harm?

    7. 11/13/07 EMR for Rheumatology 7 Medical Professionals and Information Technology Why do doctors use computers Internet and E Mail Games Glorified Typewriter Presentations Keeping Patient records (10 - 15%) Use an EMR / HIS application (2 -3%)

    8. 11/13/07 EMR for Rheumatology 8 Contents Introduction and Backgound About Electronic Medical Records About Medic Aid Software for Rheumatologists

    9. 11/13/07 EMR for Rheumatology 9 Definitions Electronic Medical Record (EMR) is the record of a patient’s interaction with a single Hospital maintained in Electronic Format. This may include multiple Hospital visits or admissions. It is under custody of the Hospital to which the patient may lay claim to depending on legal provisions. Electronic Health Record (EHR) is a patient’s life time medical record maintained in Electronic Format. It belongs to the patient and may involve visits with many different Healthcare facilities. Both are repositories of information regarding the health of a subject of care, in computer process-able form. It is a patient specific collection of shareable and non-shareable, past and present medical records containing clinical and non-clinical information captured through various electronic medical equipments and maintained in electronic standard format.

    10. 11/13/07 EMR for Rheumatology 10 Components of an EMR Patient Card (Inpt/OPD) History /Findings Investigation Reports Special Forms Reports Add ons CPOE CDSS

    11. 11/13/07 EMR for Rheumatology 11 Breaking the (Pt) Record i.e. the medical data History Examination Investigations Lab X Ray/ US/ CT/ MR Histo/ Cytopath ECG Others Invasive procedures Text Images Sounds Video clips Wave forms

    12. 11/13/07 EMR for Rheumatology 12 Components of an HMIS EMR Facility to search Data Mining Logs Billing Other Hospital Administration Tools Stocks Pharmacy

    13. 11/13/07 EMR for Rheumatology 13 Contents Introduction and Backgound About Electronic Medical Records About Medic Aid Software for Rheumatologists

    14. 11/13/07 EMR for Rheumatology 14 Concept of Change Management

    15. 11/13/07 EMR for Rheumatology 15 Types of Change Totally Fresh Learning Curve Orientation Capacity Building Resistance to change Diversion Unlearning Curve Orientation Capacity Building Resistance to Change

    16. 11/13/07 EMR for Rheumatology 16 Our development team Software made by a User (Doctor) Understands Medical Needs In house deployment and testing Debugging on the fly Same team for the last 12 years Same base technology over these years Improving with time

    17. 11/13/07 EMR for Rheumatology 17 Sybase Technology Powerbuilder (Development Tool) Adaptive Server Anywhere (SME database) Adaptive Server Enterprise (Database) Enterprise Application Server (Web Hosting) Power Designer (Database Design) Database and Application development tools for Mobile Applications

    18. 11/13/07 EMR for Rheumatology 18 About Medic Aid Client Server App RDBMS back end GUI Front End Customization in consultation with the ultimate user(s) Future ready (Web)

    19. 11/13/07 EMR for Rheumatology 19 A Question for Medical Practitioners

    20. 11/13/07 EMR for Rheumatology 20 Medic Aid to the rescue….

    21. 11/13/07 EMR for Rheumatology 21 Medic Aid to the rescue….

    22. 11/13/07 EMR for Rheumatology 22 Medic Aid to the rescue…. AND not to be ignored fringe benefits of computerization Accounting Item wise Billing Stock keeping etc. Pharmacy records Growth Charts Immunization Schedule Appointments

    23. 11/13/07 EMR for Rheumatology 23 Benefits for Consultants Allows more time for the patient Clear legible prescriptions Easy access to previous records No need to consult Weight charts etc. Easy Research and auditing of procedures Online Referrals Tele Consultations Clean Desk with more personalized reports

    24. 11/13/07 EMR for Rheumatology 24 The technology behind it Powerbuilder with ASA/ASE Client Server Environment Easily expandable to Web Possible add ons Mobile Computing RFID Tags Easy Linkages PACs Data collection from Medical Devices

    25. 11/13/07 EMR for Rheumatology 25 Technology ---cont Import Export to other packages Ready for telemedicine Customization on the fly Full Administrator Control Intuitive access Important data stored in multiple places Allowances for genuine mistakes

    26. 11/13/07 EMR for Rheumatology 26 Contents Introduction and Backgound About Electronic Medical Records About Medic Aid Software for Rheumatologists

    27. 11/13/07 EMR for Rheumatology 27 Previous IT usage Word Template since 1998 Problems of poor output for research Searching for old patients Filemaker pro– 2001

    28. 11/13/07 EMR for Rheumatology 28 Project Cycle June 2005 - Initial Discussions December 2005 Project Approval Design and System Analysis at clinic June 2006 alpha trials Facesheet and File search storage helper Payment made January 2007 Secretary gets married Major design changes June 2007 Usage in earnest Continuous redesigning and debugging for 4 months October 2007 – Launch during IRACON 2007

    29. 11/13/07 EMR for Rheumatology 29 Processes and Statistics 28 months from start to completion Personnel involved Rheumatologist Medical Informatics Specialist Code Generator Data Entry Operators Phased Transfer Integrated Hand holding /capacity building Luck???

    30. 11/13/07 EMR for Rheumatology 30 The Key Persons Prof Anand Malaviya 40 yrs Rheumatology Practice Computer Savvy Fast Typing Speed Existing Reports through Word templates Filemaker Pro S B Gogia Part of team 12 yrs in Software - not living off it Existing Medic Aid Sybase and Powerbuilder Technology

    31. 11/13/07 EMR for Rheumatology 31 New Features New Facesheet Integrated ICD 10 Short List Full list Special Forms and Calculators History and Examination DAS 28, DAS 44, SLE DAI Multi Select Lists

    32. 11/13/07 EMR for Rheumatology 32 New Features --cont Research and General Modules Rheumatoid SSA SLE Reporting Casesheet Prescription Research and Queries Follow Up Automated links

    33. 11/13/07 EMR for Rheumatology 33 Lessons learnt Involvement of user key to outcome The more complex the need, the more time it takes Choose a good base technology It is far easier to make software for many than for one The best of software may be rejected by an unwilling user

    34. 11/13/07 EMR for Rheumatology 34

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