My two cents on EMR and Filemaker:
People are acting as if the most important factor in an EMR is
privacy, security etc.
There is no doubt that there are legal mandates in this area, but that
is not the primary reason practices get benefit from an EMR.
These are sideshows to the real action.
The essential role of an EMR is to improve patient care and physician
effectivenesss/productivity.
I have an FMPro EMR solution that my 5 man cardiology practice has
been using for over ten years.
It is constantly being tweaked and fine tuned to our needs so that
there can't possibly be a commercial solution that would match it.
Unfortunately, the problem with Congress getting involved is that this
beautiful little solution will probably never get certified by
Medicare at a cost that would make it worth doing.
It's likely that all the custom made Filemaker EMR solutions will dry
up and go away (along with the thousands of hours of effort that went
into them) once EMRs are mandated.
Think about this before you embark on a FMP EMR project.
Jay Erlebacher MD
On Jan 22, 2009, at 2:24 PM, Richard S. Russell wrote:
We recently had a discussion on this forum about developing an FMP
solution for a small clinic, with particular attention to the
privacy of medical records. This topic is now starting to loom large
on the national stage as well, and I thot those interested in the
subject would profit from the following comments from computer-
privacy expert Lauren Weinstein, appearing in the latest edition of
the "Computer Risks" newsletter:
= = = = = =
Date: Mon, 19 Jan 2009 12:25:51 -0800 (PST)
From: Lauren Weinstein <[email protected]>
Subject: Electronic Medical Records, Google, and Microsoft
Lauren Weinstein's Blog Update, 19 Jan 2009
http://lauren.vortex.com/archive/000497.html
Greetings. It's well known that a significant portion of the Obama
administration's stimulus plans will likely be a major thrust toward
electronic medical records. These are touted as reducing errors,
creating
jobs, and saving money -- though it's arguable if medical consumers
are the
ones who actually pocket the savings in most cases.
But there are serious concerns about these systems as well --
reminding us
that exactly the same sorts of problems that tend to plague our other
computer-based ecosystems could now start hitting people's medical
records
in pretty much the same ways.
*The New York Times* (19 Jan 2008) had an excellent story about
privacy and
security issues associated with electronic medical records -- and the
medical industry heavyweights who are trying to water down related
provisions in associated and upcoming legislation.
http://www.nytimes.com/2009/01/18/us/politics/18health.html
A few days ago, AP reported on a range of potentially serious
medical errors
*created* by the Veterans Administration's new electronic medical
records
system.
http://www.tampabay.com/news/military/veterans/article967778.ece
Both Google and Microsoft have unveiled electronic medical records
systems
for users, and are actively seeking partnerships with major medical
treatment organizations. While they both promise comprehensive
privacy and
control by users -- in some ways that exceed those mandated by HIPAA
privacy
requirements, these systems are explicitly not actually covered by
HIPAA --
though my hunch is that this status is likely to change in the near
future.
The key concern with such non-HIPAA medical records systems isn't
their
privacy and security at the moment -- which as I noted appear to be
good at
present. Rather, an important aspect of HIPAA is that it represents
a set
of rules that cannot be arbitrarily changed by the organizations
involved.
Consumers need to know that the "rules of the game" when it comes to
their
medical records will not be subject to unilateral alterations on the
basis
of business conditions or management changes, outside the realm of
legislated national rules.
My belief is that electronic medical records in general, and the
services
like those from Google and MS in particular, have the potential for
significant benefits. I also believe that a massive rush into any
of these
environments could end up creating a whole new range of problems
that could
waste money, risk privacy, and in the worst case even cost lives.
I trust that Congress will move with deliberate speed, but not be
pressured,
in the area of electronic medical health records implementation, and
that
they will put patients' rights to privacy, accuracy, security,
control, and
choice at the top of agenda. A stampede to electronic medical records
without due consideration and care would be a very dangerous
prescription
indeed.
= = = = = =
Richard S. Russell, a Bright (http://the-brights.net)
2642 Kendall Av. #2, Madison WI 53705-3736
608+233-5640 • [email protected]
http://richardsrussell.livejournal.com/
= = = = = =
For any given complex, expensive, time-consuming problem there
exists at least one simple, cheap, easy wrong answer.
