It is my experience that as soon as the government decides to centralize anything it is out Filemaker and in Microsoft SQL and sometimes Oracle.

But over here MS SQL seems to be the winner. Everything else seems to be slowly but surely pushed aside.

Kind regards
Hans


On 23.1.2009, at 03:34, Jay Erlebacher wrote:

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:

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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.


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