"John S. Gage" wrote:
 
> Well, I already use ePocrates.  

Right, but you did seem to be interested in an open source
version on a Linux PDA.

> What I would really like is a coding
> application.  I'm checking FreePM.

I would like to be there.  I can only assume that you are NOT
going to find what you are looking for.
If you are looking for an application that scans text and
recommends certain ICD's CPT's & HCPCS codes then you will not. 
This is what 'coding' applications do.  I believe some of the
other EMR apps do what FreePM does, ie SOAPnotes, etc.  Being a
template driven system, the diagnostic codes have already been
determined:

Lower Back Pain Impression Template 
http://www.freepm.org:8080/FreePM/templates/TF008/LBP931698/index_html
(Note that this is just a 'View' it will not 'function' unless it
is selected from within a patient encounter frame).

The charge codes (aka CPT4 in the US) are a property of every
'chargeable item'. when that item is selected as part of the
encounter, it will become a part of the charges based on the
payor information that is setup for that patient.

This is not too far afield from how most of the other EMR
applications function.  But the design is based on a fairly
stringent study of data generation and flow, as an entire system,
not just an isolated portion.  This is where all of these pieces
of systems came from.  Being commercial, they had to solve 'a'
problem and go to market.  

[John Gage]
"This situation persists because physicians think that only they
can 
express what they are doing, payors don't really care what
providers are 
doing as long as they get a code, and many administrative layers
have been 
placed between providers and payors."

I think providers are justified in thinking this. The combination
of knowledge and intuition is what physicians practice.  Isn't
this the real problem with justifying to an HMO that sticks
strictly to it's 'protocol'?

My chief design goal (as requested by the open source physician
community) was a tool that allows the provider to record the
patient encounter 'quickly' & 'fully' and still give the payor's
the required codes.

I believe that FreePM now does that because it records data
centered around each patient encounter and encapsulates it as
such.  But in the same vein, it does not isolate the individual
elements of the encounter.  Each element is it's own meta type
and can be extracted through data analysis requests, then linked
back to that particular encounter.  

For example, if you go to the reports page you will see a few
VERY basic queries that I built.  One of them is setup to let you
look for all occurrences of a particular ICD since a certain
date.  So this can be used to answer the question; "How many
herniated lumbar disc without myelopathy have I seen this year"? 
This certainly very basic and not representative of the
complexity of analysis that can be done. However, I do not know
the questions you want to ask. You tell me, we can build the
queries together.  

This is certainly off topic to go into this level of detail about
one application on this list.
But I will be more than happy to discuss the functionality of
FreePM on that list.

Cheers,

-- 
Tim Cook, President - FreePM,Inc. 
http://www.FreePM.com Office: (731) 884-4126
ONLINE DEMO: http://www.freepm.org:8080/FreePM

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