Robert,
You have reminded me of one of the rules I like to follow in change
management and introducing innovation...that of starting where people are
and creating a migration path that respects the way people do things today
enough to get them to use something that will evolve into the way they will
do things tomorrow. My colleague Brian Bray in an earlier email described
the patient chart as essentially a document of documents... so a fax would
just be another type of document and any system should be able to handle it.
About 6 years ago, while still at DEC, we put together a prototype of a
system to facilitate collaboration among the various players in the
healthcare value chain... we focused in two specific niches so we didn't end
up trying to boil the ocean. But the architeture and lego blocks we used
could evolve in any direction needed. We used a software tool called
LinkWorks. It allowed us to gather information in its native format and
share it via workflow engines and view it with whatever tool was needed for
the task (of course there were some limitations based on the initial
format). Besides being politically flexible and correct this approach
allowed us to do what you are suggesting. I still firmly believe that this
is an essential characteristic of what an "EMR" should be able to do.
Cheers,
Joseph
----- Original Message -----
From: "Robert Jordan" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Monday, March 13, 2000 6:42 PM
Subject: Fred Flintstone EMR
Some of you are lucky enough to have legacy electronic databases(!).
Focusing on outpatient practices, most have paper charts, sometimes
supplemented with computers for scheduling and billing. My question, what
is the rational approach to migrating the paper to the electronic medium?
Can we have an interim system utilizing scanned and OCR-interpreted old
documents (mainly for typeset data)? Basic data info can be keyed
in...including problem lists and medications. Also, the fax seems to be the
pervasive "hi-tech" tool that lingers. How can this be harnessed
appropriately? I know the results of such an endeavor would not be easily
searchable, etc. etc. It just seems like such a quantum leap between the
paper and electronic chart and the result of going full throttle would be
redundant and time-consuming record handling for existing patients in a
practice.
Sincerely,
Robert Jordan
PS: I have looked into sending fax from a browser via a server's fax modem
in Java, say for prescription writing or consultant reports. I think the
javax.comm package provides some of the necessary classes but I'm not sure
how to proceed from there. Anyone ever have success with this problem?
