Alan,
I understand your frustrations. You are asking us to prove that what we are
doing is
going to be worthwhile for someone in your position. Unfortunately that is pretty
difficult. We
are simply not there yet. There are some technical hurdles that we need to overcome
before we will
really be able to prove to you that what we have will work for you.
So here is the state of the union in Free Practice Management Systems.
There are several good projects that have had lots of work done in this
area. FreeMED (my own project), TORCH, OSCAR and GnuMED are all
examples.
For Hospital Automation (as opposed to practice automation) it seems
like VistA is far and away the favorite.
This is basically a distilled summary of a useful thread from
linuxmednews!
http://www.linuxmednews.com/linuxmednews/1047326972/index_html
So are any of these programs ready for to totally take over a practice?
In my opinion the answer is almost. There are two reasons for this.
1. Billing System
2. EMR System
Lets talk about these briefly.
The first problem is hard because that problem is made arbitrarily
difficult by insurance companies. You mentioned that you had problems in
this regard in your original post. Various changes in the way forms are
filled out are extremely hard to track. This remains an open problem,
but there are two potential solutions to this problem.
Until you have a Practice Management system that is capable of handling
billing effectively you will either be billing by hand. Or you will be running dual
systems. In either case, the benifits that you want are impossible in those cases.
One is the Open Medical Billing Standard. If your Practice Management
System supports this (TORCH does now, FreeMED will soon, OSCAR/GnuMED
and any other listening feel free to chime in) then you can find a
clearing house that will support that protocol and you are on your way.
Tim of www.openparadigms.com fame turned me on to this, apparently he
has found several clearinghouses that are willing to support the format.
The problem with a system like this is that it makes certain kinds of
low margin medical businesses less profitable and possibly impossible.
For instance if your practice bills 500 expensive procedures a month
then OMBS would work very well. But if your practice bills 500
inexpensive procedures a day then you have a very different situation.
The second is my own project FreeB.. which is designed to enable
in-house, or mixed in-house and third party billing. FreeB is still in alpha.
So now lets talk about the second problem; EMR System. There is an
ongoing thread about the merits of different philosophies about EMR
systems. Ultimately I have a much more local problem.
I want to be able to move an entire practice from one platform to
another. Thus I need to be able to move complete patient records, doctor
profiles, and general ledger into a general format.
Jeff, the original author of FreeMED, has been working together to make
conversion scripts from Medical Manager to FreeMED. This makes me pretty
sad because I really hate to see things that only benefit one project.
I would much prefer to write a script that converted Medical Manager
Data Files to some general format that could then be imported into
FreeMED OR TORCH OR GnuMED OR OSCAR OR etc etc etc...
There are others on this list who are better able to comment on the
situation on Patient Records, but my feeling the lack of a format for
general interchange between practice management systems is the second
biggest problem in this area.
Let me ask the list; Is there a current system that is designed to do
this? Comment on the ability of HL7 and other current interchange
formats capability to handle this issue. If there is no solution is
there anyone who would be interested in starting another meta-project to
handle it?
If such a system existed it would make switching between Practice
Management System a snap. Of course only Free and Open Source projects
would support such a system because any system that supported it would
have very low vendor lock in.
In any case Alan, I feel your pain. Very soon the two big problems that
our community faces will be solved.
Just as you say that you could use our help, we could use ours.
Download TORCH, install it and try to configure it. Tim is very helpful
and there is a list setup for his project.
If TORCH does not do what you want, tell Tim exactly why! This REALLY
helps!
Then please consider doing the same with FreeMED, my project (by that
time our new .6 release will be out!)
This community IS capable of solving your problems, but you will be
very dissatisfied with us if your interface with us is limited to this
list. In order for you to have patience with the endless circles that we
tend to go in, you must look at our code!
The link above give you a who's who of Practice Management Projects. I
know that Tim has a demo of TORCH available via his website, we do on
our website too!! www.FreeMED.org user:admin pass:admin....
Get involved, and then once you are I think you will find that we are
VERY close to having several options for you to run your practice on
Free Software.
Thanks,
--
Fred Trotter <[EMAIL PROTECTED]>
synseer
--
Fred Trotter <[EMAIL PROTECTED]>
SynSeer