First I'd like to thank Adrian Midgely for a wonderful reply to this but I have just a couple of things to add.
I am interested in looking at the time and money issue so that I can address the last item of your post. Of course I do not expect you will tell me exactly how much cash you've spent (or borrowed) to implement your chosen system. The point of this exercise (at the risk of being theoretical) is to see which is/was the best decision, proprietary or open source. On Mon, 2003-06-16 at 18:56, [EMAIL PROTECTED] wrote: > I recently spent 4 years on a Novell DOS bases EMR of a defunct company and was > forced to switch a > working program to another vendor (after and extensive 3 year search) due to our > wonderful government > HIPAA and switching ECS vendors who changed data fields. I gather from this that you had a DOS based system installed on a Novell network about 4 years ago. After using it for one year you began searching for a replacement system because the company went out of business and you had no way to get upgrades to keep up with regulation changes. Was there not a source code escrow clause? If there was did you look into hiring someone to perform the required upgrades? During this three search period how many hours did you spend seeing sales people and watching demos? Did you have to travel to see demos / presentations? How much time and at what cost? > gone now without electronic claims (and therefore reimbursement IE: cash flow) for 3 > months. Was the reason for the delay due to not being able to implement the new system in time or was it due to delay in your selecting a system? > Following the extensive search it has been a 3 month project > and now I am up and running a completely new system of integrated PM, Scheduler and > EMR on > Physicians Micro Systems, Practice Partner. So during this implementation period you have not been able to file claims at all? Was there an option to contract a billing company to process electronic claims for you during this time by sending them paper superbills or whatever you were using to keep track? > While it has bugs. I find work arounds and adapt the program to my needs or I adapt > to the quirks > and have my staff do the same. All the while seeing patients. So you are flexible enough to change somewhat as long as you can maintain the patient flow. You also accept that a particular software package may not be exactly what you want and need and that there is little hope that this package will ever be. > What I would appreciate from this > list and other like it and in the effect to try and accomplish something is for > those on the list to > post that they are actually using something on the EMR/PM etc front and successfully > and how they have > implemented and funded it and what they have found to be "tricks" and "quick > improvements" that make > quality medical care with an IT flare effective, cost efficient and an improvement > over paper. I am not a physician so I cannot really address your request. But, there was the portion that I found interesting where you asked how others have funded their EMR/PM activities. Are you asking about open source applications, proprietary or both? > Now prove that to me those on this list! > > I can use your help and suggestions. Once the questions above about time and money are answered. I'd like to ask if you had 1,2,3 or more colleagues doing the same search during the same time period. Did you spend time with them discussing what you had seen, what you liked and didn't like about each system? Now, the big "What If". What if you and a couple of colleagues had spent 50% of that amount of time testing and making recommendations to an open source application over the past three years? What if you put 50% of the money spent on implementing your new proprietary system into development of an open source application? You would have had lots of extra hours to spend doing something more fun than watching demos and listening to salespeople. In addition to that, the time you spent testing the OS application could have been done at any time and any place not just when it was convienent for the salesperson. If you donated 50% of the money to an open source project you would have, well, that much more than you do now. Now you have a system that sort of does what you want. If you had been part of creating an open source application you would have a system that does exactly what you want. You would have a system that will never cause you to go through this scenario again. Therefore, over time your open source application becomes more and more valuable instead of less and less valuable. > Stop the bickering and start being practical! I think you'll find I am *very* practical. <s> > Thanks for letting me say my piece. Thank you for giving me such a great lead in to present (what I hope is) a different perspective on selecting healthcare IT systems. It is imperative for the implementation of open source applications to occur in any meaningful way, that we change the thought processes of the users. It is purely conjecture, but I feel pretty safe in saying that what you went through over this three year period was because it was what felt safe, it was how all of your colleagues did it and you were not comfortable dedicating yourself to an open source application. You also probably did realize it would take three years to make a selection. But I hear this story more and more where it takes 2,3 sometimes 4 years to make a selection. Some of this is because the technology is updating every few months. It should be less difficult to make that decision when the result will be a constant flow of gentle changes that do not interrupt your daily practice for weeks at a time. Changing habits and getting people to venture outside their comfort zones is a difficult thing. I hope we can present enough reasons and get physicians to see the long term benefits of making that change. Sincerely, -- Tim Cook, President Open Paradigms,LLC 731.884.4126 http://www.openparadigms.com
