Re: [Gnumed-devel] How to make the paper to EMR transition?

[Karsten Hilbert]

Jim, shall this (including the link) become a page in the
Wiki ? It seems excellent advice to me ...

On Wed, Aug 13, 2008 at 12:39:16PM -0700, James Busser wrote:

>> What I would like to know is how did the practisioners out there make 
>> the transition from paper records to EMR.
>
> Most doctors possess some kind of electronic index of their patients.  
> commonly from billing or scheduling systems, and from which they will  
> try to at least "seed" their EMR with a list of patients to whom care  
> had been provided. Minimum "ported" information may be the patients'  
> names, dates of birth, sex (gender), possibly their health insurance  
> number(s), and possibly additional names (aliases) if these were  
> supported in the source system. Possibly the dates of first service and 
> last service (but note GNUmed does not at the present time hold any 
> appointment information.)
>
> The above depends on being able to get this information out of the old 
> system, without having to pay ridiculous charges, and getting it in a 
> form that will go into the new EMR.
>
> The options by which to transfer and import the data would be in a  
> "batch" mode, or on an as-needed basis if an individual patient's data 
> can be exported, and then imported into GNUmed, on demand. It is  
> possible to define for GNUmed an importer template to understand the  
> form and content of the external data. GNUmed also offers a "slave mode" 
> if it is possible to get the source system to work with GNUmed. This is 
> especially desirable if doctors are already using a billing or scheduling 
> system that they may like to continue to use.
>
> As far as how much more information to transfer from each chart, the  
> options include getting the secretaries to transcribe summary  
> information from inside each chart, if patients had summaries prepared. 
> The alternative is to scan (e.g. into PDF) just the summary, or the 
> entire chart, or anything in between the two.
>
> Unless enough of the paper chart of each patient is scanned and able to 
> be imported, it will be necessary to keep the paper charts available in a 
> so-called "hybrid" model. Some doctors who move to an EMR use the first 
> subsequent visit of each pre-existing patient to populate the EMR with a 
> problem list and to identify "key pages" for scanning.
>
> The transition can take between 6 months and two years. A lot of your  
> processes (and those of the office staff) will need to be re-engineered.
>
> Here is a link to a guide that is specific to my adjacent province of  
> Alberta (in Canada) but a lot of it is generalizable:
>
> http://www.cpsa.ab.ca/publicationsresources/attachments_policies/ 
> Transition%20to%20Electronic%20Medical%20Records.pdf

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