Friday, February 20, 2009

Info For New Users

There are two different types of new OSCAR users:
  • those that are trying to get themselves up and running

  • those that have gotten help to get up and running and are now looking to improve their skills

The Self Starter - Getting Installed

If you are trying to get yourself up and running, then you will need to install OSCAR on a UNIX server. There are instructions available for those that are technically savvy.

A second option for the self starter is to acquire OSCAR preinstalled from the OSCAR Canada Users Society.

The OSCAR server is a machine that will attach to your network and sit in a corner or a closet in your office. It is good practice to ensure your OSCAR server is powered via an Uninterruptible Power Supply (750 Volt-Amps should be adequate for a simple installation). It is also recommended to consider a robust backup strategy. Because of the nature of the system, it is quite easy to configure an automated process that provides both local and remote backups.

Typically, OSCAR is not accessed directly on the server machine, but over your local area network via the web browser of your various office computers.

If your office has internet access, then you will be able to access OSCAR from your computer at home as well. Remote access is greatly simplified when your office internet has a fixed IP address. If your office is internet enabled, then you will need to ensure that you properly review and understand your computer security.

OSCAR works with Macs, PCs, and Unix workstations (virtually any modern computer with a web browser). Some doctors configure their offices with a computer in every room, while others opt for using an ultralight laptop that they carry with them instead of the traditional paper patient chart.

If you do use your laptops and desktops with a wireless network, please purchase a modern router with the latest encryption standards, as currently all but the WPA2 AES standard have been hacked.

OSCAR will work with voice recognition software, but many doctors recommend the PC version of Dragon Voice over its Mac cousin.

OSCAR can electronically generate prescriptions and other forms and documents, so it is a good idea to have network capable laser printers available in convenient locations. Wired network printers tend to start printing quicker than their wireless brethren, so this may be a useful consideration.

Scanning documents into OSCAR is also supported. Many users recommend purchasing a dedicated departmental workgroup scanner (such as the Fujitsu ScanSnap or Visioneer Patriot).

OSCAR supports automatic electronic lab uploads from a number of different sources, and each comes with different infrastructural requirements. Gamma, for example, allows you to log into their website and download the current batch of lab files, so naturally you will need internet access for this to work. Lifelabs and CML both have a dialup modem configuration that requires a WinXP computer and a dedicated phone line. Other labs such as ICL and Excelleris have their own specialized requirements. You will need to check to see specifically what your lab needs before investing in infrastructure.

Depending on province, OSCAR may support your local billing environment. In Ontario, for example, a computer with a modem is needed to access OHIP's EDT. You can also put your billing files on a floppy disk and send it to the government, although, finding a computer with a floppy drive these days is non-trivial.

Once OSCAR is up and running, you may wish to consult with the OSCAR User Manual to help you learn the bits and bobs.

Now That You Are Up And Running

Not everyone wants to install and configure OSCAR themselves. There are a number of OSCAR support companies that are happy to deliver a soup to nuts solution, train you and your staff, and support you through your migration to electronic medical records.

Once you are installed, trained, and feeling comfortable with OSCAR, there are many ways for you to enhance your environment and engage with the OSCAR community.

You may consider joining the OSCAR Canada Users Society. The OCUS has regular meetings in various locations across Canada. The national users group is also a good place to find out more about your regional and local OSCAR communities.

A number of OSCAR users participate in lively discussions on improving their patient care and best practice strategies when using OSCAR. The easiest way to engage with other users is to join the mailing list, introduce yourself, and join the discussion. (Please note that the main national users mailing list is the oscarmcmaster-bc-users list which is linked above.)

If you are an OSCAR user with a flair for the technical details and a desire to contribute code to the project, than a second discussion list is available for you.

Many users have made available their own contributions, in the form of user installable extensions to OSCAR. By browsing the resources, you will be able to find new forms, drawing packages, report templates, and queries.

There are also resources to show you how to build your own extensions.

After you've used OSCAR for a while, you may start thinking about improvements you'd like to see in the solution. If this is the case, then the thing to do is to check and see if what you are thinking is already on the wishlist. You may also consider making a donation specifically geared towards accelerating a specific piece of functionality.

Remember, the easiest way to engage with the OSCAR community is to register with the OCUS and join the discussion.

Thursday, February 5, 2009

OSCAR User Interview: Dr. Robbie Coull

Dr. Robbie Coull, Charlottetown, PEI

I'm a UK trained GP recently moved to Charlottetown, PEI.  I'm based in a community health center and I am currently building up my practice.

I've noticed that you've written a book for Locums. What can you tell us about that?

When I started doing locum work in 1998, I set up a website with my calendar and CV for practices.  I added a 'how to' section for new locums about a year later, and it grew over time.   Finally, it grew so big that I decided to tidy it up and publish it as a 'publish on demand' paperback.  

POD is great because you can publish a niche book for a couple of hundred dollars and then people can buy it through Amazon or any other bookseller.  The cost of printing and shipping it is only around $15 per book, and it's all handled by the POD company who pay you the profits each month.  It's become the textbook for locum GPs in the UK - largely because it's the only textbook for locum GPs in the UK!

When I got the OSCAR user manual printed by Staples I was taken aback to find it cost about $120.  If I get the time, I'd love to write an OSCAR handbook and POD publish it - should save users a lot of money on printing out huge PDF.

Is there an EMR community in PEI?

The government here went down the road of commissioning an EMR from a local company.  Sadly, to not put too fine a point on it, the resulting EMR was useless.  As a result, almost no one is using EMRs in PEI.  I think I know of two other doctors using one on the island.

Hopefully, OSCAR can change that!

What brought you to OSCAR?

I heard about OSCAR from Jel Coward, now a GP in Pemberton, BC.  I knew Jel online through the UK Pre-Hospital Care discussion lists.

Is being the first OSCAR user in PEI a bit of a challenge?

Actually, it's a life saver!  I trained on a DOS based EMR, and I've never worked without one.  So going back to paper was the challenge. OSCAR has allowed me to keep my sanity.

Can you describe the OSCAR set up that you have?

I think the British system of 'one room consulting' suits EMRs better because you stay by the computer and the patient comes to you.  So I've set up a consulting room with an Ubuntu computer and laser printer and I bring the patients in one at a time.

I also have a wifi box, wifi printer, and an Acer Aspire netbook with Ubuntu on it which I can take into the examination rooms.  This is useful for the walk-in clinic where multi-room consulting is more efficient.

You are showing other doctors OSCAR in your area. What type of interest are you discovering?

People here are very interested in OSCAR.  I don't think they can get their head round the idea that the software is free to use, and many of them have never used an EMR so it's quite a steep curve.

My biggest problem is that things that I think are obvious are not clear to doctors that have never used a fully-featured EMR.

Do you have any advice for doctors that haven't taken the EMR plunge?

Are you nuts?  What are you waiting for?

Seriously, though: get in touch with someone nearby who uses OSCAR and beg them to help you get yours set up.  Today.

In addition to practicing medicine, Dr. Coull writes a blog for OSCAR users. This blog can be found at The "Locum Doctor Survival Guide" can be ordered online.