Sunday, December 13, 2009

Getting Started With OSCAR - What You Need

To get your practice up and running with OSCAR, You will need to consider and source the following products and services.
  1. OSCAR servers – The typical clinic will deploy two redundant and resilient OSCAR servers in the office and, optionally, a third server at an offsite location for automated offsite backup. Your practice is a real time environment and you can not afford to have your EMR halt whilst humans continue to show up in your lobby every few minutes. Server redundancy and a robust backup strategy is a good thing.
  2. OSCAR support – You will need an annual support contract to ensure that your practice continues to run smoothly. This support is just as critically important as having a robust server backup strategy. You should ensure that your annual support includes telephone and email support, annual software updates and 24/7 emergency coverage.  
  3. OSCAR training – Both practitioners and staff will require specialized training to enable them to efficiently and correctly use OSCAR. You should plan for a minimum of staff training consisting of 2 x 3 hr sessions to cover basic functionality and 2 x 3 hr sessions to cover basic billing. Practitioner training commonly consists of 2 x 3 hr sessions to cover basic usage. Both practitioners and staff may elect to receive additional advanced level training. 
  4. OSCAR installation – Considering the risks associated with having a poorly installed EMR sitting exposed on an unsecured network, you should consider professional installation and configuration. You should ensure that you are comfortable and confident in your environment's security before entering any sensitive medical information into your EMR.
  5. OSCAR data conversion – Most established clinics move their demographic information into OSCAR. Some clinics will additionally move their billing histories, their appointments and schedule histories, and/or their electronic patient charts. Conversion continues to be "more art than science", and so it is important to understand what you will convert and what it will look like when it arrives on the new system. 
Depending on what infrastructure you currently have, there are additional items that you may need to purchase beyond the EMR that are not included above. These items may include additional user workstations, laser printers, documentation scanners, magnetic card readers and an uninterruptable power supply. In addition, your office will very likely need to be connected to the Internet, and additional phone lines may be required for billing and labs access.

Wednesday, December 9, 2009

What To Expect When You Are Expecting

When starting down the EMR path, there are a number of things that you need to consider.

Technology has the ability to improve the way you practice and interact with your patients. Technology also has the ability to degrade your practice and your patient interaction. There are no one-size-fits-all models that works for everyone.

Implemented well, you will become very happy with your new EMR and the ways that it aids in your patient care. However, with a poorly implemented EMR, you will soon pine for the "good old days", except they will never come back.

It is important to start with an open mind, a willingness to continue to adapt your strategy until you find what works best for you and your patients, and a similar willingness to abandon strongly held convictions on how things should be done, when clearly they are not working.

When adopting an EMR, join your user community and learn from those that came before you. Talk with practitioners that are using other EMR products too, as they may be able to give you insights to how different systems perform similar tasks.

Ask "why?". Ask "how?". Keep asking until you are comfortable with the answers.

Be skeptical. Don't believe what your vendor tells you just because they sound convincing. Don't believe what the government is telling you just because they too sound convincing. Ask critical questions. Apply critical thought. If it doesn't make sense, keep asking questions until it does. Check your facts and get references.

Engineers love to use Three Letter Acronyms (TLAs) just to confuse you. If you don't know what a WPA2-AES is, or why you would be a fool to move forward without using it, then ask. The same is true for hundreds of exotic sounding terms and TLAs associated with your new software. If your support team can't or won't explain plainly and simply the technology, then get a new support team.

You use technology everyday. Your mobile phone - lots of technology there. The cash machine in front of your bank - never read that user manual. Watching Star Trek parodies on YouTube - brought to you by 100 million lines of complex software. Everyday you are immersed in astounding complexity, however you've learned to live with it, to turn the utterly magical into the simply benign.

An EMR is an incredibly complex piece of industrial infrastructure. This complexity is why Health Canada and other national regulators have identified EMRs as Class II Medical Devices. These systems have come a long way from being just a replacement to your weekly shipment of paper.

After deploying an EMR in your practice you and your staff will go through a complex transformation from the old world to the new world. Many of your colleagues have already made the transition and many more are about to embark on the same journey as you.

You will be successful in modernizing your clinic if you take your time, move methodically, and remember to breathe.

Breathe, and continue to ask "why?".