Re: Information Technology in health care

[Guest guest]

a, it works very well to take a template created in Word and put

it into the Alteer template list, since Alteer EMR is Word-based.

That way it is not necessary to work back and forth between Word and

Alteer when you are seeing patients.

First, in Alteer go into Clinical Admin, Encounter Templates, and

create a new template. Name it anything you want that is easy to

remember. I named mine " aaa female complete, " " aaa male complete, "

and " az. " I made the female one applicable only to females, and the

male only to males, and the az to both, so all I have to type in on

the template line of the encounter note is aaa or az and it pops

right in.

Once you have the labels established, for each template copy the

whole thing in Word (CTRL A, CTRL C) and go back into Alteer and

paste it in as the template (CTRL V) under the correct label. Or of

course you can do it the other way, copy it, paste it in as a new

template, and then label it. I hope this helps.

>

> Terry,

> My husband Rian has had Alteer since July of 03 and I am his

office manager.

> It's great, as you say, for the business end of the practice. I

also do all our billing and it is easy. However, Rian, as others, is

really frustrated with the EMR portion - he falls terribly behind on

documentation (he tends to write very detailed notes) - he doesn't

like the templates so he uses a combination of free typing and an

older version of Dragon (medical). Because I need to know the

charges, he codes and does that portion after reviewing his hand-

written notes so I can get the claims out but his unfinished

charts " stack up " , so to speak.

>

> First thing we'll do is upgrade to the Dragon 8 version. However,

we are both hopelessly ignorant when it comes to using Word

templates and the technical end of EMRs, etc. After you use your own

Word template, are you printing it out from Word and scanning it

into the chart or can you open a Word template right inside of an

Alteer encounter note?

>

> Thanks so much for the attachments.

> a Mintek

> office manager

> Allegan, MI

>

> PS If anyone has Alteer billing questions, I think I finally

fully understand the system and I'd be glad to help someone else

>

> Re: Information Technology in

health care

>

>

>

> Dennis, I too have been working in Alteer since April 2003!

Like most office management systems, it seems more dedicated to the

business side than the clinical side, but I have been able to create

workarounds that are satisfactory. The medicine list needs an

archiving function, I believe. And the problem list needs to be

sortable for faxing and printing (when sending info to consultants),

not just on-screen.

>

> Anyway . . . I have the same problem with taking too much time

for documentation. I do as much of it as possible in the room with

the patient or right after the visit. I have a laptop on a cart

that I can position so as not to create a barrier. But still I am

way behind on completing visits so I can bill them.

>

> Being in Family Medicine, and seeing a wide variety of patient

ages and problems, I ended up not using any of the Alteer templates,

which I re! gard as much too wordy and not clinically sound and

efficient.

>

> I have two templates in Word, one for ordinary visits, and one

(actually two - one for each gender) for complete exams. I

developed the complete exam templates in the olden days when I was

dictating and my paper matched the template in the dictation tank.

I have the complete exam templates printed out for visits so I can

make quick handwritten notes while I am with the patient - sometimes

that is needed rather than industriously typing while interacting.

I'll attach them here - these may not be my most up-to-date version

but close enough. I document a lot by exception, putting a comma

after the boilerplate and typing in what is different. Other times

I delete and add as appropriate for the specific visit. The

templates help me quickly determine the CPT code also.

>

> I'm sending this to you direct, as well as here, because

attachments don't always come through in this system. If anyone

else wants an attachment and can't get to it, email me direct.

>

> Do you have any templates to share?

>

> Terry Merrifield, Andover KS

>

>

>

>

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>

[Guest guest]

Wes, thanks for sharing your experience. I have little enough

computer expertise that I needed, and still need, a combined system

where I don't have to worry about the interface issue. Maybe some

one of these years I'll know enough to put the best of both

together, or some enterprising doctor will create a system that does

both well . . .

Terry Merrifield, Andover KS

>

> I have seen the same issue on comparing business vs clinical

programs

> (Practice Management Systems vs EHRs). After looking at many PMSs

& EHRs, I

> strongly recommend looking at separate vendors rather than trying

for a

> combined PMS/EHR from the same vendor. (You might still do that,

looking

> for a more efficient separate EHR to interface with your business

program.)

>

>

>

> I've found that producing the best of breed of PMSs and of EHRs

requires

> very different competencies and different vendors. I haven't seen

any

> combinations of the two from the same vendor that do both

functions well, if

> either one. The best EHR vendors should be able to tell you which

PMS

> vendors they have proven interfaces with. Interface

standardization seems

> to be improving now, but verify this important characteristic

before you

> buy, and ask for a guarantee.

>

>

>

> Also, be sure to enter your new patients and all demographic and

scheduling

> data into the PMS first, and then import whatever subgroup of data

fields

> you need (name, gender, birthdate) into your EHR (not in the

reverse

> direction, to avoid duplicate and possibly conflicting data

fields). The

> service and diagnostic codes are generated in the EHR and exported

to the

> PMS. This data flow should be seamless with a good interface,

without

> having to resort to the lowest common denominator from a common

vendor of

> both types of programs.

>

>

>

> I use the Praxis EHR and I think its awesome, but its vendor

wisely doesn't

> pretend to be an expert on PMSs, so it includes interfaces with the

> following programs (with others pending):

>

> * PMS: Accumedic, AdvancedMD, Athena Health, Calmed,

Compumedic,

> Discus Dental, Eclipse by Galatek, EZ Health Care Systems, EZ

Office,

> G.E./Centricity (Millbrook), Immtrac (Immunization Registry),

Lytec, MD

> Office, Medbilltech, Medent, Medical Manager, Medics Elite,

Medisoft,

> Medware, Micro MD, MOMS-AT, On Staff, PCN, PDS, Perfect Care, PPM,

Practice

> Plus, Raintree, SoftAid, Ultramed, VitalWorks, Yorkmed

> * Lab Systems: Dynacare Laboratories, Dianon (Labcorp),

Labcorp,

> Labtrak, Meditech, Quest, Schuylab, Sunquist, Westcliff

> * Patient Demographics: Paradigm Consulting Inc, X-Link

> * Pharmacy Systems: Allscripts, Omnicare

> * EKG, Spirometry, Holter Monitoring: Brentwood by Midmark,

Cardio

> Control NV (Welch Allyn), Cardio Card ECG

> * Patient Medical History: Instant Medical History

>

> Wes Bradford

> Rancho Palos Verdes, CA

>

> _____

>

>

>

>

> From:

> [mailto: ] On Behalf Of Terry

Stryker

> Merrifield, MD

> Sent: Thursday, August 31, 2006 6:10 PM

> To:

> Subject: Re: Information Technology in

health care

>

>

> Dennis, I too have been working in Alteer since April 2003! Like

most

> office management systems, it seems more dedicated to the business

side than

> the clinical side, but I have been able to create workarounds that

are

> satisfactory. The medicine list needs an archiving function, I

believe.

> And the problem list needs to be sortable for faxing and printing

(when

> sending info to consultants), not just on-screen.

>

> Anyway . . . I have the same problem with taking too much time for

> documentation. I do as much of it as possible in the room with

the patient

> or right after the visit. I have a laptop on a cart that I can

position so

> as not to create a barrier. But still I am way behind on

completing visits

> so I can bill them.

>

> Being in Family Medicine, and seeing a wide variety of patient

ages and

> problems, I ended up not using any of the Alteer templates, which

I regard

> as much too wordy and not clinically sound and efficient.

>

> I have two templates in Word, one for ordinary visits, and one

(actually two

> - one for each gender) for complete exams. I developed the

complete exam

> templates in the olden days when I was dictating and my paper

matched the

> template in the dictation tank. I have the complete exam

templates printed

> out for visits so I can make quick handwritten notes while I am

with the

> patient - sometimes that is needed rather than industriously

typing while

> interacting. I'll attach them here - these may not be my most up-

to-date

> version but close enough. I document a lot by exception, putting

a comma

> after the boilerplate and typing in what is different. Other

times I delete

> and add as appropriate for the specific visit. The templates help

me

> quickly determine the CPT code also.

>

> I'm sending this to you direct, as well as here, because

attachments don't

> always come through in this system. If anyone else wants an

attachment and

> can't get to it, email me direct.

>

> Do you have any templates to share?

>

> Terry Merrifield, Andover KS

>

[Guest guest]

Gordon,

I am one who has been slowly transforming over the past few months my solo paper practice since 2002 into an IT practice in order to try to be more efficient and financially viable. I currently still refer to my paper charts and Amazing Charts simultaneously and haven't quite made the complete transition yet.

Janice Pegels

Information Technology in health care

Hi folksMost IMPs bailed from typical practices and started fresh with IT (Information Technology) from the start.I'm curious if anyone out there started by redesigning the work and then went in search of IT to support new work processes?Gordon

[Guest guest]

Gordon,

I am one who has been slowly transforming over the past few months my solo paper practice since 2002 into an IT practice in order to try to be more efficient and financially viable. I currently still refer to my paper charts and Amazing Charts simultaneously and haven't quite made the complete transition yet.

Janice Pegels

Information Technology in health care

Hi folksMost IMPs bailed from typical practices and started fresh with IT (Information Technology) from the start.I'm curious if anyone out there started by redesigning the work and then went in search of IT to support new work processes?Gordon