RE: emr data, transfer, standards

October 4, 2006

Hi Larry,

Thanks for your response. I am able to get my patient's chart, in that I could print out all the data, or I can convert it to a pdf file or tiff file and then burn it to a DVD ( I think this is what Eades does). So, the vendor is not holding my data hostage from that sense. The problem is that if you want to switch systems, they charge you to get your data into a form that the new EMR company uses. This is where the high cost comes in. They charge an exhorbitant amount to convert and export it into another system. I agree, that as the future of EMRs move forward, there needs to be some standardization of the platform of how data is transferred, so that the physician doesn't get caught holding the bag of shelling out thousands of dollars to get her records into a useable format in another EMR.

I am curious to know about other vendors. Do you guys know if your vendor would charge you to convert your data and migrate it to another system.

If they do charge you ( i find it hard to believe that no one would charge a fee for that), how much do they charge? I am willing to pay something, but only if it is reasonable. And I don't know what that reasonable cost is.

Lee

emr data, transfer, standards

there is an underlying principle at play here, and a valuable lesson.

i did a lot of research into emr's before choosing one, and my choice has been validated. that does not mean that my choice is the best, that everyone else must use it, or that it is perfect.

an analogy--

dr kildare, although the most wonderful doctor in the universe, would not in real life be the best doctor for all patients, nor would he have the ability to treat all patients. yet he certainly wouldn't prevent patients from seeking another doctor, and taking their medical records with them. nor would or could any of us prevent patients from leaving our practices. in fact, if they were not happy and we could not meet their needs, we would want them to. we are also obligated to provide their records for continuing care.

how is it then, that even if one placed oneself in the alligator's jaws, any legitimate ethical business would force itself on it's customer with such blatant extortion? it is antithetical to the nature of good business practice, and presumes that the seller has no confidence in their product and ability. rather than developing business from a helpful partnership perspective, their approach is coercive and underwritten with fear.

i would not care to do business with someone like that.

this is an opportunity for us as a group to support each other, and to help guide the development of one of the most important tools we use, of course that is the emr. i think it is also a great way for us to test our power as a group. we have more than we might think.

first, to contact the emr company and it's resellers, and to recommend alteration of any contract and it's performance, to become consistent with good business practice, and at no charge. in other words, for them to provide a way of capturing one's patient data, such that it can be converted and exported easily to another format, and then be able to be used in any other emr, or just printed out.

long, long ago and far, far away, i took a marketing class from someone who was the shrewdest marketer of them all, a man named gene call, in los angeles. i can still see him now. prior to his class, i used to think that "business" meant how to separate people from their money by any means necessary, and it was not for me.

by the end of the class, and one of the most important things i learned from him, was that in order to do business, the nature of business is inherent in each step-- to clearly identify the customer's needs, determine if one's product or service legitimately meets those needs, to price it appropriately, and only then, offer one's product or service by explaining the specific benefits to that customer, and to continue to do so as long as it benefits that customer. that's because business is the art and science of legitimately providing a benefit within a professional relationship. and if one does not provide a benefit, then one may not force the relationship.

doesn't that sound not too dissimilar from any one of us explaining the benefits of lifestyle changes or routine preventive care to our patients? oh, and we get paid for it, too. sounds like a professional business relationship.

ok, so back to the emr.

if this emr vendor makes the changes, great. if they refuse, then quite frankly to invoke the power of this group, to discuss it here at great length, and with everyone we know. one could even write articles on emr's and one's experience, and have them published in, oh, fpm, or the AMA weekly throw-away or some other prestigious rag.

another means is legal action. it seems to me that if the emr vendor prevents a physician from accessing patient data, and from being able to use it for patient care or for providing it for continuing patient care elsewhere, or holds it hostage, there is harm, to either or both patient and physician.

perhaps abby can speak more to this. didn't you comment on this before?

another aspect of this issue is standards. we hear about government, industry, vendors, newtie and hillary (i can just see them getting colonoscopies), and physician organizations developing emr standards. there is one group which already has a huge amount of experience with a whole variety of emr's. oh, that's us! rather than let the xspurts, i mean experts, who probably have no concept of medical practice and emr use on a daily basis and are not doctors, let's us develop the standards. i think it would be very straightforward.

we have a group with talent and ability, knowledge and experience. let's start using it for our benefit.

let us declare ourselves.

LL

Annie Skaggs <askaggsfayettefamilymed> wrote:

Hi ,

Does Alteer really think you would pay $10K to migrate data? That’s outrageous…I have considered changing to something cheaper than what I have, but maybe I have been hasty. I am paying $3K/yr for support and upgrades and thought that was steep, but maybe it is pretty middle-of-the-road. When I considered changing, I thought about re-entering data and decided that it was a good opportunity to “prune” charts. Only the active ones must be re-entered. Of course that means I am counting on having a copy of old charts available if ever needed. Alteer allow you to keep a static copy of all your data?

A4 is a pretty “bells and whistles” sort of system, and not cheap, but let me know if you are interested… I really do love mine and would hate to do without it…

Annie

-----Original Message-----From: [mailto: ] On Behalf Of LeeclanSent: Tuesday, October 03, 2006 7:55 AMTo: Subject: EMR

Just wanted to say that I had a fantastic time meeting everyone at the Scientific Assembly. Has anyone posted pictures yet?

Thanks!

I have come back from the Assembly all fired up with ideas of how I want to improve my practice for my patients.

One thing that I did was to sit down with the Eclinical Works people and find out how it compares with Alteer. I was shocked to see how much more it does! Technology has come so far in the past few years and Alteer is way behind. I am seriously thinking of switching, as Alteer has had no major updates in 2 years and what I am paying per month in "updates" and support is about the same if you bought the ECW subscription plan ( $ 400 a month).

ECW has patient registry and even a secure patient port you can do virtual office visits.

Is anyone using ECW... do you have any cautions with it... any advise to those of us who are thinking of switching EMRs?

It will be painful to switch because of the data transfer ( Alteer will charge $7000-10,000 to do this. I will not pay a dime to them for this and will try and figure out a way to do this myself. The longer I wait, the harder it will be.

Any advise would be greatly appreciated, especially from those who use ECW.

Thanks again to all you IMPers!

Lee

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October 14, 2006

Amazing Charts allows the export of the data in a form that is supposed to be readable at any time.I sent this out early this morning and for some reason it never went through. I am sending it again. Thanks Lee emr data, transfer, standardsthere is an underlying principle at play here, and a valuable lesson.i did a lot of research into emr's before choosing one, and my choice has been validated. that does not mean that my choice is the best, that everyone else must use it, or that it is perfect.an analogy-- dr kildare, although the most wonderful doctor in the universe, would not in real life be the best doctor for all patients, nor would he have the ability to treat all patients. yet he certainly wouldn't prevent patients from seeking another doctor, and taking their medical records with them. nor would or could any of us prevent patients from leaving our practices. in fact, if they were not happy and we could not meet their needs, we would want them to. we are also obligated to provide their records for continuing care.how is it then, that even if one placed oneself in the alligator's jaws, any legitimate ethical business would force itself on it's customer with such blatant extortion? it is antithetical to the nature of good business practice, and presumes that the seller has no confidence in their product and ability. rather than developing business from a helpful partnership perspective, their approach is coercive and underwritten with fear.i would not care to do business with someone like that.this is an opportunity for us as a group to support each other, and to help guide the development of one of the most important tools we use, of course that is the emr. i think it is also a great way for us to test our power as a group. we have more than we might think.first, to contact the emr company and it's resellers, and to recommend alteration of any contract and it's performance, to become consistent with good business practice, and at no charge. in other words, for them to provide a way of capturing one's patient data, such that it can be converted and exported easily to another format, and then be able to be used in any other emr, or just printed out.long, long ago and far, far away, i took a marketing class from someone who was the shrewdest marketer of them all, a man named gene call, in los angeles. i can still see him now. prior to his class, i used to think that "business" meant how to separate people from their money by any means necessary, and it was not for me. by the end of the class, and one of the most important things i learned from him, was that in order to do business, the nature of business is inherent in each step-- to clearly identify the customer's needs, determine if one's product or service legitimately meets those needs, to price it appropriately, and only then, offer one's product or service by explaining the specific benefits to that customer, and to continue to do so as long as it benefits that customer. that's because business is the art and science of legitimately providing a benefit within a professional relationship. and if one does not provide a benefit, then one may not force the relationship. doesn't that sound not too dissimilar from any one of us explaining the benefits of lifestyle changes or routine preventive care to our patients? oh, and we get paid for it, too. sounds like a professional business relationship.ok, so back to the emr.if this emr vendor makes the changes, great. if they refuse, then quite frankly to invoke the power of this group, to discuss it here at great length, and with everyone we know. one could even write articles on emr's and one's experience, and have them published in, oh, fpm, or the AMA weekly throw-away or some other prestigious rag.another means is legal action. it seems to me that if the emr vendor prevents a physician from accessing patient data, and from being able to use it for patient care or for providing it for continuing patient care elsewhere, or holds it hostage, there is harm, to either or both patient and physician. perhaps abby can speak more to this. didn't you comment on this before? another aspect of this issue is standards. we hear about government, industry, vendors, newtie and hillary (i can just see them getting colonoscopies), and physician organizations developing emr standards. there is one group which already has a huge amount of experience with a whole variety of emr's. oh, that's us! rather than let the xspurts, i mean experts, who probably have no concept of medical practice and emr use on a daily basis and are not doctors, let's us develop the standards. i think it would be very straightforward.we have a group with talent and ability, knowledge and experience. let's start using it for our benefit.let us declare ourselves. LLAnnie Skaggs <askaggsfayettefamilymed> wrote:Hi ,Does Alteer really think you would pay $10K to migrate data? That’s outrageous…I have considered changing to something cheaper than what I have, but maybe I have been hasty. I am paying $3K/yr for support and upgrades and thought that was steep, but maybe it is pretty middle-of-the-road. When I considered changing, I thought about re-entering data and decided that it was a good opportunity to “prune” charts. Only the active ones must be re-entered. Of course that means I am counting on having a copy of old charts available if ever needed. Alteer allow you to keep a static copy of all your data?A4 is a pretty “bells and whistles” sort of system, and not cheap, but let me know if you are interested… I really do love mine and would hate to do without it…Annie-----Original Message-----From: [mailto: ] On Behalf Of LeeclanSent: Tuesday, October 03, 2006 7:55 AMTo: Subject: EMRJust wanted to say that I had a fantastic time meeting everyone at the Scientific Assembly. Has anyone posted pictures yet?Thanks!I have come back from the Assembly all fired up with ideas of how I want to improve my practice for my patients.One thing that I did was to sit down with the Eclinical Works people and find out how it compares with Alteer. I was shocked to see how much more it does! Technology has come so far in the past few years and Alteer is way behind. I am seriously thinking of switching, as Alteer has had no major updates in 2 years and what I am paying per month in "updates" and support is about the same if you bought the ECW subscription plan ( $ 400 a month).ECW has patient registry and even a secure patient port you can do virtual office visits. Is anyone using ECW... do you have any cautions with it... any advise to those of us who are thinking of switching EMRs? It will be painful to switch because of the data transfer ( Alteer will charge $7000-10,000 to do this. I will not pay a dime to them for this and will try and figure out a way to do this myself. The longer I wait, the harder it will be.Any advise would be greatly appreciated, especially from those who use ECW.Thanks again to all you IMPers! LeeHow low will we go? Check out Yahoo! Messenger’s low PC-to-Phone call rates.

October 15, 2006

Just for comparison, I am not changing emrs, but had to buy a new server because the old one was

getting unreliable. A4 made me sign an

agreement before they will move my data from one server to the other….Up

to $2100 anticipated cost, depending on how much of their time it takes…My

data, my servers…they still get a cut.

Annie

Re:

emr data, transfer, standards

Hi Larry,

Thanks for your

response. I am able to get my patient's chart, in that I could print out

all the data, or I can convert it to a pdf file or tiff file and then burn it

to a DVD ( I think this is what Eades does). So, the vendor is

not holding my data hostage from that sense. The problem is that if you

want to switch systems, they charge you to get your data into a form that the

new EMR company uses. This is where the high cost comes in. They charge

an exhorbitant amount to convert and export it into another system. I

agree, that as the future of EMRs move forward, there needs to be some

standardization of the platform of how data is transferred, so that the

physician doesn't get caught holding the bag of shelling out thousands of

dollars to get her records into a useable format in another EMR.

I am curious to know about other

vendors. Do you guys know if your vendor would charge you to convert your

data and migrate it to another system.

If they do charge you ( i find it

hard to believe that no one would charge a fee for that), how much do they

charge? I am willing to pay something, but only if it is

reasonable. And I don't know what that reasonable cost is.

Lee

EMR

Just wanted to say that I had a

fantastic time meeting everyone at the Scientific Assembly. Has anyone

posted pictures yet?

Thanks!

I have come back from

the Assembly all fired up with ideas of how I want to improve my practice for

my patients.

One thing that I did was to

sit down with the Eclinical Works people and find out how it compares with Alteer.

I was shocked to see how much more it does! Technology has come so far in

the past few years and Alteer is way behind. I am seriously thinking of

switching, as Alteer has had no major updates in 2 years and what I am paying

per month in " updates " and support is about the same if you bought

the ECW subscription plan ( $ 400 a month).

ECW has patient

registry and even a secure patient port you can do virtual office

visits.

Is anyone using ECW... do you have

any cautions with it... any advise to those of us who are thinking of switching

EMRs?

It will be painful to switch

because of the data transfer ( Alteer will charge $7000-10,000 to do

this. I will not pay a dime to them for this and will try and figure out

a way to do this myself. The longer I wait, the harder it will be.

Any advise would be greatly

appreciated, especially from those who use ECW.

Thanks again to all

you IMPers!

Lee

How low will we go? Check out Yahoo! Messenger’s

low PC-to-Phone

call rates.

October 15, 2006

What a rip-off! I just had a new hard drive put on my server and

the whole thing (including data transfer) was only a few hundred

dollars.

Gordon

At 03:48 PM 10/15/2006, you wrote:

Just for comparison, I am not changing emrs, but had to buy a new

server because the old one was getting unreliable. A4 made me sign

an agreement before they will move my data from one server to the

other….Up to $2100 anticipated cost, depending on how much of their time

it takes…My data, my servers…they still get a cut.

Annie

Re: emr data, transfer,

standards

Hi Larry,

Thanks for your response. I am able to get my

patient's chart, in that I could print out all the data, or I can convert

it to a pdf file or tiff file and then burn it to a DVD ( I think this is

what Eades does). So, the vendor is not holding my data

hostage from that sense. The problem is that if you want to switch

systems, they charge you to get your data into a form that the new EMR

company uses. This is where the high cost comes in. They charge an

exhorbitant amount to convert and export it into another system. I

agree, that as the future of EMRs move forward, there needs to be some

standardization of the platform of how data is transferred, so that the

physician doesn't get caught holding the bag of shelling out thousands of

dollars to get her records into a useable format in another EMR.

I am curious to know about other vendors. Do you guys

know if your vendor would charge you to convert your data and migrate it

to another system.

If they do charge you ( i find it hard to believe that no

one would charge a fee for that), how much do they charge? I am

willing to pay something, but only if it is reasonable. And I don't

know what that reasonable cost is.

Lee

EMR

Just wanted to say that I had a fantastic time meeting

everyone at the Scientific Assembly. Has anyone posted pictures

yet?

Thanks!

I have come back from the Assembly all fired up with

ideas of how I want to improve my practice for my patients.

One thing that I did was to sit down with the Eclinical

Works people and find out how it compares with Alteer. I was

shocked to see how much more it does! Technology has come so far in

the past few years and Alteer is way behind. I am seriously

thinking of switching, as Alteer has had no major updates in 2 years and

what I am paying per month in " updates " and support is about

the same if you bought the ECW subscription plan ( $ 400 a

month).

ECW has patient registry and even a secure patient

port you can do virtual office visits.

Is anyone using ECW... do you have any cautions with

it... any advise to those of us who are thinking of switching EMRs?

It will be painful to switch because of the data

transfer ( Alteer will charge $7000-10,000 to do this. I will not

pay a dime to them for this and will try and figure out a way to do this

myself. The longer I wait, the harder it will be.

Any advise would be greatly appreciated, especially from

those who use ECW.

Thanks again to all you IMPers!

Lee

How low will we go? Check out Yahoo! Messenger’s low

PC-to-Phone call rates.

October 15, 2006

Annie: I know others have voiced contempt for the $2100 to upgrade your hardware, but I bet it comes with peace of mind. Our challenge as IMPs is to find reasonable services at reasonable prices for mission critical data. Annie, you have always liked A4 in your posts. Has your view changed? We need a "geek" squad of computer and IT support for every physicain office from coast to coast if EMR's are to end up in every office. Gordon does have a point and if you had the time you could fly rounf trip to have his IT professional update your computer. Satisfied, but sticker shocked? "L. Gordon " wrote: What a rip-off! I just had a new hard drive put on my server and the whole thing (including data transfer) was only a few hundred dollars.GordonAt 03:48 PM 10/15/2006, you wrote: Just for comparison, I am not changing emrs, but had to buy a new server because the old one was getting unreliable. A4 made me sign an agreement before they will move my data from one server to the other….Up to $2100 anticipated cost, depending on how much of their time it takes…My data, my servers…they still get a cut.Annie -----Original Message-----From: [ mailto: ] On Behalf Of LeeclanSent: Wednesday, October 04, 2006 7:36 AMTo: Subject: Re: emr data, transfer, standards Hi Larry, Thanks for your response. I am able to get my patient's chart, in that I could print out all the data, or I can convert it to a pdf file or tiff file and then burn it to a DVD ( I think this is what Eades does). So, the vendor is not holding my data hostage from that sense. The problem is that if you want to switch systems, they charge you to get your data into

a form that the new EMR company uses. This is where the high cost comes in. They charge an exhorbitant amount to convert and export it into another system. I agree, that as the future of EMRs move forward, there needs to be some standardization of the platform of how data is transferred, so that the physician doesn't get caught holding the bag of shelling out thousands of dollars to get her records into a useable format in another EMR. I am curious to know about other vendors. Do you guys know if your vendor would charge you to convert your data and migrate it to another system. If they do charge you ( i find it hard to believe that no one would charge a fee for that), how much do they charge? I am willing to pay something, but only if it is reasonable. And I don't know what

that reasonable cost is. Lee EMR Just wanted to say that I had a fantastic time meeting everyone at the Scientific Assembly. Has anyone posted pictures yet? Thanks! I have come back from the Assembly all fired up with ideas of how I want to improve my practice for my patients. One thing that I did was to sit down with the Eclinical Works people and find out how it compares with Alteer. I was shocked to see how much more it does! Technology has come so far in the past few

years and Alteer is way behind. I am seriously thinking of switching, as Alteer has had no major updates in 2 years and what I am paying per month in "updates" and support is about the same if you bought the ECW subscription plan ( $ 400 a month). ECW has patient registry and even a secure patient port you can do virtual office visits. Is anyone using ECW... do you have any cautions with it... any advise to those of us who are thinking of switching EMRs? It will be painful to switch because of the data transfer ( Alteer will charge $7000-10,000 to do this. I will not pay a dime to them for this and will try and figure out a way to do this myself. The longer I wait, the harder it will be. Any advise would be greatly appreciated, especially from those who use ECW. Thanks again to all you IMPers! Lee How low will we go? Check out Yahoo! Messenger’s low PC-to-Phone call rates. Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

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October 15, 2006

Yeah,

that’s how I feel about it too. Much as I love the bells and whistles, ever since Allscripts bought A4 there has been a dramatic change in

how much money they want..Makes me think I could get

along with something less fancy..