RE: PC Based EKG

[Guest guest]

You can save money by trying the preferred version of Dragon

NaturallySpeaking. (I've seen it recently for $99). This will work

especially well if you're using an electronic health record and only

need nonmedical words for description. There are of course some

medical words that are part of the vocabulary. Another idea is if

you presently are doing any medical dictation you might want to try

to get your text files-you can run the files through Dragon

NaturallySpeaking and have it pick up the medical words.

Lou Spikol

>

> Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> resident in Texas getting ready to begin solo startup in July-

August

> and looking around for office equipment. Has anyone had any

experience

> with PC based ekg equipment. I am specifically looking at

cardiocard

> ($1550). It looks pretty neat and would interface well with the

EMR I

> plan to use. Please give any input you might have on this or other

> startup tips. Along the same lines they also make a spirometer that

> can run with your laptop as well. Do you think this stuff is any

good?

>

> Dragon Naturally Speaking Medical Version 9

> Best deal I have found is on Amazon for ~$850, does anyone know of

a

> better deal on this?

>

>

> Also, If you know anyone closing a practice, or a good place to

find

> used office equipement please let me know.

>

> Thanks,

> W. Blair, Jr., M.D.

>

[Guest guest]

I have

the MidMark EKG, spirometer, & Holter. The EKG is fine but the

computer interpretation always finds “abnormalities.” The spirometer

is VERY difficult for patients to perform correctly enough to get usable

results. The Holter is good. Honestly, I rarely use any of them

because I have no MA/LPN/RN & they are just too cumbersome & time

consuming, but maybe I just need more training on them.

I use Dragon Medical version 8. The

learning curve was tough to start but now it is great, but mostly just because

I can not type fast at all. If you are a good typist Dragon may not even

speed things up that much for you. It still messes up certain words (ie, “cap

that” still comes out as “cathether” a lot, etc).

Overall though, Dragon is good. Mine did cost ~$800 - $900 though.

PC

Based EKG

Hey everyone. I haven't

posted in a while. I am a 3rd yr fam med

resident in Texas getting ready to begin solo startup in July-August

and looking around for office equipment. Has anyone had any experience

with PC based ekg equipment. I am specifically looking at cardiocard

($1550). It looks pretty neat and would interface well with the EMR I

plan to use. Please give any input you might have on this or other

startup tips. Along the same lines they also make a spirometer that

can run with your laptop as well. Do you think this stuff is any good?

Dragon Naturally Speaking Medical Version 9

Best deal I have found is on Amazon for ~$850, does anyone know of a

better deal on this?

Also, If you know anyone closing a practice, or a good place to find

used office equipement please let me know.

Thanks,

W. Blair, Jr., M.D.

[Guest guest]

I picked up a PC-based EKG of Ebay for

about $239.00. It is a Cardio-Perfect, and used to be marketed by Welch-.

The company selling had a lot of them (I think they were used in a

research study and probably surplussed when the study ended.)

I got my Dragon Medical Version a few

years ago by getting an unused older version on ebay for about $60.00 and doing

the upgrade to the latest version for about $300.00 extra. In

general, getting unlicensed older versions of software and then upgrading them

is the least expensive way to get them. You just have to make sure you

know the terms of the upgrade offer (according to the dragon web site, you can

currently upgrade version 7 or 8 medical to version 9 medical, though

they do not list the price. I generally have been happy with KnowBrainer

as a source for Dragon medical products and upgrades. I just checked

ebay, and there are no unresistered versions of dragon medical available right

now, but they come up from time to time.

dts

From: [mailto: ] On Behalf Of jpsfpdoc

Sent: Thursday, January 04, 2007

8:59 AM

To:

Subject: PC

Based EKG

Hey everyone. I haven't posted in a while. I am a 3rd

yr fam med

resident in Texas

getting ready to begin solo startup in July-August

and looking around for office equipment. Has anyone had any experience

with PC based ekg equipment. I am specifically looking at cardiocard

($1550). It looks pretty neat and would interface well with the EMR I

plan to use. Please give any input you might have on this or other

startup tips. Along the same lines they also make a spirometer that

can run with your laptop as well. Do you think this stuff is any good?

Dragon Naturally Speaking Medical Version 9

Best deal I have found is on Amazon for ~$850, does anyone know of a

better deal on this?

Also, If you know anyone closing a practice, or a good place to find

used office equipement please let me know.

Thanks,

W. Blair, Jr., M.D.

[Guest guest]

I also purchased the Cardio-Perfect on Ebay - it works great - and honestly, I have used in once in 6 months (other than practicing) and I am so glad I did not spend a fortune. Greaves [Practiceimprovemen t1] PC

Based EKG

Hey everyone. I haven't posted in a while. I am a 3rd

yr fam med

resident in Texas getting ready to begin solo startup in July-August

and looking around for office equipment. Has anyone had any experience

with PC based ekg equipment. I am specifically looking at cardiocard

($1550). It looks pretty neat and would interface well with the EMR I

plan to use. Please give any input you might have on this or other

startup tips. Along the same lines they also make a spirometer that

can run with your laptop as well. Do you think this stuff is any good?

Dragon Naturally Speaking Medical Version 9

Best deal I have found is on Amazon for ~$850, does anyone know of a

better deal on this?

Also, If you know anyone closing a practice, or a good place to find

used office equipement please let me know.

Thanks,

W. Blair, Jr., M.D.

__________________________________________________

[Guest guest]

's point is important: Do you really need this thing?

While there are some locations where an EKG makes good clinical sense,

the machines tend to exist in offices where they tend to be over used to

justify the purchase. As noted by B, these things require set

up and clean up time that may make the reimbursement a poor compensation

for the labor involved. It may be worth it if you have

clinical need, but be cautious.

Gordon

At 02:04 AM 1/5/2007, you wrote:

I also purchased the

Cardio-Perfect on Ebay - it works great - and honestly, I have used in

once in 6 months (other than practicing) and I am so glad I did not spend

a fortune.

Greaves

[Practiceimprovemen t1] PC Based EKG

Hey everyone. I haven't posted in a

while. I am a 3rd yr fam med

resident in Texas getting ready to begin solo startup in July-August

and looking around for office equipment. Has anyone had any

experience

with PC based ekg equipment. I am specifically looking at cardiocard

($1550). It looks pretty neat and would interface well with the EMR

I

plan to use. Please give any input you might have on this or other

startup tips. Along the same lines they also make a spirometer that

can run with your laptop as well. Do you think this stuff is any good?

Dragon Naturally Speaking Medical Version 9

Best deal I have found is on Amazon for ~$850, does anyone know of a

better deal on this?

Also, If you know anyone closing a practice, or a good place to find

used office equipement please let me know.

Thanks,

W. Blair, Jr., M.D.

__________________________________________________

[Guest guest]

I love cardiology. A few years ago, when starting to realize I was on the

road to burn-out in my old job, I very much contemplated jumping back to

residency and trying to get into cardiology (talked with some cardiology

friends ... really considered it).

Anyway, I chose a different path. And now for 9 months I've been trying to

get my little solo-solo IMP rolling along. When I started I never

imagined making it this long without an EKG, but here I am. I've got

cardiology offices within 10-15 minutes of my office who are more than

happy to book an EKG for a patient, it's a 2 minute phone call ... and

I've only had to do that a handful of times.

I'm still considering getting one like the one got last year (QRS

card? I think...) but I think I'll wait until I'm full ... maybe in 3-6

months, who knows?

So, yes, I think Gordon is right on this too.

(that wasn't my perspective last year before I started this IMP).

Tim

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

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message, including attachments.

> 's point is important: Do you really need this thing? While

> there are some locations where an EKG makes good clinical sense, the

> machines tend to exist in offices where they tend to be over used to

> justify the purchase. As noted by B, these things require set up

> and clean up time that may make the reimbursement a poor

> compensation for the labor involved. It may be worth it if you have

> clinical need, but be cautious.

> Gordon

> At 02:04 AM 1/5/2007, you wrote:

>

>>I also purchased the Cardio-Perfect on Ebay - it works great - and

>> honestly, I have used in once in 6 months (other than practicing) and

>> I am so glad I did not spend a fortune.

>>

>> Greaves

>>

>> [Practiceimprovemen t1] PC Based EKG

>>

>>

>>

>>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

>>resident in Texas getting ready to begin solo startup in July-August

>> and looking around for office equipment. Has anyone had any experience

>> with PC based ekg equipment. I am specifically looking at cardiocard

>> ($1550). It looks pretty neat and would interface well with the EMR I

>> plan to use. Please give any input you might have on this or other

>> startup tips. Along the same lines they also make a spirometer that can

>> run with your laptop as well. Do you think this stuff is any good?

>>

>>Dragon Naturally Speaking Medical Version 9

>>Best deal I have found is on Amazon for ~$850, does anyone know of a

>> better deal on this?

>>

>>Also, If you know anyone closing a practice, or a good place to find

>> used office equipement please let me know.

>>

>>Thanks,

>> W. Blair, Jr., M.D.

>>

>>

>>

>>__________________________________________________

>>

[Guest guest]

I practiced for 2.5 years without an EKG

but at times it was ackward. Wouldn’t you know it that my first SVT

walked in right after I had purchased my EKG so I could properly dx (well with

a HR of 200 what else could it be). Without it, everyone with chest pain

needed to be sent to ER. Presurgical consultations sent to hospital for

EKG. People expect EKGs annually with certain medical conditions and I

couldn’t do them.

But worse than all of this, it is actually

in my Aetna contract that I must have an EKG and must have a clinical

assistant in the office. I got the EKG; I do not have a clinical

assistant.

I don’t do a lot of EKGs, but plan

on doing more as I work out the kinks of the work flow in doing one. It

is not well reimbursed time. But do I feel better having one now….yes.

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

RE testing in primary care offices.

I respectfully disagree -- EKG, self interpretive well worth the money.

Reimbursement $30; 100 tests pay for the machine. Pick up LVH, arrythmias. I honestly think this is a better investment than my glucose monitor, which I've had to fight for the $2.50 I ultimately get paid for any I do in the office. Curiously, think I should keep it, but mainly to help pts learn how to use their home machines.

Spirometry too -- this is well worth it, as well as pulse oximetry. COPD monitoring as well as asthma should be monitored, folks, I see few excuses that make sense here.

Now, as for flu shots, well, I DO send those out... anyone get stuck with flu shots this year unused?

If anything, this demonstrates what a heterogeneous group this is.

Dr Matt Levin

Solo FP since Dec 2004

Residency FP, 1988

SOAPware since 1997

[Practiceimprovemen t1] PC Based EKG>>>>>>>>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med>>resident in Texas getting ready to begin solo startup in July-August>> and looking around for office equipment. Has anyone had any experience>> with PC based ekg equipment. I am specifically looking at cardiocard>> ($1550). It looks pretty neat and would interface well with the EMR I>> plan to use. Please give any input you might have on this or other>> startup tips. Along the same lines they also make a spirometer that can>> run with your laptop as well. Do you think this stuff is any good?>>>>Dragon Naturally Speaking Medical Version 9>>Best deal I have found is on Amazon for ~$850, does anyone know of a>> better deal on this?>>>>Also, If you know anyone closing a practice, or a good place to find>> used office equipement please let me know.>>>>Thanks,>> W. Blair, Jr., M.D.>>>>>>>>__________________________________________________>>

[Guest guest]

I agree with Matt. However, in

my case, I am planning on limiting my practice only to take care of patients

with diabetes and hyperlipidemia. I can not imagine practicing without an

EKG machine, and I expect that I will pay for the one I bought on ebay in the

first month of my practice. (And, my start-up date is now the first week

of July this year – I gave my current employer my 6-month notice this

week!)

T. , MD

Soon to be the Sammamish Diabetes and

Lipid Clinic

From: [mailto: ] On Behalf Of Levin

Sent: Friday, January 05, 2007

6:11 PM

To:

Subject: Re:

PC Based EKG

RE testing in primary care offices.

I respectfully disagree -- EKG, self interpretive well worth

the money.

Reimbursement $30; 100 tests pay for the machine. Pick

up LVH, arrythmias. I honestly think this is a better investment than my

glucose monitor, which I've had to fight for the $2.50 I ultimately get paid

for any I do in the office. Curiously, think I should keep it, but mainly

to help pts learn how to use their home machines.

Spirometry too -- this is well worth it, as well as pulse oximetry.

COPD monitoring as well as asthma should be monitored, folks, I see few excuses

that make sense here.

Now, as for flu shots, well, I DO send those out... anyone

get stuck with flu shots this year unused?

If anything, this demonstrates what a heterogeneous group

this is.

Dr Matt Levin

Solo FP since Dec 2004

Residency FP, 1988

SOAPware since 1997

[Practiceimprovemen t1] PC Based EKG

>>

>>

>>

>>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

>>resident in Texas

getting ready to begin solo startup in July-August

>> and looking around for office equipment. Has anyone had any experience

>> with PC based ekg equipment. I am specifically looking at cardiocard

>> ($1550). It looks pretty neat and would interface well with the EMR I

>> plan to use. Please give any input you might have on this or other

>> startup tips. Along the same lines they also make a spirometer that

can

>> run with your laptop as well. Do you think this stuff is any good?

>>

>>Dragon Naturally Speaking Medical Version 9

>>Best deal I have found is on Amazon for ~$850, does anyone know of a

>> better deal on this?

>>

>>Also, If you know anyone closing a practice, or a good place to find

>> used office equipement please let me know.

>>

>>Thanks,

>> W. Blair, Jr., M.D.

>>

>>

>>

>>__________________________________________________

>>

[Guest guest]

,

Congratulations on starting new. Will you

be keeping Practice Partner or designing your own EMR?

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

Thanks, Kathy

I am planning on going to Practice Partner

Complete, and using their integrated electronic claims submission service. I

intend to require that the patients authorize me to bill their credit

cards for the adjudicated balance owed as soon as I get the information

from their insurance companies. However, I expect to continue to use

Macro Express to fine-tune the way Practice Partner works, and will keep designing

templates and Quick Texts.

Practice Partner is not perfect, but it is

very flexible, has all the features I need, and I am very familiar with it. It

would take me years to get up to speed with another EMR, and I really don’t

know of any EMR out there that I would rather use.

If you had to do it again, would you have

chosen a different EMR?

Don

From: [mailto: ] On Behalf Of Kathy Saradarian

Sent: Friday, January 05, 2007

7:35 PM

To:

Subject: RE:

PC Based EKG

,

Congratulations on starting new. Will you be keeping Practice

Partner or designing your own EMR?

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

Would I have chosen another EMR?

Probably not but I am not looking at any of the others anymore either. I

did spend several years researching EMRs before I chose Practice Partner

it won because of the fully integrated products, the messaging and the Health

Maintenance which was no where as good then as it is now. I get

frustrated with things at times but can see on the listservs that all the EMRs

have their plusses and minuses.

I could do a lot more with it if only I

had the time and little by little do some tweaking to make it better for

me. I really couldn’t imagine doing what I am doing without

it. Am very glad that I didn’t chose some other options. You

are just such a great Practice Partner user but also great with computers in

general and what you do with Macro Express and Logic etc, that I was wondering

what your plans are.

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

Matt,

I sure do appreciate your input. Please feel free to open up and let

me know anything more that you think is important that I may not have

thought about. Since I am new at this I really do like to hear what

you guys with more experience think are worthwhile investments and

will pay for themselves. I am most interested in providing my patients

with as much as I can, but don't want to do that at my own financial

detriment! These things have come down in price. I can get an PC based

resting ekg machine for $1550 new, but for $3k I can get a PC based

Stress/Rest setup and use my own treadmill (making manual adjustments

as the computer prompts me). I know these will usually pay near $100

per test...think this is worth it? As far as experience, I have done

around fifty or so in residency and am very comfortable with the

interpretation.

Thanks,

Ramey

> >

> >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> >> honestly, I have used in once in 6 months (other than

practicing) and

> >> I am so glad I did not spend a fortune.

> >>

> >> Greaves

> >>

> >> [Practiceimprovemen t1] PC Based EKG

> >>

> >>

> >>

> >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> >>resident in Texas getting ready to begin solo startup in July-August

> >> and looking around for office equipment. Has anyone had any

experience

> >> with PC based ekg equipment. I am specifically looking at

cardiocard

> >> ($1550). It looks pretty neat and would interface well with the

EMR I

> >> plan to use. Please give any input you might have on this or other

> >> startup tips. Along the same lines they also make a spirometer

that can

> >> run with your laptop as well. Do you think this stuff is any good?

> >>

> >>Dragon Naturally Speaking Medical Version 9

> >>Best deal I have found is on Amazon for ~$850, does anyone know of a

> >> better deal on this?

> >>

> >>Also, If you know anyone closing a practice, or a good place to find

> >> used office equipement please let me know.

> >>

> >>Thanks,

> >> W. Blair, Jr., M.D.

> >>

> >>

> >>

> >>__________________________________________________

> >>

[Guest guest]

Just curious...How can you do just diabetes and hyperlipidemia? What

are you going to do with patients that need other things taken care

of? Are you family medicine trained? - W. Blair, Jr. M.D.

> >

> >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> >> honestly, I have used in once in 6 months (other than practicing) and

> >> I am so glad I did not spend a fortune.

> >>

> >> Greaves

> >>

> >> [Practiceimprovemen t1] PC Based EKG

> >>

> >>

> >>

> >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> >>resident in Texas getting ready to begin solo startup in July-August

> >> and looking around for office equipment. Has anyone had any

experience

> >> with PC based ekg equipment. I am specifically looking at cardiocard

> >> ($1550). It looks pretty neat and would interface well with the EMR I

> >> plan to use. Please give any input you might have on this or other

> >> startup tips. Along the same lines they also make a spirometer

that can

> >> run with your laptop as well. Do you think this stuff is any good?

> >>

> >>Dragon Naturally Speaking Medical Version 9

> >>Best deal I have found is on Amazon for ~$850, does anyone know of a

> >> better deal on this?

> >>

> >>Also, If you know anyone closing a practice, or a good place to find

> >> used office equipement please let me know.

> >>

> >>Thanks,

> >> W. Blair, Jr., M.D.

> >>

> >>

> >>

> >>__________________________________________________

> >>

[Guest guest]

I am a residency-trained board-certified

FP who has been practicing in the same location since 1983. I started

solo back then, and did a full range of FP. I grew the practice, added

physicians, built a new building, added more providers, and eventually sold the

practice and the building to a hospital system in 2003. I have worked for

them since.

When I started, most of what I did was

pediatrics because we had a bedroom community with lots of kids and I was the

only doctor within 5 miles. The closest Pediatrician was 15 miles

away. I was open two evenings a week and Saturday mornings, as well as

during the days on weekdays. Now, all my pediatric patients from then

have grown up and most have moved away. Their parents are in their 50’s

and 60’s, and their grandparents are in their 70’s to 90’s. These

are my patients. I have found myself focusing on diabetes and hyperlipidemia

for most of the last 5 years. 2/3 of my patient visits are for at least one

of these problems. I like the Chronic Care Model (and did it before it

was really defined), and I do a very good job of taking care of these patients.

My dilemma is that I am busier than I want

to be now, and feel like I am running on a treadmill without much reward in the

system I am in. If I cut my hours to half-time, the reimbursement plan I work

under will not provide enough to meet my desires. The system

I work for is actually doing the MGMA -practice management pretty well, the

problem is just that the overhead expenses are much higher than they used to be

25 years ago. However, I know that I will do just fine

working half-time with minimal overhead out of the basement of my home.

The dilemma is that if I were continuing

to do a full range of practice, I would end up with more patients than I could

handle, would have to hire receptionists, MAs, and people to do billing, more

doctors, and I would be right back on the treadmill again, without the

management support I have now. I have been there and have done

that. My goal is to assume responsibility for the care of about 1/3

of my current patients. Focusing on the diabetics and hyperlipdemics will allow

me to do that. I will see them for their chronic care, and

will try to save a few urgent care slots every day for when they get sick. I

will continue to treat the other illnesses within my scope of practice that

they have, but I will focus on only taking care of people in this group. I

will probably still cut out lumps and bumps, and may even continue doing

vasectomies (by referral), but I am not planning on buying casting materials,

an x-ray machine, a DXA machine, or the other equipment and materials I would

need do continue doing a full range of care for everyone in my community.

I expect to have my NCQA recognition for

diabetes care in a few months, and will be signing up for the Lipid boards sometime

this year. After 27 years of being a generalist, I am looking forward to

the opportunity to make my focus a little narrower and in a little more depth

than I have previously. I expect to practice another 10 years, and I

think that the last ten years will be the best ever.

dts

From: [mailto: ] On Behalf Of jpsfpdoc

Sent: Friday, January 05, 2007

9:55 PM

To:

Subject:

Re: PC Based EKG

Just curious...How can you do just diabetes and

hyperlipidemia? What

are you going to do with patients that need other things taken care

of? Are you family medicine trained? - W. Blair, Jr. M.D.

> >

> >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> >> honestly, I have used in once in 6 months (other than practicing)

and

> >> I am so glad I did not spend a fortune.

> >>

> >> Greaves

> >>

> >> [Practiceimprovemen t1] PC Based EKG

> >>

> >>

> >>

> >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> >>resident in Texas

getting ready to begin solo startup in July-August

> >> and looking around for office equipment. Has anyone had any

experience

> >> with PC based ekg equipment. I am specifically looking at

cardiocard

> >> ($1550). It looks pretty neat and would interface well with the

EMR I

> >> plan to use. Please give any input you might have on this or

other

> >> startup tips. Along the same lines they also make a spirometer

that can

> >> run with your laptop as well. Do you think this stuff is any

good?

> >>

> >>Dragon Naturally Speaking Medical Version 9

> >>Best deal I have found is on Amazon for ~$850, does anyone know of

a

> >> better deal on this?

> >>

> >>Also, If you know anyone closing a practice, or a good place to

find

> >> used office equipement please let me know.

> >>

> >>Thanks,

> >> W. Blair, Jr., M.D.

> >>

> >>

> >>

> >>__________________________________________________

> >>

[Guest guest]

Kathy' example is thought provoking

One part is about workflow and how to get something done in a timely

fashion

and then there is the perception part -- perception by docs and patietns

Both largely deriving from habit more than science And also deriving from

culture. patietns will not ever say they have access to us that is 100%

unless they can see us under exactly their terms 24/7 This is America, with

drive in churches tv and tsxts on cellphones etc

" it feels.. " " patients expect "

" aetna says "

" everyone with cp then had to go to ER "

what we really have to do to work for patietns

I ask Kathy how far she is fromt he hospital?

I send my patietn over to sit and wait for theoir tropponin and ekg to be

faxed to me Unless someething is pressinlgy obvious and those people rarely

get to the office anyway, few, are sent to the er.

Otherwsie it takes a fresh re looking at what we expect what is really

medically needed.

I am reminedd of teh birth experiences in hospitals of my training where

is seems like some kind of tense emergency as we carry the baby across the

room to the heater/nurse dry 'em off thing VS the lady I met outside of

Haines Alaska. there people ddescribe where they live by miles out. She

lived at 22 miles . her baby was born at 7 mo and she put the baby skin to

skin as her husband started up the truck .In jan.

5 feet across teh room and 22miles out.Not a lot of diffrence in outcome.

RE: PC Based EKG

I practiced for 2.5 years without an EKG but at times it was ackward.

Wouldn't you know it that my first SVT walked in right after I had

purchased my EKG so I could properly dx (well with a HR of 200 what else

could it be). Without it, everyone with chest pain needed to be sent to

ER. Presurgical consultations sent to hospital for EKG. People expect

EKGs annually with certain medical conditions and I couldn't do them.

But worse than all of this, it is actually in my Aetna contract that I

must have an EKG and must have a clinical assistant in the office. I

got the EKG; I do not have a clinical assistant.

I don't do a lot of EKGs, but plan on doing more as I work out the kinks

of the work flow in doing one. It is not well reimbursed time. But do

I feel better having one now....yes.

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since 4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

So, you are thinking of doing exercise stress tests in your office? Are you

prepared to have someone code in your office, with a full schedule of patients

lined up waiting? I think you'll see that once out in practice you just can't

be everything/do everything. I have found that I've had to carefully pick &

choose what I can do in the office. Referrals are not a " sign of weakness. "

Let the specialists do what they do; in fact, the standard of care is dictating

that more & more, unfortunately.

>

>

> Date: 2007/01/06 Sat AM 12:52:25 EST

> To:

> Subject: Re: PC Based EKG

>

> Matt,

>

> I sure do appreciate your input. Please feel free to open up and let

> me know anything more that you think is important that I may not have

> thought about. Since I am new at this I really do like to hear what

> you guys with more experience think are worthwhile investments and

> will pay for themselves. I am most interested in providing my patients

> with as much as I can, but don't want to do that at my own financial

> detriment! These things have come down in price. I can get an PC based

> resting ekg machine for $1550 new, but for $3k I can get a PC based

> Stress/Rest setup and use my own treadmill (making manual adjustments

> as the computer prompts me). I know these will usually pay near $100

> per test...think this is worth it? As far as experience, I have done

> around fifty or so in residency and am very comfortable with the

> interpretation.

>

> Thanks,

> Ramey

>

>

>

> > >

> > >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> > >> honestly, I have used in once in 6 months (other than

> practicing) and

> > >> I am so glad I did not spend a fortune.

> > >>

> > >> Greaves

> > >>

> > >> [Practiceimprovemen t1] PC Based EKG

> > >>

> > >>

> > >>

> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> > >>resident in Texas getting ready to begin solo startup in July-August

> > >> and looking around for office equipment. Has anyone had any

> experience

> > >> with PC based ekg equipment. I am specifically looking at

> cardiocard

> > >> ($1550). It looks pretty neat and would interface well with the

> EMR I

> > >> plan to use. Please give any input you might have on this or other

> > >> startup tips. Along the same lines they also make a spirometer

> that can

> > >> run with your laptop as well. Do you think this stuff is any good?

> > >>

> > >>Dragon Naturally Speaking Medical Version 9

> > >>Best deal I have found is on Amazon for ~$850, does anyone know of a

> > >> better deal on this?

> > >>

> > >>Also, If you know anyone closing a practice, or a good place to find

> > >> used office equipement please let me know.

> > >>

> > >>Thanks,

> > >> W. Blair, Jr., M.D.

> > >>

> > >>

> > >>

> > >>__________________________________________________

> > >>

[Guest guest]

RE Style of practice and ancillaries

Yes, I have 2.5 FTE who work with me.

We all have our choices to make.

My payroll is about $1100/week -- yes, this is the choice I've made.

Dr Levin

[Practiceimprovemen t1] PC Based EKG> >>> >>> >>> >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med> >>resident in Texas getting ready to begin solo startup in July-August> >> and looking around for office equipment. Has anyone had any experience> >> with PC based ekg equipment. I am specifically looking at cardiocard> >> ($1550). It looks pretty neat and would interface well with the EMR I> >> plan to use. Please give any input you might have on this or other> >> startup tips. Along the same lines they also make a spirometer that can> >> run with your laptop as well. Do you think this stuff is any good?> >>> >>Dragon Naturally Speaking Medical Version 9> >>Best deal I have found is on Amazon for ~$850, does anyone know of a> >> better deal on this?> >>> >>Also, If you know anyone closing a practice, or a good place to find> >> used office equipement please let me know.> >>> >>Thanks,> >> W. Blair, Jr., M.D.> >>> >>> >>> >>__________________________________________________> >>

[Guest guest]

Actually, I'd say a HUGE portion of my primary care is now based in

diabetes and cholesterol. So I look at his with interest. And, because

we live in America, diabetes and cholesterol are two fields of medicine

where there will only be more and more business in the future.

Tim

--

Malia, MD

Malia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.

Perinton Square Mall

Fairport, NY 14450

(phone / fax)

www.relayhealth.com/doc/DrMalia

www.SkinSenseLaser.com

-- Confidentiality Notice --

This email message, including all the attachments, is for the sole use of

the intended recipient(s) and contains confidential information.

Unauthorized use or disclosure is prohibited. If you are not the intended

recipient, you may not use, disclose, copy or disseminate this

information. If you are not the intended recipient, please contact the

sender immediately by reply email and destroy all copies of the original

message, including attachments.

> Yes, good question. Isn't that called being an endocrinologist? If you

> are not a trained endocrinologist, why on earth would you want to treat

> only DM & lipids? Where would your patients come from?

>

>

>>

>>

>> Date: 2007/01/06 Sat AM 12:54:35 EST

>> To:

>> Subject: Re: PC Based EKG

>>

>> Just curious...How can you do just diabetes and hyperlipidemia? What

>> are you going to do with patients that need other things taken care

>> of? Are you family medicine trained? - W. Blair, Jr. M.D.

>>

>>

>> > >

>> > >>I also purchased the Cardio-Perfect on Ebay - it works great - and

>> > >> honestly, I have used in once in 6 months (other than practicing)

>> and I am so glad I did not spend a fortune.

>> > >>

>> > >> Greaves

>> > >>

>> > >> [Practiceimprovemen t1] PC Based EKG

>> > >>

>> > >>

>> > >>

>> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

>> resident in Texas getting ready to begin solo startup in

>> July-August

>> > >> and looking around for office equipment. Has anyone had any

>> experience

>> > >> with PC based ekg equipment. I am specifically looking at

>> cardiocard ($1550). It looks pretty neat and would interface well

>> with the EMR I plan to use. Please give any input you might have

>> on this or other startup tips. Along the same lines they also

>> make a spirometer

>> that can

>> > >> run with your laptop as well. Do you think this stuff is any

>> good?

>> > >>

>> > >>Dragon Naturally Speaking Medical Version 9

>> > >>Best deal I have found is on Amazon for ~$850, does anyone know of

>> a

>> > >> better deal on this?

>> > >>

>> > >>Also, If you know anyone closing a practice, or a good place to

>> find

>> > >> used office equipement please let me know.

>> > >>

>> > >>Thanks,

>> > >> W. Blair, Jr., M.D.

>> > >>

>> > >>

>> > >>

>> > >>__________________________________________________

>> > >>

[Guest guest]

I made a lengthy post on my background

last night. I think you will find that Family Practitioners

who have been in practice in the same community for a couple of decades

eventually end up with older patients with chronic problems. If we

are being proactive with follow-up, and insist that they schedule their next

visit before they leave the current visit, we find that there are fewer and

fewer acute care slots available, and that we want to save these slots for

the elderly ill who really need our care, rather than the young worried well

who have great insurance, but for whom a visit really doesn’t matter in

the big picture.

Quality of care in medicine has much more to do with the

systems you put in place and with the diligence you apply to following through

with them, than it does with your specialty training, or with how smart you

are. In my current

practice, I provide 100% of the diabetic care for well over 100 diabetic

patients now. I have a few other patients who also have an endocrinologist.

On my most recent run of my data, 80% of

my diabetics had a HgbA1c below 7%, 68% had an LDL cholesterol below 100, and

95.5% had a documented BP, Foot exam, Lipid battery, and HgbA1c within the last

year. 60% of my patients had an HDL cholesterol above 45 at their last

measurement, and close to 50% had a BP at 130/80 or below at last measurement. Obviously,

I have a lot of work to do on the HDL’s and the BP’s, but I

don’t think that the majority of my patients would do much better under

the care of an endocrinologist than they are doing now.

From my point of view, most

endocrinologists do not have the tools or systems in place to provide quality

care for a population of diabetics, any more than most cardiologists have

the tools or systems to provide quality care for a population of hyperlipidemics

or patients with congestive heart failure.

It is really the primary care physicians

who have the best opportunity to provide quality care for chronic illness.

T. , MD

Sammamish Diabetes and Lipid Clinic

opening July 2007.

From: [mailto: ] On Behalf Of drbrock@...

Sent: Saturday, January 06, 2007

11:18 AM

To:

Subject: Re:

Re: PC Based EKG

Yes, good question. Isn't that called being an

endocrinologist? If you are not a trained endocrinologist, why on earth would

you want to treat only DM & lipids? Where would your patients come from?

>

> From: " jpsfpdoc " <jpsfpdoc>

> Date: 2007/01/06 Sat AM 12:54:35 EST

> To:

> Subject: Re: PC Based EKG

>

> Just curious...How can you do just diabetes and hyperlipidemia? What

> are you going to do with patients that need other things taken care

> of? Are you family medicine trained? - W. Blair, Jr. M.D.

>

>

> > >

> > >>I also purchased the Cardio-Perfect on Ebay - it works great

- and

> > >> honestly, I have used in once in 6 months (other than

practicing) and

> > >> I am so glad I did not spend a fortune.

> > >>

> > >> Greaves

> > >>

> > >> [Practiceimprovemen t1] PC Based EKG

> > >>

> > >>

> > >>

> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam

med

> > >>resident in Texas

getting ready to begin solo startup in July-August

> > >> and looking around for office equipment. Has anyone had any

> experience

> > >> with PC based ekg equipment. I am specifically looking at

cardiocard

> > >> ($1550). It looks pretty neat and would interface well with

the EMR I

> > >> plan to use. Please give any input you might have on this or

other

> > >> startup tips. Along the same lines they also make a

spirometer

> that can

> > >> run with your laptop as well. Do you think this stuff is any

good?

> > >>

> > >>Dragon Naturally Speaking Medical Version 9

> > >>Best deal I have found is on Amazon for ~$850, does anyone

know of a

> > >> better deal on this?

> > >>

> > >>Also, If you know anyone closing a practice, or a good place

to find

> > >> used office equipement please let me know.

> > >>

> > >>Thanks,

> > >> W. Blair, Jr., M.D.

> > >>

> > >>

> > >>

> > >>__________________________________________________

> > >>

[Guest guest]

Couldn't resist weighing in on the to-have or not-to-have ECG

machine debate: it's a need, not a want and the reimbursement equals

roughly half of what I get for a 99213 with a lot less trouble. Two

ECGs in one day equal an extra 99213. Every single ECG has been paid

(granted I hve not billed Medicare yet). It takes my MA about 5

minutes to do and the billing is just one additional click on the

CMS 1500. Well worth the time. Even if I have to do it myself when

she's out, it's almost as fast for my rusty hands. I bought a used

one for $500 from the local medical equipment repair guy, and we use

it several times a week. It has paid for itself several times over

in just one year.

We NEED it for pre-op clearance.

I wouldn't trade it for the medico-legal peace of mind it gives me

when a patient presents with chest pain.

I like to know if my hypertensives are developing LVH or my

diabetics are developing silent ischemia.

I agree completely with Matt... I respectfully disagree that it's

not a necessary piece of equipment.

, MD

Trinity Medical Care, PC

Virginia Beach, VA

Solo since 1/3/06

> >> > [mailto: ] On Behalf Of

> >> Levin Sent: Friday, January 05, 2007 6:11 PM

> >> > To:

> >> > Subject: Re: PC Based EKG

> >> >

> >> >

> >> >

> >> > RE testing in primary care offices.

> >> >

> >> >

> >> >

> >> > I respectfully disagree -- EKG, self interpretive well worth

the

> >> money.

> >> >

> >> > Reimbursement $30; 100 tests pay for the machine. Pick up

LVH,

> >> arrythmias.

> >> > I honestly think this is a better investment than my glucose

> >> monitor, which

> >> > I've had to fight for the $2.50 I ultimately get paid for any

I do

> >> in the

> >> > office. Curiously, think I should keep it, but mainly to

help pts

> >> learn how

> >> > to use their home machines.

> >> >

> >> >

> >> >

> >> > Spirometry too -- this is well worth it, as well as pulse

oximetry.

> >> COPD

> >> > monitoring as well as asthma should be monitored, folks, I

see few

> >> excuses

> >> > that make sense here.

> >> >

> >> >

> >> >

> >> > Now, as for flu shots, well, I DO send those out... anyone

get stuck

> >> with

> >> > flu shots this year unused?

> >> >

> >> >

> >> >

> >> > If anything, this demonstrates what a heterogeneous group

this is.

> >> >

> >> >

> >> >

> >> > Dr Matt Levin

> >> >

> >> > Solo FP since Dec 2004

> >> >

> >> > Residency FP, 1988

> >> >

> >> > SOAPware since 1997

> >> >

> >> >

> >> >

> >> > [Practiceimprovemen t1] PC Based EKG

> >> > >>

> >> > >>

> >> > >>

> >> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr

fam med

> >> resident in Texas getting ready to begin solo startup in

> >> July-August

> >> > >> and looking around for office equipment. Has anyone had any

> >> experience

> >> > >> with PC based ekg equipment. I am specifically looking at

> >> cardiocard ($1550). It looks pretty neat and would interface

well

> >> with the EMR I plan to use. Please give any input you might have

> >> on this or other startup tips. Along the same lines they also

> >> make a spirometer

> >> that can

> >> > >> run with your laptop as well. Do you think this stuff is

any

> >> good?

> >> > >>

> >> > >>Dragon Naturally Speaking Medical Version 9

> >> > >>Best deal I have found is on Amazon for ~$850, does anyone

know of

> >> a

> >> > >> better deal on this?

> >> > >>

> >> > >>Also, If you know anyone closing a practice, or a good

place to

> >> find

> >> > >> used office equipement please let me know.

> >> > >>

> >> > >>Thanks,

> >> > >> W. Blair, Jr., M.D.

> >> > >>

> >> > >>

> >> > >>

> >> > >>__________________________________________________

> >> > >>

[Guest guest]

This is a little off the topic but I wanted to say how much fun and how effective it seems to be to use a chronic care model. Our office has been setting up systems for management of diabetes for the last several months. We just started to send out letters to all our patients who haven't been in for their HGBA1c's in the last 3 months. It is amazing how the patients I used to label as noncompliant just needed a little reminding to make their visits. Most people it seems want to be healthy but they need more support than we traditionally give.Larry Lindeman MDI made a lengthy post on my background last night.    I think you will find that Family Practitioners who have been in practice in the same community for a couple of decades eventually end up with older patients with chronic problems.   If we are being proactive with follow-up, and insist that they schedule their next visit before they leave the current visit, we find that there are fewer and fewer acute care slots available, and that we want to save these slots  for the elderly ill who really need our care, rather than the young worried well who have great insurance, but for whom a visit really doesn’t matter in the big picture. Quality of care in medicine has much more to do with the systems you put in place and with the diligence you apply to following through with them, than it does with your specialty training, or with how smart you are.  In my current practice, I provide 100% of the diabetic care for well over 100 diabetic patients now.  I have a  few other patients who also have an endocrinologist.   On my most recent run of my data, 80% of my diabetics had a HgbA1c below 7%, 68% had an LDL cholesterol below 100, and 95.5% had a documented BP, Foot exam, Lipid battery, and HgbA1c within the last year.   60% of my patients had an HDL cholesterol above 45 at their last measurement, and close to 50% had a BP at 130/80 or below at last measurement.  Obviously, I have a lot of work to do on the HDL’s and the BP’s,  but I don’t think that the majority of my patients would do much better under the care of an endocrinologist than they are doing now.  From my point of view, most endocrinologists do not have the tools or systems in place to provide quality care for a population of diabetics, any more than  most cardiologists have the tools or systems to provide  quality care for a population of  hyperlipidemics or patients with congestive heart failure. It is really the primary care physicians who have the best opportunity to provide quality care for chronic illness.   T. , MDSammamish Diabetes and Lipid Clinic opening July 2007.From: [mailto: ] On Behalf OfdrbrockrrohioSent: Saturday, January 06, 2007 11:18 AMTo: Subject: Re: Re: PC Based EKG Yes, good question. Isn't that called being an endocrinologist? If you are not a trained endocrinologist, why on earth would you want to treat only DM & lipids? Where would your patients come from?> > From: "jpsfpdoc" <jpsfpdoc>> Date: 2007/01/06 Sat AM 12:54:35 EST> To: > Subject: Re: PC Based EKG> > Just curious...How can you do just diabetes and hyperlipidemia? What> are you going to do with patients that need other things taken care> of? Are you family medicine trained? - W. Blair, Jr. M.D.> > > > >> > >>I also purchased the Cardio-Perfect on Ebay - it works great - and> > >> honestly, I have used in once in 6 months (other than practicing) and> > >> I am so glad I did not spend a fortune.> > >>> > >> Greaves> > >>> > >> [Practiceimprovemen t1] PC Based EKG> > >>> > >>> > >>> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med> > >>resident in Texas getting ready to begin solo startup in July-August> > >> and looking around for office equipment. Has anyone had any> experience> > >> with PC based ekg equipment. I am specifically looking at cardiocard> > >> ($1550). It looks pretty neat and would interface well with the EMR I> > >> plan to use. Please give any input you might have on this or other> > >> startup tips. Along the same lines they also make a spirometer> that can> > >> run with your laptop as well. Do you think this stuff is any good?> > >>> > >>Dragon Naturally Speaking Medical Version 9> > >>Best deal I have found is on Amazon for ~$850, does anyone know of a> > >> better deal on this?> > >>> > >>Also, If you know anyone closing a practice, or a good place to find> > >> used office equipement please let me know.> > >>> > >>Thanks,> > >> W. Blair, Jr., M.D.> > >>> > >>> > >>> > >>__________________________________________________> > >>

[Guest guest]

I have an old non pc based machine that I purchased 3rd hand for very little, No machine interpretation and the ecg needs to be scanned in but it was dirt cheap. I'm not sure the fancy PC based machine is worth the money. Probably the majority of the ecg's I do are for pre-op. I have a younger population. They certainly paid for the machine in probably 2-3 months.Larry Lindeman MDLarry Lindeman MDCouldn't resist weighing in on the to-have or not-to-have ECG machine debate: it's a need, not a want and the reimbursement equals roughly half of what I get for a 99213 with a lot less trouble. Two ECGs in one day equal an extra 99213. Every single ECG has been paid (granted I hve not billed Medicare yet). It takes my MA about 5 minutes to do and the billing is just one additional click on the CMS 1500. Well worth the time. Even if I have to do it myself when she's out, it's almost as fast for my rusty hands. I bought a used one for $500 from the local medical equipment repair guy, and we use it several times a week. It has paid for itself several times over in just one year. We NEED it for pre-op clearance. I wouldn't trade it for the medico-legal peace of mind it gives me when a patient presents with chest pain. I like to know if my hypertensives are developing LVH or my diabetics are developing silent ischemia. I agree completely with Matt... I respectfully disagree that it's not a necessary piece of equipment. , MDTrinity Medical Care, PCVirginia Beach, VASolo since 1/3/06> >> > [mailto: ] On Behalf Of > >> Levin Sent: Friday, January 05, 2007 6:11 PM> >> > To: > >> > Subject: Re: PC Based EKG> >> >> >> >> >> >> >> > RE testing in primary care offices.> >> >> >> >> >> >> >> > I respectfully disagree -- EKG, self interpretive well worth the> >> money.> >> >> >> > Reimbursement $30; 100 tests pay for the machine. Pick up LVH,> >> arrythmias.> >> > I honestly think this is a better investment than my glucose> >> monitor, which> >> > I've had to fight for the $2.50 I ultimately get paid for any I do> >> in the> >> > office. Curiously, think I should keep it, but mainly to help pts> >> learn how> >> > to use their home machines.> >> >> >> >> >> >> >> > Spirometry too -- this is well worth it, as well as pulse oximetry.> >> COPD> >> > monitoring as well as asthma should be monitored, folks, I see few> >> excuses> >> > that make sense here.> >> >> >> >> >> >> >> > Now, as for flu shots, well, I DO send those out... anyone get stuck> >> with> >> > flu shots this year unused?> >> >> >> >> >> >> >> > If anything, this demonstrates what a heterogeneous group this is.> >> >> >> >> >> >> >> > Dr Matt Levin> >> >> >> > Solo FP since Dec 2004> >> >> >> > Residency FP, 1988> >> >> >> > SOAPware since 1997> >> >> >> >> >> >> >> > [Practiceimprovemen t1] PC Based EKG> >> > >>> >> > >>> >> > >>> >> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med> >> resident in Texas getting ready to begin solo startup in> >> July-August> >> > >> and looking around for office equipment. Has anyone had any> >> experience> >> > >> with PC based ekg equipment. I am specifically looking at> >> cardiocard ($1550). It looks pretty neat and would interface well> >> with the EMR I plan to use. Please give any input you might have> >> on this or other startup tips. Along the same lines they also> >> make a spirometer> >> that can> >> > >> run with your laptop as well. Do you think this stuff is any> >> good?> >> > >>> >> > >>Dragon Naturally Speaking Medical Version 9> >> > >>Best deal I have found is on Amazon for ~$850, does anyone know of> >> a> >> > >> better deal on this?> >> > >>> >> > >>Also, If you know anyone closing a practice, or a good place to> >> find> >> > >> used office equipement please let me know.> >> > >>> >> > >>Thanks,> >> > >> W. Blair, Jr., M.D.> >> > >>> >> > >>> >> > >>> >> > >>__________________________________________________> >> > >>

[Guest guest]

Duly noted and I will look into the cost for me malpractice wise for

doing stress tests. However, I think I will probably go ahead anyway

if there is any way possible that I can afford it. I really feel like

it is a service that would benefit my patients. Also, as far as your

friend that says she thinks it is too risky to even read ekgs...come

on world what are we doing. I know that I am young and maybe a little

on the edge with starting practice right out of residency, but are we

going to let practicing cover your a#$ medicine even to the detriment

of our patients. I know I would rather do an ekg when indicated in my

clinic and potentially find the pathology and start treatment when

needed than to just tell my patient they will have to wait until the

specialist I am referring them to can get them in...This is just

ridiculous. I am going to take the path of doing what I think is right

for my patients...I may get burned, and that I will deal with if/when

it happens. But I will know that I did my best to do the right thing

and not stand behind the " copout " of cya medicine. Please forgive me

for giving very blunt testimony of my feelings about this...I don't

mean to step on anyone's toes.

Ramey Blair

> > >

> > >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> > >> honestly, I have used in once in 6 months (other than

> practicing) and

> > >> I am so glad I did not spend a fortune.

> > >>

> > >> Greaves

> > >>

> > >> [Practiceimprovemen t1] PC Based EKG

> > >>

> > >>

> > >>

> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> > >>resident in Texas getting ready to begin solo startup in July-August

> > >> and looking around for office equipment. Has anyone had any

> experience

> > >> with PC based ekg equipment. I am specifically looking at

> cardiocard

> > >> ($1550). It looks pretty neat and would interface well with the

> EMR I

> > >> plan to use. Please give any input you might have on this or other

> > >> startup tips. Along the same lines they also make a spirometer

> that can

> > >> run with your laptop as well. Do you think this stuff is any good?

> > >>

> > >>Dragon Naturally Speaking Medical Version 9

> > >>Best deal I have found is on Amazon for ~$850, does anyone know of a

> > >> better deal on this?

> > >>

> > >>Also, If you know anyone closing a practice, or a good place to find

> > >> used office equipement please let me know.

> > >>

> > >>Thanks,

> > >> W. Blair, Jr., M.D.

> > >>

> > >>

> > >>

> > >>__________________________________________________

> > >>

[Guest guest]

I agree, and I am on a hospital guarantee while considering all of

this. I will have an MA to help with the tests. I think I will buy the

equipment.

> > >

> > >>I also purchased the Cardio-Perfect on Ebay - it works great - and

> > >> honestly, I have used in once in 6 months (other than

practicing) and

> > >> I am so glad I did not spend a fortune.

> > >>

> > >> Greaves

> > >>

> > >> [Practiceimprovemen t1] PC Based EKG

> > >>

> > >>

> > >>

> > >>Hey everyone. I haven't posted in a while. I am a 3rd yr fam med

> > >>resident in Texas getting ready to begin solo startup in

July-August

> > >> and looking around for office equipment. Has anyone had any

experience

> > >> with PC based ekg equipment. I am specifically looking at

cardiocard

> > >> ($1550). It looks pretty neat and would interface well with

the EMR I

> > >> plan to use. Please give any input you might have on this or

other

> > >> startup tips. Along the same lines they also make a

spirometer that can

> > >> run with your laptop as well. Do you think this stuff is any

good?

> > >>

> > >>Dragon Naturally Speaking Medical Version 9

> > >>Best deal I have found is on Amazon for ~$850, does anyone

know of a

> > >> better deal on this?

> > >>

> > >>Also, If you know anyone closing a practice, or a good place

to find

> > >> used office equipement please let me know.

> > >>

> > >>Thanks,

> > >> W. Blair, Jr., M.D.

> > >>

> > >>

> > >>

> > >>__________________________________________________

> > >>