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Re: Tablet PC recommendationsFrom: SmartOB (dr_csbloom@yahoo.com)Thu Mar 27 04:37:13 2008
Dr. Haciski, The solution I was referring to is copying all my charts digitally and working with them without purchasing a full EMR system. I also created visit forms using Microsoft Office products and then convert the forms to .pdf files (digital paper) for stacking after the visit is complete. My full explanation can be seen at http://www.smartob.com/paperlessoffice.htm. My hospital's medical records also went paperless recently and it was interesting that they used essentially the same basic idea of just scanning in charts and working with the scanned images. Dr. Homouda, It sounds like your individual approach to EMR has been more ambitious than mine and I applaud your effort. Like you, I wanted to share my Prenatal Forms for free but found that the cost of getting out the word and supporting the website was prohibitive. That's why I decided to charge a nominal fee to recoup some of those expenses. As I am finishing my gyn forms now, I would love to see what you came up with because I agree that existing EMR's are currently cumbersome or much too expensive. I was also hoping for some feedback (suggestions/criticisms) on my Prenatal Forms. Charles Bloom, MD Melbourne, Florida _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr. Khaled Homouda Sent: Thursday, March 27, 2008 4:56 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Tablet PC recommendations Actually I have this kind of software you are talking about, I programmed it myself after months of struggling with software firms to produce something that could make me comfortable and ease things for me and let time of encounters be the same before and after implementing the s/w, SO I began learning how to code in Delphi (object Pascal) and produced something that I can say it is good and I am still changing it all the time since 1996 when I started writing it and using it in my clinic, as I always come up with new ideas and cut something and put a new thing where and when I need it, it is really nice to be able to do it yourself tailored to what you need and when you need, I included every aspect of obgyn practice including general obgyn, gyneurology, gyne-oncology, IVF, appointments and a bit of accounting, and best of all I can get any statistics I need at anytime by a visual query builder. The biggest problem I encountered when I showed it to somebody as a demo, that he just copied some of its features to his software and I saw it (similar forms) in his software that is in many hospitals now, I really thought of giving it away for free to the obgyn community but I always feared of these pirates putting features and ideas in their software and selling them for tens of thousands. Khaled Homouda, MD Alsalam Hospital, Kuwait Office: 965-2540789 Cell: 965-7007325 _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Rafael Haciski Sent: Thursday, March 27, 2008 7:45 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Tablet PC recommendations Charles, what solution are you referring to? Rafael Haciski MD FACOG Anchor Health Centers GYN 800 Goodlette Rd #360 239-643-8780 office 239-571-0292 cell Naples, FL. On Mar 21, 2008, at 7:22 AM, Charles Bloom wrote: Years ago I decided to get rid of all my paper charts and go paperless. I couldn't find a cost-effective EMR that suited my needs so I found a solution that worked for me. The day I set it up, I started transferring records as new and existing patients started coming in. It was totally painless. The only paper charts left are those of patients who haven't come back since going paperless and they are archived. Interestingly, I have met others who came up with the same solution on their own so it must be fairly obvious. At Wed, 19 Mar 2008, Garry E. Siegel, M.D. wrote: My practice has not yet really looked into EMR for many reasons, and while I am reasonably into technology (I guess most of us are, to a degree), it scares the fool out of me because I think that the transition will be painful and the upside will take months, if not years, to be evident. This is from someone who uses a handheld dictaphone and, frankly, it works, it is quick, it is legible, etc. It's a shame it is costly. That said, Rafael's comments are sage. Garry It's not really that simple. If you put aside the presumed greater portability of the tablet (thus easier to use in running from room to room seeing patients) which is not always the case as other listers have pointed out, the "user friendly thing" depends ENTIRELY on the software. For example, considering one particular program (EMR) that I am familiar with, it is written to be used with a stylus on a touch screen portable (although it could just as well be on a tablet). Yet is is such a horrible POC and so poorly written that it actually slows down your patient flow. Being a touch typist (or if you have a decent speech recognition software) you can complete a patient encounter twice as fast entering the info into a basic data base, or even a word processing program, or at its most basic, an email program where you store each encounter as one letter. All easily searchable and listable. If one had an elegant program where form followed function (as, for example, iPhone) then touch screen becomes a pleasure to use and a light tablet computer comes in handy. But if no such program exists (or you do not have one) then a touch screen actually slows you down. As an example, entering a simple item such as a "chief complaint" into the EMR, it takes me 2-3 times as long to find the appropriate choice of words from the pull-down menu: ... tap on the field to open the menu, ... search (and scroll through) the long list of possible choices, ... find what matches your needs, ... click on the choice, ... close the menu window than it does for me to type the few necessary words into the field. Ideally, that pull down menu should appear as I enter the field, and as I type into the field, the choices should be gradually narrowed until I find the one or two choices needed or complete the one I need. An intelligent software. Without well written software the hardware is useless. It takes visionary software and hardware engineers to put the two together. We had one major revolution (evolution) in 1984 when the first Mac came out with the GUI interface (not even invented by Apple, but by Xerox who did not realize the beauty of their invention and let it languish on the shelves), and now Apple does it again with the iPhone (much of it is technology was already around, they just put it together in a very neat package). If only all software/hardaware packages were so intuitive and easy to use! We have no such package in medicine at the moment. All we can do is debate the benefits of meager offerings (but very expensive) we do have, and wish, and hope for that spark of genius which will give us an intuitive, easy, efficient, and intelligent software/hardware package to care for our patients efficiently.
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