Monday, February 27, 2006

Birth pains and other glitches

My office switches over to the new system for billing/scheduling on Thursday. My colleagues in the FHN have been switching one practice at a time, since last Wednesday. We've encountered some problems.

There seems to be a problem with shipping, as hardware is being delivered to the wrong practices. Our project manager has been kept busy trying to get the right machines to the right places. This seems to be OK now.

I've sent all my demographic data to myNightingale last Wednesday night; no new data will be transferred to the new system. We are printing labels for patients whose information has changed, so we can enter this manually after Thursday. I do not have any computers set up yet to access the server, but they will come and set one up tomorrow morning. My staff will re-enter all the schedule information one evening before we go live, so that we do not have to schedule out of two systems. Everyone is planning to come in a half hour early on Thursday. I've distributed all the security fobs.

The IT lead for the other FHN (which started on the new system a month ago) sent an email to let us know that SSHA is causing difficulties with remote access to the server via VPN. Apparently, there is quite a bureaucracy to deal with there, and things move very slowly. There is no VPN access yet, and we do not know when this will happen.

I run an elders clinic once a week at a Toronto Housing for Seniors, close to my office. I've asked them for permission to connect to their cable modem to access my server at the hospital. I've run into problems with their bureaucracy as well; it has taken a month so far, and I still don't have permission. I may have to stop going if they refuse access, which I am not very happy about. There are drawbacks to starting an EMR.

I turned on one of the computers; the Internet connection is good, and I am typing this from my office. I can also access my web-based email from the office. I don't quite know if that is a good or bad thing.

I just received my copy of CMAJ. The last page has Dr. Ursus' column on EMRs. It looks like he's having a lot of trouble just receiving his lab results. I'll have to see what happens to my practice.



Anonymous said...

Hi, Dr. Greiver,

Thank you for publishing this blog. Your experience will be really valuable for others considering EMR.

We have a 3 GP office in Mississauga that went EMR 4 months ago. All our 4 staff and doctors are really happy about the transition. We use a local server and wireless tablets (doctors), and desktops (reception). Remote access to server is possible using any computer with internet connection (not VPN). The software we use is called Wolf.

The benefits were immediate: results were filed so much faster, referrals and callbacks so much easier to manage, and the doctors can easily review last encounter when going through reports. Even though we are a FHG and does not receive funding, the benefits were really worth it, office morale received a boost, and work atmosphere more "relaxed".

One interesting "glitch" during demographics transfer (common to many vendors) is that double names (such as Da Costa or Van den Graaf etc) will only show up as Da or Van. It may be worthwhile to spot check these, as unexpected glitches throws people off at the beginning trying to book appointments.

Good luck with your office transition, and all the best!

Adam Chen,

Michelle Greiver said...

Thank you. It's nice to hear that things are going well for you only 4 months after the transition. I wish someone could keep track of how many family physicians are going EMR. I think this will be an increasingly popular club in the next few years.