Improving+what+we+have

"Sometimes I sit and think, and sometimes I just sit."

As you work on the wiki new ideas and directions will be needed. What we want is a good, comprehensive and accurate evaluation of electronic records. Work on expanding the sources and improving the document.

**As** you can see the wiki is not in its final form. Many of the explored sites that are listed have only sketchy descriptions—something a user would find unsatisfying and not very useful. If you review any of these sites try to flesh out the description, the pros and cons as you see it, etc. Try to apply SWOT analysis as it applies to the goal of a good EMR/EHR. This first rendition of the wiki is unbalanced and leans heavily toward the personal health record in the bibliography. While the phr is an important aspect of electronic records, many of the sites suffer from the same problem of patient input, privacy, accuracy, etc.

In my position as a primary care physician in solo practice I would want to learn more about electronic medical records—their ease of use, relative cost of startup and maintenance, and //true// ROI. I found a site called// [|practicefusion] //that is free (advertising-supported), similar to Wikispaces.com. (There is an ad for it on Wikispaces as well as for some other EMR/EHR sites). It would help to know how powerful it is for advanced uses such as data mining and trending as well as those other necessary functions like security, privacy, sorting data, office notes, images, and lab results into a patient’s record. Large multispecialty clinics and hospitals can afford more powerful systems, and they are getting on board rapidly. Do we see a cost effective way for the small practitioner to move to electronic records. Most of the items I’ve read identify the small practice as the weakest link in getting widespread acceptance of EMRs.

If any of the contributors has a strong background in EMRs we need his/her expertise to make this wiki as practical and useful as possible.

Along with expanding the information on the EMR sites on the main page can there be some better-explained parts to the EMR /EHR function, such as
 * linking billing/coding and transmission to clearing houses
 * transition problems when you go from paper to paperless
 * storage and access to records--in office or third party server?
 * can software 1 talk to software 2?
 * some of the packages will give partial access to a patient's chart for online consulting--are there any problems with security at this level.
 * backup and redundancy if the system crashes (never happens!). Does the provider come to a screeching halt if the software fails?
 * now with Windows 7 and IE8 are any new compatibility issues arising?
 * are there any Mac friendly products and if so how good are they?
 * the wiki needs someone to look at the pros and cons of CCHIT as well as the HITECH Act.
 * while we have looked at a number of ehr/emr products we do not seem to have any strong critical evaluations--the ones we have are mainly descriptive. Either we should find some critiques of some of the products or, if one of you is using one of the products, to develop a pro and con evaluation of it as it has worked for you. I know this idea is drifting away from the pure academic area, but getting the wiki to be as comprehensive as possible is our goal.
 * In December, 2009 a set of proposed indicators for meaningful use was created and will be going to the Federal Register for publication in the near future. How should provider entities - doctors, clinics, hospitals - approach these guidelines. Should the stimulus money that is being made available for the EHR conversion be an important or unimportant factor for a provider to make the conversion, since the distribution of the stimulus money depends on meeting the "meaningful use" guidelines?