There are many physicians who have the technical background to write their own EMR. For those who would like to create their own EMR, please see "Writing your own EMR" from physicians and computers magazine, November/December 2000 for a brief paper addressing this issue.
It is my hope that many physicians will take the time to write their own EMR, as this will undoubtedly improve the quality of their practice while simultaneously reducing the overhead associated with their practice.
For those physicians who are either too busy or do not have the needed expertise to write their own EMR, ComChart™ is available.
How would I customize ComChart for my practice?
ComChart can be used "out of the box" and can be customized without the need to change the programming language. Some users may choose to modifiy the programming language to further tailor ComChart to meet there office's need. We recognize that only a minority of physicians will have the time and the ability to modify ComChart's source code. For those who need to have their version of ComChart modified, and can not do it themselves, ComChart will offer customized programming for an hourly fee.
A second option is to seek out a member of the Filemaker Solution Alliance who lives in your community or whom you can contact via the internet. The Filemaker Solution Alliance is an international network of independent software experts who specialize in writing (and re-writing) custom software using Filemaker Pro. Collectively, they are referred to as the Filemaker Solution Alliance. If you are comfortable with their service, you may want to maintain a long term relationship with this software consultant to help you maintain, modify and upgrade your EMR so that it always meets your needs.
It is my hope that those physicians, who write modules for ComChart that are of general applicability, adopt the "open source philosophy" and consider contacting me about making their modules available to other users of ComChart.
How to minimize dictation and filing costs?
Template Progress notes
ComChart has a standard history and physical form which will enable you to create a comprehensive initial history and physical without the need for extensive typing. It also includes >many template progress notes< which can be used to create comprehensive follow-up progress notes, again, without the need for extensive typing. These template notes are user specific. Further, there is no limit to the number of template progress notes a user can create. The user can even string together a series of these template notes to create one large progress note.
There are two types of template notes. The first allows the user to create a full progress note, or sections of a progress note, that can be assembled in pieces, by clicking on the name of the template note, as shown below. The second set of templates allow the user to assemble a customized H & P by clicking on individual items (physical findings, positive and negative ROS) to create a truely customized and comprehensive progress notes.
 CLICK ON THE IMAGE FOR A LARGER VIEW |
Screen shot of one user's set of template notes. |
If the user had selected the "H&P: Hyperlipidemia" template note from the above listing, they would have created the progress note shown below.
 CLICK ON THE IMAGE FOR A LARGER VIEW |
Created History and Physical |
Alternatively, the user can create a truely customized progress note by selecting options shown in the next 4 screen shots: History & PMH, Habits & FSH, ROS and Physical exam. In addition, all of the options which appear in the ROS layout and Physical exam layout can easily be modified by the user.
History and PMH layout CLICK ON THE IMAGE FOR A LARGER VIEW |
Habits & FSH layout CLICK ON THE IMAGE FOR A LARGER VIEW |
ROS layout CLICK ON THE IMAGE FOR A LARGER VIEW |
Physical exam layout CLICK ON THE IMAGE FOR A LARGER VIEW |
Using the above layouts, a customized progress note that is similiar to the one shown below, can easily be created and entered into the patient's progress note.
 CLICK ON THE IMAGE FOR A LARGER VIEW |
Created History and Physical (Top of progress note)
|
 CLICK ON THE IMAGE FOR A LARGER VIEW |
Created History and Physical (bottom of
progress note)
|
Besides using the template progress notes, dictation costs can be further minimized if progress notes are dictated using an independent speech recognition program such as IBM's ViaVoice(Mac & PC), MacSpeech's iListen (Mac) or Dragon System's NaturalSpeech (PC.) These dictated notes can then be automatically filed by ComChart,(this feature does not require the purchase of a custom written filing module and is included in the free ComChart single user version.) In addition, dictation costs can still be further reduced if the user chooses to type some of their progress notes directly into ComChart during/after the office visit. Thus, through the use of the template progress notes, speech recognition technology and the judicious use of typed progress notes, transcription costs can be markedly reduced.
ComChart will
automatically file all your lab results, radiology reports and
dictated notes into the patient's
chart.
This will obviate the
need for your staff to pull and re-file a chart every time a piece of
paper comes into your office. It will also obviate the need for your
staff to type the test results into ComChart. To utilize ComChart's
automated lab and radiology filing feature, you will need to receive
your test results in ASCII format, as an email or as part ot a word
processing document such as Microsoft Word and a customized "Filer"
module will need to be written to "recognize" you lab's data format.
Once this is done, you will be able to file all your test results at
the click of a button.
