HIT Projects You Can Implement Today

Many people are sitting their on the proverbial fence waiting to see what’s going to happen with the HITECH act and meaningful use before they actually go and implement an EMR. Now, I’m not going to let those people off the hook from evaluating and selecting an EMR. That should be done anyway. However, lately I’ve been thinking that many of these clinics shouldn’t be waiting to implement technology in their offices. Sure, EMR is a game changer and a major change for any office and has tremendous upside (regardless of stimulus money). However, for those of you in the wait for HITECH act money camp, there are still a number of IT projects that you can implement today that will benefit you once you actually implement an EMR. Here’s just a few of them:

Fax Server – This is a HUGE game changer for those that have an EMR. The medical world still revolves around the fax machine and will for a long time to come. Implementing a fax server in your office is a great first step to prepare your office for an EMR. Plus, it can save a lot of paper. For example, you can just delete all those “spam” faxes that you get. Fax servers are great and by having it installed and your users trained on how to use it so that when you implement your EMR you can just directly upload your faxes into your EMR without ever printing out the fax.

IM (Instant Messaging) – I’m amazed at how useful our clinic has found IM to be in our office. It’s a great way for the nurses to communicate with the clinicians, the clinical people with the front desk and the nurses with each other. You do have to manage when to IM versus a phone call versus an email (or secure EMR message once you have an EMR), but there’s sometimes that an IM is a perfect way to communicate in a clinic.

Shared Drives – Setting up a shared drive for your office is simple to do and can save a lot of time. I’m surprised how many offices don’t use this. It’s not the best thing for patient data, but there are hundreds of other office uses for a shared drive to prove beneficial. Ideally this would be setup on active directory, but even if you just manually map a shared drive it can work well in a clinic.

IT Infrastructure – Good IT companies will come and do an analysis of your current IT setup for free. They’ll also give you an idea of what things you could do now that will prepare you for your EMR implementation. Plus, even if you don’t do some of the things until you get closer to implementing an EMR, it’s good to know the weaknesses in your IT infrastructure early so that you can make that part of your plans.

Those are just a few examples. I’m sure some will also mention ePrescribing on this list. I’m not totally sold on that idea, but would love to hear people who disagree. What other technologies can clinics implement now regardless of their EMR purchase?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

18 Comments

  • I totally agree that there are things that practices can do now. Of all of them IT infrastructure is probably the key one for me, everything relies on good infrastructure. Good being, resilient, scalable and appropriate to the business needs of the practice.

    I don’t agree with the “good companies will do it for free” statement.I believe companies who want to sell you a bunch of IT equipment will do it for free and then say you need the latest and greatest XP456x24c server with the sooperdooper XPZ accelerator ……and then present you with a large dollar amount invoice…..just remember “There is no such thing as a free lunch”

    I believe that what many practices need is an IT partner that you can go to for advice and guidance on the technology you need to create a resilient, and cost effective platform on which to build your EMR program. This is not going to be free but then the value you receive is much higher. (the old cost vs value argument….groan)

    In my company’s experience there is often the immediate reaction is to buy more: To upgrade network components, often this expense is unnecessary. There are often many things that you can do to optimize your network and leverage your existing investment and extend the life of your infrastructure you just need the organization that understands what you are trying to do rather than see you as a one off equipment sale.

    Many small practices don’t have the IT skills to make the judgment and all they truly need is an IT partner to make stuff work at its most efficient. In that case a managed service may be the way to go.

    Sure, EMR is going to bring a need for more efficient networks but it doesn’t automatically follow that you need to run out and spend a boatload of cash on new hardware. Just because the EMR vendor tells you you need to.

    Heres a solution where the D&D Consulting were able to significantly reduce the IT Hardware costs of an EMR project.

  • Gavin,
    I guess I should have clarified. Not all good companies will do an analysis for free and not all companies that do it for free are good. However, I know of a number of very fine companies that will do it for free and won’t oversell you on product. They’ll give you a good analysis of your situation and suggestions on ways to improve what you have.

    Your points about not having to spend a boatload of money and have the latest and greatest everything is well said. The beauty of a free analysis is that you can even have 2 IT companies do the analysis and compare the two to see which one has your business in mind and which one just wants to do a one time sell and be gone.

  • Love the Fax Server suggestion. eFax is a great service in this space. Google Apps is a great way to get email, IM, shared and individual calendars, shared and individual spreadsheets, etc. – there are free and premium editions available.

    PracticeFusion is also a very exciting firm in the HCIT space with both HIPPA compliant EMR and PHR platforms available. No software or hardware purchases required.

    Regarding infrastructure – shared drives are very 1990’s and providers can leapfrog this technology with Google Docs, Box.net, Signal37, Zoho, etc.

    SaaS solutions should be considered first and foremost. You leverage and trust the internet for online banking, investments, bill paying, etc. – this is better than managing your own hardware and software. You have a practice to run – focus on that. You don’t need servers and software to worry about – only services. Your time is too precious to be fiddling with IT infrastructure. Invest in a solid internet connection and be done with it. Leverage SaaS providers and do periodic reviews of their performance and other options.

  • I still think that none of the SaaS services have leapfrogged a nice shared drive. It’s incredibly useful and convenient.

    Don’t get me wrong. I use Google Apps along with Google docs and all the rest as much or more than anyone else. They have their place, but shared drives are still great technology.

    Google Apps is amazing and for the cost of free it’s even better.

  • I like this post, John — This kind of thinking is what lead to our DoxScript product (A single-computer, freestanding prescribing station.) The idea is to allow a physician to dip her toe in the proverbial waters of computerized record-keeping by electronically prescribing or printing prescriptions without having to go all out and convert the entire office.

    I’d be extremely careful about using SaaS solutions, particularly for faxing (which may not be encrypted end-to-end). It would be very easy for patient-related data to slip in to that stream over time, which would expose you to some inherent security risks.

  • Wiring is something that can be done ahead of time – many office aren’t even wired completely or they have outdated wiring that will need to be replaced. If that’s the case, they are going to need to do it at some point anyway so might as well get that out of the way until they’ve decided to move forward on an EMR solution.

  • John, besides the direct benefit these projects deliver, taking baby steps with technology will make a big implementation easier. In these small IT implementations, I would that recommend clinics and offices take the opportunity to evaluate IT integrators, network engineers and value-added resellers. Which ones are easy to work with? Who can implement the system? Who can sell the equipment? Who is going to support it? Use these small projects to find out which IT reseller really understands the challenge of healthcare (critical data/no on-site IT support) and won’t leave a doctor or administrator with a hot closet, a mess of cables or an infrastructure that won’t easily expand. Use this opportunity to ask the integrator or reseller what the IT costs and scope would be for that future (eventual) EMR implementation.

  • Dan,
    Great description and list of questions they can consider during a pre-EMR IT project. You’re right that this is a great way to get an idea of what an IT company is like to work with.

  • John, This is a great list for technology solutions but aren’t you forgetting about the process itself.
    Without a current “as-is” process map you are risking implementing technology that may not work in the overall process.

    This is a great time to evaluate your current processes to get an understanding of the non-value added task and how an EMR can/will address them.

    A good flowchart of the current process will provide a visual detail of each process and what information, data and documents, is required by each role for each task.

  • I agree with John that a lot can be done to “get your feet wet”. But the easiest and safest way to become compliant is to outsource imaging the paper. Media Spiders Online or in office solution we can easily implement a secure digital patient record archive that is made specifically for your office.

    Lets face it, as I read the comments above the fact that people are acknowledging things like efax and Im as good forward steps says a lot about where a lot of doctors practices are in the road to EMR compliance.
    The parts that always seem to be overlooked are that if you choose to take this on yourself, you are required to comply with all technologies you are currently using.

    As an example if Media Spiders scans your paper you have a document that is deemed trustworthy. If you scan your own you need a complete document work flow process that is maintained and monitored with checks and balances to insure if you get sued you can submit those patient records in your defense.
    You would also need all the supporting technology for all computers, lap tops email IM archival etc… it is an all or nothing proposition.

    Our doctors enjoy being doctors, and don’t worry about hardware software etc…
    Our online version is secure and requires no software no upgrades and give your practice a complete internet presence with email and a secure new patient registration form built right in.
    Users can be set up with different levels of access. so you dont have to efax- you can reduce the burden on your practice and have the people that require the information retrieve it themselves.

    There are so many benefits that it is difficult to list them all.
    The best part is there are no start up costs. Access for up to 50 users is $89.00 per month. All data is on enterprise level servers and backed up to a raid 6 daily with 7 days redundancy.

    Scanning is .06 per page

    If you do the math, it is truly the only real way to store your records that wont break the bank.

  • Jim,
    It’s true that these other IT projects aren’t the only things that you can be doing before doing an EMR implementation. I’ve always said that if your workflow is bad before EMR it will likely be worse after EMR. So, figure that out first.

  • Great post! I would think that most offices would also need to install a firewall (in my experience too many don’t have them yet), enterprise/SMB AV SW, as well at least look at VOIP/PBX solutions.

  • Interesting article on a timely topic. Would like to clarify one point regarding fax servers, and a posted comment that references eFax. eFax is not a fax server company. A fax server network requires dedicated hardware installed on site to manage fax distribution. eFax is an outsourced service, which eliminates the need for on site fax servers. Usually, the decision to go with a fax server or a SAAS service such as eFax comes down to resources (who will maintain/update the internal fax server hardware) and costs (fax servers can be expensive to install and maintain). For a monthly fee, an outsourced service like eFax eliminates the need to upgrade or maintain hardware. For full disclosure regarding this post, please note that I work for eFax.

  • Thanks for the clarifications Bill. I’m sure many people didn’t know the difference between a fax machine, a fax server and an outsourced fax service such as yours. However, they should learn about them all since unfortunately, fax is the backbone of the medical communication model right now. Although, I guess from your perspective you’re fortunate that it is the backbone.

  • The bottom line (as the post points out) is that fax is still necessary in healthcare today. Internet fax services (like eFax) do give health organizations a reliable, proven standard for secure information exchange, and can help with HIPPA compliance. While dedicated machine to machine fax transmission is not as prevalent (or efficient) today, companies like ours (eFax) are working to advance electronic fax technology to bring increased layers of security and features like keyword search and tagging.

  • […] GFI – FaxMaker – GFI offers a number of interesting services for small to medium size businesses. One that’s particularly interesting in the healthcare space is called the GFI FaxMaker. If you don’t already have a fax server in your office, go and read my post about the virtues of a fax server in healthcare. […]

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