Communicating with Patients and Staff via Electronic Office Communication Systems

What are the costs of implementing an electronic system? It depends largely on the user base and the level of sophistication, said Mr. Smaistrla. Depending on one’s practice management system, EMR, or existing IT hardware, the costs may be extremely small. In our setting, we spent $15,000 for software and hardware improvements, which was quite affordable. This amounted to about $10,000 for the software and $5,000 for a hardware-based virtual private network (VPN) device. If you have to add a network server, costs will jump even more.

Advice for Newcomers to EMR

Bradley F. Marple, MD

According to an analysis of the medical literature, as of 2005, only one in four medical practices were using EMR systems in the United States.1,2,3 What would our interviewees advise their colleagues about getting on the bandwagon with EMR? I would be very wary about just asking somebody else about it, said Dr. Marple, and I would certainly shop around and get several bids.

Perhaps the best and most cost-effective way to start up with EMR, and that which would be the best investment of time and resources, would be to consult an expert who can ask you about your needs and desires of the practice and the practitioners, and can begin to educate you about what to look for and the product variables from which to choose.

Go slowly is the best tip I can offer, said Mr. Smaistrla, and leverage existing systems to their capacity. When we had sufficient controls in place for less strict EMR messaging in place, we then added office email using an exchange server. We then extended remote access for a VPN and this stretched capacity even more.

If you are looking into implementing a system, examine the matter of checks and balances so no automatic default transmissions will oppose what you would want to happen, said Dr. Marple. You need to think of all the worst-case scenarios.

References

1. Jha AK, Ferris TG, Donelan K, et al. How common are electronic health records in the United States? A summary of the evidence. Health Aff Web exclusive, October 11, 2006.

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2. Kane B, Sands DZ. Guidelines for the clinical use of electronic mail with patients. J Am Med Inform Assoc 1998;5:104-111.

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3. Waldren SE, Kibbe DC. Email in clinical care. BMJ 2004;329:E325-E326.

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