EMR - Software & Hardware
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1 Appln Appln Server Server Scanners Wi-fi PCs??? TCs Network Network D Pen Backup Backup Server Server EMR - Software & Hardware T. Rathinam Medical Research Foundation 5 th Aug
2 Pieces of Puzzle! Software! Hardware! Soft-Hard-Ware! How to go about? 5 th August
3 S/w & H/w! Software? -Mind! Hardware? - Money 5 th August
4 Software Front End! VB! Easy! Inexpensive! Java/ J2EE! Cost effective 5 th August
5 Software! Java/ J2EE/.Net! Integration! Web based! Internet Browser! Internet + VPN 5 th August
6 Software Back End! Linux! Redhat! MS 2000! Unix 5 th August
7 Software Database! Oracle! MS SQL 2000! DB2! Interbase 5 th August
8 Software! To comply with Standards! HL-7! DICOM! CPT for Surgical Procedures! SOAP (Protocol)! HIPA for Insurance! NABL (National Accreditation Board for Labs)! Interface with other applications 5 th August
9 H/W Clinical Aspect! TCs! PCs! Digital Pad! PDA! Scanners! Document! Film Clinical Side Devices Server 5 th August
10 H/W Clinical Aspect! Interfacing hardware with equipment! Imaging Equipment! Fundus Camera, OCT, HRT etc! Diagnosis Data Equipment! HFA, Auto-Ref, Auto-Keratometer, DBR etc! Wireless Network! Security 5 th August
11 H/W- IT Systems Aspect! Server! Application! Database! Backup! Others! Desktop Workstations 5 th August
12 H/W- IT Systems Aspect! Hardware! High processing speeds to run difficult networks! High storage capacity! Although equipment will continue to become more compact, faster & cheaper What is purchased today will work effectively in office for next 5yrs. 5 th August
13 Hardware! Storage! Typical EMR Requirement 3 Terabytes in 2 to 3 years! Scalability upto 5 TB! Archiving Policy! Online! Offline! Inline 5 th August
14 Hardware! Storage! High Availability! Proven trackrecord! Depends on criticality! Basic! Redundant Array of Inexpensive Disks- RAID Server Server 5 th August ! RAID Level 5 R1 R2 R3 R4 R5 HD1 HD2 HD3 HD4 HD5
15 Hardware! Storage! Sophisticated!! SAN Ideal!! Expensive!! Blocks Blocks Blocks Blocks Blocks Blocks 5th August
16 Hard-Soft-Ware! Redundancy/ Load Balanced! Application Server! Database Server Application Servers LAN 5 th August
17 Hard-Soft-Ware! Redundancy/ Load Balanced! Networking! Switches! Connectivity Blk 1 DC Blk 2! Power! UPS for an UPS Blk 3 5 th August
18 Hard-Soft-Ware! Backup Policy! Log backup! Typically 15 mins! Disk to disk! Overall backup! End of the day! Disk to Disk to Tape! HD-HD-ALT 5 th August
19 H/W- IT Systems Aspect! Network! Design addressing the extra-bandwidth Requirements! Redundancy! Disaster Recovery 5 th August
20 When to go for EMR? 1.Starting a new clinic 2.Remodelling a old clinic 3.Adding a remote clinic 4.Availability of funds 5.Current billing or scheduling software needs updating 6.Concerns about the practice s ability to meet the Health care financing administration s billing guidelines and to provide appropriate legible documentation 5 th August
21 How to go about? 1. In-house/ Out-Sourced 2. Analysis of the current system 3. Depicting the required system 4. GAP! 5. Identifying the developers 6. Process of making it 7. IMPLEMENTATION (Plan & Execution) 8. Maintenance 5 th August
22 EMR HMS Visionary Organization Patient Services 5 th August
23 A Sankara Nethralaya Presentation 5 th August
24 Need? Need = Requirements + Expectations 5 th August
25 Need! Requirement! Medical Record (Physical)! Expectations! Image Management! Direct Data Acquisition! Intuitive 5 th August
26 S/W- Clinical Aspect! Data Interfaces! Other packages! Equipment! Slit Lamp Imaging, Fundus Imaging, HRA/ HRT/OCT/ GDx & others! Auto-Ref data, DBR/ Keratometer Values, Perimeter Data, etc! Avoid dead data!! Documents as images! Images without any search-ability 5 th August
27 S/W- Clinical Aspect! Standards! ANSI HISPP! ANSI HISB! CPRI! FESMCC! HIMA! HIMSS! HOST! MRI! NIST! WEDI! ANSI ASC X12! ASTM Committee E31! HL-7! HIBCC! IEEE! NCCLS! DICOM! NCPDP! NISO! NUBC! ACGIH! Facct! JCAHO! NCQA! URAC! DHHS Data Council! HISSB! NCVHS! CEN/TC 251! EDIFACT! ICE! NAHDO! NAPHSIS! NASIRE! NHIRC! COSTART! CPT-4! HCPCS - HCFA! ICD! AICD-10 CM! ICIDH! ICPC! LOINC! NDC! SNOMED! UMLS! LTCCUDS! MDS! UACDS! UHDDS 5 th August
28 S/W- Clinical Aspect! Standards! CPT-4 - Current Procedural Terminology! Created and maintained by the American Medical Association, which holds the copyright. Required for reporting of outpatient procedures and physician services in the United States. 5 th August
29 How to purchase an EMR?! Software not able to offer similar guarantees as Hardware companies! Need a successful software company who can offer a long-term technical support and frequent updates. 5 th August
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AMERICAN BOARD OF UROLOGY 2018 LIFE LONG LEARNING (LLL) LEVEL 2 PEDIATRIC UROLOGY SUBSPECIALTY CERTIFICATION EXAMINATION PROCESS INSTRUCTIONS FOR SUBMISSION OF ELECTRONIC LOGS Please read all instructions