PennWell Dental Community
EHR / PACS - The Great Debate ... please share your input
In 2006, U.S. Health and Human Services Sec. Michael O. Leavitt, in an address to the ADA House of Delegates said, "There is understandable anxiety about this — it's a big change." He also emphasized that a medical record void of dental records is incomplete, paying notice to the oral/systemic link of which we so desperately need to convince our patients. Thus, it is important, as EDS systems evolve, that dentists help insure the transparency, AND the interoperability with other systems, medical and dental. With this, should we decide to jump on the pioneer wagon of EHR and possibly PACS, we can make sure the investment will ultimately lead to a double return, with value not only to patients, but to providers as well.
With all the debate among us, fueled by the ADA's position on the "inevitability" of going EHR in our practices, and possibly PACS (image sharing), upon which many dental specialists rely daily, let us compile a detailed LIST of the particular issues/questions you (dental team members) have.
With that, working with an accomplished writer, and nationally recognized, independent consultant, specializing in the evaluation, implementation and oversight of EHR and PACS systems, we will provide you with articles that address your questions and concerns, as well as tips on the "tricks and traps" to know and avoid as you consider long-term relationships with vendors.
Please post your questions/concerns here. Please note, 'discussion/response' is not a feature, as this is intended only to gather the list. Thank you!
With all the debate among us, fueled by the ADA's position on the "inevitability" of going EHR in our practices, and possibly PACS (image sharing), upon which many dental specialists rely daily, let us compile a detailed LIST of the particular issues/questions you (dental team members) have.
With that, working with an accomplished writer, and nationally recognized, independent consultant, specializing in the evaluation, implementation and oversight of EHR and PACS systems, we will provide you with articles that address your questions and concerns, as well as tips on the "tricks and traps" to know and avoid as you consider long-term relationships with vendors.
Please post your questions/concerns here. Please note, 'discussion/response' is not a feature, as this is intended only to gather the list. Thank you!
Replies to This Discussion
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Permalink Reply by Jill Kring Carter on -
My name means nothing to him. Better idea. Contact Kevin Henry at PennWell and ask HIM to invite Tom.......
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Permalink Reply by Darrell Pruitt on -
Tom is a nice guy. Take a chance, Jill.
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Permalink Reply by Kevin Henry on -
Just an FYI folks, the National Dental EDI Council is having its meeting from May 5-7 in Phoenix. Might be a good time to have your voice heard...
click here for more information
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Permalink Reply by Darrell Pruitt on
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The National Dental EDI Council is the eDR stakeholder and hobbyist fan club, isn’t it?
If they knew I was coming, and that I might ask difficult questions about data breaches, HIPAA compliance and the NPI number in front of large audiences, do you think someone might lock me in my hotel room? D. Kellus Pruitt
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Permalink Reply by Christine Taxin on -
we have to ask these questions. i am goint to electronic data meeting. I will send kevin all the new information.
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Permalink Reply by Darrell Pruitt on
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I think that is wonderful, Christine. I would love to be there to perhaps aggravate an eHR stakeholder or two, but I will not be able to make it as far as they know. Give ‘em hell.
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Permalink Reply by Christine Taxin on
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Will there be tax incentives to go paperless?
How do offices get the training and information needed.
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Permalink Reply by Darrell Pruitt on
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Are there tax incentives to go paperless? Not any more than for the purchase of any other office equipment.
How do office staff get training and information? From vendors.
The ADA should be at the very front of the discussion about eDRs, but remains silent.
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Permalink Reply by Darrell Pruitt on
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MyFax eHR/fax hybrid system - a Nobel-worthy idea
At the end of an interview with Matthew Holt last week, Mark Leavitt, the head of CCHIT, stated that he anticipates that by 2014, only 50% of the nation’s physicians will be using interoperable, CCHIT-approved electronic health record systems. (He failed to mention dentists. Sorry).
It is my guess that by 2014, less than 5% of dentists will have paperless practices and none will be interoperable with anyone but insurers - predictably causing dentists to avoid interoperability. Even if it means laterally by-passing a mandated system, is it important for dentists to have the opportunity to share in handy communications with physicians as well as other dentists? I say yes. Is it possible for even dentists with paper practices to take part in magic discoveries that can only happen with more efficient professional communications? I say yes, yes. Thanks to innovative companies like MyFax.
I present to you a brand-new idea, never widely discussed as far as I know. Whoever thought of this deserves a Nobel Peace Prize and a lot of money. MyFax now offers a platform for a hybrid solution to interoperability in healthcare in the nation that encourages participation instead of fear of HIPAA. All that is required is a phone line and a $200 fax machine. In addition, one doesn’t even need an NPI number or signed and dated HIPAA forms. That means that sharing medical information will soon be not only cheaper than going through the Internet, but it will also be safe, simple and adaptable to whatever record system a provider might have. What more does healthcare reform need? The adoption of variations of the MyFax product would certainly cost much less than the $20 billion our children will spend on CCHIT-certified eHRs.
The following PR piece advertises a common sense product that is not likely to become CCHIT-certified. So who cares? What is more important, the package or its contents? D. Kellus Pruitt
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http://www.businesswire.com/portal/site/google/?ndmViewId=news_view...
April 16, 2009
MyFax Gives Medical University a Healthy Dose of Fax Management
Internet fax service helps Medical University of South Carolina meet HIPAA requirements, organize and manage more than 60,000 faxed pages per month
OTTAWA--(BUSINESS WIRE)--The Medical University of South Carolina (MUSC) Medical Center, which receives 50,000 faxed pages per month and sends another 10,000, recently found that faxing was rapidly becoming both a cost issue and a logistical nightmare. A full cost analysis based on current fax volume and anticipated future growth resulted in the selection of Internet fax service MyFax.
Many industries like healthcare still rely heavily on faxing to transmit sensitive information. Because of requirements for security and privacy in HIPAA, email is considered too vulnerable to interception without having a costly and complex secure messaging system in place, thereby putting patient privacy at risk. Faxes are considered more secure since they cannot be pulled out of cyberspace. That meant Sujit Kar, IT manager for business development and marketing services at MUSC, had to find another solution for managing faxes more efficiently and cost-effectively.
When reviewing alternative faxing options, Kar determined eliminating fax machines at MUSC was in order. The question was whether to replace them with email, fax servers or an Internet fax service. The option of moving to fax servers was eliminated due to the volume of faxes.
“We didn’t want to get into managing fax servers,” said Kar. “We wanted an outsourced solution, where we could get some help with development, and once it was running all the technical management would be handled for us.”
Kar ultimately chose Internet fax service MyFax to initially serve the inbound fax needs of 700 users. Since making the move to MyFax, Kar reports that potential HIPAA violations have been reduced significantly.
Today when faxes come in, they are tagged with medical record numbers, if required, critical patient information is pulled in from the medical records system. The faxes are then routed automatically to the right department by software that scans the cover sheets and determines where they should go, regardless of the fax number it was sent to originally.
There has also been a direct cost benefit to the Medical Center. Paper consumption has been reduced by a total of nearly 60,000 sheets per month, which works out to nearly three quarters of a million sheets of paper per year. The organization is also saving the energy needed to power all the old fax machines. Kar says there are the labor savings too, particularly in the ability to fax directly out of an application and MyFax’s ties to other systems such as Doctor Manage.
Including both incoming and outgoing faxes, MUSC today has more than 3,500 MyFax users. “Anyone who uses MyFax is hooked on it,” Kar said. “And the support we’ve received from the company has been beyond excellent. I wish all enterprise-level tools worked this smoothly and were supported this well.”
About MyFax
MyFax is the fastest-growing Internet fax service used by individuals, small, medium and large businesses to send and receive faxes using existing email accounts or the web. MyFax offers services in North America and Europe, including the United Kingdom, to industries recognized among the fastest-growing adopters of Internet fax including finance, insurance, real estate, healthcare, transportation and government. More than 15,000 new customers subscribe to MyFax each month. MyFax is part of a total Software-as-a-Service (SaaS) business communications offered by Protus that also includes my1voice feature-rich virtual PBX service and Campaigner, an email marketing service enabling organizations to have highly personalized one-to-one email dialogues with their customers. Additional information is available at www.campaigner.com , www.my1voice.com or www.myfax.com .
Contacts
Sue Rutherford, Protus
(613) 733-0000 x 519 or srutherford@protus.com
or
Tracy Shryer, Tech Image
847-279-0022 x230 or tracy.shryer@techimage.com
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Permalink Reply by Darrell Pruitt on
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I posted this on Anne Zieger’s FierceHealthIT blog in response to her article, “Spotlight: DoD rolls out dental EMR.”
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http://www.fiercehealthit.com/story/spotlight-dod-rolls-out-dental-...
Digital dental records are less than worthless.
Anne Zieger, please permit me to issue an open challenge to anyone, civilian or military, who would like to argue that electronic dental records are a good idea. I declare they are absurd.
Attention IT stakeholders in dentistry: Come on out anonymously if you are short of confidence. I can certainly understand why you might feel inadequate these days. I challenge anyone to give it their best shot. Please give me a chance to help you describe why you are wrong about IT technology. If you don’t have a name, I can assign one.
A week ago, I read Peter Buxbaum’s PR piece about the DoD’s dental electronic health records in GovernmentHealthIT. It is obvious that Air Force Col. Page McNall, the chief dental officer at the Defense Health Information Management System, is excited about the newest and coolest waste of tax dollars that does nothing to improve soldiers’ health. In fact, because the military is notorious for copious and routine data breaches of health information, including patient identifiers, anyone can see that soldiers and their families are much more likely to be harmed by electronic dental records than helped. But what can those in the military say? Not much, because they are in the military.
Meanwhile, back in the real world, where physicians are allowed to drag their feet in adoption of eMRs, eDRs are simply going nowhere. And as digital information becomes increasingly expensive to maintain because of HIPAA and the Red Flags Rule, dentists arguably could start abandoning computers altogether. (Gasp!) The price of being HIPAA compliant already gives an unfair market advantage to dentists who do not transmit patient data electronically. What does that say about the value of eDRs? It confirms that they are worse than worthless. But for the military, that’s no big deal. They waste far more tax dollars than this on things that actually make some sense.
I understand why Col. McNall is excited. I’m certain that officers’ interest in IT technology can mean quick advancement opportunities, including perhaps business opportunities in IT fantasy upon retirement. However, the experiment in which the colonel invested his career ultimately dead ends at the junction with the real world. His protected efforts may continue to make sputtering progress in the military ranks, but only because of the momentum of entrenched and politically connected IT sponsors. IT is, in fact, a lie.
In the real world, by comparison, the lie is supported by well connected stakeholders such as Glen Tullman of Allscripts who listen to stockholders for the common good, rather than the doctors who will be bribed, and later threatened, in order to force them to purchase Allscripts’ products that are so transparently inferior that they cannot succeed in the fee market on their own merits. The built-in unaccountability of our nation’s ad hoc $20 billion five-year plan reminds me of the development of the worse automobile ever made - the 1975 Soviet East German Trabant. The difference is that the Trabant is more user-friendly, reliable and has fewer leaks around the doors. In addition, pound-for-pound, the Trabant is also worth more in salvage than eDRs, even though its body is made of non-reusable and environmentally harmful materials that are impossible to dispose of safely. Most importantly, the Trabant killed fewer Americans than contaminated digital health histories will.
Since the military is isolated from the cleansing affect of natural competition as well as liability, Air Force colonels don’t have to listen to anyone who might be hurt by bad military decisions. Orders will simply be obeyed. Period. This means the military’s practicing dentists’ motivations to get along are far different than the marketplace influences in civilian practice. While captains in the dental corps say things like, “Yes, Sir. Right away, Sir.” to colonels, we obey consumers. Which brings me to a wonderful chunk of irony in this Memorial Day story: I am always grateful for the selfless, brave protection of US soldiers. For one thing, their proven professionalism and courage in battle allows me to say far less respectable things to national leaders without fear of endangering me or my family. Not all citizens, even in the western hemisphere and as close as Cuba, enjoy the freedoms that our soldiers defend.
Allow me to give you an example of what it means to be an American: I have the Constitutional freedom to say, “Glen Tullman, you can take your worthless IT crap and just move on down the road and don’t look back. There is nothing in my neighborhood that would interest you, so try not to embarrass yourself in front of your stockholders.” In turn, Tullman has the freedom not to respond, and he’d be wise to take advantage of that freedom.
Col. McNall says that because of interoperable eDRs, “medical providers and dental professionals can now share information that is relevant to their treatment of patients.”
Come on now, Colonel. It that the best you’ve got? Have you never heard of the telephone, the fax machine or even the US mail? Improvise, for crying out loud. Don’t make lame rationalizations.
I wish the colonel and I could have a sincere nose-to-nose discussion somewhere on the Internet about the merits of eDRs. If he has any fight in him, I think we could draw a crowd. I can easily bring along some sports fans I know.
Colonel McNall should bring a ladder and a sack lunch.
D. Kellus Pruitt DDS
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Permalink Reply by Darrell Pruitt on
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Prodding Col. Page McNall
I posted this on Twitter today.
@mhsocio Still have not heard from Col. Page McNall. I say eDRs are expensive and dangerous and don't improve care. What's he have to say?
D. Kellus Pruitt DDS
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Permalink Reply by Darrell Pruitt on
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A friend of mine who is in the military took exception to my raw opinion of Col. Page McNall’s intentions. He closed the email he sent with this noble attempt at defending a fellow officer:
“She's just doing her job trying to figure out a way to improve DoD dental care in a very complicated world, one which is just as ‘real’ as the one in which you reside and one about which you are no expert. I recommend that until you've ‘been there, done that,’ you steer clear of the military as a target. Stick with the ‘real world’ which you understand.”
I understand the point he is trying to make, and I am grateful that I have friends who feel comfortable enough in their relationships with me that they give me their best shots. Here is my response to my friend, LT. (Edited for profanity and other good reasons.)
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Thanks, LT. Even though I am grateful that you confirmed that my taunts at least have the potential to cause one solitary person in the nation to respond, if privately, I do hope you are not sincerely angry with me. If so, you misinterpret the reason I’m such a butt.
By now you should already know that my primary objective of transparency, after three years of attempting everything from excuse-me polite to in-your-face rude, is unchanged. And I discovered that if I am going to be ignored anyway, I am oh so fond of in-your-face rude, which is much more fun than the approved chain of command for trouble makers. Did you know that my officially designated TDA rep, who is a member of my local dental society, was the first good ol’ boy to give me the bum’s rush when I told him in February of 2006 that I had questions about the appropriateness of the HIPAA Rule in dentistry? He told me that nobody at state level was concerned about HIPAA, and if I wanted to pursue it, I was “on my own.” Does that not scare you just a little bit? And what gives the gatekeeper who practices in Weatherford the right to be officially rude to me? Don’t we both pay the same amount in dues each year?
Currently, I am trying to bring the discussion of the merits of eDRs into the open so others can see that at least in private practice, they are a dangerous waste of money (unless they become de-identified). As a nation, we simply must defeat biased IT/insurance/government alliances such as HIMSS and CCHIT. Otherwise, our grandchildren will pay dearly to reimburse China for loaning us billions of dollars that will be wasted on fantasy in dentistry - just because bone-headed enthusiasts inside and outside the military think digital health records are cool. Politically-inclined, clueless dentists who are successfully elected to positions they cannot handle, are part of the problem in the ADA.
Come on, LT. So what if I know nothing about the military? Big deal! Since I represent only myself, and since my career is worlds apart from those I am prodding into defending themselves, I think you can see that I really don’t really care what people think of my Internet persona. My family and friends don’t even seem to mind. Those few who are paying attention vicariously enjoy my adventure, actually.
So what if I’m misinformed? I’m actually hoping my lack of knowledge makes me an easy target to someone who assembles enough courage to recklessly protect an IT hobby. That would be wonderful. It’s sort of like fishing, and I would love to publicly set the hook deep in the belly of whoever aggressively and confidently swallows that chunk of bait.
And even though you present military reasons for digital dental records that superficially appear sound, I still argue that floating even more identifiable information on the Internet is an unnecessary risk of military families’ welfare, not just soldiers’. Face it, LT, like civilian leaders in IT such as Newt Gingrich, leaders in the military, like Col. Page McNall, envision technology as the goal, and information the tool - not the other way around. She is as guilty as Newt, in my opinion. And I would love for her to correct me about her actual motives. I’ll crush them one by one in front of everyone.
As for Gingrich, if he had any confidence, he would have said something long ago when my critical comment “Beware of the Newt - neither patients’ nor dentists’ friend,” from October remained on his first page for months.
http://community.pennwelldentalgroup.com/forum/topic/show?id=201342...
Super-stakeholder Newt Gingrich simply has no backbone.
What’s more, the harmful effects of McNall’s blind enthusiasm don’t end with the military, and that is the reason my pre-emptive attack is so necessary for the future of the profession. You are probably unaware that a couple of months ago, Delta Dental stepped up its lobbying efforts to persuade Congress to mandate universal adoption of eDRs like AHLTA as part of the stimulus package. Delta leaders are keeping close track of the military’s progress because controlling information using the voluntary but irreversible NPI number as the legal key, means control of dentist-patient relationships for Delta. On principle alone, based on getting to know the sleazy organization up close, whatever Delta Dental is for, I am solid against. Delta Dental is evil and I will do everything possible to crush anything that company promotes - even if it means taking on their favorite eDR lie before it has a chance to gain political and bureaucratic momentum. Why do you think Delta goes to congress to shop their ideas about interoperability in dentistry, yet refuses to discuss digital records with those who will have to pay for them? Forget about dentists’ interests. What about their patients’ interests? Without representation from dentists like me, dental patients have NO representation, especially in the military.
Let me show you more about the danger of helping Delta Dental sleaze to the control of our profession: Dr. Kathleen O’Loughlin, the new executive director of the ADA who will take charge in a day or so, served as President and CEO of Dental Services of Massachusetts (Delta Dental) from 2002-2007. Through her leadership, the company doubled its reserves, grew membership by 400% and executed a dramatic five-year growth plan. Now she has been chosen by the Board of Directors to be the executive director of the ADA. How many dentists will she be able to sign on with Delta now?
Did you know that there were over 200 viable candidates for the highest paid position in the ADA, yet dental members will have to settle for the ethics of Delta Dental’s Dr. Kathleen O’Loughlin? Let me repeat. She was at the very top of Delta during their sleaziest years ever.
LT, if you are one of those who think honest discussion of eDRs might have a chance to take place if I would only behave myself and follow traditional rules of civil engagement by writing polite letters to my Congressman, then you are one who is naïve about the dangers of civilian life.
Above everything else, thanks for caring, and thanks for being open with me. I welcome challenges like yours. They help me prepare for the inevitable battles that I will continue to win in entertaining ways.
D. Kellus Pruitt DDS
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General dentist in Fort Worth, Texas. I surround myself with the most wonderful staff and the kindest patients in the nation. It is our mutual confidence and respect that grants me the freedom to stand nose-to-nose with anyone in the marketplace. I’m blessed. And I like to write.
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