RE: alternatives to Instant medical history

[Guest guest]

When I was at the Scientific Assembly in chicago, I

saw the Formedic Medical Questionnaire. It looked a

lot like IMH. I do not have any experience with

either, but might be worth investigating - and I think

it is free. (is there such a thing as free? -I'm a

cynic) I do not have a link, but I'm sure we should

be able to research that. If anyone is using it, I

would love to know what you think too.

Ortega-Schmitt

--- familydocta wrote:

> Are there any alternatives to instant medical

> history?. Paying $50 for

> the rest of my adult life for that program seems a

> bit expensive. Are

> there any alternative software that we can install

> on our website? i am

> looking at online-dating softwares lately. I wonder

> whether an IT

> specialist can configure the template to match the

> history format. I

> rather spend $600 one time than $50 every month. any

> ideas out there?

>

>

________________________________________________________________________________\

____

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know-it-all with Yahoo! Mobile. Try it now.

http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ

[Guest guest]

Heck

yeah.

Formedic may turn out to try to upsell me something

down the line but their site rocks!

I have set up my account and started using

it.

I will do the visit, document, scan it and

give to pt as handout.

Done.

OR --- get their check box history working

on my WACOM touch screen convertible laptop.

Anyway, this looks simpler than instant

med history, but way cheaper.

I am glad I held off IMH

Dennis galvon

But anyway, I think this

Re:

alternatives to Instant medical history

When I was at the Scientific Assembly in chicago,

I

saw the Formedic Medical Questionnaire. It looked a

lot like IMH. I do not have any experience with

either, but might be worth investigating - and I think

it is free. (is there such a thing as free? -I'm a

cynic) I do not have a link, but I'm sure we should

be able to research that. If anyone is using it, I

would love to know what you think too.

Ortega-Schmitt

--- familydocta <familydocta>

wrote:

[Guest guest]

I don't know what Formedic is like, but using IMH you can bill some insurances- united and medicare in RI for 96103- computerized psychological assessment, for positive screening for depression anxiety ADD bipolar - paying about $30 - if you do two per month, it pays for the program + a little bit. Do you have 2 patients a month with the right insurance and diagnoses that might defray the cost? (Also planning on using it as backbone for cheap virtual visits, if I ever complete that last little URL.)I do like IMH and even though I am an overhead/IT cheapskate, I think it is easily worth the $50/month. Comparatively, I don't think my malpractice or my health insurance costs per month ($600/month part time discount, $275/month medical and dental) are worth AT ALL what I pay, but I am sure my IMH cost is. It's good to be careful about what you spend on but on the other hand I find if I need/want /find some tool useful I buy it and don't look back.I'm interested in hearing more about Formedic and its capabilities- subscribing also to the Clemenson theory -if a cheaper better piece of software will do the job, just swap it out (of course easier said than done once the sytem is set up). Here's a table from Dr. Bachman listing other automated programs, don't know anything about them:this was from the ''automated medical history" article July - August '07 FPM. Currently available systems Here are some of the systems that allow

patients to enter their own history. EncounterSuite's

TurboHX (http://www.medicalnetsystems.com)

This program, which currently is in beta

testing, is used in numerous EHR systems and patient portals. Instant Medical

History (http://www.medicalhistory.com) This program can interface with several EHR

brands. Medisolve

(http://www.medisolve.ca) The company furnishes a computer kiosk, and

the program includes 30 languages.LynnTo: From: jortegaschmitt@...Date: Tue, 4 Dec 2007 18:37:05 -0800Subject: Re: alternatives to Instant medical history

When I was at the Scientific Assembly in chicago, I

saw the Formedic Medical Questionnaire. It looked a

lot like IMH. I do not have any experience with

either, but might be worth investigating - and I think

it is free. (is there such a thing as free? -I'm a

cynic) I do not have a link, but I'm sure we should

be able to research that. If anyone is using it, I

would love to know what you think too.

Ortega-Schmitt

--- familydocta <familydocta> wrote:

> Are there any alternatives to instant medical

> history?. Paying $50 for

> the rest of my adult life for that program seems a

> bit expensive. Are

> there any alternative software that we can install

> on our website? i am

> looking at online-dating softwares lately. I wonder

> whether an IT

> specialist can configure the template to match the

> history format. I

> rather spend $600 one time than $50 every month. any

> ideas out there?

>

>

__________________________________________________________

Be a better friend, newshound, and

know-it-all with Yahoo! Mobile. Try it now. http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ

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[Guest guest]

I know that Dr. Wenner has some versions of IMH that are free. I'm a D.O. and the AOA has recently signed an agreement with Dr. Wenner to provide the IMH (lite as he calls it) to its members free of charge through the do-online website. Dr. Wenner says the functionality is not as great but it is quite useful, especially at the beginning.

I just started with IMH this week, have had one psychological screen I can bill. I put it into my virtual visit page on my website last night and can almost do a virtual visit now!

I know you risk a lot of advertising when you choose the free version of the IMH that has been licensed by someone.

Also, the technical support is absolutely incredible. These guys basically showed me exactly how to do an online virtual visit using my existing website and paypal with imh and this was all part of my imh monthly cost. I looked at relay health and medfusion and they wanted gobs of money for this. Medfusion wanted $3500 just to do this portion. Dr. Wenner called me when his support people were busy to help me implement.

Just my opinion, but I'm liking the IMH. KrisCheck out AOL Money Finance's list of the hottest products and top money wasters of 2007.

[Guest guest]

I checked out Formedic.com and it looks like a FREE alternative to Instant Medical History. Maybe because it is Instant Medical History? I found this article online about Formedic and am printing it here because it is no longer available from the newspaper's web site. It mentions Formedic licensing Instant Medical Questionnaire from Dr. Wenner, who also happens to be the developer of Instant Medical History and a vice-president of the company that sells it. How is that business model supposed to work?Anyways, I plan to check it out.  SetoSouth Pasadena, CA------------Formedic charting new course in patient record-keeping  By BOB CONSIDINE Staff WriterFRANKLIN (Somerset) -- The answers often are given in an initial phone call to the doctor's office, then written on a form in the waiting room, followed by an interview with the nurse and finally related, again, to the physician.Sometimes it's enough to make a patient lose patience and give an ever-rushed doctor his own headache.So, Formedic, a leading provider of patient record forms, is championing a more efficient and electronic way for patients to explain what ails them and for doctors to better manage their patients' maladies and histories.The company, headquartered in Somerset for the past 25 years, is offering software that will document a patient's medical history and symptoms prior to the meeting in the examination room.Formedic says its recently released Medical History Questionnaire is 15 years in the making and designed by doctors to ask specific questions and follow-up queries for all kinds of illnesses.A demonstration on its Web site, www.formedicmhq.com reveals the ease of use for patients. Formedic claims the program will save a doctor four to five minutes' worth of interrogation per patient visit, which ultimately can result in more patients per day. It's also free for any health-care professional to use.Yet, Formedic knows it has a formidable challenge ahead in gaining mass acceptance in the medical field."There is a hesitation for many doctors on any kind of computerized product," said Raj Singh, vice president and general manager of Formedic. "But we're hoping that once they understand how well it actually works for them, that it will allay a lot of their fears."Q & AThe Medical History Questionnaire is run on a personal computer and is meant to be accessed either at the patient's home before a visit or in a waiting area or exam room of a doctor's office.The patient is given every opportunity to answer specific, symptom-based questions, whether it's for an episodic visit, an annual exam or for chronic disease maintenance. And each response is programmed to ask a related follow-up through a series of algorithms.For example, if the patient enters "cough" as a reason for the visit, the patient is asked how long he or she has had it, if he or she has had a recent cold or flu, the regularity of the cough, the nature of the cough, and so on.All of the responses can be given with a point-and-click of a mouse. There are up to 5,000 unique question sets in the program for almost any type of ailment.When the questions finally are answered, a printout is made. One page is for the patient and provides recommended questions to ask the doctor. The other two are for doctors, listing the subjective history of present illness in the same clinical and laborious format they are taught in medical school to inscribe."This also helps them become better doctors," said Bruce Rowan, general manager for MHQ. "It allows them to systematically document and practice better medicine."Rowan contends that in addition to speedier expediting of the subjective note, doctors ultimately can run a more profitable business using MHQ because patients have more opportunity to describe everything that is wrong with them.And because it's documented by the patient, physicians can make an easier case when filing for reimbursements from insurance companies and third-party providers and have less risk of, as Rowan said, "leaving money on the table.""Doctors generally charge by a level of effort they put into your visit," Rowan said. "If you go in complaining about a cough, sore throat and fever, that's usually a Level 3. They might charge anywhere from $55 to $85. "But if you come in and start complaining of a cough, a skin rash, dizziness and a hang nail on your toe, you've got a Level 4 or 5, which can bring the bill up. And the doctor can justify it and code at the appropriate level."You might be asking how Formedic makes money from the MHQ. Simply, the patient printout features a banner advertising medications designed to help patients with whatever ails them. Those ads are paid for by pharmaceutical companies.Doctor approved?Singh said Formedic, which still provides customized medical forms to more than 188,000 physicians, started soliciting doctors' interest in MHQ only three months ago and has received 6,000 responses. He said the company hopes to install the program for 25,000 to 30,000 doctors in the next few years.Trends indicate a slow gravitation toward physicians' acceptance of computer interconnectivity. Manhattan Research surveyed 1,353 physicians this year and found that 30 percent of them are using Electronic Medical Records to do business with insurance companies.While MHQ is not a full-fledged EMR system, it still is a giant step away from paperwork. Dr. Wenner, a family practice physician from West Columbia, S.C., who created the Medical History Questionnaire and licensed it to Formedic, said the time has come for physicians to step into the electronic age to improve health care for their patients."The whole principle is, right now, there are no standards for what a doctor should ask a patient," Wenner said. "If you go in to see one doctor with abdominal pain and then you go and see another doctor with abdominal pain, you might get a different set of questions. Why isn't there a standard?"Wenner, once described by Medical Economics as the 'EMR guru,' added it is "absolutely critical" that the patient has the power to give the most information as possible about their ailments at a time when physicians are most occupied."People like to talk about what is wrong with them," Wenner said. "But what they don't like is a doctor cutting them off after 17 seconds, and that's what happens."Patient history by computer interview is more complete than traditional oral history taking. The patient directs the interview and has full control over the input without being interrupted. Patients are more willing to reveal sensitive information during a computer interview, such as information about impotence and suicide attempts, adolescent sexual behavior, alcohol abuse and suicide risk.""We think eventually it will get a high level of acceptance," Rowen said. "Because it's a baby step, it's easy and it can be integrated with any system they use now or will use."Heck yeah. Formedic may turn out to try to upsell me something down the line but their site rocks!I have set up my account and started using it.I will do the visit, document, scan it and give to pt as handout.Done. OR --- get their check box history working on my WACOM touch screen convertible laptop. Anyway, this looks simpler than instant med history, but way cheaper.I am glad I held off IMH Dennis galvon  But anyway, I think this  Re: alternatives to Instant medical history When I was at the Scientific Assembly in chicago, Isaw the Formedic Medical Questionnaire. It looked alot like IMH. I do not have any experience witheither, but might be worth investigating - and I thinkit is free. (is there such a thing as free? -I'm acynic) I do not have a link, but I'm sure we shouldbe able to research that. If anyone is using it, Iwould love to know what you think too. Ortega-Schmitt--- familydocta <familydocta> wrote:

[Guest guest]

Re: Formedic-- and other physicians--thank you for the input re: Formedic. I just wish it didn't have the pharmaceutical advertising on the forms.

Jill Baron

Jill R. Baron, MD, PCPrimary Care and Holistic Medicine44 East 32nd Street, 11th FloorNew York, New York 10016www.drjillbaron.comCheck out AOL Money Finance's list of the hottest products and top money wasters of 2007.

[Guest guest]

Hey This is the coolest free stuff of the year. I am so excited about it. thanks a bunch Seto wrote: I checked out Formedic.com and it looks like a FREE alternative to Instant Medical History. Maybe because it is Instant Medical History? I found this article online about Formedic and am printing it here because it is no longer available from the newspaper's web site. It mentions Formedic licensing Instant Medical Questionnaire from Dr. Wenner, who also happens to be the developer of Instant Medical History and a vice-president of the company that sells it. How is that business model supposed to work?Anyways, I plan to check it out. SetoSouth Pasadena, CA------------Formedic charting new course in

patient record-keepingBy BOB CONSIDINEStaff WriterFRANKLIN (Somerset) -- The answers often are given in an initial phone call to the doctor's office, then written on a form in the waiting room, followed by an interview with the nurse and finally related, again, to the physician.Sometimes it's enough to make a patient lose patience and give an ever-rushed doctor his own headache.So, Formedic, a leading provider of patient record forms, is championing a more efficient and electronic way for patients to explain what ails them and for doctors to better manage their patients' maladies and histories.The company, headquartered in Somerset for the past 25 years, is offering software that will document a patient's medical history and symptoms prior to the meeting in the examination room.Formedic says its recently released Medical History Questionnaire is 15 years in the making and

designed by doctors to ask specific questions and follow-up queries for all kinds of illnesses.A demonstration on its Web site, www.formedicmhq.com reveals the ease of use for patients. Formedic claims the program will save a doctor four to five minutes' worth of interrogation per patient visit, which ultimately can result in more patients per day. It's also free for any health-care professional to use.Yet, Formedic knows it has a formidable challenge ahead in gaining mass acceptance in the medical field."There is a hesitation for many doctors on any kind of computerized product," said Raj Singh, vice president and general manager of Formedic. "But we're hoping that once they understand how well it actually works for them, that it will allay a lot of their fears."Q & AThe Medical History Questionnaire is run on a personal computer and is meant to be accessed either at the patient's home

before a visit or in a waiting area or exam room of a doctor's office.The patient is given every opportunity to answer specific, symptom- based questions, whether it's for an episodic visit, an annual exam or for chronic disease maintenance. And each response is programmed to ask a related follow-up through a series of algorithms.For example, if the patient enters "cough" as a reason for the visit, the patient is asked how long he or she has had it, if he or she has had a recent cold or flu, the regularity of the cough, the nature of the cough, and so on.All of the responses can be given with a point-and-click of a mouse. There are up to 5,000 unique question sets in the program for almost any type of ailment.When the questions finally are answered, a printout is made. One page is for the patient and provides recommended questions to ask the doctor. The other two are for doctors, listing the

subjective history of present illness in the same clinical and laborious format they are taught in medical school to inscribe."This also helps them become better doctors," said Bruce Rowan, general manager for MHQ. "It allows them to systematically document and practice better medicine."Rowan contends that in addition to speedier expediting of the subjective note, doctors ultimately can run a more profitable business using MHQ because patients have more opportunity to describe everything that is wrong with them.And because it's documented by the patient, physicians can make an easier case when filing for reimbursements from insurance companies and third-party providers and have less risk of, as Rowan said, "leaving money on the table.""Doctors generally charge by a level of effort they put into your visit," Rowan said. "If you go in complaining about a cough, sore throat and fever, that's

usually a Level 3. They might charge anywhere from $55 to $85. "But if you come in and start complaining of a cough, a skin rash, dizziness and a hang nail on your toe, you've got a Level 4 or 5, which can bring the bill up. And the doctor can justify it and code at the appropriate level."You might be asking how Formedic makes money from the MHQ. Simply, the patient printout features a banner advertising medications designed to help patients with whatever ails them. Those ads are paid for by pharmaceutical companies.Doctor approved?Singh said Formedic, which still provides customized medical forms to more than 188,000 physicians, started soliciting doctors' interest in MHQ only three months ago and has received 6,000 responses. He said the company hopes to install the program for 25,000 to 30,000 doctors in the next few years.Trends indicate a slow gravitation toward physicians' acceptance of

computer interconnectivity. Manhattan Research surveyed 1,353 physicians this year and found that 30 percent of them are using Electronic Medical Records to do business with insurance companies.While MHQ is not a full-fledged EMR system, it still is a giant step away from paperwork. Dr. Wenner, a family practice physician from West Columbia, S.C., who created the Medical History Questionnaire and licensed it to Formedic, said the time has come for physicians to step into the electronic age to improve health care for their patients."The whole principle is, right now, there are no standards for what a doctor should ask a patient," Wenner said. "If you go in to see one doctor with abdominal pain and then you go and see another doctor with abdominal pain, you might get a different set of questions. Why isn't there a standard?"Wenner, once described by Medical Economics as the 'EMR guru,' added it

is "absolutely critical" that the patient has the power to give the most information as possible about their ailments at a time when physicians are most occupied."People like to talk about what is wrong with them," Wenner said. "But what they don't like is a doctor cutting them off after 17 seconds, and that's what happens."Patient history by computer interview is more complete than traditional oral history taking. The patient directs the interview and has full control over the input without being interrupted. Patients are more willing to reveal sensitive information during a computer interview, such as information about impotence and suicide attempts, adolescent sexual behavior, alcohol abuse and suicide risk.""We think eventually it will get a high level of acceptance," Rowen said. "Because it's a baby step, it's easy and it can be integrated with any system they use now or will use."On Dec 4,

2007, at 8:18 PM, Dennis Galvon wrote:>> Heck yeah.>>> Formedic may turn out to try to upsell me something down the line > but their site rocks!>> I have set up my account and started using it.>> I will do the visit, document, scan it and give to pt as handout.>> Done.>>> OR --- get their check box history working on my WACOM touch screen > convertible laptop.>>> Anyway, this looks simpler than instant med history, but way cheaper.>> I am glad I held off IMH>>> Dennis galvon>>>> But anyway, I think this>>> Re: alternatives to Instant medical > history>>> When I was at the Scientific Assembly in chicago, I> saw the Formedic Medical Questionnaire. It looked a> lot like IMH. I do not have any experience with> either, but might be worth investigating - and I think> it is free. (is there such a thing as free? -I'm a> cynic) I do not have a link, but I'm sure we should> be able to research that. If anyone is using it, I> would love to know what you think too.>> Ortega-Schmitt> --- familydocta wrote:>>>>>

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

[Guest guest]



Can the history and physical be imported into your EMR such as Amazing charts without having to print it out and scan it in? This is the advantage with IMH. I don't want to use paper but rather keep it all on the computer.

Lee

�Re: alternatives to Instant medical history

�

When I was at the Scientific Assembly in�chicago, Isaw the Formedic Medical Questionnaire. It looked alot like IMH. I do not have any experience witheither, but might be worth investigating - and I thinkit is free. (is there such a thing as free? -I'm acynic) I do not have a link, but I'm sure we shouldbe able to research that. If anyone is using it, Iwould love to know what you think too. Ortega-Schmitt--- familydocta <familydocta> wrote:

[Guest guest]

Absolutely.  Right now I open my IMH output into WordPad and then

cut and paste it into my EMR.  When everything is working properly, my EMR has

a text loader that will automatically load the IMH output and open a progress

not for me.  Mine also has an option of using codes to move Past Medical

History into that section and Social History into that section, Family History

into that section automatically, without my intervention.  IMH has the ability

to convert their basic output into a variety of proper formatting for different

EMRs.  I also have billed for the computerized psych testing but don’t know if

I have been paid and frequently forget that.  I got a memo from Aetna that I

need to find that says something about getting paid for doing the PHQ-9

annually on its members (psych screening-Personal Health Questionnaire) so need

to see what that is about; IMH will definitely make this easier.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Leeclan

Sent: Wednesday, December 05, 2007 8:40 AM

To:

Subject: Re: alternatives to Instant medical

history



Can

the history and physical be imported into your EMR such as Amazing charts

without having to print it out and scan it in? This is the advantage with

IMH. I don't want to use paper but rather keep it all on the

computer.

Lee

-----

Original Message -----

From: Seto

To:

Sent: Wednesday, December

05, 2007 2:02 AM

Subject: Re:

alternatives to Instant medical history

I checked out Formedic.com and it looks like a FREE

alternative to Instant Medical History. Maybe because it is Instant Medical History? I found

this article online about Formedic and am printing it here because it is no

longer available from the newspaper's�web

site. It mentions Formedic licensing Instant Medical Questionnaire from Dr.

Wenner, who also happens to be the developer of Instant Medical History

and a vice-president of the company that sells it. How is that business model

supposed to work?

Anyways, I plan to check it out.�

Seto

South Pasadena, CA

------------

Formedic charting new course in patient record-keeping

�

By BOB

CONSIDINE

Staff Writer

FRANKLIN

(Somerset) -- The answers often are given in an initial phone call to the

doctor's office, then written on a form in the waiting room, followed by an

interview with the nurse and finally related, again, to the physician.

Sometimes

it's enough to make a patient lose patience and give an ever-rushed doctor his

own headache.

So, Formedic, a leading provider of patient

record forms, is championing a more efficient and electronic way for patients

to explain what ails them and for doctors to better manage their patients'

maladies and histories.

The

company, headquartered in Somerset for the past 25 years, is offering software

that will document a patient's medical history and symptoms prior to the

meeting in the examination room.

Formedic says its recently released Medical History

Questionnaire is 15 years in the making and designed by doctors to ask specific

questions and follow-up queries for all kinds of illnesses.

A

demonstration on its Web site, www.formedicmhq.com reveals the ease of use

for patients. Formedic claims

the program will save a doctor four to five minutes' worth of interrogation per

patient visit, which ultimately can result in more patients per day. It's also

free for any health-care professional to use.

Yet, Formedic knows it has a formidable

challenge ahead in gaining mass acceptance in the medical field.

" There

is a hesitation for many doctors on any kind of computerized product, "

said Raj Singh, vice president and general manager of Formedic. " But we're hoping that

once they understand how well it actually works for them, that it will allay a

lot of their fears. "

Q &

A

The Medical

History Questionnaire is run on a personal computer and is meant to be accessed

either at the patient's home before a visit or in a waiting area or exam room

of a doctor's office.

The patient

is given every opportunity to answer specific, symptom-based questions, whether

it's for an episodic visit, an annual exam or for chronic disease maintenance.

And each response is programmed to ask a related follow-up through a series of

algorithms.

For

example, if the patient enters " cough " as a reason for the visit, the

patient is asked how long he or she has had it, if he or she has had a recent

cold or flu, the regularity of the cough, the nature of the cough, and so on.

All of the

responses can be given with a point-and-click of a mouse. There are up to 5,000

unique question sets in the program for almost any type of ailment.

When the

questions finally are answered, a printout is made. One page is for the patient

and provides recommended questions to ask the doctor. The other two are for

doctors, listing the subjective history of present illness in the same clinical

and laborious format they are taught in medical school to inscribe.

" This

also helps them become better doctors, " said Bruce Rowan, general manager

for MHQ. " It allows them to systematically document and practice better

medicine. "

Rowan

contends that in addition to speedier expediting of the subjective note,

doctors ultimately can run a more profitable business using MHQ because

patients have more opportunity to describe everything that is wrong with them.

And because

it's documented by the patient, physicians can make an easier case when filing

for reimbursements from insurance companies and third-party providers and have

less risk of, as Rowan said, " leaving money

on the table. "

" Doctors

generally charge by a level of effort they put into your visit, " Rowan

said. " If you go in complaining about a cough, sore throat and fever,

that's usually a Level 3. They might charge anywhere from $55 to $85. " But

if you come in and start complaining of a cough, a skin rash, dizziness and a

hang nail on your toe, you've got a Level 4 or 5, which can bring the bill up.

And the doctor can justify it and code at the appropriate level. "

You might

be asking how Formedic makes money from the MHQ. Simply, the patient

printout features a banner advertising medications designed to help patients

with whatever ails them. Those ads are paid for by pharmaceutical companies.

Doctor

approved?

Singh said Formedic, which still provides customized

medical forms to more than 188,000 physicians, started soliciting doctors'

interest in MHQ only three months ago and has received 6,000 responses. He said

the company hopes to install the program for 25,000 to 30,000 doctors in the

next few years.

Trends

indicate a slow gravitation toward physicians' acceptance of computer

interconnectivity. Manhattan Research surveyed 1,353 physicians this year and

found that 30 percent of them are using Electronic Medical Records to do

business with insurance companies.

While MHQ

is not a full-fledged EMR system, it still is a giant step away from paperwork.

Dr. Wenner, a family practice physician from West Columbia, S.C., who

created the Medical History Questionnaire and licensed it to Formedic, said the time has come for

physicians to step into the electronic age to improve health care for their

patients.

" The

whole principle is, right now, there are no standards for what a doctor should

ask a patient, " Wenner said. " If you go in to see one doctor with

abdominal pain and then you go and see another doctor with abdominal pain, you

might get a different set of questions. Why isn't there a standard? "

Wenner,

once described by Medical Economics as the 'EMR guru,' added it is

" absolutely critical " that the patient has the power to give the most

information as possible about their ailments at a time when physicians are most

occupied.

" People

like to talk about what is wrong with them, " Wenner said. " But what

they don't like is a doctor cutting them off after 17 seconds, and that's what

happens.

" Patient

history by computer interview is more complete than traditional oral history

taking. The patient directs the interview and has full control over the input

without being interrupted. Patients are more willing to reveal sensitive

information during a computer interview, such as information about impotence

and suicide attempts, adolescent sexual behavior, alcohol abuse and suicide

risk. "

" We

think eventually it will get a high level of acceptance, " Rowen said.

" Because it's a baby step, it's easy and it can be integrated with any

system they use now or will use. "

Heck yeah.

�

Formedic

may turn out to try to upsell me something down the line but their site rocks!

I have set

up my account and started using it.

I will do

the visit, document, scan it and give to pt as handout.

Done.

�

OR --- get

their check box history working on my WACOM touch screen convertible laptop.

�

Anyway,

this looks simpler than instant med history, but way cheaper.

I am glad

I held off IMH

�

Dennis

galvon

�

�

But

anyway, I think this

�

-----Original

Message-----

From:�

[mailto: ]�On Behalf Of�

Ortega-Schmitt

Sent:�Tuesday,

December 04, 2007�6:37 PM

To:�

Subject:�Re:

alternatives to Instant medical history

�

When I was at the Scientific Assembly in�chicago, I

saw the Formedic Medical Questionnaire. It looked a

lot like IMH. I do not have any experience with

either, but might be worth investigating - and I think

it is free. (is there such a thing as free? -I'm a

cynic) I do not have a link, but I'm sure we should

be able to research that. If anyone is using it, I

would love to know what you think too.

Ortega-Schmitt

--- familydocta

wrote:

[Guest guest]

How/when is everyone asking people to use IMH?Absolutely.  Right now I open my IMH output into WordPad and then cut and paste it into my EMR.  When everything is working properly, my EMR has a text loader that will automatically load the IMH output and open a progress not for me.  Mine also has an option of using codes to move Past Medical History into that section and Social History into that section, Family History into that section automatically, without my intervention.  IMH has the ability to convert their basic output into a variety of proper formatting for different EMRs.  I also have billed for the computerized psych testing but don’t know if I have been paid and frequently forget that.  I got a memo from Aetna that I need to find that says something about getting paid for doing the PHQ-9 annually on its members (psych screening-Personal Health Questionnaire) so need to see what that is about; IMH will definitely make this easier.  Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing   From:  [mailto: ] On Behalf Of LeeclanSent: Wednesday, December 05, 2007 8:40 AMTo:  Subject: Re: alternatives to Instant medical history Can the history and physical be imported into your EMR such as Amazing charts without having to print it out and scan it in?  This is the advantage with IMH.  I don't want to use paper  but rather keep it all on the computer.  Lee�Re: alternatives to Instant medical history�When I was at the Scientific Assembly in�chicago, Isaw the Formedic Medical Questionnaire. It looked alot like IMH. I do not have any experience witheither, but might be worth investigating - and I thinkit is free. (is there such a thing as free? -I'm acynic) I do not have a link, but I'm sure we shouldbe able to research that. If anyone is using it, Iwould love to know what you think too. Ortega-Schmitt--- familydocta <familydocta> wrote:  

[Guest guest]

Group-here 's infomation about IMH / Formedic from the source I asked Ferrante of IMH about the differences. He wrote:Well, one very big difference - the only thing Formedic outputs is a PDFon a Formedic Form. I've attached a sample for you (the Formedicads get replaced by drug ads in the real one). it's really designedas a 'starter IMH' for practices that don't have an EMR. Couple of other differences, like IMH is configurable and Formedic is set(you can't adjust the questionnaires).attached the pdf sample he sent. I think the old adage about getting what you pay for rings true here. Just to skip the drug ads alone, I will pay. LynnTo: From: DrJillBaronMD@...Date: Wed, 5 Dec 2007 08:18:16 -0500Subject: Re: alternatives to Instant medical history Re: Formedic-- and other physicians--thank you for the input re: Formedic. I just wish it didn't have the pharmaceutical advertising on the forms.Jill Baron Jill R. Baron, MD, PCPrimary Care and Holistic Medicine44 East 32nd Street, 11th FloorNew York, New York 10016www.drjillbaron.comCheck out AOL Money Finance's list of the hottest products and top money wasters of 2007. You keep typing, we keep giving. Download Messenger and join the i’m Initiative now. Join in!

[Guest guest]

Most patients do the IMH when they check in for their

appointment.  However, we are trying to get patients to do it from home over the

internet.  There is a little problem sometimes with patients figuring out what

their “chief complaint†is but we will even put that on the appt card.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Guinn

Sent: Wednesday, December 05, 2007 9:56 AM

To:

Subject: Re: alternatives to Instant medical

history

How/when is everyone asking people to use IMH?

Absolutely. Right now I open my

IMH output into WordPad and then cut and paste it into my EMR. When

everything is working properly, my EMR has a text loader that will

automatically load the IMH output and open a progress not for me. Mine

also has an option of using codes to move Past Medical History into that

section and Social History into that section, Family History into that section

automatically, without my intervention. IMH has the ability to convert

their basic output into a variety of proper formatting for different

EMRs. I also have billed for the computerized psych testing but don’t

know if I have been paid and frequently forget that. I got a memo from

Aetna that I need to find that says something about getting paid for doing the PHQ-9

annually on its members (psych screening-Personal Health Questionnaire) so need

to see what that is about; IMH will definitely make this easier.

Kathy

Saradarian, MD

Branchville,

NJ

www.qualityfamilypractice.com

Solo 4/03,

Practicing since 9/90

Practice

Partner 5/03

Low staffing

From: [mailto: ] On Behalf Of Leeclan

Sent: Wednesday, December

05, 2007 8:40 AM

To:

Subject: Re:

alternatives to Instant medical history

Can the history and physical be imported

into your EMR such as Amazing charts without having to print it out and scan it

in? This is the advantage with IMH. I don't want to use paper

but rather keep it all on the computer.

Lee

�Re: alternatives to

Instant medical history

�

When I was at the Scientific Assembly in�chicago, I

saw the Formedic Medical Questionnaire. It looked a

lot like IMH. I do not have any experience with

either, but might be worth investigating - and I think

it is free. (is there such a thing as free? -I'm a

cynic) I do not have a link, but I'm sure we should

be able to research that. If anyone is using it, I

would love to know what you think too.

Ortega-Schmitt

--- familydocta

wrote:

[Guest guest]

sorry for the duplicates, these did not post, they are sure to turn up

in a few more days:

also a few more points:

Explain why you are using IMH, patients are bewildered by your request

that they do this and particularly why they need to do it for each

visit, often they are too polite to ask. I usually say something

along the lines of - your insurance requires that for EACH visit and

EACH problem, in order to bill the visit, I am required to document 4

points from column A, 2 from column B, 1 from column C, etc. We can

spend a lot of time with me asking you questions 'Do you have this ?

Do you have that?' (often non-contributory to the issue at hand but

required for documentation) and then I have to type it in (to generate

my only product that matters to your insurance - THE NOTE-) OR you

can fill this out on the computer before the visit, and then it's fast

to zero in on what matters to you, we can spend our time talking about

what matters and what to do about it. They usually get it when I

explain it this way and are HAPPY to comply.

Seems like this would be the one situation where I would welcome a

front desk person.

The pig sign is outside the office door and says " please come in and

do your Instant Medical History " . Also there are instructions tacked

up next to the computer screen that explain what to do and how to pick

the problem. Often both are ignored, but I like the pig.

Also keep the kiosk with the screen on auto return every 15 minutes to

the start screen, in case the next person wanders in.

Lynn

From: lynnhri@...

To: practiceimprovement1

Subject: RE: Instant medical history- it's

all about flow

Date: Wed, 5 Dec 2007 23:23:39 -0500

Patient questionnaire flow work-arounds for the solo solo-

Lots of entry portals from website and in-office kiosk:

About 20 -30% now doing it every time from home from my website

without prompting. Unless a PE, often they pick the wrong problem and

the history is not useful. ('follow up' and 'check up' are

particularly pernicious).

For chronic f/u best is to tack a macro onto the printed visit

summary that I handed out at the end of the last visit with precise

instructions on how to access the link, when to do it, and in quotes-

what to use as the 'problem' .

Next best- in previewing schedule - notice there is an

appointment coming up and send email with instructions as above ( and

lab orders too if needed)

For PEs - catch these when they book on-line, when you get the

confirmatory email, send a quick reply with the above instructions.

For new patients - when they call or book on line, I make sure

they understand the instructions and follow up with email and attached

registration documents too.

For acute visits- if they call, I tell them at time of call with

correct problem. If via email, almost auto reply email as for PE above.

If all else fails, before the visit if it looks like time will be

adequate.

Sometimes because of the pig with the instructions on it and past

experiences in the office, while I am finishing with the last patient

the next patient has come in and has started entering their history

for that visit. I am always happy about that.

Otherwise (sob!) I have to do the history the old fashioned way

with the templates in my EMR, not nearly as efficient as the above

machinations.

A few points:

Older people are slower (book more time) but more accurate.

Occasionally use in the room AFTER or in the middle of seeing the

patient to try to get a rating scale ( for BPH, depression and anxiety

disability dizziness), I do something else while they are filling it out.

I do have the instructions on my appointment making website as a

policy, but people generally ignore those instructions.

Eventually with training, I think maybe about 40-50% will do it

properly from home.

Also use above techniques with HowsYourHealth sometimes in place

of IMH and/or if they can stand it, sometimes together depending on

time etc.

Waiting for IMH to embed HYH.

Getting about 80-85% penetrance, generally I get it when I want

it, but not always.

I think if you have a front desk person, it may be a little easier

to coordinate this - seems the alert and activated front desk person

could coordinate this well if they dig to find the right (and ALL of

the) problems to start with. This would give you slightly more

wiggly visit times though- you'd on average have to book an extra

5-20 minutes before your actual see the patient time.

Lynn

[Guest guest]

>

> Are there any alternatives to instant medical history?. Paying $50 for

I was challenged to see if I could write a literate medical history

program, and my attempt is called sherlock.exe

http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

You can edit the questions.r file to create your own branching questions.

It would take a helluva lot of work to create a comprehensive system

and I was just toying with the idea of creating the framework.

I didn't like IMH and their relations because of the stilted output.

Graham

SynapseDirect.com

[Guest guest]

This is very interesting. I would hope it could remain in the simple

file format to encourage mere mortals to contribute to it. I think if

it goes to a database backend, people will get intimidated, and you

will be less likely to get contributions from the users.

I also programmed a decision making tool called " MedMapper " in

conjunction with Dr. Pepper of the UCSF, Fresno Family Practice

program. has developed numerous (over 700) decision making

" Maps " , as he calls them. They are basically a sort of branching

tree decision making logic, starting with a basic problem commonly

faced by a practitioner, such as a patient with a " Red Eye " or

a patient with a " Sore Throat " etc. They are more for the clinician

to use than for patients. Computers can store branching tree like

data structures in memory that mimic the logic laid out on

paper. The idea we had was to document a patient encounter by

clicking our way through the map. It would kill two birds with one

stone, it would ensure that your decision making was based on

evidence based medicine and logic, and it would also write stements

in the patients progress notes that would document your work and also

would add some structure to the notes so that they could be used

later possibly for research purposes. We were making the notes in an

XML format, so they could be both displayed in a web browser and

also parsed by an XML parser in a computer program to extract data

for reports on a large patient population database. You can read more

about it at http://medmapper.sourceforge.net

One of our later maps on CHF is available as a runnable program for

Windows at:

http://medmapper.sourceforge.net/chf.exe

another one based on the 1997 NIH 1997 Asthma guidelines is at

http://medmapper.sourceforge.net/notebook.exe

These should run on any Windows computer. They are just samples of

what it might look like. As Dr. Chiu says, it would take a tremendous

amount of work to develop the computer logic tree for all the

possible problems in Medicine. But with a large group contributing,

it could be feasable if an agreed upon standard could be developed

for storing the information.

Caldwell

> >

> > Are there any alternatives to instant medical history?. Paying

$50 for

>

> I was challenged to see if I could write a literate medical history

> program, and my attempt is called sherlock.exe

> http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

>

> You can edit the questions.r file to create your own branching

questions.

>

> It would take a helluva lot of work to create a comprehensive system

> and I was just toying with the idea of creating the framework.

>

> I didn't like IMH and their relations because of the stilted output.

>

> Graham

> SynapseDirect.com

>

[Guest guest]

Graham,

I just tried sherlock.exe, and it's interesting. and another doc

( Pepper, M.D.) started a project called MedMapper a few years

ago, which is sort of similar, but documents an entire SOAP note for a

given problem based on answers to questions. They developed a

MedMapper for red eye, asthma, and congestive heart failure.

said the programming was a lot of work. The website is

http://medmapper.sourceforge.net/, and you can download and try their

examples (Tcl starkits made as Windows executables).

I didn't get a chance to play around with the questions.r file yet,

but I'm presuming that it's a text version of dialog boxes.

Jerry

> >

> > Are there any alternatives to instant medical history?. Paying $50

for

>

> I was challenged to see if I could write a literate medical history

> program, and my attempt is called sherlock.exe

> http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

>

> You can edit the questions.r file to create your own branching

questions.

>

> It would take a helluva lot of work to create a comprehensive system

> and I was just toying with the idea of creating the framework.

>

> I didn't like IMH and their relations because of the stilted output.

>

> Graham

> SynapseDirect.com

>

[Guest guest]

Jerry and Graham,

The CHF " Map " was the most recent iteration of our

MedMapper project. Medmapper is a little like Instant

Medical History, but was for the clinician to use

in his or her decision making, rather than for the patient.

has hundreds of clinical decision making algorithms for

common problems faced by Family Practice physicians. He has

based them on a combination of his experience and evidence

based medicine.

http://medmapper.sourceforge.net/chf.exe

It has a file containing all the questions, very similar to the

question.r file in it. You won't see it, as it's packaged

up inside the program. The " Map " is a branching tree algorithm

starting

with a basic problem faced by the clinician, such as a patient

with a " Red Eye " or a " Sore Throat " or Asthma or CHF.

The idea we had was to combine the decision making with

the medical record documentation, so that you sort of killed two

birds with one stone. Your main focus could be on the decision

making with the help of the computer, and the progress note would

be done automatically as a sort of bonus by-product of doing your

decision making

by clicking your way through the decision making map or tree.

Hopefully the excellent decision making you built into your

branching tree logic would ensure that your notes would be

consistent with cutting edge evidence based medicine. Also the

notes could be more structured than our progress notes often are.

We added an XML tag structure so they could be displayed in a

web browser and appear more or less as a free flowing text, but

there is also an underlying XML structure that could be used to

extract structured information from the progress note data on a

larger

population of patients by a computer program using an XML parser

tool.

Caldwell

> > >

> > > Are there any alternatives to instant medical history?. Paying

$50

> for

> >

> > I was challenged to see if I could write a literate medical

history

> > program, and my attempt is called sherlock.exe

> > http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

> >

> > You can edit the questions.r file to create your own branching

> questions.

> >

> > It would take a helluva lot of work to create a comprehensive

system

> > and I was just toying with the idea of creating the framework.

> >

> > I didn't like IMH and their relations because of the stilted

output.

> >

> > Graham

> > SynapseDirect.com

> >

>

[Guest guest]

, Jerry

MedMapper is clearly a more ambitious project. I did find the

interface a little confusing but of course did not read any

documentation

I was hoping to create a framework where others could do the grunt

work of actually thinking thru the questions and adding them to the

questions.r file, whereas it looks to me medmapper places that onus on

the author. My final aim was to just produce a history that one could

paste into the medical record without being too ashamed of it!

Although the data is in a file ( questions.r ), I did intend the

questions to be in a database so that no one has to physically edit

any text file. And the text file is actually a serialized Rebol

object so not really good to edit by hand !

If anyone wants to contribute and feels there is some merit here, I'll

re-activate the project ... if not, no big loss, as I only spent a few

hours to get it to this current point.

>

>

>

>

>

>

> Jerry and Graham,

>

> The CHF " Map " was the most recent iteration of our

> MedMapper project. Medmapper is a little like Instant

> Medical History, but was for the clinician to use

> in his or her decision making, rather than for the patient.

> has hundreds of clinical decision making algorithms for

> common problems faced by Family Practice physicians. He has

> based them on a combination of his experience and evidence

> based medicine.

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system

[Guest guest]

Graham-What a great perspective you're bringing to the group! Thanks!I can see you are in the Jerry- camp where you guys will try to goad us slugs into contributing to open source work. It is a great idea and I feel guilty that I don't, but I personally am up past my ears just running the practice and can't take on a few more ongoing time sinks. In defense of automated stilted output: I frankly don't care how stupid the output looks. I am mainly using IMH to document a note with 8 points from column A and 4 from column B for the bean counters so I can code a 99214, to do it every time and to not miss key questions I should have asked and then written down. If it looks dumb, so be it. All I really need from my perspective, from my note for me, is a 1-3 liner explaining why the patient is really there and that is the part I refer back to when looking at my old note to orient me. The rest is often just so much medicolegal insurance crap which I am happy to have an automated program to populate. Nice but not required, the literate note has fallen by the wayside. So to me IMH with its 70000 questions (which I did not have to make up myself) is totally worth it. Just a view from the slug camp....Lynn Ho

> >

> > Are there any alternatives to instant medical history?. Paying $50

for

>

> I was challenged to see if I could write a literate medical history

> program, and my attempt is called sherlock.exe

> http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

>

> You can edit the questions.r file to create your own branching

questions.

>

> It would take a helluva lot of work to create a comprehensive system

> and I was just toying with the idea of creating the framework.

>

> I didn't like IMH and their relations because of the stilted output.

>

> Graham

> SynapseDirect.com

>

The best games are on Xbox 360. Click here for a special offer on an Xbox 360 Console. Get it now!

[Guest guest]

Lynn,

Wow! I see that I missed a good chunk of the Instant Medical History

vs Formedic Medical History Questionaire discussion, so I went back

and reviewed it.

Formedic has an option to to use online vs download their program, and

use it on local machines with frequent updates.

I'm a cheapskate who likes free when possible, so I'm wondering about

the feasibility of Formedic's MHQ. Has anyone tried both the online

and local machine versions to compare them?

I'm also wondering if we would be reinventing the wheel with programs

like Graham's sherlock.exe, since capable free stuff is available. On

the other hand, I doubt if Formedic's MHQ would allow for

user/community imput to add " customized " questions, so maybe something

like sherlock.exe has a place. I'm thinking that making more natural

sounding English requires a lot more programming, though, and I agree

with your assessment that the literate medical note appears to be an

increasingly endangered species.

Jerry

>

> Graham-

>

> What a great perspective you're bringing to the group! Thanks!

>

> I can see you are in the Jerry- camp where you guys will try to

goad us slugs into contributing to open source work. It is a great

idea and I feel guilty that I don't, but I personally am up past my

ears just running the practice and can't take on a few more ongoing

time sinks.

>

> In defense of automated stilted output: I frankly don't care how

stupid the output looks. I am mainly using IMH to document a note

with 8 points from column A and 4 from column B for the bean counters

so I can code a 99214, to do it every time and to not miss key

questions I should have asked and then written down. If it looks

dumb, so be it. All I really need from my perspective, from my note

for me, is a 1-3 liner explaining why the patient is really there and

that is the part I refer back to when looking at my old note to orient

me. The rest is often just so much medicolegal insurance crap which I

am happy to have an automated program to populate. Nice but not

required, the literate note has fallen by the wayside. So to me IMH

with its 70000 questions (which I did not have to make up myself) is

totally worth it. Just a view from the slug camp....

>

> Lynn Ho

[Guest guest]

Instead of reading repeatedly, He denied, He denied, etc., maybe

output from Formedic's MHQ or IMH would be easier to read if was just

placed into a table. The rows would be the symptom category being

addressed (e.g., Cough Duration, etc,) the three columns would be

" Admitted " , " Denied " and " Other " (like refused to comment, equivocal,

or whatever).

True, this would no longer look like a nicely scripted medical note,

but as we have discussed, but in this context the literate medical

note is dying anyway. I think it would be a lot easier to read than

irregular columns of " She admitted " , " She admitted " , etc.

I don't think placing a medical history into a table would matter from

the standpoint of reimbursement.

Jerry

[Guest guest]

Graham and Jerry,

With MedMapper, we were thinking along the similar lines. We were

intending to provide a computerized " framework " and users could

design their own decision making algorithms without knowing

how to program. Our earlier version, for which our example was

the Asthma 1997 NIH guidelines, includes a " Visual " tool that allows

you to design your own algorithm tree by adding various kinds of GUI

objects - like question boxes and answer buttons onto an initially

blank " canvas " widget in a GUI. There is a tutorial about it here:

http://medmapper.sourceforge.net/Tutorial.html

As you add the objects, you also included statements that would go

into the notes as the answer buttons were clicked. You could design

your own decision tree without knowing how to program. It works, but

it is not real intuitive and takes a lot of practice. I have not used

it for quite a while, so I'd have to relearn it again if I got back

into it. Obviously, it did not take off, otherwise I wouldn't still be

practicing medicine, we'd have been bought up by Google. The needed

programs in the links on the Tutorial page are no longer there, but I

still have them if anyone is interested. The progress note statements

were designed to go directly into the Tkfp EMR. But they could be

generalized to go in other EMR's, if only by cut and paste if all

else fails.

Our latest example which is the CHF example, uses a different

strategy. Instead of the " Visual " programming tool, where you drop the

objects onto the blank canvas, we stored the logic for the decision

tree in a file which looks very similar to your questions.r file. It

uses nested curly braces instead of the brackets to structure the

decision tree, but the various branches and nodes of the tree are all

structured into the file. When the program reads it in, it gets

converted into the interactive questions and the graphic tree

representation the user sees. It is quite flexible and once you get

the hang of it, it's not that hard. I used a special editor called

ASED which can keep track of the nested curly braces, along with

indenting the text in the file to keep track of things. A large

decision tree stored in a flat file can get a bit confusing to

visualize.

Caldwell

> >

> >

> >

> >

> >

> >

> > Jerry and Graham,

> >

> > The CHF " Map " was the most recent iteration of our

> > MedMapper project. Medmapper is a little like Instant

> > Medical History, but was for the clinician to use

> > in his or her decision making, rather than for the patient.

> > has hundreds of clinical decision making algorithms for

> > common problems faced by Family Practice physicians. He has

> > based them on a combination of his experience and evidence

> > based medicine.

>

> --

> Graham Chiu

> http://www.synapsedirect.com

> Synapse-EMR - innovative electronic medical records system

>

[Guest guest]

Lynn,

Did you ever think that if you used more free stuff, you might not

have to work so hard? Then you could sink more time into the open

source stuff!

The tkFP EMR has what I think is a unique template system that is

built into it that

allows you to re-use statements that you have used previously

on the same problem for other patients. It makes the notes sound much

more natural than some of the canned stuff I've seen from some EMRs.

The templates are linked

to various problems by ICD-9 code. They are line oriented or sentence

oriented and

you evolve them gradually over time through re-use. You can start by

just writing a note

on a patient in the template and saving it. Then you can go back

and refine the template gradually so that it can be generalized

to more situations by adding options. For example, the computer

already knows if the patient is a male vs a female. So every place in

the template where you wrote he vs. she or his vs. hers or Him vs.

Her, gets converted to a variable and when you use the template the

next time, it automatically converts to the proper gender. There are

many other situtations where you can have one line in a template

change so that it can be both a positive statement or a negative

statement, or have various kinds of modifiers as to intensity,

location, duration etc that you choose from dropdown choice lists in a

template sentence. It is much harder to explain that to use. I will

try to post some screenshots. Kathy Broman and Becky and

Jerry Park are using it and they seem to like it.

Caldwell

>

> > >

>

> > > Are there any alternatives to instant medical history?. Paying $50

>

> for

>

> >

>

> > I was challenged to see if I could write a literate medical history

>

> > program, and my attempt is called sherlock.exe

>

> > http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

>

> >

>

> > You can edit the questions.r file to create your own branching

>

> questions.

>

> >

>

> > It would take a helluva lot of work to create a comprehensive system

>

> > and I was just toying with the idea of creating the framework.

>

> >

>

> > I didn't like IMH and their relations because of the stilted output.

>

> >

>

> > Graham

>

> > SynapseDirect.com

>

> >

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> _________________________________________________________________

> The best games are on Xbox 360. Click here for a special offer on

an Xbox 360 Console.

> http://www.xbox.com/en-US/hardware/wheretobuy/

>

[Guest guest]

The really important point to remember about open source is that once

there is even one open source EMR that really works and does

everything we need whether it's Synapse, tkFP, GnuMed, CottageMed

or ?? , we will all be forever free of vendor lock. Once a program like

that is out there and the code is freely available and can reproduce

itself on the Internet and be maintained and modified forever by any

interested programmers and groups of users, we will have close to

EMR Nirvana. Open source software licences specifically prohibit

making the code secret. Part of the license agreement requires that

you share it with others. It is the total antithesis of the business models

we have in the proprietary software world. That's not to say you can't

make money with open source software. But you do it by providing

support and services related to installation, maintenance, upgrading,

hardware, rather than licensing the code itself.

Caldwell.

> >

> > > >

> >

> > > > Are there any alternatives to instant medical history?. Paying

$50

> >

> > for

> >

> > >

> >

> > > I was challenged to see if I could write a literate medical history

> >

> > > program, and my attempt is called sherlock.exe

> >

> > > http://compkarori.no-ip.biz:8010/Unrelated_Software_Resources

> >

> > >

> >

> > > You can edit the questions.r file to create your own branching

> >

> > questions.

> >

> > >

> >

> > > It would take a helluva lot of work to create a comprehensive

system

> >

> > > and I was just toying with the idea of creating the framework.

> >

> > >

> >

> > > I didn't like IMH and their relations because of the stilted output.

> >

> > >

> >

> > > Graham

> >

> > > SynapseDirect.com

> >

> > >

> >

> >

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___________________________________________________________

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> > The best games are on Xbox 360. Click here for a special offer on

> an Xbox 360 Console.

> > http://www.xbox.com/en-US/hardware/wheretobuy/

> >

>

[Guest guest]

Hi Lynn

My perspective is somewhat different. I do understand your need to

gather the necessary points to reach a certain level of service ( what

if everyone uses IMH, will the insurers say you didn't do the work,

but the computer did and so they will lift the bar? ), but I work in

an environment whereby patients, and only patients pay me. I do not

in general deal with 3rd party payers. ( New Zealand )

I also always send reports back to referring GPs/FPs/Physicians and so

do require a less robotic history in my notes

>

>

>

>

>

>

> Graham-

>

> What a great perspective you're bringing to the group! Thanks!

>

> I can see you are in the Jerry- camp where you guys will try to goad us

> slugs into contributing to open source work. It is a great idea and I feel

> guilty that I don't, but I personally am up past my ears just running the

> practice and can't take on a few more ongoing time sinks.

Actually it's not so bad. If you have a million people using the

program, there will always be a certain tiny % who will help and that

number can be significant. Of course if you only have say 10 people,

then the likelihood of someone contributing may well be very below 1 !

>

> In defense of automated stilted output: I frankly don't care how stupid the

> output looks. I am mainly using IMH to document a note with 8 points from

> column A and 4 from column B for the bean counters so I can code a 99214, to

> do it every time and to not miss key questions I should have asked and then

> written down. If it looks dumb, so be it. All I really need from my

> perspective, from my note for me, is a 1-3 liner explaining why the patient

> is really there and that is the part I refer back to when looking at my old

> note to orient me. The rest is often just so much medicolegal insurance crap

> which I am happy to have an automated program to populate. Nice but not

> required, the literate note has fallen by the wayside. So to me IMH with

> its 70000 questions (which I did not have to make up myself) is totally

> worth it. Just a view from the slug camp....

--

Graham Chiu

http://www.synapsedirect.com

Synapse-EMR - innovative electronic medical records system