Re: MacFriendly EMRs, Vaccine ?s

[Guest guest]

Congratulations -where in Portland? Seto uses a Mac with a different EMR. He's our MacGuru. Let us know about your practice.  Hello, all.I am a newcomer to the group. My med-peds"nanopractice" opens in early February in Portland,OR. I am excited about leaving the fold and doingthings in away more consistent with my values.Using a Mac is important to me, and I am thinkingabout MacPractice MD. Do any of you have experiencewith that EMR? It recently added iPhone capability sothe whole EMR is available any time, any where.I am also struggling with vaccine choices. Consideringrx for vaccine to be picked up at pharmacy andadministered in office, avoiding the purchasing piece.Has anyone tried that? What else are folks doing,especially in Oregon?Thanks for any advice!Chrissie Ott, MD... after the last no there is a yes, and it is on that yes that the rest of the world depends...

[Guest guest]

Hi Chrissie,

I have done just as you suggest for things like Hep A and Typhoid

for travelers who don’t want to go to our local travel clinic.    The

patients always grumble about the cost, because they know if I did it in my

office I would have to take what their insurance allows, however much less than

the cost that allowance is.

The latest wrinkle is that the pharmacies just give the vaccine,

so the patient doesn’t have to return.  Which is fine, because  if they

only thing they get on return is the shot, and they bring up no other problems,

I don’t charge anything for the second visit.  But in an entirely

predictable move,  I now get requests from the pharmacies for me to fax the

prescription for the Zostavax or whatever, and I am expected to provide the

prescription with no visit at all……

Hmmmmmm….

Annie

From:

[mailto: ] On Behalf Of Chrissie Ott

Sent: Sunday, December 30, 2007 9:42 AM

To:

Subject: MacFriendly EMRs, Vaccine ?s

Hello, all.

I am a newcomer to the group. My med-peds

" nanopractice " opens in early February in Portland,

OR. I am excited about leaving the fold and doing

things in away more consistent with my values.

Using a Mac is important to me, and I am thinking

about MacPractice MD. Do any of you have experience

with that EMR? It recently added iPhone capability so

the whole EMR is available any time, any where.

I am also struggling with vaccine choices. Considering

rx for vaccine to be picked up at pharmacy and

administered in office, avoiding the purchasing piece.

Has anyone tried that? What else are folks doing,

especially in Oregon?

Thanks for any advice!

Chrissie Ott, MD

.... after the last no there is a yes, and it is on that yes that the rest of

the world depends...

[Guest guest]

Welcome, Chrissie

I had the same vaccine plan when I started last year(!), but ran into

a couple of issues. Since essentially all pediatric vaccines in North

Carolina are covered only under the state program, patients cannot get

them paid for through the pharmacy. They have to go to the health

department for that, and lots of people don't like that.

The pharmacy can't bill insurance for some vaccines, so patients will

end up paying out of pocket if they get them directly from the

pharmacy. I have a pharmacy that will store vaccines and dole them out

to me one-by-one at their cost. They bill me and I bill the patient's

insurance. I do Menactra, Gardisil, Adacel, Td, Pneumovax, and

Zostavax (non-Medicare) this way.

Zostavax is complicated since paid through Medicare Part D. It means

that the pharmacy can do the billing, but keeping it frozen until it

can get to me for administration is tricky.

I've spent a lot of time trying to make vaccines manageable for

patients. But I'm still managing to avoid the costs of keeping them

in-house.

Haresch

> I am also struggling with vaccine choices. Considering

> rx for vaccine to be picked up at pharmacy and

> administered in office, avoiding the purchasing piece.

> Has anyone tried that? What else are folks doing,

> especially in Oregon?

[Guest guest]

Chrissie,Welcome to the group! Sorry for the delayed response but there have been a ton of new posts that pushed your message way back. What's up with all these posts?! Don't you guys have patients to see or something?I use 2 Macs in my solo practice:1. MacBook on which I run my EMR (SpringCharts), schedule (iCal), e-mail, e-prescribing (RelayHealth), create and generate forms 2. Mac Mini which runs my practice management program (MacPractice) with which I do e-billing. I also receives faxes, scans. This computer is used mainly by my part-time biller, but before I hired her, I did everything on my laptop.I looked at the demos for MacPractice's EMR and while I like the idea of an integrated EMR/PM system, it is basically still a beta program that is in the midst of development. They were asking for $2500 if you bought it before 12/31/07, and they said it would be at least $3500 after that. Personally, I thought that was more that I wanted to pay for something that is still so rough around the edges. I will keep using my paid for SpringCharts, which does the basics of what I need it to do, although I really really wish it had a disease registry function. The MacPractice-iPhone thing is kind of neat, but I think the actual implementation of it would be really slow. Plus I would rather have an iPhone without an EMR first before paying for a replacement EMR.If you want an EMR on an iPhone, LifeRecord claims to be the first and only EMR that runs on an iPhone. Only $9999.99! It appears even more underdeveloped than the MacPractice EMR. I think the idea of an EMR on an iPhone-sized screen is basically a bad idea. Other EMRs for Macs include PowerMed (Larry Lindeman and Anemaria Lutas use this), ComChart, AltaPoint and CottageMed. Someone from MedPlexus claims it will run on a Mac, but it is totally unsupported. I am supposed to arrange a demo. Marius Laumans is running SOAPware on his Mac using VMWare to emulate a Windows PC. I think another option would be AmazingCharts running on the Parallels virtualization program.I do buy and administer all the usual childhood and adult vaccines except for Zostavax, just because I couldn't figure out how to get paid for it. It definitely can get pretty expensive buying all these vaccines. I buy the smallest amount I need and so far have not had to waste too much unused product before it has expired. I figured if I was going to do well child care to grow my pediatric population, I really needed to be able to give vaccines and am willing to take a small loss on some vaccines in order to attract this segment. In Southern California, many pharmacies advertise that they give vaccines for flu, Pneumovax, Zostavax but I don't know about their ability to order other vaccines. I do know that if you decide to order vaccines yourself, they are usually cheaper if you can order directly from the vaccine manufacturer if you can. And forget about those combo mini-fridges that have the freezer section inside. I found that for vaccines that require freezing, eg. Varicella, you need to get a dedicated mini-freezer to maintain constant temperature. On the plus side, I've gotten really good at giving shots.Best of luck! SetoSouth Pasadena, CAHello, all.I am a newcomer to the group. My med-peds"nanopractice" opens in early February in Portland,OR. I am excited about leaving the fold and doingthings in away more consistent with my values.Using a Mac is important to me, and I am thinkingabout MacPractice MD. Do any of you have experiencewith that EMR? It recently added iPhone capability sothe whole EMR is available any time, any where.I am also struggling with vaccine choices. Consideringrx for vaccine to be picked up at pharmacy andadministered in office, avoiding the purchasing piece.Has anyone tried that? What else are folks doing,especially in Oregon?Thanks for any advice!Chrissie Ott, MD... after the last no there is a yes, and it is on that yes that the rest of the world depends...

[Guest guest]

One small point - if you have expired vaccines, most manufacturers

will take them back and give you partial credit.

Loehr, MD

At 03:52 AM 1/4/2008, you wrote:

>I do buy and administer all the usual childhood and adult vaccines

>except for Zostavax, just because I couldn't figure out how to get

>paid for it. It definitely can get pretty expensive buying all these

>vaccines. I buy the smallest amount I need and so far have not had

>to waste too much unused product before it has expired.

[Guest guest]

Hi,

I use AC on my MacBook, running Parallels to emulate a Windows

system. It gets bogged down once in a while, but in general runs

very well. I love my Mac computers, wouldn't use anything else, and

I really wanted to use Amazing Charts. I take my laptop home in the

afternoon ( I work about 20 hours a week, working around my kids and

my husband's schedules....) If patients call after my office hours,

I have ready access to their charts.

-Jean

>

> > Hello, all.

> > I am a newcomer to the group. My med-peds

> > " nanopractice " opens in early February in Portland,

> > OR. I am excited about leaving the fold and doing

> > things in away more consistent with my values.

> > Using a Mac is important to me, and I am thinking

> > about MacPractice MD. Do any of you have experience

> > with that EMR? It recently added iPhone capability so

> > the whole EMR is available any time, any where.

> >

> > I am also struggling with vaccine choices. Considering

> > rx for vaccine to be picked up at pharmacy and

> > administered in office, avoiding the purchasing piece.

> > Has anyone tried that? What else are folks doing,

> > especially in Oregon?

> >

> > Thanks for any advice!

> >

> > Chrissie Ott, MD

> >

> > ... after the last no there is a yes, and it is on that yes

that

> > the rest of the world depends...

> >

> >

>

[Guest guest]

I agree that Mac practice is not ready for prime time. I spent quite a bit of time playing with it at the academy meeting. It might be better in about 1 year. Y There are several companies that host PC type emr's and you access them through any web browser including those on Macs. Larry Lindeman M.D.Roscoe Village Family Medicine2255 W. RoscoeChicago, Illinois 60618 Chrissie,Welcome to the group! Sorry for the delayed response but there have been a ton of new posts that pushed your message way back. What's up with all these posts?! Don't you guys have patients to see or something?I use 2 Macs in my solo practice:1. MacBook on which I run my EMR (SpringCharts), schedule (iCal), e-mail, e-prescribing (RelayHealth), create and generate forms 2. Mac Mini which runs my practice management program (MacPractice) with which I do e-billing. I also receives faxes, scans. This computer is used mainly by my part-time biller, but before I hired her, I did everything on my laptop.I looked at the demos for MacPractice's EMR and while I like the idea of an integrated EMR/PM system, it is basically still a beta program that is in the midst of development. They were asking for $2500 if you bought it before 12/31/07, and they said it would be at least $3500 after that. Personally, I thought that was more that I wanted to pay for something that is still so rough around the edges. I will keep using my paid for SpringCharts, which does the basics of what I need it to do, although I really really wish it had a disease registry function. The MacPractice-iPhone thing is kind of neat, but I think the actual implementation of it would be really slow. Plus I would rather have an iPhone without an EMR first before paying for a replacement EMR.If you want an EMR on an iPhone, LifeRecord claims to be the first and only EMR that runs on an iPhone. Only $9999.99! It appears even more underdeveloped than the MacPractice EMR. I think the idea of an EMR on an iPhone-sized screen is basically a bad idea. Other EMRs for Macs include PowerMed (Larry Lindeman and Anemaria Lutas use this), ComChart, AltaPoint and CottageMed. Someone from MedPlexus claims it will run on a Mac, but it is totally unsupported. I am supposed to arrange a demo. Marius Laumans is running SOAPware on his Mac using VMWare to emulate a Windows PC. I think another option would be AmazingCharts running on the Parallels virtualization program.I do buy and administer all the usual childhood and adult vaccines except for Zostavax, just because I couldn't figure out how to get paid for it. It definitely can get pretty expensive buying all these vaccines. I buy the smallest amount I need and so far have not had to waste too much unused product before it has expired. I figured if I was going to do well child care to grow my pediatric population, I really needed to be able to give vaccines and am willing to take a small loss on some vaccines in order to attract this segment. In Southern California, many pharmacies advertise that they give vaccines for flu, Pneumovax, Zostavax but I don't know about their ability to order other vaccines. I do know that if you decide to order vaccines yourself, they are usually cheaper if you can order directly from the vaccine manufacturer if you can. And forget about those combo mini-fridges that have the freezer section inside. I found that for vaccines that require freezing, eg. Varicella, you need to get a dedicated mini-freezer to maintain constant temperature. On the plus side, I've gotten really good at giving shots.Best of luck! SetoSouth Pasadena, CAHello, all.I am a newcomer to the group. My med-peds"nanopractice" opens in early February in Portland,OR. I am excited about leaving the fold and doingthings in away more consistent with my values.Using a Mac is important to me, and I am thinkingabout MacPractice MD. Do any of you have experiencewith that EMR? It recently added iPhone capability sothe whole EMR is available any time, any where.I am also struggling with vaccine choices. Consideringrx for vaccine to be picked up at pharmacy andadministered in office, avoiding the purchasing piece.Has anyone tried that? What else are folks doing,especially in Oregon?Thanks for any advice!Chrissie Ott, MD... after the last no there is a yes, and it is on that yes that the rest of the world depends...