Re: OneNote for EMR?

April 29, 2008

good site. It has me thinking I might start a website "Lowell Kleinman, MD" wrote: I just built this website with the help of yahoo…$12.00/mo www.old-fashionedhousecalls.com It needs some work still but I set it up to look simple and easy to read. Lowell Lowell Kleinman, MD 5601 Norris Canyon Rd. Suite 340 San Ramon, CA 94583 www.drkleinman.com drkdrkleinman From:

[mailto: ] On Behalf Of Pamela Barton, MDSent: Tuesday, April 29, 2008 7:56 AMTo: Subject: Re: OneNote for EMR? , It sounds like your friend's practice is very close to what I have in mind. My plan is to see 15-25 patients a week - mostly frail elderly, with a smaller panel size than hers - 75 to 100 patients at the very most. I'm still working on my website. When it's up I'll post a link to give you a better idea of what I'm doing. I would love to talk to your friend. If you would be willing to pass along my email address to her, perhaps we could share ideas a bit. I did work for another doctor for awhile doing home visits before deciding to go out on my own so perhaps I might have something to offer her as well. This is the PowerMed quote I got: EMR + scheduling $1000 for software, includes setup, then: $120/month To be honest, and I've had a hard time admitting this even to myself, I am turned off by the aesthetics of so many EMR's, including PowerMed. I know that's shallow, but to work so intimately with software that's visually annoying is something I won't choose unless I absolutely have to.

This was one of the things I liked about SpringCharts - it has a less cluttered, more serene appearance. I like the look of OneNote too. Incidentally, I've looked into a number of EMR's and am happy to share my research - which I just typed up over the weekend - with anyone on the list who's interested. By the way , your website is lovely. As I built mine - which is very different - I kept going back to look at yours and marvel. Bravo. Pam One Note does look very interesting. And it's users are certainly enthusiastic. However, no sign it will be available on a Mac platform - leaving you back in Parallels land. I have a friend that just started a home visit practice, geriatrics/Medicare based. She is now using template driven notes (her own macros) in a document program on a Mac. Her entire panel is 150 patients, about 35 visits a

week. I think that having such a small panel allows her to use simpler software. I think she's just filing labs, faxes, etc, in folders. She did tell me that she has a good method of documenting home health oversight - using drop downs for phone call, time, etc. Also - I have heard that one of the more sophisticated EMRs/PM systems that does run on a Mac, PowerMed, might be available at an annual lease fee of $1,000. I haven't investigated that. What will your home visit practice look like? Guinn Albuquerque BTW - if I remember right, AC is actually built using Outlook. . . Hi all, I'm an FP new to this list (though not new to the idea of micropractice). I'm setting up my second solo practice*, this time with the idea of doing home visits exclusively, and am in search of an EMR that will be stable, easy to set up and maintain, not too expensive, and fun to use (oh, and it should bring us world peace while it's at it). Anyway, yes, I think I could use an EMR. I used eMDs in the past and would not go that route again. I've also used SpringCharts recently and liked it, not least of which because it works on a Mac - a big plus in my book. I kept wondering if there might be an even simpler solution, which made me have a look at OneNote. I posted this question yesterday to the AAFP's EMR list, and haven't gotten any responses. So I thought I would give it a try with you guys, since you're more firmly attuned to the small is beautiful philosophy. So, here goes: I'm wondering if any of you has tried using OneNote http://office.microsoft.com/en-us/onenote/default.aspx as an EMR, or

if you know of anyone who has. This company http://www.abletfactory.com/EMRSuite.html has a couple of products designed for EMR use on OneNote. At lease one of the products comes with ICD-9 codes & a drug database. My thoughts so far: On the plus side: OneNote looks like it could easily satisfy the organizational needs of paperless charting - with tabs, room for scanned docs, flexible organization, and the ability to flag & label things. I believe it has a solid interface with Outlook as well, which could be handy. Down the road, if I hire staff, the product appears to be able to accommodate multiple users. Possible

negatives: I've read that documentation on tablets can be very slow. OneNote doesn't have to be used that way, but it's what it's designed for. Any thoughts, insights, warnings, encouragement, or other feedback welcome. Oh, I should mention that

I've had a look at Soapware and Amazing Charts and a few other EMRs as well, none of which I'm inclined toward. At this point I'm still gathering information on other solutions before making a choice. I really appreciate any advice at all. Thanks, Pam *the demise of the first practice was secondary to family demands - sudden burdens that couldn't easily be shouldered by anyone but me - not due to business failure, though I was, truth be told, just keeping my head above water with a high volume,

high overhead solo office, taking insurance (or what they would give me), etc. This time will be different ;-)

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April 29, 2008

Pam,I did a Google search for "onenote" and "mac" and found a similar program called Notebook which also has a 30 day free trial. The company has an odd name, though:http://www.circusponies.com/I have been using SpringCharts on a Mac for the past 4 years, and agree that aesthetics played a role in my decision. It is not entirely "Mac-like" but it is good enough. I wish it had some kind of registry function to allow tracking of patients with chronic diseases. It is relatively low cost and doesn't require a monthly fee. I like having the data on my own computer and knowing that I could not pay the company another dime and I would still be able to use my EMR for another 5 years (but I do pay for the annual support fee). SetoSouth Pasadena, CAI'd pretty much rejected the ASP idea for a number of reasons, one of which you've stated.OneNote doesn't work on a mac, unfortunately, not unless you use a virtual machine type of product like VMWare:http://vmware.com/products/fusion/If I committed to OneNote I'd go get a Windows-based tablet. Probably better to separate my home from work computers anyway.For now I'm reluctant to buy a tablet until I've seen one with OneNote working efficiently in practice.I asked the ablet factory developer if he could hook me up with an MD using his product. That would be most persuasive.Pamwhat about using an asp version of an emr, would that work well, using one note tablet entry into various fields? would it not matter if one used pc or mac?the only problem is making sure your data is your own.LLFrom: Pam Barton <pbartonmdgmail>Subject: OneNote for EMR?To: Date: Tuesday, April 29, 2008, 6:04 AMHi all, I'm an FP new to this list (though not new to the idea of micropractice) . I'm setting up my second solo practice*, this time with the idea of doing home visits exclusively, and am in search of an EMR that will be stable, easy to set up and maintain, not too expensive, and fun to use (oh, and it should bring us world peace while it's at it).Anyway, yes, I think I could use an EMR. I used eMDs in the past and would not go that route again. I've also used SpringCharts recently and liked it, not least of which because it works on a Mac - a big plus in my book. I kept wondering if there might be an even simpler solution, which made me have a look at OneNote.I posted this question yesterday to the AAFP's EMR list, and haven't gotten any responses. So I thought I would give it a try with you guys, since you're more firmly attuned to the small is beautiful philosophy. So, here goes:I'm wondering if any of you has tried using OneNote http://office. microsoft. com/en-us/ onenote/default. aspx as an EMR, or if you know of anyone who has.This company http://www.abletfac tory.com/ EMRSuite. html has a couple of products designed for EMR use on OneNote. At lease one of the products comes with ICD-9 codes & a drug database.My thoughts so far:On the plus side: OneNote looks like it could easily satisfy the organizational needs of paperless charting - with tabs, room for scanned docs, flexible organization, and the ability to flag & label things. I believe it has a solid interface with Outlook as well, which could be handy. Down the road, if I hire staff, the product appears to be able to accommodate multiple users.Possible negatives: I've read that documentation on tablets can be very slow. OneNote doesn't have to be used that way, but it's what it's designed for.Any thoughts, insights, warnings, encouragement, or other feedback welcome.Oh, I should mention that I've had a look at Soapware and Amazing Charts and a few other EMRs as well, none of which I'm inclined toward. At this point I'm still gathering information on other solutions before making a choice.I really appreciate any advice at all. Thanks, Pam *the demise of the first practice was secondary to family demands - sudden burdens that couldn't easily be shouldered by anyone but me - not due to business failure, though I was, truth be told, just keeping my head above water with a high volume, high overhead solo office, taking insurance (or what they would give me), etc. This time will be different ;-)Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

April 29, 2008

Thanks, , I had seen that before but hadn't taken a closer look. I will now.PamPam,I did a Google search for "onenote" and "mac" and found a similar program called Notebook which also has a 30 day free trial. The company has an odd name, though:http://www.circusponies.com/I have been using SpringCharts on a Mac for the past 4 years, and agree that aesthetics played a role in my decision. It is not entirely "Mac-like" but it is good enough. I wish it had some kind of registry function to allow tracking of patients with chronic diseases. It is relatively low cost and doesn't require a monthly fee. I like having the data on my own computer and knowing that I could not pay the company another dime and I would still be able to use my EMR for another 5 years (but I do pay for the annual support fee). SetoSouth Pasadena, CAI'd pretty much rejected the ASP idea for a number of reasons, one of which you've stated.OneNote doesn't work on a mac, unfortunately, not unless you use a virtual machine type of product like VMWare:http://vmware.com/products/fusion/If I committed to OneNote I'd go get a Windows-based tablet. Probably better to separate my home from work computers anyway.For now I'm reluctant to buy a tablet until I've seen one with OneNote working efficiently in practice.I asked the ablet factory developer if he could hook me up with an MD using his product. That would be most persuasive.Pamwhat about using an asp version of an emr, would that work well, using one note tablet entry into various fields? would it not matter if one used pc or mac?the only problem is making sure your data is your own.LL--- On Tue, 4/29/08, Pam Barton <pbartonmdgmail> wrote:From: Pam Barton <pbartonmdgmail>Subject: OneNote for EMR?To: Date: Tuesday, April 29, 2008, 6:04 AMHi all, I'm an FP new to this list (though not new to the idea of micropractice) . I'm setting up my second solo practice*, this time with the idea of doing home visits exclusively, and am in search of an EMR that will be stable, easy to set up and maintain, not too expensive, and fun to use (oh, and it should bring us world peace while it's at it).Anyway, yes, I think I could use an EMR. I used eMDs in the past and would not go that route again. I've also used SpringCharts recently and liked it, not least of which because it works on a Mac - a big plus in my book. I kept wondering if there might be an even simpler solution, which made me have a look at OneNote.I posted this question yesterday to the AAFP's EMR list, and haven't gotten any responses. So I thought I would give it a try with you guys, since you're more firmly attuned to the small is beautiful philosophy. So, here goes:I'm wondering if any of you has tried using OneNote http://office. microsoft. com/en-us/ onenote/default. aspx as an EMR, or if you know of anyone who has.This company http://www.abletfac tory.com/ EMRSuite. html has a couple of products designed for EMR use on OneNote. At lease one of the products comes with ICD-9 codes & a drug database.My thoughts so far:On the plus side: OneNote looks like it could easily satisfy the organizational needs of paperless charting - with tabs, room for scanned docs, flexible organization, and the ability to flag & label things. I believe it has a solid interface with Outlook as well, which could be handy. Down the road, if I hire staff, the product appears to be able to accommodate multiple users.Possible negatives: I've read that documentation on tablets can be very slow. OneNote doesn't have to be used that way, but it's what it's designed for.Any thoughts, insights, warnings, encouragement, or other feedback welcome.Oh, I should mention that I've had a look at Soapware and Amazing Charts and a few other EMRs as well, none of which I'm inclined toward. At this point I'm still gathering information on other solutions before making a choice.I really appreciate any advice at all. Thanks, Pam *the demise of the first practice was secondary to family demands - sudden burdens that couldn't easily be shouldered by anyone but me - not due to business failure, though I was, truth be told, just keeping my head above water with a high volume, high overhead solo office, taking insurance (or what they would give me), etc. This time will be different ;-)Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

April 30, 2008

Hi Graham,This is the abletfactory's response to the concern you've raised here:Dr. Barton, I try to avoid these kinds of discussions. Our solutions are really “hybrid” in nature. They are more than simple Document Management Systems (DMS). Alt-Shift-F will timestamp any entry , the password scheme to lock records for privacy is one of the strongest crypto methods that is allowed, a complete list of drugs prescribed is only a instant search away if a recall list is needed, the history file is a complete audit trail . I have perceived an anti-Microsoft bias, if not with OneNote then with Window devices. I have tried to fully disclose our products strengths and weaknesses. We have never proclaimed that we are CCHIT certified. However, I can recommend GE Centricity as an alternative. They have a very comparable SOAP Note as demonstrated on our website. Best wishes in your EMR search.I'm not sure I understand everything he's referring to here, but I want to comment on his "anti-Microsoft" assertion.The reason he perceived an anti-Microsoft bias was because I started off by telling him that I was a Mac user (strike 1), that I didn't own a tablet (surprisingly, this was strike 2) and, while I was on the phone with him, before I could observe his demo on one of my kids' (brand new, running Vista) PC's I had a hell of a time getting the machine to respond and finally had to do a hard shutdown in order to get Explorer to come up. I mentioned that this wasn't such a problem under the circumstances but could be very frustrating, even dangerous, with potential loss of data, when you're working/ seeing patients. (strike 3)His response was something along the lines of - "Oh I could tell you stories about doctors . . . " meaning he had analogous complaints about the medical profession. Aargh.Anyway, I have found Macs to be much more stable, but don't have an axe to grind either way, just like a machine to work predictably if possible.Finally, I had asked for a reference of an MD using his product - someone I could observe or at least talk to - and didn't get one. PamPamThe main argument against using products like OneNote is that there isno versioning of documents.So, there is no audit trail if you need medical defence.Also, OneNote is really just electronic paper .. with the samedisadvantages. Just one step above real paper.Doing things like audits, recalls etc are extremely difficult in thisenvironment.What was the problem with eMDS?On Wed, Apr 30, 2008 at 1:50 AM, Pamela Barton, MD <pbartonmdgmail> wrote:> OneNote doesn't work on a mac, unfortunately, not unless you use a virtual> machine type of product like VMWare:> http://vmware.com/products/fusion/You can't use vmware on a Mac ... because you still need theunderlying hardware support for the tablet OS.So, you'd need a pressure sensitive tablet as well.-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

April 30, 2008

Hi Pam

>

> Hi Graham,

> This is the abletfactory's response to the concern you've raised here:

>

> Dr. Barton,

>

> I try to avoid these kinds of discussions.

>

> Our solutions are really " hybrid " in nature. They are more than simple

> Document Management Systems (DMS). Alt-Shift-F will timestamp any entry ,

> the password scheme to lock records for privacy is one of the strongest

> crypto methods that is allowed, a complete list of drugs prescribed is only

> a instant search away if a recall list is needed, the history file is a

> complete audit trail .

Perhaps Fritz of Ablet factory didn't understand the question? I

don't know what timestamping an entry means ... it could mean

inserting a date/time into the note which is not really sufficient.

Or it could mean that he maintains a log of all the changes made so

that you have an audit trail. Which he also mentions.

If you use the tablet enough you'll find that either you're content to

keep text as a scribble on screen, or let the tablet recognize the

text and turn it into true text. And my own experience is that my

handwriting remains illegible, and it is just too slow waiting for the

text recognition when you're busy. I got a Toshiba tablet a couple of

years ago and ended up giving it to my daughter instead. She loves it

... I hated it!

Tablet screens also tend to be smaller to keep the cost down .. and

make them more portable. But it gets really old carrying these around

from room to room ...

> Anyway, I have found Macs to be much more stable, but don't have an axe to

> grind either way, just like a machine to work predictably if possible.

>

Yes, because Apple build to a reference stable platform. They don't

have to support a zillion possible hardware changes. I also bought an

Intel based Mac with wide screen etc, and decided it just wasn't me.

It's in my other daughter's room now .. the only time I ever use it is

when I download and watch House MD with her

I tend to use VMs now if I want a stable machine. Just install the

application I need to run and nothing else. And since the hardware is

all virtual .. I don't get those stability problems.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

April 30, 2008

One time cost of license is about 5600. Yearly support and all upgrades are

1700/provider/year. Beats 35,000 for office help and no workman's comp

insurance, 940, and 941, benefits etc. Such a deal.