POSSCON Presentation 2013
Using Open Source Software in a Primary Care Setting
Implementation of OpenEMR in a Paper Primary Care Office
Historically, implementation of electronic health records in medical offices have been problematic. Specifically, poor implementation of these products is the leading cause of failure of acceptance of EHRs in these offices. Implementation of EHRs in the small physician office remains poorly documented and this contributes to this failure rate. To address this need, OEMR (The OpenEMR Non-Profit) developed an internship experience with the Department of Medical Informatics and Clinical Health Epidemiology at Oregon Health and Science University to develop a road map for converting a small physician's office that is still using paper records to OpenEMR, an open source electronic health record, while using open source tools to implement and document the transformation. Documentation was made public on the OEMR wiki as a template for future implementations.
The IT consultant had the infrastructure in place including a blank slate installation and a raw data file of demographics from the billing company. A project plan was written, and a pre-implementation HIPAA privacy assessment was completed to have a baseline. A day was spent observing the workflow and the systems in place, considering the possible changes after the electronic health record was installed. Lookup tables and insurance information were imported. A crucial element in the transformation is the decision about how to handle the transfer of data from the paper chart to the electronic health record. This is best achieved by scanning the charts, but how much is scanned is a personal decision. The calendar and scheduling were started on the new system to familiarize staff with the software. A HIPAA security assessment was then performed, and another project plan was written to complete the implementation. Documentation includes options for clinics to choose from in order to meet their needs. The process is highly dependent on organizational structure and personal preference of the clinicians.
This presentation is an overview of the documentation completed for the wiki. There are many paths to implementation, but the destination is meaningful use of the OpenEMR system.
