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From: Gary Seto <glseto@mac.com>
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Thu, 14 Apr 2005 02:08:43 -0700
Subject: Re: [Practiceimprovement1] Mac environment
Reply-To: Practiceimprovement1@yahoogroups.com

Thanks, Gordon. Here's two more articles about a family physician and

an OB/Gyn who use Macs in their practices:

http://www.apple.com/business/profiles/marlow/

http://www.apple.com/business/profiles/spier/index.html

For his EMR, Dr. Marlow uses SpringCharts which is what I have been

using for a little over a year. Like the doctors mentioned in these

articles, I run my solo practice completely from my Mac, which is a 12

inch Powerbook 867 MHz laptop. I also use Quickbooks for accounting;

Excel for keeping track of patient registries, demographics, practice

trends, financial forecasts; Appleworks and Microsoft Word for word

processing; iCal for scheduling. I scan all documents with an HP 6100

All-in-one multifunction scanner/printer and file them as jpg files,

although I'm considering getting a high-speed scanner. I use Medrium

for medical billing. I automatically back up critical files daily to an

offsite backup data service.

I chose to use the Mac platform because its security allows me to be

free from worrying about viruses, spyware and frequent systems crashes.

While I don't have a network at my office, I do use a wireless base

station so I can bring my laptop into the exam room and look up things

on the internet with the patient. If I ever need another computer in

the office, I could easily network it like I have done with my

computers at home. While Macs sometimes have problems, too, I feel

totally comfortable with troubleshooting any problem as long as it is

not a broken hardware issue. I couldn't say the same about Windows

computers I have had to use.

I realize most physicians, like the rest of the general population, use

Windows-based PCs. And frankly, there are a lot more choices for EMR

and practice management programs on the PC than on Macs. But I suspect

some may wonder what life is like on the other side of the computing

world. In general, it's wonderful.

It would be a major investment in time and money to scrap a

pre-existing PC system for Macs. That is why it makes the most sense

for someone who is just starting out their own office to consider which

platform to go with. But even so, the costs of IT support, computer

repair and headaches that come with a PC system can be weighed against

the benefits of a user-friendly, intuitive, virus-free computing Mac

environment that gets out of your way and just lets you do your work.

For those who are interested in knowing more about SpringCharts (Bill),

I'm still waiting for a better EMR program that won't cost an arm and a

leg. SpringCharts' main advantage was its low cost: $500. I also bought

one year of support for the first year (another $500) but never had to

make any calls for help so I didn't pay to renew technical support. As

for quality, you get what you pay for. It is a serviceable program and

functions mainly as a smart word processor to write progress notes

with. It allows both free text entry, which is what I mostly use, as

well as self-generated lists of items you can point and click on. You

can also create your own customized templates, but I'm not a template

kind of guy. You can import scanned documents and photos. You can set

up reminders to follow up with Mrs. Smith about her cholesterol. It has

an E&M Coder which tries to guess what E&M level a visit should be, but

I haven't found it to be very accurate. It has the capability to

receive/send e-mail, but it's poorly implemented so I don't use it.

Part of the problem is that it is written in the Java programming

language, to make it compatible with Macs, Windows and Linux computers.

Java-based programs usually don't run as smoothly as programs that are

written natively for Windows or Macs. I consider SpringCharts a work in

progress, but one that shows promise.

I also considered Amazing Charts running on Virtual PC on my Mac,

PowerMed (expensive at $12000 initially then $2000/yr), Comchart (I

think it was more expensive a year ago, but it is priced at $500 for a

single-user version now. I thought it's interface was kind of ugly.

Funny how little things like that can make or break a decision.) Since

I've gone into practice, I've also heard about Cottage Med from Alex

Caldwell which is free. And I was just looking up OpenEMR, a free

open-source EMR for Linux, when I happened to find OpenEMRX, which is a

free port of OpenEMR for the Mac! So I will download it and play around

with it to see if it is a worthwhile replacement for SpringCharts.

Probably not yet, but it might be someday.

This article from Family Practice Management discuss "affordable" EMR

options for both PCs and Macs:

http://www.aafp.org/fpm/20050200/31purc.html

Sorry for the long rant about PCs vs Macs, but I feel that if we are

looking at practice improvement and investing in systems that work

better, I think we've got to consider our information systems as well.

Gary Seto