04/23/2004    Bruce Lebowitz, DPM

Medinotes

Query: Medinotes

My medical group is going to begin using
Medinotes. As I understand, it was first
designed by and for podiatry. I would appreciate
hearing from users regarding their overall
satisfaction. I am particularly interested in
the usefulness of the podiatric templates.

Bruce Lebowitz, DPM
Baltimore, MD
blebowit@jhmi.edu

Other messages in this thread:

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05/21/2009    Michael Brody, DPM

MediNotes and Eclipsys (Marc Garfield, DPM

RE: MediNotes and Eclipsys (Marc Garfield, DPM)
From: Michael Brody, DPM

Dr. Garfield is correct is writing that there is
not currently a defined standard of meaningful
use. HITSP, is currently working on the
interoperability component of that (I happen to
be a committee member of CCHIT). Hearings were
held last month by the committee that is
advising HHS on how "Meaningful Use" will be
defined. All software vendors are waiting for
this definition to be published. But there will
be a defined standard of meaningful use. The
first draft of Meaningful use is due out within
60 days. There will then be a public comment
period and then a final definition will be
published.

CCHIT is trying to be that organization and
probably will be. Keep in mind CCHIT cost a
vendor $200,000 + and does not presently mean
anything. CCHIT certification costs
approximately $37,000 for the initial
certification and there is an annual renewal
fee. It is based upon a 'version of the
program' if the program has enough changes that
result in a new version number it must be re-
certified. Details can be found at CCHIT.org.
CCHIT certification currently means that the
software has passed the tests developed by
CCHIT. It does have meaning because many third
parties such as private insurance companies and
individual states have ongoing incentive
programs for implementation of EMR and all of
these require CCHIT certification. For example,
do a Google on the New York State Health grant
program.

If you are using a program that is not
committing to comply with HITECH standards, then
you should begin looking for a vendor that will
commit. The upcoming systems WILL be required to
meet the "PQRI" standards, of which, most
systems have little or no means of satisfying
right now even if they have CCHIT
certification. Given the input that GE has in
formulating EMR policies, Centricity will
probably be the standard for such a system. Be
careful before you leap into a new system, but
do not wait to start
looking.

GE, IBM, Kaiser Permanente, the DoD, the VA
system - the developer of VistA is also
involved, as id McKesson, Siemens, and a host of
other large companies. Allscripts / MiSYS is
also has a large voice in this process,
therefore it is not appropriate to think that GE
Centricity will be the standard.

There are numerous studies that demonstrate that
use of e-Rx and HER reduce medical errors, and
reduce the cost of medical care to both payors
and patients. That is the reason for the
incentive. PQRI is a precursor to the quality
reporting features that will eventually be part
of "Meaningful Use." The government is 'priming
the pump' by getting physicians to utilize e-Rx
and EHR this will save them billions more in
health care costs than the cost of the incentive
program which is capped and has an expiration
date.

I have done my research, I am a committee member
of HITSP, I am a member of the New York E-Health
Coalition, I am a member of HIMSS, attend an
average of 3 seminars (both live and online) on
Health Information Technology and sit in on
about 8 meetings a month with people who are
working to define "Meaningful Use" and direct
the future of Health Information Technology.

Michael Brody, DPM, Commack, NY,
mbrody@tldsystems.com

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05/06/2006    Larry Kosova, DPM

MediNotes EMR Software (Jeff Oster, DPM, C.Ped)

RE: MediNotes EMR Software (Jeff Oster, DPM,
C.Ped)
From: Larry Kosova, DPM

At the Midwest Podiatry Conference, PICA
presented a risk management
seminar. In the packet they distributed, it
states that you should
not use a boilerplate or "canned" type of chart
notes....this is
exactly what these types of systems do. Most of
the notes look the
same. This system basically does just this. A
boilerplate is when
the form is "mostly" filled in.

This is a template-type of system (like a SOAP
note) with only
normals filled in and then it allows you to put
in what is important
for that patient encounter and what makes that
patient encounter
unique. Make sure the "normals" apply to that
patient! Doctors are
getting in trouble when they don't look and
review their notes and
then the normals do not apply etc.
Learning "template building" as
Dr. Oster called it is making a canned note.

A good EMR program should make your employees
glad you bought it and
make their life easier, not make them quit! I
would also send in
your "boilerplates" or "templates" to your
malpractice
company for
approval and suggestions.

Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com

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05/05/2006    Jeff Oster, DPM, C.Ped; Alan Kalker, DPM

MediNotes EMR Software (Stuart Goldman, DPM)

RE: MediNotes EMR Software (Stuart Goldman, DPM)
From: Jeff Oster, DPM, C.Ped

We've been using MediNotes, and in particular,
MediNotes e, since 3-
1-06. MediNotes e is the newest release and a
complete redesign of
the older version that was called Charting Plus.
We chose MediNotes
because they know podiatry. The founder of
MediNotes is a
podiatrist and MediNotes e comes packed with
podiatry templates. So
one distinct advantage is that MediNotes
training and support are
very familiar with your needs. Also, MediNotes
support and training
are very good.

MediNotes is a relational database program made
user-friendly. But
to use MediNotes, you need to know the program
cold. You can't begin
to use it and assume that you'll learn as you
go. It'll take you 20
minutes just to print out a work release for a
patient. And while
you do that, you get backed up. The key to
success is that you need
to be prepared to learn the program and
customize it. To do so,
you'll need to dedicate many hours to template
building.

Implementing MediNotes for me was very
stressful. It completely
changed my office workflow. I lost an employee
who didn't have
sufficient computer skills. In terms of patient
care, I initially
found EMR very distracting. Computer input took
me away from direct
patient interaction. But EMR seems to be the
wave of the future and
we chose to implement an EMR to get out ahead of
the curve.

EMR is in its infancy. But as it becomes more
common, EMR will
evolve into integrated records that will include
your referring
doctors, your hospital, pharmacies, etc. If
you're not in the loop
and a part of that development, you'll simply be
left behind. Now's
the time to get into an EMR and MediNotes is a
good choice.

Jeff Oster, DPM, C.Ped., Granville, OH,
support@myfootshop.com

The most comprehensive forum I've found online
is at:
http://www.emrupdate.com/forums/default.aspx
Medinotes has been
reviewed. Type it into the search function and
you will see many
opinions. Be aware of when they were written as
EMR's is a very
rapidly changing business. Last years' version
is very old for most
companies.

Alan Kalker, DPM, Middleton, WI,
ajkalker@facstaff.wisc.edu

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05/04/2006    

Medinotes EMR Software

Query: Medinotes EMR Software

I am considering going with Medinotes EMR
software and would
appreciate feedback about the program, its value
in improving
efficiency and bottom line in podiatry, and the
quality of their
support staff. If any Medinotes users had the
opportunity to go back
in time, would you use them again?

Stuart Goldman, DPM, Boca Raton, FL,
podmohel@pol.net

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04/24/2004    Elliot Udell, DPM

Medinotes (Bruce Lebowitz, DPM)

RE: Medinotes (Bruce Lebowitz, DPM)
From: Elliot Udell, DPM

For many years every time I saw the Medinotes
display at a seminar
or convention, I turned my nose up and said to
myself, "I will never
spend a fortune on a computer product that I
don't need. After all,
I can handwrite my notes."

Then one day I bumped into a colleague who was
audited and had to
pay a huge sum of money because Medicare could
not read his
handwriting. I quickly faced reality. My
handwriting was worse than
his. So, I bought the program. I have had it now
for three years and
it has done more than just make my notes look
good. It enables me to
send out referral letters as soon as the patient
leaves my office. I
can track specific pathology which helps me when
I give a lecture at
a seminar. It also makes the life of my staff
easier because every
time they need to reply to an insurance company
they no longer have
to ask me to translate my handwriting. Also the
templates are not
really templates. They are interactive sample
charts where you
modify all of the objective criteria for each
patient. It has more
than paid for itself.

Elliot Udell, DPM
Hicksville, NY
Elliotu@aol.com