02 emr - hardware software requirements- tr- ver 4- 05 aug...
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EMR - Software & HardwareEMR - Software & Hardware
T. RathinamMedical Research Foundation
5th Aug 2006
T. RathinamMedical Research Foundation
5th Aug 2006
ApplnApplnServer
Server
Scan
ners
Scan
ners
NetworkNetwork
PCs
PCs
DD’’ P
enPen
TCs
TCs
WiWi--fifi??????
BackupBackupServer
Server
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Pieces of PuzzlePieces of Puzzle
! Software
! Hardware
! Soft-Hard-Ware
! How to go about?
! Software
! Hardware
! Soft-Hard-Ware
! How to go about?
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S/w & H/wS/w & H/w
! Software?
! Hardware?
! Software?
! Hardware?
- Mind
- Money
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SoftwareSoftware
Front End! VB
!Easy! Inexpensive
! Java/ J2EE!Cost effective
Front End! VB
!Easy! Inexpensive
! Java/ J2EE!Cost effective
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SoftwareSoftware
! Java/ J2EE/ .Net! Integration!Web based! Internet Browser ! Internet + VPN
! Java/ J2EE/ .Net! Integration!Web based! Internet Browser ! Internet + VPN
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SoftwareSoftware
Back End! Linux
! Redhat
! MS 2000
! Unix
Back End! Linux
! Redhat
! MS 2000
! Unix
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SoftwareSoftware
Database! Oracle
! MS – SQL 2000
! DB2
! Interbase
Database! Oracle
! MS – SQL 2000
! DB2
! Interbase
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SoftwareSoftware
! To comply with Standards! HL-7! DICOM! CPT for Surgical Procedures! SOAP (Protocol)! HIPA for Insurance! NABL (National Accreditation Board for
Labs)
! Interface with other applications
! To comply with Standards! HL-7! DICOM! CPT for Surgical Procedures! SOAP (Protocol)! HIPA for Insurance! NABL (National Accreditation Board for
Labs)
! Interface with other applications
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H/W– Clinical AspectH/W– Clinical Aspect
! TCs! PCs! Digital Pad! PDA! Scanners
! Document! Film
! TCs! PCs! Digital Pad! PDA! Scanners
! Document! Film
Server
Clin
ical
Sid
e D
evic
es
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H/W– Clinical AspectH/W– Clinical Aspect
! Interfacing hardware with equipment! Imaging Equipment
! Fundus Camera, OCT, HRT etc
! Diagnosis Data Equipment! HFA, Auto-Ref, Auto-Keratometer, DBR etc
! Wireless Network! Security
! Interfacing hardware with equipment! Imaging Equipment
! Fundus Camera, OCT, HRT etc
! Diagnosis Data Equipment! HFA, Auto-Ref, Auto-Keratometer, DBR etc
! Wireless Network! Security
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H/W- IT Systems AspectH/W- IT Systems Aspect
! Server! Application! Database! Backup! Others
! Desktop Workstations
! Server! Application! Database! Backup! Others
! Desktop Workstations
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H/W- IT Systems AspectH/W- IT Systems Aspect
! Hardware ! High processing speeds to run difficult
networks! High storage capacity! Although equipment will continue to
become more compact, faster & cheaper –What is purchased today will work effectively in office for next 5yrs.
! Hardware ! High processing speeds to run difficult
networks! High storage capacity! Although equipment will continue to
become more compact, faster & cheaper –What is purchased today will work effectively in office for next 5yrs.
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HardwareHardware
! Storage! Typical EMR Requirement 3 Terabytes in 2
to 3 years! Scalability upto 5 TB! Archiving Policy
! Online! Offline! Inline
! Storage! Typical EMR Requirement 3 Terabytes in 2
to 3 years! Scalability upto 5 TB! Archiving Policy
! Online! Offline! Inline
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Server Server
HardwareHardware
! Storage! High Availability! Proven track-
record ! Depends on
criticality! Basic
! Redundant Array of Inexpensive Disks- RAID! RAID Level 5
! Storage! High Availability! Proven track-
record ! Depends on
criticality! Basic
! Redundant Array of Inexpensive Disks- RAID! RAID Level 5
HD1HD2HD3HD4HD5
R1R2R3R4R5
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HardwareHardware
! Storage! Sophisticated
! SAN! Ideal! Expensive
! Storage! Sophisticated
! SAN! Ideal! Expensive
Blocks
Blocks
Blocks
Blocks
Blocks
Blocks
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Hard-Soft-WareHard-Soft-Ware
! Redundancy/ Load Balanced
! Application Server
! Database Server
! Redundancy/ Load Balanced
! Application Server
! Database Server
LAN
ApplicationServers
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Hard-Soft-WareHard-Soft-Ware
! Redundancy/ Load Balanced
! Networking! Switches! Connectivity
! Power! UPS for an UPS
! Redundancy/ Load Balanced
! Networking! Switches! Connectivity
! Power! UPS for an UPS
Blk 1DC Blk 2
Blk 3
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Hard-Soft-WareHard-Soft-Ware
! Backup Policy! Log backup
! Typically 15 mins! Disk to disk
! Overall backup! End of the day! Disk to Disk to Tape
! HD-HD-ALT
! Backup Policy! Log backup
! Typically 15 mins! Disk to disk
! Overall backup! End of the day! Disk to Disk to Tape
! HD-HD-ALT
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H/W- IT Systems AspectH/W- IT Systems Aspect
! Network! Design addressing the extra-Bandwidth
Requirements! Redundancy
! Disaster Recovery
! Network! Design addressing the extra-Bandwidth
Requirements! Redundancy
! Disaster Recovery
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When to go for EMR? When to go for EMR?
1.Starting a new clinic2.Remodelling a old clinic3.Adding a remote clinic4.Availability of funds5.Current billing or scheduling software needs
updating6.Concerns about the practice’s ability to meet
the Health care financing administration’s billing guidelines and to provide appropriate legible documentation
1.Starting a new clinic2.Remodelling a old clinic3.Adding a remote clinic4.Availability of funds5.Current billing or scheduling software needs
updating6.Concerns about the practice’s ability to meet
the Health care financing administration’s billing guidelines and to provide appropriate legible documentation
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How to go about?How to go about?
1. In-house/ Out-Sourced2. Analysis of the current system3. Depicting the required system4. GAP!5. Identifying the developers6. Process of making it7. IMPLEMENTATION (Plan & Execution)8. Maintenance
1. In-house/ Out-Sourced2. Analysis of the current system3. Depicting the required system4. GAP!5. Identifying the developers6. Process of making it7. IMPLEMENTATION (Plan & Execution)8. Maintenance
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EMR
HMS
Patient Services
Visionary Organization
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A Sankara Nethralaya Presentation…
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Need?Need?
Need = Requirements + ExpectationsNeed = Requirements + Expectations
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NeedNeed
! Requirement! Medical Record (Physical)
! Expectations! Image Management! Direct Data Acquisition ! Intuitive
! Requirement! Medical Record (Physical)
! Expectations! Image Management! Direct Data Acquisition ! Intuitive
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S/W- Clinical AspectS/W- Clinical Aspect
! Data Interfaces! Other packages! Equipment
! Slit Lamp Imaging, Fundus Imaging, HRA/ HRT/OCT/ GDx & others
! Auto-Ref data, DBR/ Keratometer Values, Perimeter Data, etc
! Avoid dead data!! Documents as images! Images without any search-ability
! Data Interfaces! Other packages! Equipment
! Slit Lamp Imaging, Fundus Imaging, HRA/ HRT/OCT/ GDx & others
! Auto-Ref data, DBR/ Keratometer Values, Perimeter Data, etc
! Avoid dead data!! Documents as images! Images without any search-ability
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S/W- Clinical AspectS/W- Clinical Aspect! Standards
! ANSI HISPP! ANSI HISB! CPRI! FESMCC! HIMA! HIMSS! HOST! MRI! NIST! WEDI! ANSI ASC X12! ASTM Committee E31! HL-7! HIBCC! IEEE! NCCLS! DICOM! NCPDP! NISO! NUBC! ACGIH! Facct! JCAHO! NCQA! URAC
! Standards
! ANSI HISPP! ANSI HISB! CPRI! FESMCC! HIMA! HIMSS! HOST! MRI! NIST! WEDI! ANSI ASC X12! ASTM Committee E31! HL-7! HIBCC! IEEE! NCCLS! DICOM! NCPDP! NISO! NUBC! ACGIH! Facct! JCAHO! NCQA! URAC
! DHHS Data Council! HISSB! NCVHS! CEN/TC 251! EDIFACT! ICE! NAHDO! NAPHSIS! NASIRE! NHIRC! COSTART! CPT-4! HCPCS - HCFA! ICD! AICD-10 CM! ICIDH! ICPC! LOINC! NDC! SNOMED! UMLS! LTCCUDS! MDS! UACDS! UHDDS
! DHHS Data Council! HISSB! NCVHS! CEN/TC 251! EDIFACT! ICE! NAHDO! NAPHSIS! NASIRE! NHIRC! COSTART! CPT-4! HCPCS - HCFA! ICD! AICD-10 CM! ICIDH! ICPC! LOINC! NDC! SNOMED! UMLS! LTCCUDS! MDS! UACDS! UHDDS
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S/W- Clinical AspectS/W- Clinical Aspect
! Standards! CPT-4 - Current Procedural
Terminology! Created and maintained by the
American Medical Association, which holds the copyright. Required for reporting of outpatient procedures and physician services in the United States.
! Standards! CPT-4 - Current Procedural
Terminology! Created and maintained by the
American Medical Association, which holds the copyright. Required for reporting of outpatient procedures and physician services in the United States.
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How to purchase an EMR?How to purchase an EMR?
! Software not able to offer similar guarantees as Hardware companies
! Need a successful software company who can offer a long-term technical support and frequent updates.
! Software not able to offer similar guarantees as Hardware companies
! Need a successful software company who can offer a long-term technical support and frequent updates.