Additional tasks to the Inpatient Module, by client request.

Inpatient Module
Creation of a script to whiten the hospitalization tables within the database.

Screens with individual patient data, sorted by Area / floor and by Surname.
Facility to view or print all the data of a single patient at once. More patient data can be added, upon request.

PowerPointPoint file, descriptive of the hospitalization procedure.

Granting of admin permissions for the hospitalizations and of doctor (medical user, medical supervisor) for the hospitalization reports. That way the the bosses can intern, register, change beds and create beds. Common doctors can see the listings, but not change them.

Added fields to the Inpatient List report. Telephone, room, social work, date of internment, doctor in charge, etc. Sort by Floor, Room and Bed. Prepared to print to PDF.

Downloadable or online forms. Inclusion of Health Insurance Provider in all pre-printed downloadable forms with patient variables. The original set of keywords (keywords) was limited, and we had to resort to PHP programming to add data on medical insurance, hospitalization, date, age, etc.

Clinical data form of hospitalization, with internist physician, diagnosis, purpose of the hospitalization, etc. Then it will be complemented with Surgery, Evolution or Epicrisis.

Correction of documents and forms to adapt them to digital environment.
Adding  missing fields, standardization of terminology. Classification according to its stage of use.

Added 70 disposable items and medications to online and downloadable forms, to meet audit requirements.

Added current date and time to online forms and downloadable forms. PHP and MySQL programming. Change of date format, from the original YYYY-MM-DD to DD-mm-YYYY. (PENDING)

AGE field, which did not exist in the system. It was incorporated into online forms and downloadable forms.

Simplification of insurance data loading forms, with only 2 of the 10 existing fields.

Correction of the necessary forms to intern a patient: General and Common Informed Consents, Obstetrics, Indications, Identification Sheet, Sanitary Bill. Alignment of the fields for better use of space.

Demography: When creating a new patient, check of duplicates in ID and Clinical History. More than one form of patient identification, by Clinical History, ID or other document. Newborns without documents, or foreigners with documents or passport are taken into account.

Translation and simplification of 12 possible relationships between RESPONSIBLE and PATIENT (relative, employer, employee, partner, etc.)
A new online system was prepared to continue testing and teaching, prepared for when the current system is used in production.

Completing English to Spanish translation. Done in a 75%

PowerPoint document with use of disease codes and treatments, Word document loaded on this site.

Video conference with members of the Sanatorium to introduce the use of the system.

Counseling users on how to use the Digital Signature in OpenEMR.

Preparation of users with different levels of permission: accountant, receptionist, doctor, medical coordinator and administrator.

Pending Stages:
• Loading data from laboratory shipment
• Loading diagnostic image data
• Visit to Jujuy for training Personalized staff (2 or 3 days)
• Accounting and Billing
• Stock management

Digital clinical data for Occupational Medicine companies

Most Occupational Medicine companies perform periodic examinations where doctors record the data in blank paper forms. This practice represents a waste of time, because the doctor must question each patient about old episodes of work accidents and diseases that the company already knows. Employees may also omit important records. And it is known that this type of control is done against the clock, because the labor doctors have little time to review all the employees of a company. The digital clinical history would solve this problem.

The ART in Argentina and other countries are providers of Labour Insurance, covering work accidents and occupational diseases. These ART run periodical checkups of every worker, looking for work-related health problems. These companies are starting to request that the occupational medicine companies inform them in real time about the work accidents and the results of the periodic exams. This also implies to record all the data in a fast way, that both companies agree on the format and on the interconnection norms of both servers. Usually the HL7 standard is used, but this is not implemented in all the digital systems used in our environment. OpenEMR is ideal for this purpose, because it can also be used in a tablet or even a cell phone, whether the system runs in the cloud or in a local server of the company. It is required to program some simple forms for the most common events in each company, and to make an appropriate interface for the connection of the servers.

The business can expand. The ART can propose the use of this system to other occupational medicine companies. Likewise, the adopting labor medicine company can offer the interconnection of servers to other ARTs with which it works.

Request from us an example and technical and financial information …

Our Inpatient Module for OpenEMR

The hospitalization system covers the main data registration needs in a hospital or clinic.

The first stage is to create the beds. A bed is always inside a room, in turn within a floor and within an area. The area can be General, Emergency, Surgery, Maternity, Intensive therapy, etc. The beds can be male/female, have TV or Oxygen. Other features can be added upon request. Continue reading “Our Inpatient Module for OpenEMR”

Inpatient module for OpenEMR – Ongoing project

The OpenEMR was originally for outpatients, but many claimed a new feature that allows the monitoring of hospitalizations. We are developing an Inpatient Module, including location, type of bed, floor, room, bed number, additional room , such as TV and oxygen, etc.

The reports include: Free beds – Inpatient days – Standard Inpatient  Number – Released patients – Accumulated cost for bed use

Continue reading “Inpatient module for OpenEMR – Ongoing project”

Legal issues concerning digital medical records in Argentina

I see on Facebook Alejandro Abraham’s initiative for the country to adopt the Digital Clinical History, and I have already adhered. Public request

Law 26.529 that regulates the rights of the patient, in terms of the autonomy of the will, the information and the clinical documentation, specifies certain guidelines that a clinical history must meet. Among these guidelines, there is the confidentiality of information between the doctor and the patient, and any health professional who may have access to it. Article 14 specifies that the patient is the owner of the clinical history and that at its simple request a copy of it must be provided. But in turn, article 17, indicates the uniqueness of the clinical records by establishment. That is, each health facility must have a particular clinical history, completely isolated from any other institution.

Relevant in Law 26,529, articles 2 (sections C and D), article 13, article 14, article 17 and article 18 are relevant. I believe that all health professionals waste a lot of time and effort trying to understand the handwriting of colleagues in all types of clinical documents, which causes delays and sometimes serious errors.

The forums of biochemists and pharmacists are full of queries about what the doctor meant in such a doodle. And as it remains mandatory that prescriptions be MANUSCRIPTS, the responsible is the same State and its adherence to archaic legislation. Added Nov.2018 : the new legislation on electronic signature says that this modality can replace previous methods of signature, which authorizes to sign recipes digitally. But the body of the recipe is still subject to the letter of the law, which requires it to be handwritten. By not repealing or changing the Law of Exercise of Medicine, the issue remains confused and subject to controversy.

Online Electronic Medical Records (EMR) and Electronic Health Records (EHR)

The Electronic Medical Records issue is quite complex, because there is no standard yet, and thousands of competing applications try to conquer the big clients. Some are Open Source, some are free, many are sold. A few countries and states have decided to implement a single EMR application, to lower costs and focus all the development effort in a single product. However, not even Socialist countries have reached that goal. Continue reading “Online Electronic Medical Records (EMR) and Electronic Health Records (EHR)”

Psychological Testing and Treatment

To this proposal, the 3 medical businesses described above apply: Online EMR, Telemedicine, Marketing and Marketplaces.

Psychology is a discipline that can greatly benefit from the Internet, because there is no strict need for physical contact between patient and doctor. Of course, something is lost when human proximity is replaced by a webcam. There are a number of clues from the environment, body language and details that help the psychologist to make a diagnosis. But psychological tests are objective and can be easily implemented and carried out online. The advantage of offering Web Psycho Testing is to centralize the tests, to assure uniformity, and to be able to chain the tests according to the results and following a predetermined algorithm, thus automating most of the diagnostic process.
Continue reading “Psychological Testing and Treatment”

Opportunities for Pharmaceutical Companies

The 5 previous proposals have many advertising and sponsorship places for drug companies. Doctors who are active online are likely to be more influential and see more patients that those who are hiding in their offices, and pharm sales reps need to identify them and see them, virtually or physically.

When a product is being discussed in a forum, the “virtual reps” can intervene defending the drug from attacks. Although it is not correct, they can do so anonymously or without identifying themselves as company members.
Continue reading “Opportunities for Pharmaceutical Companies”

Medical Knowledge Marketplaces

Once the patients have an online medical record (EMR) most patients can examined by online doctors, and in many cases those remote professionals can solve the problem. Of course we are excluding many cases in which human contact is necessary for physical or psychological reasons.

 

I conceive the near future of medical care as a connected, distributed space where only a few persons have direct contact with the patient, and a number of consultants examine the relevant data and make recommendations. The eHealth paradigm will make medicine ultra-specialized, a bit de-personalized, faster and cheaper than today.

 

Imagine a situation where a complicated case is exposed to an inexperienced doctor, far from a high complexity centre. Let ‘s assume that this patient has his data online, but physically-present doctor does not have a marketplace where to seek advice. He can maybe bother a friend once or twice, or even pay him. But this friend is no assurance of quality, availability or price.

 

There is not a site where patients or doctors can publish their cases (with the necessary EMR) and seek advice from online doctors. It would be ideal for isolated places where no doctor would visit, for second medical opinion and for 3rd World doctors willing to sell their knowledge in the 1st World.

 

Such marketplace would implement many mechanisms to validate doctors, and to assure quality responses. This concept intersects the Verifiable CV business described elsewhere.

 

In order to sell services online as Telemedicine, doctors will need a little more than a diploma and a license. The competition will be intense, and they will need to demonstrate their knowledge, plus cost-efficiency, availability, response time, technology and marketing. They will need ability to receive payment in many forms, offer guarantee and credit, thinks that they very rarely do in the real world, in traditional Medicine or even in the many popular TV series that depict the medical world.

 

A few forms of knowledge marketplaces within the Health area:

 

– Business-to-Consumer markets, where the patient demands service offers from all the possible providers;

– Business-to-Business markets, where clinics will find complementary institutions across the Net

– Auctions and reverse auctions, where medical services/hours are sold to the best buyer.

– Professional Social Networks, which proved their value in other marketplaces

 

These “medical knowledge marketplaces” should have at least these features:

– access to a reliable online EMR (electronic medical record) for patients

– a doctor’s database, with a critical number of providers in any field. These providers do not need to travel to market their knowledge, because the transactions are essentially online.

– a companies database, ready to buy knowledge on given clinical cases, from doctors online. These companies will be validated in their contact data, and they will be required to pay any services bought thru the marketplace. Or face blacklisting.

– quality assurance service for doctors who want to validate their credentials by any necessary mean

– transaction platform, including bidding, alert mailing and auction.

 

 Other features present in current service eMarketplaces:

  • forum
  • contests
  • tests – quizzes
  • blacklist of those who broke the market rules
  • product offerings
  • group purchases
  • physical meetings

 

This market would be ideal for isolated places where no doctor would visit, for second medical opinion and for 3rd World doctors willing to sell their knowledge in the 1st World. In the near future, it would be nonsensical NOT to have a Medical Knowledge Marketplace

Medical Marketing

Doctors have ethical restrictions for doing marketing, and for that reason there are Patient Referral Services that with supposed objectivity advice patients as to which doctor to go. They have existed for a long time, but the web based ones are easier to run, more efficient and have wider reach.

Medical Marketing can sell the previous two medical businesses, EMR and Telemedicine. They can first convince the patients that they need an EMR, in order to recommend a specialist or sub-specialist. In order to produce the EMR a medical assistant and probably a doctor are necessary, so this is already Telemedicine. Once the patients have an online EMR, a remote doctor can provide some advice, maybe suppressing the original need for a physical encounter with a doctor.

Medical Marketing is currently applied to clinics or health organizations within a certain geographical area. However, some services are likely to be sold internationally, like Dentistry, laser eye optic correction, all kinds of cosmetic surgery and controversial surgeries like abortion, in vitro fertilization, cloning, sex change or virginity restoration.

Here in Argentina there are several opportunities for that, and the country already receives lots of Health Tourists. Let’s do a simple math to find the balance point: a round trip airfare from North to South America can cost U$D 1200, and 3 days hotel maybe 200 more. Procedures that are not covered by medical insurance, and cost over 2000 in the US, are likely to cost from 20 to 40% here.

Personal View

A step further would be to fit a boat with medical facilities and Argentine or other qualified and inexpensive doctors, and approach her to the coasts of Miami or London. The boat could carry the flag of some Medical Malpractice paradise, like Ruanda or Etiopia. To round off the project we need a country that allows alcohol and casinos. Convalescence does not need to be boring. If patients do not come to you, you go to the patients…