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EMR Databases – Which is Best?

Posted on December 26, 2005 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Which is the best database for your EMR to use is a very tough question. In fact, like most questions the best answer is it depends. Here’s a few things to think about when you choose an EMR vendor and their associated database.

My first suggestion is that you avoid any database that is proprietary. When I say proprietary I mean any database that doesn’t allow you to add tables and modify the way the database is designed. Sure, almost every vendor will have policies on which tables and which parts of the database you are allowed to modify in order to maintain the integrity of the database, but no database should forbid you from adding tables in order to get the most out of your EMR. I think this is espescially important for custom reports you may want to create.

Second, look at the cost of the database as part of the overall cost of the EMR. Many colleges are lucky to have a site license for Oracle and so if some EMR is based on oracle then the expense will be much less for those in College Health and have this advantage. However, if your institution doesn’t have this site license then Oracle would be a very costly alternative. SQL Server licenses are also quite costly even if you could the college health education discount. MySQL is open source and therefore could be downloaded for free. If you have some in house expertise then you also will be able to avoid most other costs related to your database, but just know that because the software is delivered free there are often unseen costs that show up in managing the database. That covers the top 3 alternatives I think.

Understanding the language and the server software(ie. Windows, Linux, etc) you will be using is another important consideration when choosing a database. It doesn’t make much sense to use VB and connect to MySQL. Likewise, I don’t think it is wise to run MySQL on a Windows machine. If you go open source stay open source. If you go with Windows stay with windows. If you choose oracle then look at your in house skills, but I believe linux is better.

One final suggestion has to do with vendors who support multiple databases. You should consider the above criteria, but more importantly you should have a conversation with the vendor to see what database was used for the original development and which database was the program meant for. You will be best served if you use the database that the vendor is most familiar with so they can support you if and when any problems occur.

What’s an Interface?

Posted on December 17, 2005 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was browsing the internet and ran across a webpage that described an interface between MediNotes and Quest. It described how you could download the results from Quest’s website and then upload them into MediNotes. As far as I’m concerned that’s not an interface.

An interface receives the lab request and then passes the results back to the original system. I’m fine with talking about one way and bidirectional interfaces. Just have the result passed back or just have the request made. Although I don’t think that makes much sense with labs I can at least understand it. However, manually uploading the results yourself isn’t what I call an interface. It is Electronic Medical Record, but it’s not an Interface(at least not a good one).

Tablet Signatures

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been trying to convince my EMR vendor to implement a digital signature for a while. I had 2 requirments. I want the signature captured by a signature pad similar to one you might use at a local shopping mark. The second was capturing it on a tablet PC. I’ll discuss this more in the future and some of my thoughts on the subject, but I learned something really interesting the other night. A tablet PC keeps track of pen pressure, angle and a whole bunch of other things that recognize not only that someone is writing, but I’m told that you can also recognize if it is the same person writing the signature. I’m skeptical, but the idea is quite interesting.

Imagine someone comes into your Health Center or Counseling Center and you capture their signature the first time they are seen. Then, you can verify the fact that it is them when they are filling out any consent forms or referral forms by verifying the same signature tendencies as captured by the tablet. I’d like to test this, but it sure adds a great layer of security to the signature.

Wireless Technology/Security

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Wireless Security is always a hot topic when you look at using it in Healthcare. There are some best practices that should always be implemented:

  1. Hide the SSID
  2. Restrict Access by Mac Address to only your machines
  3. Create a public network and a private network so patients/clients have access to the internet without access to your private network
  4. Encrypt the data going across the wire
  5. Use WEP or some sort of VPN technology to encrypt all wireless communication(ie. passwords that may be the same as your EMR)

I’m sure there a few more things, but I’ll add those as I get them. This implementation will give you a good start and I believe with this well documented will satisfy HIPAA Security Rule compliance quite well. Personally I also reccoment not using WEP for protection, but I much prefer using a secure password protected VPN technology to encrypt the data. I personally use L2TP technology to encrypt the data and provide a secure VPN connection on the wireless.

EMR and HIPAA Blog

Posted on December 11, 2005 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My desire is to post things I find of importance related to HIPAA and EMR. My personal experience is in College Health so I will focus on posting items related more specifically to College Health. However, I will try to incorporate any aspects of EMR and HIPAA because I think best practices across the industry are important to know. Please feel free to post all you want if you find some good information that I haven’t seen and correct me if I’m wrong. This is my best knowledge from my research and is not guaranteed in anyway.

EMR BLOG