Independent Physicians Association of Lee County

Florida Heart Associates implemented the GEMMS (Gateway Electronic Medical Management) ECIS (Electronic Clinical Information System) in the Fall of 2003. The system is a hybrid SQL relational database using the MedInformatics platform. Designed specifically for cardiology specialty, the clinical configuraton is mapped closely to the clinical process a cardiologist would typically use to interrogate, diagnose and treat her/her patient. The software runs on Windows SQL 2005 in a "thick" and "thin" client enterprise. Using wireless "pencharts", the clinician moves about the clinic with free mobility to interact with the patient. Several of the diagnostic services are being interfaced with the ECIS platform to foster bi-directional communication with patient demographics and test/result reporting. All software resides with in a Dell server nest.

The experience with the ECIS system has been positive and results very effective. Improved documentation, coding and billing, resulting in decreased errors, denials and receivable days. Practice efficiency improved, communication improved and quality of patient care improved.

The GEMMS company is reletiively small. Based in Indianapolis, IN the company enjoys a solid reputation for a quality cardiology product. The GEMMS operation model does not encourage "hand holding" in implementing and maintaining their product on a daily basis. The practice must provide smart, motivated clinical and business staff as well as internal IT skills to operate and maintain this formidable product. Florida Heart Associates employs one full time IT Systems Engineer to keep all workstations/applications functioning while contracting with a local Cisco certifed network support company (CRS Technology) to provide remote and "on-site" monitoring of the enterprise network.

Finally, when making a business decision about practice clinical/business application software and hardware, understand that the hardware infrastructure (servers, workstations and printers) are not permanent equipment. Compuetr peripherals are expendable, expensive tools that become obsolete very rapidly (3-5 years life cycle) and must be budgeted for replacement on a predictable business cycle in order to avoid warranty and revision depletion.

When your practice decides to make a substantial investment in the technology, be sure to invest in the long term of the vision rather than short cut and "low ball" on the cheap. If you choose correctly, your practice will benefit in multiples. Remember to adopt a philosophy of commitment when taking the leap for it won't take long to realize that all of your meaningful business and clinical data flow permanently though the arteries of your network. Protecting that information (security & redundency) as well as critical recovery plans are essential.

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jwpenuel Members Profile Find Members Posts Newbie Joined: 22 Sep 2008 Online Status: Offline Posts: 7	Quote Reply Topic: EMR Posted: 22 Sep 2008 at 9:35pm
	Colleagues, We invite your comments regarding electronic medical records. Please feel free to share experiences with your own system, hardware, software, vendors, problems, ideas, etc. Jim Penuel

plotti Members Profile Find Members Posts Moderator Group Joined: 23 Sep 2008 Online Status: Offline Posts: 3	Quote Reply Posted: 02 Oct 2008 at 1:34pm
	Florida Heart Associates implemented the GEMMS (Gateway Electronic Medical Management) ECIS (Electronic Clinical Information System) in the Fall of 2003. The system is a hybrid SQL relational database using the MedInformatics platform. Designed specifically for cardiology specialty, the clinical configuraton is mapped closely to the clinical process a cardiologist would typically use to interrogate, diagnose and treat her/her patient. The software runs on Windows SQL 2005 in a "thick" and "thin" client enterprise. Using wireless "pencharts", the clinician moves about the clinic with free mobility to interact with the patient. Several of the diagnostic services are being interfaced with the ECIS platform to foster bi-directional communication with patient demographics and test/result reporting. All software resides with in a Dell server nest. The experience with the ECIS system has been positive and results very effective. Improved documentation, coding and billing, resulting in decreased errors, denials and receivable days. Practice efficiency improved, communication improved and quality of patient care improved. The GEMMS company is reletiively small. Based in Indianapolis, IN the company enjoys a solid reputation for a quality cardiology product. The GEMMS operation model does not encourage "hand holding" in implementing and maintaining their product on a daily basis. The practice must provide smart, motivated clinical and business staff as well as internal IT skills to operate and maintain this formidable product. Florida Heart Associates employs one full time IT Systems Engineer to keep all workstations/applications functioning while contracting with a local Cisco certifed network support company (CRS Technology) to provide remote and "on-site" monitoring of the enterprise network. Finally, when making a business decision about practice clinical/business application software and hardware, understand that the hardware infrastructure (servers, workstations and printers) are not permanent equipment. Compuetr peripherals are expendable, expensive tools that become obsolete very rapidly (3-5 years life cycle) and must be budgeted for replacement on a predictable business cycle in order to avoid warranty and revision depletion. When your practice decides to make a substantial investment in the technology, be sure to invest in the long term of the vision rather than short cut and "low ball" on the cheap. If you choose correctly, your practice will benefit in multiples. Remember to adopt a philosophy of commitment when taking the leap for it won't take long to realize that all of your meaningful business and clinical data flow permanently though the arteries of your network. Protecting that information (security & redundency) as well as critical recovery plans are essential.
	PLotti

plotti Members Profile Find Members Posts Moderator Group Joined: 23 Sep 2008 Online Status: Offline Posts: 3	Quote Reply Posted: 18 Aug 2009 at 5:03pm
	It is now August 2009, almost one year from the announcement that the government was going to underwrite as much as $42,000 per physician over a five year period for implementing an EHR. Since that announcement we have experienced stimulus plans, bail outs and TARP. Now we watch as the Congress and Senate propose complicated legislation to "improve" our American healthcare system. We see fellow citizens be labled "un-American", "Nazi-like", and "disgruntled" when they show up to express their frustration and distrust with their representatives and the proposals. Coincidentially, the office of CMS has annouced a proposed fee reduction to physicians in FY 2010 of 21%, and in some cases as high as 30%. Imagine the math it takes to offer 1/5 of $42,000 in the first year of an EHR implementation that costs ten times that amount to purchase, while your operating funds are reduced by 21% in the same year!!! Somehow I don't see Mr. O'Bama's vision achieving more than wish and a prayer of success.
	PLotti

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