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How I, A Doctor, Came To Build An EMR

My desire for integrating the power of technology with primary care started nearly two decades ago. It was then, when working as a family physician in a busy medical practice, that I began experimenting with typing my notes and using computers in front of my patients.

In 2001, I launched a new medical practice DocTalker, focusing on access of medical care to patients, and almost immediately I started searching in earnest for an EMR solution to fit my needs. However, I was not happy with the systems I looked into and tested and felt that they didn’t do what I needed them to. 

Some of my discontent came from the way my medical practice consults with patients, which is primarily via telephones and emails and house calls (in addition to the common office visit). Because of our ability to offer telemedicine, we often treat patients when they’re not  in town, but rather traveling for business or taking a vacation. We therefore must interface with hundreds of different local labs, radiology groups, pharmacies, and specialists.

My biggest concern with the EMR solutions available was that each felt like it was designed by a biometric specialist who put more focus on data mining than on physician interface. Too, each EMR specialized more in coding notes and billing algorithms for insurance companies than on patient care. I needed a system that offered efficiency, speed, and ease of use for doctors in order to deliver this care. Since our practice has a doctor to staff ratio of 1:1 and we’ve automated as many extra staff as we could,  the EMR needed to do the rest.

With none of the EMR solutions available fitting my requirements, I decided to craft my own. I started by building my own EMR from existing, off-the-shelf software that was both functional and affordable. This homegrown solution only carried me about five years when the practice grew to the point that we needed to design a more formal EMR that was easily expandable for other doctors and nurse practitioners.

At this point, I had an advantage when it came to designing such a solution: Five years of hands-on experience building and using my own EMR which gave me the insights into what a doctor needed a system to do. Plus, I was blessed to know a good programmer, who happens to be my son, who understood through years of osmosis and proximity to health care exactly what an EMR needed to do. Too, he knew the system I’d built initially inside and out. Three years ago, we started our development path to create what is now MDHQ by collaborating daily. We’ve beta tested and used, rebuilt and tested again in our medical practice and at long last feel that our EMR work ready for other doctors to try out, too.

The MDHQ EMR is a cloud application, meaning no software is needed to install and that users can  access it from anywhere including via cell phone or iPad. All that’s needed is Internet or a network card. Data is backed up daily and stored in hardened facility, nearly eliminating the risk of losing data.

MDHQ operates on its own dedicated virtual private server, unlike other cloud-EMRs, meaning that you can easily customize any part of the system without affecting other clients. This customization any unique features your practice may have, or displays and functionality that you’d like built, or new online portals for patients that you want developed.

I wanted to ensure that MDHQ was affordable. Just think: If you collect $250K each year in billings, then your primary work tool, which centralizes charts, communications, insurance billings and patient accounts and that also manages patients searches will cost you 1 percent of your gross income. 

The website is being populated in the weeks ahead with tutorials that can walk you through all aspects of the system. We also offer a live, fully-functional DEMO version populated with the Greek and Roman Gods as patients so you can play with them and throw down thunderbolts of your own for a change. We think you’ll be pleased to discover a newfound power that is super-affordable.

Until next week, I remain yours in primary care.

Alan Dappen, M.D.


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