innocuous wrote on Tuesday, May 02, 2006:
Hi all,
The HMO project I mentioned earlier in my posts is underway and taking shape. I would like help with the OpenEMR community to help us use the oss for our project.
In short the trial HMO will be of 100 doctors managing healthcare of 50000 families (4 members per family) spread over a WAN. The area is a slum area of India, but a perfect testbed for diseases and illness.
We will have a central server which will be accessed by the GP’s. Links to pharmacy and hospital will be also there.
Some of the shortfalls/development required are:
1) Doctors can view only their own patients and not all patients. Secondly if referral is given with access code, they can view other GP’s patient also.
2)Calender to be modified so that only the calender of logged in doctor is shown.
3)Patient data to be exportable. We plan to give rewritable CD’s to each patient so that they have their medical data with them wherever they are. This data can then be invaluable incase of emergencies where their primary provider is not available. The data should include all the data of the patient including demographics, encounters etc. Obviously, the data should be updated with each encounter
4)The prescription module needs considerable addons which are:
a)there is no way to delete or delist medications?
b)there is no time frame for taking a medicine i.e. start date and end date
c)DRUG DRUG interaction check is CRUCIAL for us. This should be part of the database on the central server which is updated constantly. An alert should popup if any adverse drug reaction is present.
d)CLINICAL DECISION SUPPORT SYSTEM to be built into the system. We have access to a wealth of information from research institutes, medical sources, colleges etc to build the database.
This should be as an alert system. For example if a person above 65yrs with xyz disease is being prescribed abc drug and the preferred drug is zzz then an alert should popup that the preferred drug for this patient for this ailment is zzz.
I am sure everyone will agree that this will be invaluable to healthcare
5)One major hurdle we see is that GPs’ are not comfortable using a computer and will be reluctant to attend ‘computer classes’. Therefore if possible the encounter screens can be made more graphical with point and click showing images instead of text where needed (for example if chest are is targetted, then a chest icon brings up relavant forms and information.
6)With the same computer literacy concern, the initial medical history capturing becomes a concern. What we are trying is to build an instant medical history program wherein a series of question (in vernacular) are asked the patients and they reply with simple yes or no. Intelligent branching can be used to choose only relevant questions. There are sources available for this, the links of which I will post shortly.
7)Upgrade ICD9 with ICD10 and the ability to add custom codes.
8) Since we are working on a family system, the patient database to be modified to include a family system with 2 parents and two children and the ability to link all the members of the family ie If I click on the male parent, then links to his wife, children are provided.
9)Security and encryption needs to be implemented.
I request all of the developers out there to help us develop these features. Everything will be released as GPL and I am sure that this can be an important landmark in medical history with OpenEMR. I understand that some development will require funding. Please send me your quotations for these features and also which feature will someone be willing to do for free.
Ours is a not for profit HMO and targeting the poor. THe main purpose of this HMO is to bring good healthcare to the poor, who are in dire needs of good healthcare but cannot afford it.
We have bookmarked appx 3000 US dollars for the software for the trial.
Any advise and help will be highly appreciated.
Thanks