Searched the forums, and found no conclusive answers, just really old threads.
Has OpenEMR been used successfully in hospital scenarios ?
Some Issues that come to mind immediately:
- How can I tell where in the hospital a patient is ?
- How can I manage Operating Rooms ?
- Staff in OR and Patient booking for OR
- Multiple Surgeons booking OR time etc.
- Room Management ( Booking Rooms for patients in advance etc.)
- Patient Medication Required while in rooms and logging of these medications
These are just some that come to mind for me a developer, I am sure that for those in the medical industry there are many more.
We would love to contribute to these issues, but would need some guidance as to what has already been done and what is practical to actually do.
I am sure that Brady is going ot reply to this question soon. To my knowledge (which is limited to the past two years), OpenEMR has not be deployed in a hospital enviroment. The OpenEMR was developed to solve the SOHO issue of needing and EMR. The community has been approached by Hospitals but the issues you have raised has caused the product to be over looked. There are those in the group that would like to take on the challenge of expanding or creating a new version of OEMR for hospital use. The needs of the SOHO office are not the same as that of a hospital.
I have seen hospital systems and they are very different than OpenEMR. Patient tracking is very important and the system seems from looking from the outside to be centered around that fact. Before I get to far into the scenerios, the development would be welcomed I believe.
All good questions. OpenEMR is currently designed for outpatient services. Inpatient raises a substantial number of new requirements for information capture, reporting and most notably institutional billing. If you start looking at the 837i spec that will give you a pretty good clue as to the underlying data requirements on the clinical and administrative sides.
Things I’m used to in hospital EMR’s from a physician standpoint are (note many EMR’s function both in clinic/hospital, so it is definitely practical to think that OpenEMR could do this (with lots of code, of course) ):
Room of patient (and tracking beds; ie. Bed Control)
Team and/or primary physician that are responsible for patient while in house
Active medications (and include Medication Administration Record, ie. the MAR)
Display and graph/trend labs and vitals
Maintain a custom patient listing (good to have ability to link this to “teams” in addition to individual physicians)
Ability to print/display report of patient listing
- A report focused on sign-out (things to watch out for, overall plan etc. gathered from a user modified field)
- A report focused on rounding (basically includes location of patient, active meds, most recent vitals/labs, and user modifiable field(s) )
I stay far away from the OR, so I don’t really have much input there.
On the billing aspect, I am also clueless.
Hello
I am new to OpenEMR and I was looking at the flow of it and I was exited to see the Inpatient Flow,but couldnt find.
Can any one please guide me how to setup the Inpatient Flow it would be great helpful.
In an inpatient hospital, patient arrive or get admitted by two means - 1. VIA Emergency Department and 2. Via OPD directly by the consultants/provider
If openemr needs to be inpatient compatible, it should have the ability to admit patients seen in the opd to the bed numbers vacant in specific ward and also the Emergency department needs to have same mechanism of adding patients to the wards/ICU by checking the central system showing the vacant bed status.
These two should not conflict with each other, otherwise mis information might occur. The current OpenEMR should have a queue system available, by which the patient registering first at the OPD will be attended first by the provider. The appointment system dont really work out in there.
The patient admission can also be done by a separate person called as “Admission Manager” who has the sole access to the admission screen and request generated by the system to him/her for admission of the concerned patient under a particular provider’s care
Now, in the wards,
The nurses should have
control for entry of the medications according to the patient tag/ID
requisition of drugs as ordered by the physician for the patient from the pharmacy
requisition of the blood tests/radiology as done by the physicians for the patient
Must have a reminder within the system, if nurse misses out any medication at a particular time for the patient
Must be able to generate chart labels with barcode
Barcode to be extended to the pharmacy orders and the lab orders requisition
Various forms for recording timely clinical data for the nurses like Temperatur, Pulse, BP, Blood Glucose, Urine Output etc
A module for the instruments, bed linen count and goods used and issued to a particular patient
A hospital will have OT facility, for that all the OT count, OT linen, OT instrument before and after surgery counts, autoclaving and disinfection report, Nurses forms for patient records in OT
Now for the physicians,
Physicians should be able to fill out forms and check the vitals recorded by the nurses for the particular patient under his/her care
Daily ward round report and assessment of patient forms
Physicians Medication orders and Lab work order
In case of OT, Anaesthesia record form, OT surgeon record form for details of the procedure done etc
MOST IMPORTANTLY -
1.Consent forms, blood requisition forms should be scanned and put against each patient with date timne stamp
Ability to generate invoices/Bills and insurance payments stuff
Ability to create patient list with bed numbers and ward ID and provider name in it. We should be able to search with provider name too
Ability to create report of upcoming OTs or other minor/major procedures
Chemotherapy or Radiotherapy report forms for each patient
Ability to check out radiology and blood reports directly from the lab via PACS system
Discharge forms, LAMA/DAMA forms
I guess that will be enough for a hospital to start up with
You might send these people a mail for information. It is a Hospital setting they use Open EMR. Probably not a University hospital with many beds, but you will only know after asking.
After looking at the Bay Area Surgical website. I would presume that they would be interested in an application suite for one of their ambulatory surgical centers.
Since contact has been established with Jeff Papineau, would you like to approach him about their funding of the effort? You are reimbursed for your work & the Project gets the codes. Win-win.
A surgi-center is a hospital in miniature (infantile skeleton), thus a good place to start. While you do your thing, I’ll do the med stuff.
With successful completion of above, then we can proceed to work on forms for a proper hospital.