Pediatric Informatics: Computer Applications in Child Health (Health ...

16 Prioritizing Pediatric Investment for IT in Smaller Practices 231
application software like antivirus and antispam software, some decision support
software, and hardware. The hardware costs covered two servers (one was a
redundant system for emergency recovery), one workstation and a scanner for the
front office, one laptop per exam room and one laser printer for each laptop.
DSL (broadband) connectivity was already covered in the practice overhead
(no additional) costs. Training through Internet-based sessions (1 h every 3–7 days)
was covered as part of the cost of the initial software license. Training covered
the clinical EMR (which I use primarily) and the integrated practice management
(which my biller uses). Training for simple “crossover” tasks (appointment scheduling,
patient registration, vaccine entry, and encounter charges) was provided to
all staff. Annual maintenance fees would start after the first year and were about
10% of the purchase price.
Transitioning our office charges and collections while we moved from the old
PMS into the new integrated EMR/PMS required concurrent use of both systems.
As new patients were added, we billed and charged them in the new system, with
manual review and clearance of older charges (from the old system) as payments
arrived. This dual system was maintained through two monitors, one to the old
PMS and one to the new integrated system, and we maintained the dual system for
about a year (although most of the payments were cleared within 6 months).
Since starting in the newer practice location patient numbers and income have
almost doubled without requiring more staff. Setup of the EMR, hardware, and
maintenance costs were recovered in less than 2 years.
16.7 Additional Resources: EMR Buyer Support Tools
EMR cost calculator
URL: http://www.aafp.org/fpm/20020400/57howm.html
A spreadsheet tool from Family Practice to help compare long-term costs of an
electronic health record for a small practice.
EHR Review
URL: http://www.aapcocit.org/emr
A Website created and hosted by the American Academy of Pediatrics Council
on Clinical Information Technology (COCIT) to help users discover and share
experiences of peers with commercial EHR products.
Implementing an Electronic Health Record Toolkit
URL: https://www.nfaap.org/netforum/eweb/DynamicPage.aspx?webcode = aapbks_
productdetail&key = afd90736–5fad-4674-b909–5489e5553bee.
A CD-ROM toolkit consisting of the AAP Policy Statement on the “Special
Requirements for Electronic Medical Records Systems in Pediatrics” and other
information for adopting an EHR.