IT in Private Practice

Dr Ritthy Sovann

Ryan Tham

Definite Web

Benefits of fully computerised Practice

• Fast access to patient record• Faster script writing• Save time!• Patient recall ability• Professional/legible letter writing• Space saving (no need for storage of patient files)• Internet access, email facility• Better patient care (checking of drug interaction through

MIMS and eMIMS)• Increase income through EPC item numbers (GP)

MD2• Lion’s share GP’s desktop market• 16,000 GP users• Parent company HCN has revamped the database in the coming

version (MD3) to raise stability, scalability and data integrity. MD3 will share a database with PracSoft 3. Additional Microsoft SQL licensing fees need to be factored into overall practice IT costs.

• Costs:1 part-time doctor $110/year1 full-time doctor $495/year

Min per practice $495Max charge $3890

Genie

• Developed by Dr Paul Carr since 1995• 100’s users• Target for both Specialist and GPs• The system offers integrated billing and a full menu of

clinical features, including the ability to write a prescription with one click only (QuickScript). It is compatible with Windows, Macintosh or mixed environments.

• Costs:$500 per doctor$120/doctor/year ongoing cost

IBA Spectrum• Medical Spectrum software• 800 practices• The program operates in a Windows environment on a single

machine or scales to a large network using a single SQL database. • Spectrum integrates a range of clinical and practice management

duties.

• Initial cost:$3300 full product license + $550 per doctor

• Ongoing cost:$1320/site/year$120/doctor/year

ProMed clinical (formerly Medibase)

• Acquired by Promedicus

• 14,500 GP/Specialists

• ProMed Clinical uses an Interbase database and is designed to handle a large volume of data, multi-site practices and practices with many doctors.

• Cost similar to MD2

MedTec 32• Been in NZ for 20 years• 5000 users (NZ, Aust, Asia)• The fully integrated system works from an SQL database and incorporates

an extensive range of practice management and clinical modules, including billing (approved for use in Australia) as well as clinical recording for plans, diagnoses, prescriptions and referrals.

• Good for auditing

• Initial cost:$1500 for server$400/workstation upfront

• Ongoing cost:$150/server/month$15/station/month

Profile• IntraHealth Profile• 500 clinicians in Aust• This integrated clinical and practice management

system incorporates the international Good Electronic Health records standard.

• Allow multiple user to look up single note without locking up

• Initial costs:$1500 per server and $500 per station

• Ongoing:$500 per server, $250 per station per year

VIP 2000

• NZ-based Houston Medical• 750 practices internationally (90 in Oz)• Fully integrated clinical and practice Mx

system; appointments, consultations, prescriptions, and referrals.

• $3000 and allows for one-at-a-time access to the system by an unlimited number of doctors. Subsequent licences are cheaper.

Best Practice Software• Developed by Dr Frank Pyefinch• No advertising• SQL database• The Best Practice Clinical application retails for $1100 (inc GST). • Annual subscriptions start at $550 (inc GST) for a full-time doctor;

$275 (inc GST) for a part-time doctor working less than 25 hours per week.

• For large practices, the subscription rates are calculated on a sliding scale. Subscriptions cover ALL updates to Best Practice Clinical databases, minor software upgrades and remote software support for the product.

Medipak CRS

• since 1998. • The new product is reportedly now installed in

11 practices. • It touts a "problem oriented" approach, many

features including voice activation, an Interbase backend and the ability to "easy convert" data from Medical Director.

• It is available from $825 per doctor, but costs vary depending on practice configuration.

Cost Comparison

Best Practice Initial: $1,100

Ongoing: $550/FT Doctor/Year

$275/PT Doctor/Year

Genie Initial: $500/Doctor

Ongoing: $120/Doctor/Year

MD2 Min: $495 Max: $3,890$495/FT Doctor/Year

$110/PT Doctor/Year

MedTech32 Initial: $1,500/Server $400/Station

Ongoing:$150/Server/Month $15/Station/Month

Cost Comparison

Medipack $825/Doctor + other costs

Profile Initial:$1,500/Server $500/Station

Promed Refer to MD2

Spectrum Initial: $3,300 + $550/Doctor

Ongoing: $1,320/Practice/Year

$120/Doctor/Year

VIP 2000 $3,000 + other costs

Recommended systems requirement

Ability to run most current medical softwares• Server

Intel Pentium 4 or equivalent w SATA/RAID1GB of RAM at least (2GB for bigger practices)Fast gigabit Ethernet (for bigger practices)Window server 2003

• WorkstationIntel Pentium 4 or equivalent512MB of RAM at least10/100 EthernetWindow XP Pro

• Printer• Fax• Scanner• Cables• UPS • Tape drive/Portable HDD/ DVD writer• Antivirus and firewall• Network switch• Broadband router (wireless optional)• Word/Document processing software

Schematic Network Diagram

Cost Overview of IT Equipment

Server System From $1,600

Workstation System From $1,200

Win XP Pro $220

Win Server 2003 From $720

Portable HDD From $140

Security Software From $50 + ongoing cost

MS Office Basic Suite $250

Adobe Acrobat Pro $450

Fax From $300

Costs of IT Equipment

• Estimated cost of IT hardware for 10 workstation:– $ 32,260

• Upgrade system every 2-3 years due to evolving new software.

Laser Printer From $500

Scanner From $112

Broadband Router From $150

UPS From $60

Tape Drive From $320

Tape Cartridges From $30

Legal Requirement for Electronic Record Keeping

• On site or/and remote

• Ability to be reinstalled onto your computer

• Have a consistent backup policy (Eg: every night on tape drive; weekly on a re-rewritable medium)

• Rewritable medium has to be dated and signed

Different mediumMedium Costs Pros Cons

CD 50cents (800MB) Cheap

Best used as legal evidence

Limited capacity

Can be difficult to operate and slow

DVD $1 (4.7GB)

$9 (8.5GB)

Cheap

Best used as legal evidence

Limited capacity

Can be difficult to operate and slow

Zip $160 /drive (250MB)

$21 per disc (250MB)

Portable Outdated. Replaced by flash drive.

System must have zip drive

Tapes $400 per drive

$40 per tape

Can backup entire drive

Portable

Can’t verify backup data

External HDD $140/HDD (80GB) Can store large amount of data

Portable

Fast (Plug & Play)

Cannot schedule backup w/o third party scheduling software

Backup softwares

• Softwares such as Retrospect

• CD Burning softwares such as Nero and Toast

• Automated backup software such as Back Up Magic and grbackpro

Tips

• Automated backup can create a false sense of security, so verify data regularly

• You are responsible for you own data, not the software company

• Delegate the backup task to someone capable and confident in performing it

• Disaster is a result of a series of unrecognised minor mistakes

More Tips

• Store backups in a safe but easy to retrieve place

• Ensure backups are also stored off site (in case of fire or explosion)

• Do not write on the CD/DVD with an oil pen, it will soak through and destroy the media (also biro will scratch reflective surface)

RACGP Practice Standards

1. Recall system2. IT requirement (passwords, virus protection,

firewalls, screensavers, backing up, disaster recovery plan)

3. Human resource management (induction, staff roles, person leading clinical improvement)

4. Patient feedbacks5. Health summaries 6. Practice improvement (Plan, Do, Study, Act)

Recall system

• Different software has different built in Recall system

IT Security

• Password• Be aware of social engineering• Avoid using passwords that are associated with our lives

(telephone number/DOB/car rego number)• Important to choose difficult and unrelated passwords

• Screen Saver• Remember to log out of your computer when you are away

from it, or to configure the computer to lock the system without logging out after a certain time of inactivity - Screen Saver function

• In desktop mode right click on the background/properties/screen saver

• Locking computer• Window Key + L

Protect your computer

• Enable auto-update function of your anti-virus software

• Do not open any email attachments if you don’t know the sender

• Secure external drives/devices when not in use.

Optional Hardware

• External HDD

• USB Flash drive

• PDA (interfacing with Best Practice)

• Multifunction printer (Fax,scanner,copier all in one)

• UPS

Other software

• Adobe reader

• Open Office

• Mozilla Firefox

Adobe Acrobat Pro• Create PDF files from a scanner• Covert Microsoft Word file to PDF file• Covert multiple PDF files into one file• Create a web page into PDF file• Create PDF file from clipboard images• Add comments to PDF files or images• Add stamps to documents (approved,

sign here, witness)• Editing functions (eg cross out texts)• Add digital signature on to the

document• Select text from PDF document and

has “copy and past” function• Quickly email the PDF file to someone

quickly using an email software (eg Outlook, outlook express, PDA)

• Search for a PDF file on the computer• Plus MUCH MORE!

Internet Browsing

– Most popular internet browser is Internet Explorer

– New browser in the market is Mozilla Firefox– Firefox is currently 8% of the market and

growing – “Better than Internet Explorer by leaps and

bounds.” - Forbes– Download for free from http://www.mozilla.org/

What’s so good about Firefox?• Popup Blocking

– Stop annoying popup ads in their tracks with Firefox's built in popup blocker.

• Tabbed Browsing – View more than one web page in a single window with this time saving

feature. Open links in the background so that they're ready for viewing when you're ready to read them.

• Privacy and Security – Built with your security in mind, Firefox keeps your computer safe from

malicious spyware by not loading harmful ActiveX controls. A comprehensive set of privacy tools keep your online activity your business.

• Smarter Search – Google Search is built right into the toolbar, and there is a plethora of

other search tools Live Bookmarks • Hassle-Free Downloading

– Files you download are automatically saved to your Desktop so they're easy to find. Fewer prompts mean files download quicker.

Beware of the WWW

• Your computer can get infected with Spyware and viruses from the internet.

• **Tip: If your internet connection is unusually slow, your computer probably has spyware.

• Get a spyware cleaner to rid your computer of spyware.

• Download for free from http://www.download.com/Spybot-Search-Destroy/3000-8022_4-10122137.html

IT Support for Practices• Web page design• IT setup (all kind businesses; we supply the

computers)• Medical practice network/server setup and

maintenance• IT technical support/upgrade for offices/practices

(experience with MD, Genie, Best Practice)• Data backup/protection/recovery• Quality repairs and backup service• Desktop and laptop computer retail

Staffs

• Lester Boey Web page designer

• Adrian Kok Web page designer

• Ryan Tham IT engineer

• Ritthy Sovann GP Registrar, medical software specialist

• http://www.definiteweb.com/resources.htm

• Tel: 9262 0471