Status update for OSCAR

A talented Physician/programmer just wrote a "web page app" that allows you to make your own e-forms for OSCAR.

This means that if you have a "form" that you use regularly - like a lab form, a Radiology referral form or a specialist referral form - you can have it rendered into a "computerized" version for OSCAR very quickly and easily.....all by yourself!

Other EMR software programs require you to pay hundreds of dollars or more per form!

All you have to do to make your own eform is to go to the OSCAR site and download the 4th version of the "E-form generator".

Then, just scan your form into a black and white low resolution image and clean it up in photoshop or something - save it at about 150 dpi 8 1/2 x 11 B&W *.png image. This is pretty straightforward, and if this is beyond you - just post a request for help on the OSCAR forum. Somebody will be bound to help you out right away (this is the nature of open source software).

Now just follow the directions on the Eform Generator in order to make your form. Upload the generated forms in OSCAR (that you made with the eform generator) and start using it right away! Specific directions are on the website above. See here for instructions on scanning and preparing your images.

Now, you don't have to have numerous pads of various forms for Radiology referrals, Specialist referrals, lab form referrals, etc., etc. You just click on the form you want from the list in your patient's chart on OSCAR - and it will automatically have the patient information in it as well as your information. Just print it and give it to the patient.....or print it to the fax machine and fax it directly to the service that you want!

I created "signed" forms by signing the forms prior to scanning them.

BTW - After a few snags (like difficulty finding reliable programming people) - we're only a little ways away from getting labs done and a totally new Alberta Health Billing system done for OSCAR. The design of the billing system is being done by an Accountant/programmer....so it will be uniquely sophisticated for both insured and uninsured billings.

Stay tuned.....

Note: ipad/iPhone printing is just around the corner.....this means that you can soon use your ipad in the office to run OSCAR - and even print prescriptions from it.

Latest Status

There appears to be a critical mass of interest in OSCAR going on in Alberta. Several Docs and clinics have contacted me in regard to coming over to my office to see OSCAR in action. I happily comply! So far, 5 new clinics are coming over to see OSCAR in action.

Interestingly, two of these clinics are interested in considering OSCAR in replacement of Wolf. I am therefore researching methods of helping them change from OSCAR to Wolf without too much pain. It shouldn't be too hard to do so.

The Labs module is just around the corner now....we've had to concede to acquiring another programmer to assist with this (it's 99% done, but that last 1% is, of course, the most difficult part). Part of what has made this so slow is that Calgary Lab Services and all other jurisdictional services in Alberta have now become consolidated under "Alberta Health Services". They have additionally adopted version 3 of the new HL7 data standard.

While I enthusiastically criticize the Provincial Government and all Executives in Alberta Health services whenever an opportunity arises (and many do) - I have to say that this recent decision of theirs to consolidate labs under one umbrella and data standard - has been surprisingly insightful of them! A smart decision by Government and Administrators! WTF? I pinched myself and it's not a dream! If they could only now start to grasp the concept of Provincial Health Care Worker morale - we'd be off to the races!

Maybe there is hope......

We are also going to forge ahead with this new programmer to get the Alberta billing module finished - but it will include a robustly built private billing module for the growing list of uninsured services in Alberta that Physicians must collect and keep organized for business and tax reasons.

The billing module will be anticipated to be "real time". This means that a "billing clerk" will no longer be necessary other than for periodic consolidations. The treating Physicians will simply click radio buttons on an OSCAR page to complete their billings for every office visit.

It's going to be pretty cool.

Slow but steady wins the race

Ah, things are slow on the OSCAR in Alberta Development front - but at least they are methodical. The lab module should not be too much longer, and the developer is redesigning the approach to the billing module. The Alberta billing module approach will be innovative and a marked improvement on other provincial billing modules. Nice to be able to stand on the shoulders of giants!

In the mean time, I've been busy trying to create some templates for OSCAR that are Alberta specific. It isn't really all that hard with the new template generator that Shelter (a brilliant person that does OSCAR development) made. This is the real beauty of an open source project like OSCAR - it is always evolving, and so many people are always contributing that unlike any other software out there - OSCAR is "alive".

I hope to also contribute my parts to ongoing OSCAR development. These contributions range from actually getting parts made for OSCAR (and then submitting them to the CVS) to conceptual ideas.

Medicine is going more and more private in Alberta.....my colleagues that are totally dependent on Health Care Dollars are dropping like flies and closing their offices in droves. It is laughable that the "official regulatory authorities" in Alberta "have no official knowledge" of Doctors offices closing in droves. These Docs aren't bothering to inform the regulatory authorities. They're simply going totally private or are getting jobs in private clinics while doing the odd shift in a walk-in clinic (thereby not being counted by regulatory authorities as having given up practice).

It is disenchanting that our regulatory authorities are increasingly perceived as being increasingly disconnected from what is really going on in Alberta. I am convinced that there is a will to set things right, however, and innovations are happening despite poor leadership, poor regulatory authority connection and coordination and a seemingly hopelessly deficit financial situation.

OSCAR is an ideal example of what can spring out of that cauldron of boiling problems.

I should know a lot more within two weeks. So far, several other Physicians have signed on to OSCAR in Alberta....and I'm just waiting for them to get back from holidays before we get their installs going.

More soon!

Countdown to Electronic Labs

Okay - we didn't "quite" pass the validation for the electronic labs. Just a minor glitch due to some slight differences between the old and the new (version 3) of the HL7 standards.

But we are well on our way. Should have everything ready for final validation within a couple of week - with the goal for electronic labs capability in Alberta being by the middle of June.

Things are going well. I have been able to make electronic forms with my own preferences using the new electronic forms generator. It is remarkably easy to use, and it works flawlessly.

I'm starting to "electronicize" more forms for my office - with the goal to having all of these forms totally electronic. It is really nice to have them printed out with the patient's demographics, and my referral comments for the referrals (ie. x-rays, etc.) very neatly typed. It is also really nice to have a copy of every referral form I have ever made for every patient - this is information not normally stored and only sometimes recorded - until now!

Vendor Lock-In and how to switch to OSCAR without pain

Vendor Lock-in is bad for consumers, but good for business (not YOUR business - THEIR Business!).

What this means in terms of an EMR is that once you choose a "proprietary" EMR - you're pretty much stuck with them because of the inordinate amount of effort it

takes to leave them and switch to another.

Here is a great summary of Vendor Lock-in:

Vendor Lock-in Wiki

and

Vendor Lock-in from the Linux Folks

So - how do we make it "EASY" for users of other EMR's to switch to OSCAR?

Simple: we provide a repository of information of switching to OSCAR from other EMR's. I am going to devote a Blog with information from users that have

"done the switch" to add their contact information, wisdom and tips on how to get this done.

What I hope to eventually achieve, will be a repository of "turnkey" information and services that will allow users to switch from their current EMR's to OSCAR.

There will be a variety of posts on the blog:

1) I don't

have an EMR, but I'm cheap and I want everything for nothing - so how do I get OSCAR?

2) I am an EMR user and I'm sick of my Vendor - how do I get OSCAR?

If you are a user of any of the medical systems below - we will attempt to provide you with information on how to switch from your EMR to OSCAR (note that OSCAR has the "coolest" Logo - not an "official" logo - I just liked this one).

Click HERE to go to the OSCAR site....more coming, so stay tuned!

OSCAR for 8 months already?????

Damn!

I can't believe I've been using OSCAR for 8 months already!

Sure - I don't have Alberta Health Billings working yet - nor do I have labs going yet....but OSCAR is really resulting in a significant time savings for me.

I'm still using paper charts for my Family Medicine Practice. The staff puts the paper charts in the door for me, and I use the paper charts to quickly refer to recent labs, etc. during patient visits. I make all of my notes on OSCAR on my Macbook Air.

I've learned to never type away when interacting with patients - it's just too interruptive to the process of a medical session. I take my laptop outside the room with me after the visit and type my notes.

When I don't really get time to finish my notes as well as I'd like, I simply take my tiny little Macbook Air home with me and log in to my server while in my underwear on the la-z-boy. This is much better than dragging 30-40 lb of charts home in a box like I did for years.

Alberta Health Services recently migrated to V3 of the HL7 data standard.....and so we're a little delayed getting labs into my OSCAR installation.

Looking forward to full functionality soon.