Preparing For Your EMR – Do You Really Need An Equipment Overhaul?

Most Eye Care Professionals are in two camps; either they have an Electronic Medical Records system or plan to get one.  This creates an opportunity not only for EMR vendors, but for equipment vendors to nudge you into “upgrading that old equipment” because you are going to have to upgrade it anyway.   Is this true? The answer is……maybe.

The issue is getting the information from your diagnostic devices into the EMR system. Conventional wisdom would lead you to believe you need a piece of equipment that is “EMR-ready” which would mean having an Ethernet port that would allow you to plug in an internet cable that looks like an oversized phone cord. In addition, you would expect that the operating system would be one that is current such as Windows 8 vs. a version no longer commercially available such as Windows 2000.

(As an aside, one of the reasons why so many otherwise high tech pieces of diagnostic equipment are not internet ready or run on an old operating system lies in the relationship between the manufacturer and the U.S. government. Increasing rules and regulations for FDA approval of new technologies and upgraded versions of existing technologies has become a nightmare for manufacturers. Often, what should be a simple process takes so long that an operating system or hardware configuration that was once state-of-the-art is now outdated. However, the manufacturer is hesitant to upgrade any part of the technology that was approved for fear that the FDA will force them to go through the entire process all over again, delaying sales of the product that took so long to approve in the first place).

It is true that devices that have an Ethernet port and a newer operating system are the easiest way to export data, including images, into your network and EMR system. However, it is also true that this necessity is exaggerated by those who may have a vested interest in upgrading your equipment.

One example – Humphrey Field Analyzer Model 750 vs. Humphrey Field Analyzer Model 750i

A new HFA 750i series unit with table and training will price out in the low to mid $20’s including shipping. A reconditioned HFA 750 non I series with table and training runs in the low to mid teens.

If you are trading in a non I series for an I series, which is common, the price difference net of trade is somewhere in the mid to high teens. Bottom line, you will pay $10,000 – $15,000 or more to upgrade.

What does this buy you?

Both of these units are identical to the average ECP in appearance and features. Both are the top-of-the-line models with head-tracking, vertex monitoring, pupil measurement, kinetic testing, blue-yellow, etc.

The key differences? 

1.       The HFA 750i has an Ethernet port for direct connection to a network .

This direct connection is convenient, but there are alternatives. For example, if you are only doing 2 -3 fields per day, purchase a $250.00 flat bed scanner and have your tech take 30 seconds to scan the printout. Since the image is black and white, the scan quality is excellent and you can then import the scanned image into any folder, including an EMR or imaging system.

2.       The I series has a newer version of the GPA program.

The latest GPA software is excellent. If you plan to use historical test results to track small changes in progression for your glaucoma patients, there is no equal to what Zeiss has developed. However, most HFA owners do not utilize this software on a regular basis. Some HFA non I series come with the original version of GPA, although Zeiss will no longer offer this to current non I HFA customers.

3.       The I series offers “HFA NET PRO” SW, designed to make it easier for EMR vendors to integrate their software.

The original iSeries HFA allowed you to export images or print. This feature was later replaced with HFA NET PRO software, which is a more robust solution for EMR systems and image export. However, if faced with a $10,000 – $15,000 trade in proposition, there are alternatives. For example, there are devices that will connect to the parallel printer port of the HFA that will turn the data output into a PDF and export that image into a nearby laptop or PC. This set up would cost you a maximum of $1,500.00, including the laptop. (Note if you are purchasing a preowned iSeries HFA, if the unit does not have HFA NET PRO software, you may need to purchase it from Zeiss prior to exporting images into your EMR). 

Other points such as…”you can’t get parts for the HFA non I series” do not pass what an old friend of mine used to call the “reasonableness test”. Take a look at both units; do they look like the parts are different? True, some of the internal parts are different, but the Eye Care Alliance and several other companies who service this equipment have no problem with replacement parts.

Finally, understand that EMR vendors HATE to have to accommodate legacy equipment into their systems. It causes them to work with old operating systems, develop customized software and then become ultimately responsible for data that somehow stops making its way into their system.

So, if you find yourself being told from the new equipment rep and/or the EMR company that your current equipment does not pass muster, feel free to call us for a second opinion.

 

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