Technology Overview
The VIM Clinic of the Cascades was the first volunteer-powered clinic in the U.S. to employ electronic medical records (EMR) in the delivery of care. In order to make this decision, we partnered with Oregon Health Sciences University’s Program of Medical Informatics to investigate if and how we could use EMR in our Clinic. In addition to software and hardware system requirements we specifically researched how to recruit and retain a high-quality volunteer staff capable of utilizing a paperless system, the differences between a private practice and a volunteer medical setting and what obstacles must be overcome in order to facilitate physician adoption of the EMR system. To learn more about how we made this decision and the obstacles that needed to be addressed in order to implement EMR, please see the attached reports.
VIM Project Report
VIM Scope Analysis
The EMR system was challenging during the first 6 months. We had a problem with the tablet pc’s losing their signals but that was resolved and for the past 3+ years the system has functioned very well and requires little maintenance. We use e-mds software and it has served us well. In 2002 when we were evaluating software, there were not that many choices in our price range and it met our needs for simplicity and solid content management. Today, there are many EMR and EHR software choices and we would encourage other clinics to do a full literature review and product testing before choosing an EMR software. From a QA and operational perspective, the EMR system has been extraordinary.
Technology Description
Server Infrastructure (3 servers)
-Microsoft Small Business Server 2003 – Primary Domain Controller/MS Exchange Server
-Microsoft Windows 2003 Server – Primary EMR Application Server (MS SQL Server Based)
-Microsoft Windows 2003 Server – Secondary EMR Training server
Hardware Infrastructure
-Dell Poweredge Server Quad Core Xeon (Primary Domain Controller – SMB 2003 Server)
-HP Proliant Servers DH140 (Supporting Servers – Windows 2003 Server)
-Tablet PC’s Toshiba Protégé 3500 Series Pentium 3 Systems
-Workstations (Primarily Dell Optiplex Systems)
-4 B/W Networked Laser Printers
-1 Color Laser Printer
Software
-e-MDs (Primary Electronic Medical Record Application “EMR”)
-Microsoft XP Professional (Client Workstations including tablet PC’s)
-Microsoft Office (Workstations)
-Microsoft SQL Server 2003
-Microsoft Small Business Server 2003 R2
-Microsoft Server 2003
Network
-Linksys Rv042 VPN Endpoint Router – (Primary Firewall/Router)
-Gigabit Switches
-Linksys 54G Wireless Access Points
-Microsoft Exchange 2003 – Primary E-Mail Communications Server
Backup and Security
-Managed Hardwired Firewall Solution
-Panda Enterprise Solution with TruPrevent Technologies
-Onsite - Daily Backup Server (Daily internal Server Data incremental Backup)
-Offsite - server backup e-MDs SQL database (Daily Backup)
-Onsite/Offsite Weekly Rotation - Hot Swappable SATA External Drives (All Office Data )
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