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 By Neil B. Gailmard, OD, MBA, FAAO, Editor August 4, 2010 - Tip #442 
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Hardware That Makes EMR Easier

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Implementation of an electronic medical record system is not for the faint of heart.  It can be stressful on doctors and staff members and it can slow down patient flow at first.  But take comfort in knowing that the good far outweighs the bad.  The proper hardware technology in your office can make life much easier.  Consider these devices:

  • Laptops.  Technically these may be called notebook PCs.  They are extremely useful because they connect wirelessly to your network and they can go from room to room with the patient, or can be viewed outside the exam room by the doctor.  They also provide a second screen in the exam room for a scribe to work on, but the doctor can still view some parts of the record or retinal photos on the desktop workstation.  I like 14 or 15 inch diagonal screen laptops.  I have to hunt for that size but it is worth it.  Any smaller and you can't see much of the record at once and any bigger and the device gets heavy and large to lug around.  Be sure you get the proper operating system for your EMR.
  • Tablet PCs.  These are amazing devices that convert handwriting with a stylus into text.  For some reason, however, most of my staff prefers standard laptops.  They seem to prefer a keyboard and mouse arrangement.  There are tablet PCs that convert to either way, but tablets are more expensive and you may need several.
  • Netbooks.  These are the mini-laptops with about a 10 inch screen that were really designed for personal use with email and internet, so they may not work properly with your system.  But they are incredibly cheap and very easy to carry around.  We have one and it works fine even though the screen is very small.
  • Wireless router.  This is a must if you want to use laptops.  You may need repeater stations to get proper signal strength all over your office.  Be sure to have a firewall and password protection so your network is secure.  Don't hesitate to hire an IT professional for assistance.
  • Scanners.  These devices are great for everything you used to put in the paper file from copies of patient insurance cards to lab invoices to incoming referral letters.  Your EMR has a special tab that links to the documents within the patient's record.  I would invest in a dedicated, commercial grade scanner rather than rely on a multifunction printer device.  A duplex scanner will scan both sides of a document at once and they are very fast.  Be sure to check if your scanner must be TWAIN compliant.
  • Network printers.  Now very inexpensive and readily available, these devices have an Ethernet jack (or they could be wireless).  They allow you to print to any printer from any workstation or laptop in the office.  This comes in very handy for many functions.  You can print an eyeglass order that is created in your dispensary on a printer in your optical lab.  You can be in an exam room and print a contact lens order in the CL lab.  You can print a patient handout or drug Rx and have it ready at the front desk.  When you go to print, a drop down box appears that asks you where you want to print to.  You can label the printer names whatever you wish.
  • Monitor Y cables.  In larger exam rooms, these inexpensive splitters allow you to have dual monitors so a scribe and the doctor can each have a screen.  However, this device limits you to both seeing the exact same thing.
  • Wireless keyboard and mouse.  I love these because it eliminates the wires that can get hung up on a desktop making it very easy to share the keyboard and mouse with a scribe.  Just plug a small USB device into the PC and you're in business. 
  • LCD monitors.  Nothing unusual here, but I like how lightweight a standard 19 inch monitor is because it allows the doctor or scribe to turn or slide the monitor across the desktop.  We put felt pads over the rubber ones on the bottom to facilitate this.

Be creative as you analyze your work flow with EMR.  Ask yourself what would make the process more efficient and then look for ways to achieve that.  The odds are good that there is technology available to assist you.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

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