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 Special Feature

Medical group goes paperless

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   February 2010

Mike Soler, IT systems and support manager for Florida's Intercoastal Medical Group (IMG), says his organization has already transitioned to paperless operations. His group serves the residents of Florida's Sarasota and Manatee counties with six locations specializing in everything from neurology to orthopedics, family practice to internal medicine, and gynecology to cardiology. The group also operates a weekend clinic at its Hyde Park, Fla., location for patients unable to wait for acute, non-emergency medical care from their regular physicians.

IMG handles 85,000 lab tests, studies 80,000 images and logs more than 255,000 patient visits in a given year. The clinics needed a system robust enough to reduce errors and ensure excellent care.

Before implementing its current electronic health records (EHR) system, IMG's 65 physicians and additional medical personnel had to manually enter every lab test, exam result and set of visit notes, making data susceptible to human error and incorrect record keeping.

"All the transactions we track create a lot of room for human error," says IMG Chief Administrative Officer Geoffrey Simon. "HP thin clients, packaged with Altiris and EHR software, advance our ability to detect and address patient problems in a timely fashion."

Altiris is used for managing both the thin clients and the HP Compaq dc8500 desktop PCs being used for more general tasks in the doctors' offices.

IMG executives considered a variety of solutions and decided that thin clients met the significant cost requirements, IT management and security advantages they were seeking.

Currently, IMG is using 200 HP Compaq 5730t thin clients in exam rooms and check-in stations, in addition to HP t5540 thin clients at nurses' stations and front offices within the practice.

In a thin-client environment, solid-state devices connect to a remote server where the bulk of the processing takes place. There is no hard drive on the unit, allowing for more secure storage on the server. Keystrokes, mouse movements and screen images are the only items sent between the client and server, making the device more secure.

IMG's shift to paperless records has taken place in stages, starting with Citrix gateway access for patient medication and allergy history and moving to lab test orders and results. Soon, the practice will include doctors' notes in the system. Once completed, data should be available to all relevant medical professionals, with little chance of gaps in information as the patient visits bounce back and forth between primary-care physicians and specialists. The next phase of the transition will include biometric security so doctors and nurses will not be required to log in and out of the system multiple times a day.

Uploading anything — particularly information as sensitive as personal health records — to an electronic forum raises concerns about security and privacy, admits Soler. With its HP thin clients, IMG is prepared to address any of these security concerns. Unlike a traditional desktop or notebook computer, no applications or data are stored locally on the thin client. All the data is uploaded to a remote server — in this case, 10 Citrix Access Gateway servers .

"With thin clients, we're able to log in remotely with no drive time or expense," says Soler. "It's simple to roll out thin clients. Imaging them takes about 10 minutes or less, compared to several hours to load applications on a PC. Upgrades are fast and easy. Rolling out upgrades to 300-plus traditional desktops and notebooks would take days, compared to a few hours for thin clients."

A remote server also cushions the organization's bottom line, since all configurations, set-up requirements, updates, virus scans and patches are conducted on the server rather than on site at the medical facilities' individual locations.

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