I am running a security enhancement written by Ken Chappel of MI-2. This has improved our security a lot and prevents unauthorized users from peeking at records that they have been unauthorized to access. It has worked exceedingly well for our use case (though management of the access controls could be enhanced).
After looking over the portal I am very impressed, but me being me, I want more.
It would be very useful for our practice to have several different classes of portal users:
Patient (or responsible party) Right now the functionality looks very good. As I get more experience with the portal I will give more feedback.
Other Health Care Providers A common problem is the transfer of records back and forth to other providers. In spite of all the “compatibility” of Electronic Health Records, Medical Practices almost universally fax records back and forth. The records if they get to the practice prior to the patient arriving are placed in some sort of poorly organized infinite holding tank, never to seen again. Having the ability to download CCDs and upload CCDs from the portal may improve the interoperability…maybe.
Home Health / Hospice agencies I currently receive some 200 billable Home Health Plan of Cares, Certifications and recertifications per month. This amounts to $130,000 in reimbursement per annum. Yes most of this works by faxing. I lug around a 4-6 inch pile of papers to sign. The Home Health and Hospice Agencies are desperate to get their documents signed (they only have a limited of time or they lose their reimbursement) and invariably start faxing additional copies 2-3-4 times thereby increasing the size of my pile of paper and slowing the process for everyone. This has been the bane of my existence for 30 years now.
Allowing the Home Health and Hospice agencies to upload and track the progress of their documents would be invaluable to these agencies and the medical doctors who sign them. For our office having an electronic work list to verify the orders prior to sending them to the physician for signature. For the physician the ability to sign documents electronically with CMS valid signatures is extremely helpful. Then returning the signed documents electronically by allowing the Home Health / Hospice agencies to download the signed documents.
I do have two electronic web based hubs that use Inscrybe.net and SutureSign.com. Both of these sites help tremendously to speed the flow of information back and forth between the agencies and the physician. Using the LibreHealth EHR changes the hub location to the portal. I know that Inscrybe uses the US Postal service to verify the electronic signatures. I am not sure if this type of third party verification helps that much but it is worth considering.
Sam Bowen, MD Open Source Rabble Rouser