I have been e-mailing back with Shawn Barrett at Ability Software. I have known the guy quite some time, and he is quite bright and has been very helpful previously. I sent him some questions by e-mail, and if you have been following my steps in setting up billing and EMR, you may find the following interesting.
I have edited a bit of this for clarity, it is my e-mail with his comments embedded in it…
Hey Shawn,
I am hoping to get this set up within the next week.
I have a good relationship with David Churbuck one of the V.P.’s of Lenovo, so I predict I will get excellent customer service.
[Shawn Barrett>>] Yes, that is always very advantageous.
I still have some “confusions†on the difference between a server, and simply a powerful desktop computer. Perhaps they are the same thing these days, and the name only implies the difference of use? It is confusing though that I can not find any servers on the lenovo site. My guess after searching is that the term server is generally used for a machine that will handle a network much bigger than mine.
[Shawn Barrett>>] Server, has two meanings:
1. A computer, usually robust with plenty of memory and hard drive space, designed to share data (files and databases) and devices (printers, scanners, etc.) for multiple users on a network. This is a central location where everyone on the network should be storing their files and an automatic backup runs on a regular schedule to backup all the data. This can have either a desktop operating system (Windows XP Professional) or a server operating system (Windows 1123 Server) installed on it.
2. A computer that is setup as #1 above that is out of the way and not used by anyone directly. It is not designed to be used as a workstation, only to store and share files, etc. It also keeps the configuration for the network and the users providing proper security permissions and keeping sensitive data (accounting information, etc.) properly secure. This configuration is usually used for larger networks (8 or more computers) and/or higher demand (large databases, storage of scanned documents, office e-mail, etc.). A true server has the server operating system installed on it such as Windows 1123 Server. A true server usually has some redundancy built into it (extra hard drives, power supplies (should one fail), sturdier components, etc. This is why true servers are more expensive than just workstations. A true server is expected to last for at least 5 years with minimal repair.
For a small network like yours, you can use a good workstation as the ‘server’, especially if you only have Medisoft and some documents to store and share on it. However, you would want to make sure to have a good backup system in any case. Also, keep in mind some of the requirements under HIPAA are that a good and update to date anti-virus system is in place on all computers and that backups are done on a regular basis and then taken off site. You also need to have a backup computer and/or plan incase of loss or failure of the main computer(s).
In terms of actual use, our office currently sees around 40 visits per day, with each visit requiring being scheduled in office hours, and on average two procedure codes entered for each visit. After the billing system is up and running, I will be planning on adding in EMR, so I would like the system to be able to handle that info also. With the lower costs of computers, I am totally O.K. with getting machines that are a little cheaper, and then upgrading them as needed over time, in say 2 years.
[Shawn Barrett>>] I can definitely understand that. Just keep in mind that if you go paperless, you have to be able to still get to the patient charts to provide healthcare should the computer system go down. Going paperless provides a lot in benefits (reduces office space taken by charts, puts everything into the computer for better access – no more missing or misplaced charts), however, there are costs involved in making sure that the computer system (or some part of it at least) is always accessible in case of computer problems. This part is the main downfall to using any type of ASP (Application Service Provider) over the Internet for your EMR – if the Internet is down, then you have no patient charts.
Before you do the work below, could you give me some idea of pricing for your time helping me get everything set up, even if it is just the hourly rate.
[Shawn Barrett>>] I am putting those pricing together right now.
Then, could you take a look through Lenovo’s site, and recommend three computers for me.
[Shawn Barrett>>] I would be glad to do that, but do you want notebooks or desktops? Desktops are cheaper in price and have generally better performance than notebooks, however, notebooks are more mobile; essentially, you pay for the ability to be able to move the computer around (or take it out of the office) with notebooks. If you don’t plan on taking them out of the office, then get desktops. Notebooks are also more easily stolen and damaged (dropped or knocked off desk, etc.).
I have a 750 square foot office. In the front, in Div 3 is where I will have one of the workstations.
There is a large open treatment room with a small desk in the middle of it where I would like another work station.
In a small room in the back of the office, too crammed to work comfortably, I would like the computer to be where Medisoft will be installed. This machine will rarely, or never be used, except for administration of the network. This machine is the one that is right next to the cable modem, so can be hard wired. I was planning on connecting this machine hard wired to the router, and the other two computer connected to the internet via the newest Belkin wireless router. I have had excellent experience with Belkin in the past.
[Shawn Barrett>>] I reviewed the workstations to find you a workstation/server from the above website, and found “ThinkCentre A55 Tower 8705CTO†which seems that it would work. You would need XP Professional and 1 GB of ram along with a DVD R/W and some type of backup system.
I was thinking of this router,
http://reviews.cnet.com/Belkin_Wireless_Pre_N_router/4505-3319_7-30993672-2.html?tag=rate
[Shawn Barrett>>] I reviewed the router and it looks fine, however, this note on the specifications concerned me:
“This product uses the draft version of the upcoming 802.11n standard. Its compatibility with other and future products is not guaranteed, and it may interfere with current 802.11b and g products. “
I have it at home already and it works great.
Tell me your opinion of the above. If you would like to charge me for advice as we go along, that is fine, but I would like to know in advance. I would like to get your advice today if possible, so I can make my hardware purchases and get them sent to me quick.
Thanks!
dk