the path to paperless
EMR and Imaging Solutions
Eight key factors in choosing an imaging system.

A major factor in the choice of an EMR system is the capability to handle high-resolution imaging. This was particularly true in our case because we have a multi-subspecialty practice including glaucoma and retina, which require the ability to view electronic images from a variety of diagnostic devices.

While many EMR systems have built-in image viewing modules, practices may wish to consider a stand-alone solution that has more robust capabilities, such as viewing multiple images simultaneously or scrolling through several previous reports, as well as viewing images across a wide-area network between office locations. I asked Steve Thomas, C.R.A., of Florida Ophthalmic Consultants, an independent imaging consultant, to discuss the key factors that a practice should consider when choosing an imaging system:

2. Durability. This is based on the reputation of the manufacturer and the average amount of use. Can you get it fixed fast if it breaks? Who provides the technical support?

3. Usability. Do you need to hire special staff to operate the equipment? If not, does the manufacturer provide extensive training? Is ease of use offset by a lack of capabilities?

4. Resolution. What image resolution (for FA and FP systems) will be required to suit your practice needs? Don't fall into the higher-res-is-better trap — a high-resolution image viewed on a lower-resolution monitor may lose critical fine details, such as microaneurysms, due to compression. Match the resolution of the system to that of your monitors with the lowest resolution.

5. Licensing. Is the system licensed per practice, per doctor or per user? If it is per user, does the system limit how many users can be logged on at any one time? Can you network the system into all your exam rooms without having to purchase additional licenses?

6. Expandability. After the system has been in use for a number of years, will you need additional computer resources to manage the increasing patient image information? How do you back up this information to protect loss?

7. Accessibility. Can you access the information from office to office if your practice grows. How easily/quickly can you view these images across a wide-area network? Will you be able to perform any telemedicine with the equipment?

8. Interoperability. Is it a self-contained system? Will it dovetail easily with your existing EMR system? Or is the "digital" part from a third-party manufacturer, complicating service issues when the system goes down?

Technical issues such as hardware or software interfaces between various devices and the imaging system should also be considered in the decision-making process.

Next: Is your staff ready for EMR?

Peter J. Polack, M.D., F.A.C.S., is co-managing partner for Ocala Eye, PA, and a specialist in cornea, external disease and refractive surgery. Founded in 1971, Ocala Eye is a ten-physician, multisubspecialty ophthalmology practice located in Ocala, Fla. The practice, which has six locations including an ASC and laser center, has 140 employees. He can be reached by email at ppolack@ocalaeye.com.

In a multipart series, Dr. Polack is describing how a seven-partner practice, Ocala Eye in Ocala, Fla., with five locations and 140 employees, makes the major transition from paper medical records to EMR. During the course of the series, Dr. Polack will provide readers with a "real-time" look at how the implementation is progressing. This is part 18 of the series.