Toronto OSCAR EMR mini conference #2 Reflections

Excerpts from an email from Ian Pun:

This meeting was an excellent way of physicians helping physicians in their clinical use of OSCAREMR. It put actual faces to the names we read about on-line in the forums and we shared useful information and experience as detailed below:

I showed various keyboard shortcuts to navigating around your computer screen such as Command-TAB to switch between windows of the two applications you have opened (i.e. Firefox and Mail).

I stressed the importance of regular exercise to my patients with minimum of 150 min of moderate activity per week. I put my Macbook on top of my treadmill (on a stand) and walk/run 2 - 2.5 mile everyday while doing my OSCAR work (including this post right now). Exercising without really knowing you are exercising.

With a free google account, you can dictate medical histories without cost into google docs.  It knows most medical terminology but it had difficulty with brand names such as "Coversyl".  But it knew "Crestor".  A family doctor said he directly dictates using Google Chrome on his Android phone directly into Oscar eChart.  With a paid Google Gsuite business account, this is HIPAA compliant.

I showed how to attach photos into the eChart (without use of third party apps).  A few family doctors were delighted that they could take pictures directly into OSCAR using their iPad or iPhone.

A vascular surgeon said he routinely takes pictures with his iPad directly into OSCAR of his patients with vascular ulcers to follow the progression.

I showed various diabetes templates for CV risk -- the ABCDES of diabetes.

A general surgeon asked if the ticklers default choices can be set to 7 months instead of six months and a year because she has patients do their repeat breast ultrasounds in 6 months and she sees them at 7 months.  This can be fixed on the server side easily or with greasemonkey.

I showed my lab search RbT to find abnormal PSA values, to find any patients that have a most recent high PSA value that needs a biopsy.

Many thanks to Leo Pavone who contributes many eforms for the CE LHIN Toronto, including new Lakeridge and Rouge Valley/Scarborough Hospital forms. You can download them at
/oscar-users/emr-resource/eform/eform-examples/ontario-specific

Remember to hashtag "#" any important information in your eChart for easy searching.

Some doctors were complaining about the "certification" fees paid to OSCAR service providers and eHealth.  $500 for a checklist for compliance for a few questions like "HAve you upgraded your windows?" and no support. They were concerned about the "tax" grab and close sourcing of the OSCAR project in Ontario just like how Indivica went ASP on-line only. As a few were concerned in order to get OLIS and HRM requires certified OSPs and payment in order to get the access key. As doctors, we need to voice our concerns to our OSPs and not get "locked-in" with fees paid that is not contributing to improvement of the software but for bureaucratic and profit overhead.

Finally, our special guest speaker, Dr. David Chan, founder of OSCAR,  demonstrated his KNOW2ACT clinical decision makers and a CV risk eform for patients which showed risks graphically in terms of the number of happy and sad faces.

/oscar-users/emr-resource/eform/eform-examples/calculators/cvd-risk-calculator-2015

I have uploaded the slides and material to my google classroom.
https://classroom.google.com/o/OTUxNjY5MTE4M1pa
Just PM me at ianpun@gmail.com to join

The tickler idea was so good (I was fixing the dates manually all these years), I fixed it in my system. Sometimes you do things routinely for years out of habit until suddenly somebody gives you a better idea.

If somebody can fix the BC-user group on nabble website, it would be good.

The next meeting will be scheduled for March 2018.

Ian PUN MD