About

The Open-Source Anesthesia Electronic Medical Record (OSAEMR) is a solution developed by the tireless efforts of Dan Simonson and Jack Hitchens.

Dan recently retired from full-time clinical practice in Spokane Washington, but has been actively involved in the coding and development of this AEMR.

Jack is working in Clinical private practice, in Harford and Baltimore County Maryland and has been collaborating with Dan on this AEMR Solution.

The following is our Abstract for our Poster presented at The World Congress of Nurse Anesthetists  in Glasgow Scotland May 13-16, 2016

Introduction

Currently there are no widely available open-source anesthesia electronic medical records (AEMRs) specifically for Nurse Anesthetists.

Our goal was to create an open-source, widely-available AEMR that can be downloaded and installed on a tablet computer (the Apple® iPad). For simplicity and ease of use, its focus will be on solo- or small-practice nurse anesthetists operating in environments with limited or no network and computing resources other than the iPad. One patient, one nurse anesthetist, and one iPad.

Methods

We chose to use FileMaker® database management platform to create our anesthesia EMR solution because once created in the FileMaker program on a desktop computer, the solution file can be downloaded and installed for free on any iPad that has previously installed the free FileMaker Go® iOS app.

We had additional concerns that had to be addressed:

Ease of use – the solution must require minimal learning and setup time, and allow maximum attention to be placed upon the patient and not on data entry. Also, for international use, it must be “localizable” such that different languages may be accommodated.

Open-source – the solution should be licensed in such a way as to allow users (or developers they employ) to modify and expand the basic code for their own particular uses. However, the license will prohibit commercial use or sale of the solution unless it has been substantially modified.

Security – the solution must comply with USA government security requirements as put forth in the Health Information Portability and Accountability Act (HIPAA) and 21 CFR Part 11 statutes.

Data reporting – the solution will allow simplified data reporting for quality improvement activities and requests by national or international data repositories or agencies, such as the Center for Medicare and Medicaid (CMS) Physician Quality Reporting System (PQRS).

Billing – the solution will allow secure transmission of billing data to third parties.

Results

 Anesthesia_EMR_version_x_xx.fmp12, a downloadable FileMaker solution file.

Discussion and Conclusion

 Given the movement by both governments and insurers to require electronic data collection and transmission for payment, compliance, and quality improvement efforts, solo- or small-practice nurse anesthetists with limited financial and computing resources may find it increasingly difficult to care for their patients in these settings. Governments and insurers may either refuse or decrease the payments to practitioners who cannot supply EMR data. This trend is well underway in the USA, where CMS is reducing payments to providers who cannot supply data to the PQRS.