EMR in the ED

  1. we are currently looking at different vendors for emr in our emergency department. if your ed is using emr i would love to hear your comments, pitfalls and all please!!! we will be doing a site visit at houston medical center in georgia to check out ibex next week.
    thanks for your input....
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    About ERnursie172

    Joined: Oct '04; Posts: 10; Likes: 1
    Charge Nurse, Emergency Department


  3. by   Dixielee
    Obviously I can be of no help because I have never heard of EMR or IBEX. I have been a traveling ER nurse for 5 years and have not come into contact with anything with those initials. Maybe you could enlighten those of us in the dark.
  4. by   ERnursie172
    i'll give it my best dixielee
    emr= electronical medical record
    it is a complete emergency department tracking system being installed in thousands of emergency departments throughout the country. starting with triage thru disposition everything is done via the computer, no more paper. all nursing and physician documentation is provided in "real time". also does discharge instructions, rx's and drops the ed bill at completion of the chart. they interface with your hospitals present lab, x-ray software allowing the ed instant order entry. the present day "grease board" is no longer used, instead a mega size plasma screen tracking board which can be customized to your ed's needs.
    if you continue as a travel er nurse within the us you are bound to come across it very soon, i'm almost certain of it.

    Quote from dixielee
    obviously i can be of no help because i have never heard of emr or ibex. i have been a traveling er nurse for 5 years and have not come into contact with anything with those initials. maybe you could enlighten those of us in the dark.
  5. by   Dixielee
    Why didn't you say so! I worked with a good one in Oklahoma city but can't remember the name of it. But I encountered the worst one possible in Tucson called Amelior. Run from it if you hear of it. It was supposed to have backup to its backup but crashed one night with 52 patients in the ER and a waiting room full. The charge nurse tried the help number and they didn't even have a record of us ever having it! We had to go room to room getting basic info again...."can I have your name again, what is wrong with you, and have we done anything about it"??? What a mess, we had to call an "internal disaster" and go on all kinds of divert to get it straight. We have not seen it again since, but they keep threatening that it is coming back. It was cumbersome, kept triage backed up for miles. We had a 40% "leave before triage" rate. It did not want you to be able to free text, so it made it horribly difficult to do so. You had to click 5 different icons before you could actually begin your assessment. What a pain. My contract ends in May and it is supposed to come back soon, sure hope I am gone before it does, we are busy enough without it.

    One more problem with it, is the medical records did not trust it (they were wise) and we still had to make hard copies of each chart, just adding to our workload. Good luck. If you find a good one, let us know!
  6. by   EMTPTORN
    The ER i work at uses IBEX, I love it. It is very easy to use. Nice features is you can look up past visits, see previous d/c instructions(ie you were told not to come back here seeking pain meds, you were given a dr to followup with, why did you not do as you were instructed?) Our IBEX system has only "crashed" once or tiwce in the past yr..even when hurricanes came the computers worked with backup generators...so, it is much neater than paper and very user friendly.

  7. by   needsmore$
    We use codonix currently in our ED. The hospital uses Meditech. These 2 do not work together. The docs bought Codonix to help with their billing-fair program- We will be switching to Meditech in the summer--hope it's a good system for ED charting

  8. by   candyndel
    we use ibex. we were the first ed in nj to go paperless, but not without heartache. the quality of our documetation is suffering, not to mention the ease of finger swipe errors. people just arent documenting things they would have had it been right in front of them. i have the unlucky pleasure of doing hundreds of chart audits a month and i read some charts and cringe.
    for example, we had a brain dead pt (huge bleed) who wound up being an organ donor very quickly.
    after being declared brain dead twice and the procurement, the me read the chart and noticed the pt was a&ox3 on arrival. this was no where near the truth, but was entered into the mr by habit. now this a big problem.
    it also time stamps when you do your charting. if you dont enter the actual time you did something, it looks like it was done at the time you charted it. this was a big problem with another pt expiration.
    the recall of pt visits and legibility is invaluable. rx writer should be great, too, once we get it.
    it also takes a while to get software changes made through programming.
    it also cant interface with our hospital's main charting system, which are jcaho problems w/ medication reconcilation and ed holds.
    these problems might be inherent with any emr system, who knows? shop around and good luck!

    uote=ernursie172]we are currently looking at different vendors for emr in our emergency department. if your ed is using emr i would love to hear your comments, pitfalls and all please!!! we will be doing a site visit at houston medical center in georgia to check out ibex next week.
    thanks for your input.... [/quote]
  9. by   CamaroGirl13
    Hey. I'm not a nurse (just a student nurse), but I work as an ER tech. I couldn't help but notice this thread.

    I work as a sort of assistant to the ER manager. I used to help with chart audits...length of stay times...that sort of thing. But anyway, my boss (the ER manager) has been trying to get EMR. It looks very nice. And I feel that it would cut back on charting errors and that sort of thing.

    We currently have a lady who scans ER records and saves them to a program called Optimaxx. I hate it. It's not user friendly, and, half the time, nobody uses it. I would love to have EMR in our ER. Hopefully, one day, it will happen.
  10. by   rjflyn
    I have been lucky or unlucky enough depending on ones point of view to have uses 3 different systems. Codonix- incidently at the hospital that originated it which of the ones I have used was the best. The second also at the hospital that originated it, sold it, then waited for ever to upgrade and still had bugs after almost 6 months. The third is just for triage and tracking so far.

    The biggest issue seems to alway be getting something that is compatible with what the rest of the hospital has/getting and still works. That and something that doesnt take forever and day to triage or chart on a patient.

  11. by   jawadhabib
    have you thought of making your own or having it made for you? i know veterinary setting is a lot different but AMCNY made their own. thought it might be useful.
  12. by   traumaRUs
    Have used T-charts on paper and they also have an EMR version - very nice and easy to use.

    Have used IDX (originates from Texas) and though it was fine, it didn't integrate into the hospital system - this is a biggie for continuity of care.

    The big (700+) bed hospital in my area is going to Epic - haven't had my training on it but it is suposed to be seamless from ER to admission to discharge.

    McKesson puts out several products and they are all similar but the charting looks kinda weird because of the "preprogrammed" sentences!
  13. by   Larry77
    We looked into the IDEX or IDX system when we purchased our TSystems system but like others stated, it didn't talk to our hospital system which is Carecast (used to be Lastword). While it does have some downfalls the TSystem EMR system is nice and easy to use.

    Our billing dollars skyrocketed with the electronic charting and we actually are better at checking boxes that Jcaho wants checked...

    Would be great if you could look at a few systems and talk to the users and IT dept's to find out the issues they have had and make sure it talks to any of the systems you already have in place.
  14. by   LilgirlRN
    We use FirstNet!!! LOVE it!!!!!!!!!