Scaling SOAPware EHR-EMR for St. Nicholas Medical PC

Background
St. Nicholas Medical PC is a two-physician medical practice with 3 different locations in Queens, New York. The SOAPware EMR running in all three locations was suggested and installed by a PGY-3 resident helping the clinics out occasionally.

Challenge
As it was implemented by a computer-savvy, yet non-IT-professional, the setup was quickly reaching its workstation-level database limit of 2GB. In addition, as it was installed and planned one location at a time, without factoring in future expansion, the consistency of patient records became a nightmare the number of locations increased. For instance, a new patient will come to location A for the first time. All his/her records were entered. However, when this patient had to go to location B out of convenience, the records were simply not there. Therefore, the inefficient process of entering the patient's history at location B began.

Overtime, this process became a nightmare with 2 different set of records and history at two different locations. It became downright dangerous and lawsuit-prone. For instance, if a medication prescribed at location A or the patients' allergic history was not available at the other two locations, the physician might have a chance of prescribing a wrong medication to the same patient showing up there.

How we helped
After analysis and planning, the first thing we did was getting a faster cable/DSL connections with static IP for all location. Then, we setup the secure site-to-site VPNs among all locations. Afterwards, we converted the database, merged the data into a single coherent database to be imported into a full blown full database server without the 2GB limit. Then came the task of setting up replication for the database servers. Now, instead of data inconsistency, a single copy of the patient's record would be shared among all three locations.

Results
Due to what we did, the two physicians seeing patients at three various locations will no longer have to worry about location issues, or having different copies of patients' data at all the locations. Single copy + single patient history entry = happy physicians and staff. Happy patients as well, since patients wait time were shorter, without all the unnecessary data entry.

Our experience
SOAPware is designed by a physician for the physicians. Therefore, there is a great satisfaction with the people using it. And if properly implemented, it is worthy of your consideration if you run a smallish practice.

Have a similar growing pain?
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