SynapseDirect

OCR, or optical character recognition, is a process whereby a paper document, or fax, is turned back into a near digital representation of the original.  This allows data to be extracted from source, and possibly inserted into the EMR as discrete data.  Typically though the process of OCR requires the user to select fields to scan, to check and correct the text, and then add it to the correct patient.

Synapse has a new optional utility that automates much of this by automatically OCR any documents of type TIFF or PDF, and associating them with the scanned image.  If the image is of sufficiently high quality, it may be possible to take results from the OCR and then inject them into the database.  You might want to check them first though to make sure that the accuracy is good enough.

In the first run, it took about 12 hours to automatically OCR several thousand of my own scans.  Thereafter it sits waiting for more scans to arrive.  Because the processing is done as a web service, there is very little CPU usage on the server. 

We may expand this facility to automatically scan patient intake forms and enter patients into Synapse based upon these forms.  Note that OCR web services can be purchased for about $250 - $300 per year, and that does not include any integration with Synapse.  Our price will be about a third of this

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TEPR 2007  (the annual Towards the Electronic Patient Record show ) is now in progress, and Schiller, a world leader in manufacturing medical monitoring equipment will be demonstrating Synapse EMR's bidirectional interface with their PC based software.

Eddie Hernandez, IT Products Specialist for Schiller America,  will demonstrate how an EKG, and other examinations, can be requested from Synapse EMR, and how the result can be imported back into the patient record.

Founded in 1974, SCHILLER is a leading international manufacturer and supplier of computer based Electrocardiographs, Spirometers, Patient Monitors and External Defibrillators, located in Baar, Switzerland near to Zurich. SCHILLER has inspired confidence in Physicians for almost 30 years, providing quality products and leading edge technology. This passion for success has propelled SCHILLER to the worldwide market leader in the Cardiac Diagnostic Physician based markets.
 

The template language has been updated to allow users to include patient specific variables, and the ability to insert numerical data into the patient's results.  You can also specify fields that are the result of a calculation based upon the data in the other fields. 

You can read about these new features in our wiki
 

Some of our users have asked us about the possibility of porting Synapse EMR to Linux.  Since Synapse EMR is written in Rebol, the application is essentially platform neutral.  There are some features quite specific to Windows such as the Skype, Paperport, and scanning interfaces ... but without those, it should be quite feasible given enough interest.

The Synapse Server port would require moving to a different database .. likely to be Postgresql instead of Firebird as there is no suitable obdc interface.  We would look at doing this after we have completed the Linux Synapse EMR Client port.

The World Wide Web has in recent years become a major and reliable delivery mechanism for a number of useful services.  However, accessing those services  can be a major headache as more often than not they are designed to be used by web browsers only.  If you want to automate things such as using the Google api to implement your own search functions, you need to obtain your own developer's license .. and of course you need to know how to program.

A case in point.  In New Zealand, we recently underwent a nationwide change in Zip codes, and it is now deemed necessary to incorporate the correct zip code as otherwise your mail will be delayed.  The Post Office does supply a web lookup form to get the new zip codes, but you have to fill their form in with the number, street, town and city all in different fields.  For 10,000 patients, this could become a little tedious.

Now the usual way to automate this is to look at the underlying HTML of the form, look at the form method, the form variables etc, and then write a script to automate populating the form with our data. We can do this, but the script has to be hard coded into Synapse, and this is not good.  If the form changes, we have to recompile Synapse EMR to accommodate the change.  And say, a user wants to use this data to go to some online white pages to check telephone numbers instead.  They can't.

But there is now a solution, at least if you are using Firefox!  Chickenfoot is a Firefox extension from some nice guys at MIT that allows you to control the browser using scripts.  They give demo scripts for showing how to rearrange web pages, alter web pages by adding new buttons ( eg. adding a specific search button to google's search page ) and so forth.  These scripts can be setup as triggers so that if you go to a specific web page, then the script is automatically run.

So, how does this help with the checking of 10,000 users and their Zip codes?  Easy!  We create a button on the patient details page.  This generates a local web page with the address details.  The chickenfoot script is automatically triggered, the address details are grabbed from our local web page, firefox is told to browse to the web page, fill it in, and then press the search button.  Up then pops the new page with the patient's new zip code details.

Now since the chickenfoot script is local, and hosted in the browser, the user can write their own script to do a telephone search instead on their local whitepages directory.  Neat!

How hard is chickenfoot?  Not too hard, and you should be able to modify existing scripts to do what you need.

Here's my chickenfoot script that does the zip code search:

number = find(/Number: ([\w\s]+)/).groups[1];
street = find(/Street: ([\w\s]+)/).groups[1];
suburb = find(/Suburb: ([\w\s]+)/).groups[1];
city = find(/City: ([\w\s]+)/).groups[1];

with(openTab('http://www.nzpost.co.nz/Cultures/en-NZ/OnlineTools/PostCodeFinder/', true)) {
	enter("Number",number)
	enter("Street Name",street)
	enter("Suburb",suburb)
	enter("City",city)
	click("SubmitAddressSearchImageButton")
}

What this means is that we can provide you with a way to search diagnoses, drugs etc on your favourite websites even if they are subscription based, and without the need for us to code these scripts within Synapse EMR.  So, if you use Update.com or other subscription services, we can provide the local web page which your own script then takes you to the relevant search page there, fills it in, and brings up the required data.

Some users have expressed a wish for some way to turn existing forms ( PDF etc) into forms that can be used within Synapse-EMR, and then be printed, and possibly be saved.  One reason that this might be required is if the institution who's form it is, refuses to accept any other forms other than their own.

We will therefore offer a custom service to take an existing PDF form, and turn this into a Synapse form.  This may not necessarily that closely resemble the original form on screen, but when printed, will be almost indistinguishable from the original.  The onscreen form will be prepopulated with any relevant data from demographics and so forth, and will allow entry of further data as required by that form.  The final PDF can be saved like any other file as part of the patient's record.

This process will involve some custom programming, and will be chargeable at US$195 per page.  We reserve the right to decline any requests to turn any particular PDF into a form.

If the same exact form is required by other users, the fee will reduce to US$50 per page, and this will be credited back to the original commissioning customer to a maximum of US$195 per page.  This means that the original commissioning customer may end up paying nothing for the form!  All payments and credits will be thru Paypal.

Server 0.0.62, and Client build 187 now allow portal messaging. Patients using the client can login to the portal and send/receive messages in their "Patients/Messages" tab.

Staff can see these messages in their "Inbox/Messages" tab, create new messages and reply to existing messages.

It is planned to allow staff to send attachments and voice messages to patients.  This attachment could be any file, or it could be a scanned file that is already within Synapse EMR.

Currently emails are not sent to the patient to inform them of a new message, but this will be done once we are satisfied that there are no problems.