This section of SETMA's website is intended to make available to our colleagues and medical community information about the tools which we have built in order to improve the quality of care we provide our patients. The first document is a discussion of the philosophy which guided SETMA's development of our EMR and which directed us to the concept of electronic patient management. (Click Here to Read) As will be seen, a great deal of what we have done has been founded upon the work of Peter Senge at MIT and which was presented in his book, The Fifth Discipline.
The making of this material available on our website, is a further step in one of SETMA's goals. It is not intended to be pretentious, as it may appear so, but the genesis of this effort began nine years ago when a very good friend of SETMA asked the question, "What is your goal; what do you want to accomplish?" I said, "I have never said this out loud, but I want to change how healthcare is delivered in America." I realized then and do so now, the improbability of that becoming a reality but this is the motive behind our giving unfettered access to these tools to anyone.
These tools are built upon the NextGen@ EMR platform. In order to make the tools work as a plug-and-play function, it would be necessary to purchase their product, but other than that, there are no fees required to download, to study and to learn from the tools which we have developed.
Where did the concept of "electronic patient management" come from? In May, 1999, SETMA published a paper entitled, "More Than a Transcription Service: Reorganizing the Practice of Medicine With Electronic Patient Records (EMR)". That article is still on our website under Your Life Your Health. At that time, SETMA had been using EMR for only four months. We began Tuesday, January 19, 1999, after having purchased the EMR in March, 1998. By May, we already recognized that succeeding with an EMR was a short-sighted goal. We began to understand that if all we were gaining with EMR was an electronic means of documenting a patient encounter, it was too expensive and too hard to justify the expense and the effort. Our goals changed and we began to pursue "electronic patient management" (EPM). EPM focused on the gaining of leverage and advantage in patient care and treatment outcomes with the EMR. EPM remains our goal to this day and has been the guiding principle in the development of our disease management tools, our patient-care functions and our reporting modules.
It was in May, 1999, that we had a sentinel event which has continued to define our efforts in development of EPM. In that month, my co-founding partner, Dr. Mark Wilson, speaking of where we were in the use of the EMR, lamented, "We haven't even begun to crawl." He was discouraged and worried that we had bought a very expensive and useless toy. I responded, "Mark, when you oldest son turned over in bed, did you call you wife and say, 'this retarded child can't even crawl all he can do is turn over in bed?' Or, did you cry out, 'Come see, he turned over in bed?' The reality is that you celebrated his turning over in bed. You expected him to crawl and to walk, in due time, but right now you enjoyed his progress. So shall I. you're right, we aren't even crawling but we have started. If in a year, all we're doing is what we are presently doing, I will join your lamentation, but until then I am going to celebrate that we have begun."
As I look back on the things we were writing and thinking and doing, eleven years ago, it is almost embarrassing, but we had started and today in some ways we are at the front of the parade if not leading the parade. Yet, I am confident that in eleven more years, we will look at what we are currently doing and think, "Can you imagine that we thought we were doing something special?" As we anticipate the future; we celebrate the present.
It is with this celebratory and anticipatory spirit that we offer these tools to all who will find them valuable. Hopefully, you will find them more valuable than what you will pay for them. We would welcome your feedback, positive or negative, on any of this work. Please understand, we do not represent this work as being complete or perfect. It is a start and that we celebrate, while anticipating improvement as we move along.
James L. Holly, MD
CEO, SETMA, LLP