Liquid Medical Office, Inc.

LiquidEMR | Frequently Asked Questions

1. Are electronic medical records safe? What about computer crashes? How does data get backed-up?

For each of LMO's delivery methods, we have guidelines that, if followed, will provide the highest level of data redundancy and uptime.

For our enterprise (client/server) environment:

The server storage is protected by RAID 1 array, which is a technical term for using 2 disks in parallel to store the data in parallel. This will protect the data in case of a single hard disk failure. The server is scheduled to perform complete online backups to another machine daily during the off hours. A mirror image of the complete office medical records is set up on an offsite machine, often a doctor's home computer. At the end of each day, that computer is "hot-synced" with the main server to bring it up to date with the current day changes. The "hot-sync" typically finishes in less than 5 minutes. This image serves as a full backup of all medical records.

For our hosted environment:

In case of extensive downtime due to the main server crashing, the computer can be served as a fully functional EMR system. The office and the doctor can still view and make changes to patient records on the computer. Once the server is back online, the laptop can be "hot-synced" back to the main server to update the new changes. Another option is for each office to be set up with a redundant server with the same hardware configuration for both a daily backup and a full time substitute server. The worst-case scenario is that somehow the main server self-destructs, without having a backup server, and all data is lost. The maximum risk is only the current day's worth of patient information.

2. Will digital documents stand up legally in court? How?

Yes. Each patient note is automatically locked after 5 days as the default. This means the note cannot be modified by anybody. You can still add comments to the note as an addendum, but the original note content cannot be modified.

Notes that were scanned can be annotated, but by its nature, scanned documents cannot be edited nor modified.

Patient journal is automatically locked after each day. Each entry in the patient journal is automatically stamped with the name of the person creating that entry.

We recommend that the office periodically back up the medical records onto CD or DVD. The media can then be signed and dated directly on the back of the media itself, and sent in sealed envelop to an attorney for safekeeping. Alternatively, some medical offices open a safe deposit box and have the bank officer date and signed the envelop prior to deposit in the safe deposit box.

3. Is this all HIPPA compliant? How?
  • Liquid EMR is fully HIPAA compliant. Each user is issued a login and password. Extensive audit trails are provided to track changes that users made on the Liquid EMR system. Each user can be restricted individually from accessing unauthorized patient notes.
  • Patient privacy requests can be logged in the journal. Once anyone accesses that patient record, the privacy requested will be displayed as a red-flagged item.
  • Each patient record release event can be logged in the patient journal with the date, the reason, the source of the request, and the information released.
4. I have a lot of existing charts. How would they be converted to paperless form?

We recommended that you approach the conversion process one day at a time. First, you would populate the daily schedule with outstanding appointments. Then you would see the list of patients for the next day to see which patient chart has not been converted yet. You would retrieve those charts and scan in enough patient notes for the MD to make a diagnostic, and for the biller to know how to bill. Those paper charts can then be set aside afterward for offsite storage. As the electronic charts are built up overtime, the physical charts can be weaned down at the office to the point that you can set aside all paper charts to offsite storage, to be retrieved as needed. Typically after one year, the remaining paper charts are for one-time patients that don’t have any follow-up.

LMO also offers a total chart conversion service that you can pay for by the chart. The final product is a patient entry in Liquid EMR with the complete physical chart digitized and split upon request.

5. Will I have to change my billing practice? How will Liquid EMR interface with my billing software?

No, you don’t have to change your current billing practice. In terms of billing purpose, Liquid EMR can be viewed as a physical chart for the biller. All information on the physical chart is provided via Liquid EMR. This includes the patient demographics, the insurance card, the ICD9 and CPT codes, the patient notes, the type of visit, etc…

Liquid EMR EMR has the capability to export each billable encounter event to any Windows or Dos based billing software. However, just as any biller desires to review individual patient charts before determining the correct code to bill, we don’t think automatically exporting the billable event to the billing software is the prudent thing to do. Liquid EMR does offer the option of using our billing module which integrates with OfficeAlly for electronic claim submission.

6. I am currently using an old billing software. Can you import my patient demographics data to Liquid EMR?

Yes, we can, if your billing software provides the ability to create customized reports. We use that capability to create a report containing the current patient demographic data to import into Liquid EMR. Alternatively, if your billing software already has some reports that have all the information that you wish to carry over to Liquid EMR, we can work with that data.

Transfering that data to Liquid EMR is not a problem. We have a universal solution that could capture and transfer the information even if your billing software has no ability to write that data to disk. For example, we have transferred data from a 20 year old billing software running on a proprietary UNIX platform.

7. What if I am not ready to use a note template yet? Can I still use Liquid EMR? What if another MD covered for me during vacation?

Just like any doctor’s office’s usage of superbill, Liquid EMR can create a superbill printout at each patient encounter that is pre-filled with the patient’s demographic, last visit date, current allergies, current medications. The superbill will also contain the entire template that the current superbill has. The doctor will have the paper printout of the superbill ready prior to the exam. During the exam, the patient’s existing notes can be viewed via Liquid EMR without needing any technical knowledge. The doctor can complete the exam by filling in the superbill, just as he or she normally does. This note is turned over to the front office at the end of the exam to be scanned in as a patient note.

8. What kind of hardware would I need?

There are many factors that come into play for this question. However, in our experience with new clients, much, if not all, of the hardware requirements have already been met. Please ask to see our hardware/software recommendation guide.