Fall 2004

I n f o r m a t i o n   T e c h n o l o g y
What's up with NELL?


Those of you who have been reading Nexus and attending the AGM are aware that our organization has taken on the significant task of getting our members online with an electronic medical record (EMR).

by Dr. Gerard Farrell

     Those of you who have been reading Nexus and attending the annual general meeting are aware that our organization has taken on the significant task of getting our members online with an electronic medical record (EMR) in the next two to five years. This is a large and complex project that has attracted national attention in a number of forums. Some of you may be wondering what's happened over the summer and where we are with the initiative.
     As a review, the idea is to make an EMR available and affordable to the entire membership of the NLMA. To do this we have partnered with Unisys, an important IT company. We have discussed at length what the project has to accomplish, from desktop support to application development, networking, hardware, training, service, and support. All of those things fit under the business umbrella of "costs." Given that, we then had to deal with the issue of how this project will pay for itself. A number of transaction-based models have been explored. A transaction is like the fee you pay to the bank when you use an instant teller or your debit card. Every time you use it, the bank charges a fee.
     The challenge has been to see if proposed transaction fees would be sufficient to cover projected costs. This exercise, a business case, has occupied our time through the early parts of the summer. The good news is that, even though we have more work to do in this area, the early numbers seem to indicate that the approach is prudent and that the transaction method can in fact see returns offset expenses. In other words, our theory for financing NELL appears sound.
     There is, however, much yet to do. The business case is a high level document and many of the numbers must be confirmed. The business case supposes agreements with other agencies and health care providers. While we have initial support from these groups, support is not an agreement and formal agreements are necessary; these agreements must be reached. Finally, we must fashion a framework agreement with Unisys to allow us to proceed with the planning and development of NELL, from application development to beta testing to piloting to full scale rollout.
     So, much has been done and much more needs to be done. J.R.R. Tolkien had a chapter in Lord of the Rings called "Many Meetings." So it goes.

     Dr. Gerard Farrell is chair of the NLMA’s EMR Project Steering Committee.


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Nexus is published quarterly for Newfoundland and Labrador's physicians. It is a forum for the exchange of views, ideas and information for members.