Wednesday, July 21, 2010

Google Ga Ga

In my earlier post EHR's and APA I outlined more than you would ever want to know about my tech resume. What follows is a brief overview of my recent moves into the cloud with free Google offerings. I do not expect that you will want to copy my implementations, but I hope this will help you generate your own ideas for managing and presenting information for your practice, and maybe your personal life. (I have found that combining personal and practice makes for much increased efficiency.)


I am not sure why I chose this particular platform, my first real foray into things Google, but I like that when I comment on other Blogger blogs I do not have to enter my name, email address, etc.


I started forwarding almost all my email to Gmail to take advantage of the spam filter, but after a long period with no messages I feared that Google might have identified my domain as spam and started filtering everything. Soon I expect to move the whole domain to a new server at which point I will probably move the email account with my domain to Google. Meanwhile I found a compromise: I set Gmail to bring over all the messages at random intervals. The downside: I have to delete spam from two accounts.

Google Voice

By invitation only as of now. It took a couple months, but I set up this account just before I purchased an HTC Evo with Android. I selected a new phone number (yes, for free) and connected the account to my office and mobile phones. Ironically I see to use the Evo less than before. I record my voice mail out going message at Voice from the browser. Voice transcribes messages to text. Although the errors are numerous I can glean the main points of most messages without listening to them. I could forward them via email or archive them. I can easily listen to a selected message from phone or computer without listening to all older messages. To make a call now while at the computer I copy and paste the number, tell Voice which phone I want to use and click connect. The phone rings. I pick it up and hear the ring tone until the person (or robot) I am calling picks up. Regardless of which phone I use, the recipient sees only the caller ID of my new Voice number. Since I do not block this number my patients do not have to turn off blocking of unidentified calls for me to return their call from my mobile or home numbers. I have not used the feature which makes all my designated phones ring when a caller dials my Voice number (which is a local number by my choice).


I chose the Evo for many reasons, but particularly because of the integration of Android with the other Google offerings, something iPhone cannot offer. Almost everything I see from my browser now appears on my phone as well. I use GoldMine to manage all my personal, business, and professional contacts. Although outdated I expect it will continue to do the job until I find a comparable application in the cloud. Google still does not do all I need, such as keep a history of prescriptions ordered for patients, appointments and phone calls. But with Companionlink I can sync a select group of my GM contacts (phone numbers, addresses, etc.) to the Evo. Android allows me to direct all calls from selected contacts, mostly patients, to voice mail. Voice alerts me by text message that a caller has left a new voice mail message, and the phone notifies me with a distinctive ring tone.

I have not yet been able to configure the Evo to only take calls from numbers in my contacts. I tried an Android app called Gblocker, but it seemed that every few days my phone would go into silent mode with no action on my part. I deactivated Gblocker almost a week ago, and the problem has not recurred. Since then I downloaded an upgrade to Gblocker. I will likely try it again soon.


My favorite! Integrated with gmail this to do list allows me to keep items in order and it appears in all my browsers as well as on my phone. I use it for shopping lists, too. For example, I keep on an item entitled "Home Store" a list of all the items I need to buy next time a shop at one.


I could sync a Google calendar with GoldMine, but I am not yet comfortable having all my patients names in the cloud. But I can sync with the Evo anyway, so I have a calendar there that is as up to date as the last time I synchronized using CompanionLink. I maintain one personal calendar accessible to selected family members, some of whom have permission to make edits themselves.


It works fine as a browser but also allows me to add widgets (?). The Voice widget displays the number of unplayed voice mails. It also allows me to easily initiate calls (or texting, which I rarely use) as described above without searching for the Voice tab. Also, phone numbers displayed on Web pages appear as links. To call the number I simply click on it, select the phone I want to use, etc. Since I started using it I have also been hearing sporadic bells ringing. Unless I am hallucinating I believe one or more of my devices may be alerting me to the arrival of a new message.

The Gmail widget turns a flip when a new message arrives and tells me how many unread messages reside in my inbox. Clicking on it takes me to the inbox. I installed another Gmail widget that should allow me to send the current URL in the browser to a selected email address. I have not used that one yet.


Not all that sexy, but I have started moving documents that I might want to access from different computers to the cloud. I wish it would allow me to incorporate the name and address from my Google contact list, which I do not really use, into a letter template. For that I still rely on GoldMine and Word.


I have recreated my practice Web site and am in the process of redirecting my domain. Again, the price is right: free. And it offers some functionality that was not available in my now obsolete MS FrontPage.


One of my other reasons for selecting the Evo: It has a front facing camera that should in theory allow for videoconferencing. In fact, soon before I purchased mine I found an Android app called Fring that allowed use of a Skype account with the phone. The only time I tried it the quality was unacceptable, but I was only using 3G, instead of 4G. Since then Skype pulled the plug on Fring. I hope to try Google's own video conferencing when I get a chance.

I would like to keep patient records in the cloud, but I need to determine how private and secure they will be first. Fortunately I am not a covered entity, so I do not have to worry about HIPAA.

As for moving contacts out of GoldMine and into the cloud I understand that comparable cloud based apps exist, some of which may actually use Google apps.

With all these capabilities available for free, and with all their integration, I see little need to venture into a costly EMR.


  1. I just sent you an email from your request as of my letter to the editor with APA News. If you wish to share parts (as it is long and wordy) of my email please do.

  2. Thanks for contacting me. How I got started with computers. In 1987 I held that computers where "an instrument of devil sent to destroy mankind." My two sons called me "illiterate" (meaning computer illiterate) a challenge I could not avoid. I now build my own computers and work with them aside from my profession with my wife's publishing company doing video and graphics. By the way I have returned to my original premise of 1987 for different reasons.
    Among some of the reasons are the current misuses of computers (I think people should be licensed to use them like autos;) the confusion of information vs wisdom; compete screwing up of statistical meaning: and the endless recording of completely useless data. However, I could not do without my six computers. I could not live without Google. I attempt to harness the infernal machine to my use in clinical practice and fighting off all of those other obstacles to good clinical practice called managed mental health care (which would be impossible without the computer.) I have made my pact with the devil.
    My current irritation is Electronic Medical Records. (If it is there they will be misuse. ie, NSA, MIB ect) (If it works well someone else will "improve it" and screw it up.) (Commercial licensing software companies will create a plethora of one size fits all programs which will compete until all others die and two or three will corner the market and survive, none of which will communicate with each other.) Therefore, I approach this subject with much cynicism for the cultural impact computerization in a capitalistic society. Let DARPA invent it and let Open Source Software Market it.
    To get the the point of what I do, I have always used a laptop or notebook computer. It is secure because it is always with me and backups are locked up. I cover my track by having two identical hard drives constantly synchronized. I have currently a Panasonic Toughbook (as I break them otherwise.) I use a Seagate DiskWizzard Imaging system. If the hard drive crashes I pull out the drawer and swap out with the copy from an external drive bay and buy a new Seagate drive.
    Software.. I have built up over time and have some old programs that can't be upgrade because the producers died. First is my personal information manager Netmange Eco Pro formerly Arabesque (which can be pass worded.) Microsoft put is out of business with Outlook, an inferior program. I use it because I can paste in addresses by clicking on an arrow. I like it and I give it away to others as I think it cannot even be licensed any more. I use the address book (highly modifiable) to cut and paste to started my patient files. It contains all the critical information.
    I use Word Perfect because ite can be pass worded easily. It is modest priced and continuously upgraded by a Canadian Company who needs support. I set up a series of folder beginning with "My Patients", subfolders "Active" or "Inactive" and subfolder of patient's last and first name, . Under patient name I have an "External" Subfolder into which I scan outside reports to separate them from my own confidential files. My main patient file is set up in CAPS to easily find the file name. The beginning the file (after making a header) is pasted the information from my information manager. I insert a scanned Medical Card. I fax this to my bookkeeper with a new patient. I use a Word Perfect macro for each procedure code. It include number, code name, date, narative, mental status, medications and next visit all preset in structure.
    I also can use Nuances Dragon Naturally speaking, the best program around. I have followed it from the first programmers. It the regular flavor not the medical one which is overcharged for.
    (cont'd in next comment)

  3. (Anon comment cont'd)

    I also use Copernic Summarizer program which abstracts long wordy contracts or reports to boil them down taking out the essence.
    When I get reports or labs I PDF them through Nuance's Omnipage 17 putting them in my file or in the external file depending. If I need to send records I use Adobe Acrobat to combined all of my files and labs into one PDF file. Here in Massachusetts I can email it to, a secure server which holds the files until an email is sent to the recipient, who then downloads the file. It is a medically sponsored web site.

  4. Anon: I understand your reluctance to enter the cloud. I just set up my own Google Health account to see how I feel about having my health info there.

    You would probably like Act! or GoldMine for managing contact info.