I have been using AC for over 3 years now as a General Pediatrician, and it has been a Godsend for my throughput, and for getting paid for my work. It is not perfect , but pretty close considering its cost. I am using the Peds Med Database that Bert worked on , and I have further modified it for drugs that I use. The Consult letters are great and I have made templates for requests for consultation, although I do not consult for others. I dont worry about the vaccine part of the program at this time as I am using a Web Portal for the state of GA that manages my inventory, shot certificates and recommendations for vaccines. I merely created templates in the Asses and Plan areas for the appropriate vaccine ICD codes, and the CPTs in the Plan areas for typical vaccine schedules that I use w/ a given age. I usually state that the parents have been councelled and that questions were answered, and the VIS was given to the parent to satisfy the legal aspects. I use a separate PM called Medware that I have been using since 1992, w/ electronic billing and is able to transmit to all venders including Mcaid. It does not integrate w/ AC, but my staff is so used to its ease of use, that we just generate a paper superbill which I code, and my Insurance person enters the details and ICDs from AC into it and transmits. So essentially the clinical portion of note writing is handled by AC, and the business end is handled by Medware. My claims have never been audited, but I feel that they will stand the test of review w/o any problems due to the detail of my notes. An average WCC takes 3 min to write, and the average Sick visit takes 2 minutes. My time is more available for patient contact, and hence higher turnover.
My MA enters CC, and a line of HPI and Vitals, She sends me the chart, I have a paper "cribsheet" that I use to jot notes on as I examine the pt, but transfer any PE findings and adjustments to the Hx to the electronic record when I exit the pt room to generate Rx's . I have 1 touchscreen PC or Tablet computer per every 2 rooms I use in a small "cubby" alcove or station where my Laser duplex printer is. The printer has 2 drawers, 1 for Rx paper, and 1 for plain paper. I return to the room w/ the Rx for the pt and they leave. I message my Triage nurse to arrange for consultations as needed, and the request is written at the conclusion of the visit along w/ my most recent note. The visit is coded on a superbill, and given to the clerk for entry into the PM. It doesnt get any smoother than this.
I had a horrible experience w/ another EMR some years ago and it cost me $54,000. I used it for less than 2 years when they went out of business, and they never delivered what they promised to me. They went bankrupt, and I almost did also. Pediatricians have to be very lean and mean to survive, and I suggest you dont spend over $5,000 in software. I am excited to see what V4 brings to the table, but am very happy so far. I agree that there are some Peds specific products out there like Office Practicum, and I considered Medtuity, but the former is too expensive, and I am afraid of the risk. The latter is too "granular" , ie. specific, and will take too long to complete a simple note and based on my volume of patients will cost between $5 K and $10 K per year to implement, not to mention it requires a dedicated server, which you dont presently need in AC.
