Roy,
No need to appologize my friend, I for one am very glad to air this out and that means there should and will be differences of opinions. Freedom of Speech, don't hold back. I do like your analogy of a subscription service, which I guess is what AC is now becoming. It would be nice to have that clearly stated and perhaps pre-warned as such changes come down the pike. I too really thought I was purchasing a software that I could keep and hold forever as long as I had an proper OS to run it on. That is really what I wanted and what I will continue to seek and advise others to purchase for all the good reasons stated previously by you, myself and others.
As for that beta site issue, I do totally agree and have said previously, that yes it is a very symbiotic relationship between beta's and vendor/developer. We beta's get to test drive the lastest and greatest and in the case with AC even have a reasonable amount of input as to what gets developed and included in the product. Absolutely wonderful. It is one of the main and many reasons I first feel in love with AC and supported and respect Jon so. I used to promote AC to almost anyone who would listen, really I did. And when it came to other vendors they better start designing interfaces with Jon for AC if you wanted my business long term as well.
But when we first stepped up to the plate and chose to be a beta site I had a long conversation with Carlos (not to put a great man who needs to maintain his job with the company on the hotseat, but this was quite real) when the NYS Rx's came out beta about a year ago now (spring of '06 I think). He promised me that Jon would not leave a beta tester hanging if the beta hurt their stuff. He said, "what do you think you are paying for the support for? Jon would never do that, I would never allow that to happen to you. We just not that type of people, Jon's a great guy. You can trust him, trust me." (I am slightly paraphasing here, but only a bit.) So I stepped up to the plate feeling a sense of obligation to assist the folks who were putting features in their product that I had been hounding them for and made Village Medical a beta site. If I wasn't willing to communially help out for items I had wanted then who would. I had nothing but good intentions and perhaps high but understandable expectations, right?
Now I have submitted a great number of bug reports, talked with Jon and tech support about a good deal of issues we have found that has assisted in the design and development of this product just as many others have. We already had MidMark Ritter ECG and Spirometry so we Beta'd that as well. And yes we got the real advantage having it in the product and getting to use it early and first, no doubt about it. But just as you now wonder about saving everything to paper I start wondering about saving all those tests in the original format with patient named specific file names, by running them on the original MidMark software that we own and then copying them back into the inported section of the patient's chart for all the same concerns.
But I have beta'd other high tech stuff as a studio level Audio and Video engineer so I have some experience with this stuff although not in software per say. The beta understands that there is some amount of risk to be "down" a bit more, but the vendor also knows that you are taking such risk for the mutual development of their product. So there is a sort of covenant that I always sort of understood between the beta and vendor/developer. We as small offices may not know how databases work all that well, so if and when the beta starts hurting our data, the vendor will assist in hopefully gettting it straightened out, cleaned up or what have you. Not all of us are Roy's and Vinny's. And developers need both types of users to "bang" on the product to get really tuned-in. You better understanding and more knowledgable sites can actual get into the code and find the bugs at their root cause sometimes. meanwhile us more average users can show the developer where and how it do or does not work for the main portion of the intended end users. As my friend David Danto used to say about designing a product whether consumer or pro level; design it with the end user in mind. "A gas peddle should always be a gas peddle and brake should always be a brake. When properly designed a new user should be able to take the darn thing out of the box and put the thing through 75% of it's tasks without ever opening the manual" So anyway us average level users have a place as beta test sites as well. Does it work for the intended end users. Office staff and providers who "Don't" know how databases work at the root levels and how to write and correct code for them.
We dropped our old EMR ChartWare for just this reason. As we were trying to get to know it and use it, tech support was treating us like troglodites and retards because we didn't understand from the get go what SQL Server was and how it works and all the other fine points of databases and their managment. All with NO help files in the help section (totally vacant I kid you not)and no user manual. Just insane and this guy was an AAFP perfered and multistar vendor!
So as an average level beta user who was requested and invited to beta test the product because it had many features that would be positive for both sides, I still would like to know, will AC and Jon help fix our data, any of us, if it proves or looks highly likely that beta testing hurt our data? I certainly can't go in there and correct things and find the causes, and repair what needs to be fixed or piece a health data set back together from various earlier back-ups. And should I have too? I wouldn't even know what caused such an issue and so I and many others like me would be at the vendor's mercy as to what caused such problems. Was it something wrong in our system or network or was it the program and it's inner workings, or what have you? This is why we fell in love with guardian angel. Just help me please, I don't really understand this stuff all that well. Thank you for not requiring me to be from silicone valley and thanks for great support.
So, how high end of a user should I have to be before I can be in on this? And then if perhaps I shouldn't be, then please let me know and I will certainly pull out. But I just got a call last week to let me know that the newest beta was out there for us to toy around with, so I guess we are welcome guests to beta around. After over a year of talking and assisting and helping me with my issues I am positive that AC knows what level of user I am, trust me. So yes I have been invited and encouraged to participate as I am and at my present level of technical knowledge.
Here's my example as I explained it to Carlos. Let's say I work for Jeep as a line employee and so they need a number of regular folks to daily drive new models to ring the bugs out of them. Only if folks like us test drive them do they get to find these bugs. We understand that on any given day that the car may crap out on us and leave us stranded goodness knows where. But we get to test drive the lastest and greatest and have input of the final product. But only under such testing conditions of cold, wet, hot and so on will they find that issue with the engine managment computer and it's harness that it gets funky, runs rough and dies when cold and damp let's say. But who should pay for the tow??? And I'm not asking for anyone to fix my bad hardware or something like that. We too are trying to go paperless so most of our charts are ones and zeros too. It's the actual data and data coruption that I'm talking about. And we all know that many times it really is hard to pin the cause down. Such foul ups can come from a number of causes. So as a paid subscriber to support and updates and an invited beta user can I count on, should I be able to expect help if and when our data gets fouled up? Is this part of guardian angel?
And I as a fellow struggling small business person I understand Jon's and AC's financial restraints. There is just so much they can provide at a certain revenue stream. But I have suggested to Jon and offered to pay him more for top quality support. Again most users can't open the hood and go, "oh, it's the fanbelt". We need and have to trust our vendor and support people to help us get such things straight. I would gladly pay AC a decent amount more for well defined inclusive support coverage. I even suggested to Jon that he set up a multi-tiered support program so people could buy what they need. High tech users could purcahse less, while us average user might purchase a bit more for the peice of mind and security. As I've said before that last thing I want to do is shoot my goose who is laying my golden eggs. Jon's and AC's continued success is in all our best interests and I hope he makes it all the way. Imagine if AC was one of only an handful of market dominant EMR's. They and therefore all of us would have to be accomidated and included as the market shakes itself out. I want AC to be a prolific as QuickBooks or Word. Then people will have to come to us...if only, right?
In another part of the EULA, somewhere it it's details is language that the program and the vendor (AC) promises nothing at all, Limit of Liablitiy. This is part of what I was told when this issue arose as well. Their is no promise that the program will do what you would or could expect to do and their is no promise that it won't misbehave and no liability if it does. I was told that all the other high cost, pain in the butt programs have such language in their contracts too and such is surely true. Now yes we all need to protect ourselves and the smaller you are the more you need to avoid expensive litigation, but this is an EMR folks. Our butts are on the line when we use and perhaps falsely depend on it's accuracy everyday for all the laws and reasons laid out in previous statements and threads. I thought I remembered a vendor who wasn't going to act like this and hide behind such stuff. The wonderful man who made fun of all the others for being this way and promised to always be there for us and to treat us fairly, because he was always go to treat us as he would want to be treated himself. As I said before when I first read the old EULA, I made Nancy and the staff read the entire thing. I used to brag about my EULA, my vendor, and my EMR to all other comers who couldn't come close to this level of customer friendly and ethical behavior. I really felt like I had found a safe harbor in this awful and ugly side of the business of medicine.
When we were having the issues with the financial numbers is when the new disclaimer came in as one logs on to the financial section. So instead of being able to depend on the program to do what it seemed to be able and was designed to do, instead we all got a new disclaimer about not trusting it or using it as such. But this was only post facto after most of us had been using it for quite some time. This is about the time that I honestly got very rude because I found that extremely offensive and not AC like at all. As I gather most of you would have too, although many of you might have been a bit more diplomatic about it than I was. I'm just a kid from the Bronx at heart. But does any of this seem very good old fashioned AC to any of you?
Until we went with AC we were almost going to try good old paper because at least all these awful games could not be played on us. It would be only us in control and responsible for our records. Personally I think in the end if the gov't wants us to all go E.charting then someone has to develop law that protects both providers and patients from all this stuff. But the laws that govern all things takes time to catch up to the needs as new things come to market. But this is probably what is needed in the long run.
Be well to all and let's continue the spirted debate. Although perhaps a bit upsetting or stressful, it is none the less very healthy I think....To AC's Continued Success!!!
Paul
