I predicted this a year ago with CCHIT and MU and PM. There was a time when every provider chose how he or she were going to run their (it should be his or her, but I will substitute the wrong pronoun for sake of time) own practice, whether it meant 10 minute appointments vs 30, doing suturing or not, or using an EMR. Those that wanted to use an EMR wanted to use it to help patients, had some "love" for computers and decided what things they wanted to track with their EMR. Then, as always, the government came along and had to get involved and try to make every physician use an EMR by promising them thousands of dollars. Along with this, though, were certain requirements which, on one hand, may be helpful but on the other hand may not. For me, I have decided not to do the MU. Mainecare pays me $50,000 annually anyway for P4P. But, worse than all this, every EMR company in America had to stop what they were doing to make their EMR compatible with MU. Not only did this mean losing a year and a half of important development and neglecting issues with the software, it only added to them.
When I researched EMRs years ago (and I looked at a lot), I came across AC. The fact that it didn't have a PM didn't stop me. In fact, it was likely much cheaper ($250) because of it. Sure, this means sales of AC were restricted to those who didn't mind using Medisoft, Lytec, Medware or whatever for billing or, more likely, already use it. But, you have to have a niche. A company has to decide are we going to compete with EMRs that have a PM component, or are we going to stay with our niche: the one to five group practice who want an affordable program that can work the way a doctor works and chart fast. In order to keep that niche, a company would have to make sure their product was very good at what it does. It seems to me, given all of the awards and #1 votes AC has garnered, Amazing Charts and Jon have done something right.
In my opinion, what has happened is in the rush to get out MU and the diversion of working on the PM, v6 was possibly put out too early with the script writer and TSP issue overlooked.
I don't know. Maybe I need to delete this message. The big question is how many people would buy the program without MU and how many would have jumped ship if we did not have it. I sort of feel like because of the $44,000 (certainly a tidy sum), we and AC have followed the Pied Pipers in Washington, and we are paying for it now.
Is there anyone on here that can actually say, "Damn, I was practicing really bad medicine before MU came along. Those guys in Washington really got it right. Is there anyone putting up signs in the exam rooms stating your visit will now be meaningful thanks to the government unlike all your meaningless visits in the past?"
** I have no idea if in the future Medicare or the government will require MU for all reimbursement.
** I don't use support much. When I do, they have always been prompt and helpful. Today I needed them, and I couldn't get through. Even my email bounced back.
I am quoting myself, since none of my comments made it into the discussion. I don't mean I am being vain about it, but I don't want to repeat myself.
I get in trouble, because in r/l I generally say what I want and don't really care what people think about it. Here goes a few.
1. Do NOT go to v6 unless you absolutely want to sell your soul to the devil for this stimulus money. This should have been put on the board by AC. It has "showstoppers." This is a programming term for a bug that absolutely doesn't allow you to release a program. There are two huge issues with v6. For many, there will only be one. But, if you can deal with
this then you will be happy with v6. And, yes I am Bill Gates' doctor
. When you view the video (and this is a quick opening of the script writer -- it's embarrassing in front of patients to wait 10 to 30 seconds to open) be sure to look at the check marks for DEA and License. 'Cause they won't be there the next time or will they? As for the TSP800, it still doesn't work. I created a workaround (that's my middle name), which works, but it still means printing a letter to the Star Printer which is four inches wide when you forget to switch back to the TSP as the default.
2. I wish every day that the government hadn't come up with this whole MU thing. I recall thinking, it better not go to new EMR users and not me, but now I wish it had skipped current users. It was awful that I had to see > 30 patients a day this week to make up for the dreadful Medicaid reimbursement, but I spoke with a doctor today who used to see in the 25 range, but now sees 15, because visits take longer while he checks off this and that. How is that better medicine.
3. Obviously, I didn't get to Admin by ripping AC or not being a strong advocate for the program. But, you are correct, Jon can't do it all himself. But, what are we supposed to do to help. We have already created a culture on the board that helps this EMR and physicians more so than any other EMR board. While EMRUdate isn't affiliated with one particular EMR, try going there and finding any love. We have had three AC user conferences which went a long way toward helping AC with ideas, etc. And, we have put together "The 81."
4. While my guess is it would have been tough not to add MU to the product, I, personally, wish the PM had never been started. I realize there are 50% that think the other way, but I think staying small and concentrating on what AC did/does do best is what made it #1 in many categories
5. It is sad that we can't get together as physicians to, if not go all cash, at least get the reimbursement right. Likely, as a group, we would have to be one of the most powerful union around. Sure, the government could take away DEAs and Licenses, but could they do it from one million physicians at one time? But, it's hard to organize when you are seeing > 30 patients a day when you are looking at a drop down box for smoking that contains five of the silliest multiple choice questions ever. Why not do you smoke or do you not? If you do, then quit. If you don't, then good for you. My favorite is "Unknown if ever smoked." Smoking affects the lungs, not the brain. Most patients ought to recall if they have smoked or not.
So, I will go on the record and state that I do not intend to do MU. I refuse to use interactions that make the script writer even slow AND makes it look like a Christmas tree.
So, I came up with a silly acronym: DAMU pronounced Damn You (govt). Doctors Against Meaningless Use. I am naming myself CEO. I am going to ask Leslie to be the Chairperson of the Board.
