James,
I have to disagree with you to a large extent because of all the things I have discussed with others here, outside, folks who were looking at AC and asking for our experience and insight, THIS being one of the most Continuous on going repeating thread themes and conversations here at this board, Years Before You (no offense meant by this) and half the other people here now on either side of the issue existed on this board or were even using AC at all. It is also something that has been discussed at length with Dr Jon and Nancy & Myself, and MANY other user clients, again for years....
Just about a year or so ago, Jon Asked for my insight into what were the reasons folks did or did not eventually move, purchase, use AC and I told him what I had seen repeatedly both HERE on the Board as well as when discussing AC with other practices for over four years back when Nancy (my wife and doc) was still part of a fairly good sized regional IPO, IPA org which was looking to get involved with ONE vendor that would make it easy for the docs and Org to all interface together and with the two hospitals that the Org was formed around (docs with priviledges and or on staff at these two out of four hospitals in Syracuse) that without the PM module that was integrated so many people already had present "Medent" crap that only because of regional market penetration and super old fashioned IBM like sales and marketing to a closed loop almost has dominated our region for many years now. Ask a Syracuse Practice what PM they use and I can almost make it a lock that over 50-60% use Medent with a good amount of Medisoft followed by some of the also rans based on goodness only knows until you get to the small guys like us here who make choices based on actualy bang for the buck and semi-reasonable prices.
Jon was also VERY interested in IMP like members like ourselves and many other small, one or two docs, solo and what we call solo/solo (a solo doc with pretty much NO support or other clinical staff, MAYBE a part-time spouse or what have you, a doc and a room or two basically) who seemed like a good amount, dare I say even a majority forming of the newer ones making choices TODAY as of a year or two now, were going with Practice Fusion. And I told Jon what my observations were at the IMP board and talk with friends and members there and it was 1) HUGE Price incentive of FREE!!! Including only needing good high speed internet access and normal, run of the mill PC's to access and use the thing in full.... 2) INTEGRATED Practice Managment....
It was clear to me from numerous conversations with other practices and docs outside of the AC circle that the equation went like this basically:
Let's See here...
1) Intro Buy In Cost:
Pratice Fusion, $0; Amazing Charts $500, $995, now $1995. Answer Practice Fusion
2) Annual Updates and Suppport:
Practice Fusion, again $0; Amazing Charts, $500, now $995. Answer Practice Fusion
3) Fully Integrated Practice Management and Billing:
Pratice Fusion YES to ALL of the Above!!! Great!; Amazing Charts, Basically NO and this continued drawn out, delay after Delay, yes, maybe, its coming, well now this, that and the other thing side tracked us and got in the way.
4) COST of Practice Management and Billing....
Practice Fusion Included as Part of ZERO Dollars, Cost
Amazing Charts: Not really there, may not be there, final answer was almost certainly the same higher prices we already know for Amazing Charts in the Previous 3 Bullet Points....
Conclusion: If you are not a real Constitutional, Left (me) or Rigth (Nancy) wing Libertarian who views the over exchange of PHI, sort of and hopefully depersonalized enough or not as a BAD and Horribly, Nation Destroying thing on the same level as Warrentless Searches and Indefinate Holding of Suspects in Undisclosed Locations, were too wrapped up in day to day business and patients, and medical rules and laws, lesser concern for those who simply don't care to ask and demand better from docs or gov't... 95% of those Very Small and even Very Medically Super Ethical (why else be an ala IMP like practice in the first place right? Personal Choice and Freedom from the System and a personal inability to run the 5-10, 40 plus patients a day "Hamster Wheel" for yourself and your entire panel of patients, that's why.) Docs, not the usually don't care, blow things off, stay focused on the daily flow of bodies and cash docs.... the clear and repeated answer was and still is it seems to many....
Practice Fusion.
It seemed to me that Jon sort of felt and understood them as do I too for that matter, that Practice Fusion was AC's largest in the same League, Level of Competition, Competitor for this small practice market. And so he was very interested in having this conversations with many others to gain insight into these issues and or keep his finger on the pulse of the market in a larger context as both a business man, vendor as well as Journal Editor and the like as well.
As I said I believe that Practice Fusion AC's Main, right up their butt fighting for the same subset, slice of this larger market. AC was not orginally designed nor is it really today, designed to be a product to be marketed to larger places such as hospitals and Large ACO's and the like. It was always the Brain Child of a Man who wanted to put a thorn in the side of the larger guys who prayed upon the likes of us and I believe that Practice Fusion who came later and took advantage of modern early 21st century Larger and Cheaper Memory in both RAM, Servers, Drives for main and back-up storage, and the spread and constant improvements in High Speed access and internet providers nationwide, and the VALUE of DATA Mining in exchange for a Cheap or Free Product, went after this same slice of the market with a newer, more Virtual or Cloud based, Hosted model in their version for it. And they saw the constant issues and heard the questions too, and even probably good and bad feedback about AC from those that use it, used it or looked at it and decided NOT to go with AC too, and so PF made their choice to integrate Practice Management for those like ourselves to capture the sales for those that such a thing was a good part of their bullet points on their shopping list. It was MINE and many others here as well.
Answer Practice Fusion
I would like to believe that even in today's climate knowing both my own and Nancy's belief in ownership and Posession of DATA, and Control of Data, and our shared mutual belief in not playing a part in the creation of the Big Brother State with singular, one chart for an entire lifetime and all that comes with that, we would have still chosen Amazing Charts. But in all honesty as someone who just had ANOTHER long, unpleasant 20 minutue conversation with our outsourced Billing Company about the submit the printed Bills, Invoices out of AC and send them via fax or PDF to our billing company, where they go into the HOSE ME Layer of the Atmosphere, the HOSEZONE, or my favorite term for those of us who make use of a non-connected Billing Company, those claims then enter the "Black Box" where without a real decent program it is almost Impossible to keep track of what is out there, where they are in the entire flow and chain of it all, why any or many of them are going thru well, stuck or lost or anything else, no less be able to decern some sort of explaination, reason, no less a SOLUTION to the different CRAP reasons these Abusive Paid Off our Entire Gov't to remain alive and viable when they should all be Dead already Crooked Insurance Carriers.... I need Access to real time, visable, with reasons and codes, Red Flags Screaming at me, reports and all the rest and I need it NOW, I needed Many Yesterdays ago already... Ever since Nancy and I along with a few old timers around here like Leslie and others first started whispering and then speaking louder and gaining concensious around here back in 2006-'07 when we first joined on, signed on back in Feb of 2006.
Today has been a rude re-awakening for me on so many levels including that our billing company, perhaps almost ANY Billing company, will always STINK and not give a Rat's Behind about most clients, no less some of the smallest, solo primaries whose every claim practically rarely exceeds $100.00 or so... So do the MATH, and chew things out on a larger, Macro Level, don't spend too much time on any given claim, perhaps even put a time or dollar limit on any given Office Visit like and Sized claim and then simply bury it, write it off and give the client a HORSESHIT explaination about whatever rule that hung up the few that they are aware of and never own up to the real reasons behind their just not giving a $#!t.
But my other rude re-awakening and much more than it has been in many years now is that when combined with the first problem up above this AC does not have an integrated PM, so we can see things on a daily, patient by patient level, and either do most or all of this for ourselves or at least very Harshly Babysit the heck out of the Billing Vendor of our Choice with real time access to data, letting them perhaps make use of "Log Me In" to fly a spare computer on our network, to stop this billing enmass with little concern for the real individual or long term, modest group reasons for our claims...
I fear AC's lack of bring a PM to market and our lack of investing in another one because of the Continuous, Oh, here's the newest reason for this half a year or a year as to why there is not yet a Practice Management Module in place has lost us MANY Untold and Difficult to Accurately Quantify Thousands upon Thousands of Dollars. And it is this lack of tracking, over the shoulder watching, constant butt riding that both the Billing Companies as well as the Insurance Carriers, CMS TOO count upon as means of saving and or Profitting again Untold Millions of lost dollars we Doctors and their Offices, Practices honestly earned and deserve. Perhaps enough in our case to make or break the difference between the teetering on the brink of collapse that we have been facing for way too long vs starting to dig out and perhaps actually have our first year solidly in the Black in a good number of years now....
Software Vendors in industries such as ours are supposed to creating and assisting in "Problem Solving & Elimination", Control of the Out of Control, Tidying up the out of Control Messes, and creating Order out of what without their help would almost certainly be tons of continuous Kaos (Get Smart, "Sorry about that Chief..."). And an Integrated Practice Management Solution is HUGH an MOST Logical solution to such problems in our industry. And it is the same kind of problems and solutions across the nation, not just regionally in our area or yours... BUT everywhere for sure.
I would not be so upset if at some point a few years ago AC's accurate and honest answer was, "Hey ya know what? This is a very large undertaking and with all the other crap on the Horizon, we don't really want to promise anything and we know that we shouldn't be either.... And so like in other places we want to be very square with all of you loyal long term users and clients who have been asking and waiting, that you need to start looking at other solutions for the foreseeable future, as we don't really know if and when we are going to finally get this done to a level that is satisfying to ourselves as well as you our loyal customers... SO please go out and get yourself something good or at the very least decent because the more we research this the more we realize that this is not a small or easy to crack nut and we don't want you, our customers to suffer monetary losses and otherwise because of goodness only knows how long delays."
This is Not the first time we have heard and seen the goalposts being moved another notch or two further down the field, so we don't ever acheive any real, visable and meaningful progress towards the all too needed End Goal, End Zone. This is one of a good number of such repeated set backs and disappointments over a good number of years now. I would hope that after the first year or so of looking at basic requirments and codes, and what most offices use a PM for and do with it, that at some point, the basic concept and internal needs and designs would have been understood well enough to at least offer all of us a good solid answer, even if that answer was, the above this is very large, its not going to be easy and it probably will even Hurt now and again for both our side and yours too. So please do the right thing, take good care of your needs today and for the foreseeable future and if and when we get truly close enough to be ready to really release something we'll get back to you then...
That's the kind of good solid answer we all needed a good long time ago. But for many reasons not know to us we were never let in on the Enormity of the task at hand and the real life potential sidetracks and delays. Instead we got those repeated, 6 months, one more Business Quarter, 3rd quarter or 4th quarter of whatever year, many years back now. That's not cool or appropriate and it sort of hurts and destroys trust and faith. Just help me and provide the solutions you can honestly provide and deliver. And equally just as important, let me know when you can't or are not sure and don't really have a solid understanding of the parameters and timelines and so simply let me know to look elsewhere for those solutions you can't or can't yet provide or assist with for an undertermined and almost certainly long period of time... Just let me know so I can take care of MYSELF instead of sitting on my hands waiting for what one would hope was at least understoond well enough to let me know and I'll start to look elsewhere instead.
And I Guess it is in that repeated pattern of promises or predictions made, and repeatedly repealed and modified, set back again and again that really upsets not just us, but many others who have been waiting and those that even bought in based upon a promise that it was just around the corner only to start to be part of this long chain of disappointed and left hanging docs and practices.
