Bert:
AC, as it exists today, does not value the community's input.
Well, it makes me sad to hear that you think that. Given your time here and the breadth of your experience, it also makes me think.
What does it make you think?
Mario:
Speculations, really. Not necessarily exclusive. It makes me wonder if you know something about the recent partnership that I don't. Or if I'm just being obtuse and can't see what is in plain sight. Or if something not directly related to AC has made dour your perception of AC's appreciation of community input.[/quote]
No it has nothing to do with Pri-Med or anything sinister. I, like others, have been using AC so long, singing its praises, helping other users, that we/I feel we have a right to criticize sometimes. I think AC listens, I just don't think they do anything with the feedback. I would ask anyone to name five things that have been suggested that have been incorporated into AC since v4. I don't mean things like the slow down of eRx or the TSP800 melt down. I mean small things that would make a big difference. The users on the board have made it clear that the letter writer in its current existence was unacceptable. This is basically the same letter writer saved in HTML since the program started. Yes, finally, a new and improved one is becoming a reality. I know developers will say that it isn't just one line of code. Understood. Then tell us. Here is a classic example. When you print a lab requisition, the documentation in the chart is:
ORDERED/ADVISED: - Custom Order (CBC
ESR
CMP
LDH)
Why do we need Custom Order?
Why is CBC on the first line?
Why do we need parentheses?
It is all about what is important to the developer and what is important to the end user. For me, formatting is huge. For the developer, not so much. But, if a hundred users are telling you the same thing, edit the line of code that puts parentheses there and tell the program to put the first lab two lines down.
Small thing: Allergies:
When you update allergies, you will get:
(Updated by BERT on 01/18/2011 12:53 PM) Formatting again. Do we need the user name? Possibly, if it is a medicolegal issue. From my point of view, no.Do we need the time? That's crazy. How about Updated 1/18/11. Does it really need to be red?
Now some would argue on the latter. OK, fine. That is where 500 users send in recommendations on that, and the developer selects what they want.
Please don't get me wrong. Amazing Charts is the best EMR for the small office there is. Unfortunately, the government came along and wasted two or more years from development. Now v7 is the same. When I was looking at the last update, there were many, many changes. I found I could only use one.
If you took a poll, I am sure 50% would want a PM and 50% wouldn't. I am of the latter, and that is not AC's fault. I just think it would be really cool if we could focus on making AC leaner and meaner and bug-free (close) and continue to improve it based on the suggestions of actual users. But, that hasn't happened. Which is why I say we haven't truly been listened to. That's my only frustration with AC.
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Bert:
Wow Praxis! We demoed that for about six weeks. Didn't know it had all those problems. The concept processor and the bell shaped curve just seemed very cool.
Mario:
I went to the praxis website to learn more about it. One of it's central premises is that templates don't work. I like templates; however, I do recognize that if done incorrectly, they can lead to problems. Just seeing the "templates don't work" line made me a little less receptive to their message.
How well does the concept processor work? It seems to me that it might not work well for the finer details/descriptions that go into encounter documentation.
Templates are great. I use them all the time. I think the problem with them at times is I find myself documenting a referral to cardiology for an arrhythmia and the exam says "normal rate and rhythm."
I think the message is good. You have to show off your product. I think the bell shaped curve is amazing. To base your note on the exam line: Right ear red and draining and have it pull up a note from among 50 notes and then edit it, saving it in the curve so that next time you get an even more similar note is a great concept. And, since the note that was pulled that matched your initial information was close to being identical (the more you use it, the more it becomes identical), it automatically prescribes amoxicillin at 80 mg/kg/day divided bid and Ciprodex drops. You can edit the note and add the comments you were referring to. You always edit the HPI using placeholders, etc.
Now, this was based on a one month demo over nine years ago. The learning curve is steep. You basically practice on one patient after another with a tutor on the phone. But, I am in no way pushing this EMR. I don't know if it works or is slow or whatever. Robert Lowe, the president, is cocky as hell. I just think the idea is very cool. I have always said, the are all the EMRs in the world and then there is Praxis. Again, if I bought it, I may come running back here with my tail between my legs. So, right now, I most likely would purchase it again. It is still the best. I just want the features put in.
