Bert and the Greater Gang,
Bert sorry if I ruffled your feathers here, but yes I was sincerely confused and upset by what seemed to be your change in position on this subject. I am glad to see you truly are the man I always thought you were. But damn if you don't play a mean devil's advocate sometimes (Although good for really teasing things out frequently).
Althought most people would be correct in saying that:
1) Althought most vendors have some really messed up, pro-vendor langue in their contracts and most of us simply click "yes" everyday, and that most vendors such as giants like MS would never bother to go after their smallest end users, AC is a little different. WE are all but little users and there is a whole lot less cover here for any of us. We have seen at least once that we certainly know about, and I believe there were 2-4 others that were spoken of last year, that there were times when the langue as it is now written was actual thrown in a licensed user's face. So please; let's not forget our history here folks.
This is why this whole line of discussion is here. It is not simply an exercise in intellectual debate, but instead a valid real concern. These terms are really in here for a preconceived reason, with intent to execute them if certain conditions prevail. As it was said in Casino Royale, the first kill is always the hardest, after that it gets much easier once the person has crossed that mental threshold once before. AC has now certainly crossed the threshold. Therefore, I feel we (Ourselves and Roy and Others) are validly concerned for all users whether they know they should be or not.
2) I whole heartedly agree as I was thinking the same thing here over the weekend, that Bert and Adam are talking legal and possible actual terms and possiblities, while many times I was talking more, how does one feel about the product or the vendor. Yes there were a lot of personal feelings in there. They are hard to forget. The company has certainly evolved and so our relationship with the company and its people has changed. Such as the mention of be careful of what you wish for.
But the inaccuraces also speak to how the corporation is promoting itself publicly verses what it says more hidden away in fine print. It is just so not "AC" as Jon tries to promote it. I would just think that it would be a great and positive thing to have both sides match and not in the negative way, but instead in a way that matches the "we will always treat you fairly" way. It is a major part of what attracted many of us here to AC in the first place. The corporate philosophy was so much different than all these other, large, greedy, ugly enterprise type vendors that saw us nothing more than a "conduit to their money" as I have put it many times before.
To put it simply, many of us did actually buy AC not only for the program itself, but for the greater corporate image and policies that it was and to some extent still is promoting. At one time they were brave enough to put those things in writing too. At times I sometimes wonder who believes in the "spirit of AC" more, some of us stauchest users or Jon and AC? That is what our Ben and Jerry's, Waterbury VT thing is all about. That is what an AC user meet is all about. Yes the tech and other stuff will be great, but so is the Gestault of it too.
And having thought we had purchased the product outright legally as laid out in the orignal EULA, keeping an old copy so as to always be able to access our old records was our god forbid, end game, exit stratigy. Having the terms and conditions changed on us in this manor, basically destroyed our dooms day back-up plans. I am sure this is what Roy and many others had in mind as well. To take this away from us only after we have thought we had (known we have???) purchased it is really rude and ethically if not legally wrong.
And yes if one day AC gets aquired by some less admirable larger corporate giant, I would like to have some amount of comfort in knowing that at least Jon and AC gave us some amount of a leg to stand on as a parting good-by present. Again, that is what a good contract is all about. It is part of your exit plans and it should be.
But here is something I suggested to Jon a very long time ago as a way of providing a service to some, a new stream of revenue for AC which really is good for all of us too, and could be marketed in the best of the old we will always treat you fairly. Some people want the ease and convenience of an ASP model for many reasons such as logging in from many locations, be outside billing, off-site charting, multiple office just to name a few. Now as long as someone has reasonable computers all their machines and locations can easily access and build one singular database. There is also the reasons of not having to do alot of network things, maintain servers, perform back-ups and all sorts of other computer maintainance and headaches.
So I suggested to Jon that he (AC) start to offer AC in both the standard, own your own, purchase your own type way, as well as the new virtual ASP fashion, we'll take care of almost all the headaches and issues for you and to do this in a reasonable monthly, quarterly, annual fee much like all the other ASP's.
But here is the big linch pin, difference in my plan verses almost everyone else's. To insist, since AC is so reasonably priced to begin with, that ASP users must still purchase and legally own licensed copies of AC!!! And here is how and why. Because Jon could promote it to the HILT! We will not hold your data hostage, we will always treat you fairly, and even in the unlikely event that we do have a big falling out and both sides choose to go their separate ways, you will always be able to access, use, maintain and even continue to grow your database in AC. This is the new potential "AC", "we will always treat you fairly" type of way of providing an ASP type EMR software because is respects all of the issues on chart ownership and responsibility we have all been discussing. Now he can make lots of money by showing all these other vendors for being the SOB's that they are while providing a needed service for many users at the same time. A true win-win for everyone. Heck if done in the way i envisioned it, I would seriously consider signing up for it for our office, no joke.
I can not and did not claim this idea to be my own, but I felt it fit Jon and AC to a "T" and would help move him into a new King of the mountain position on these matters by taking that AC ethical high road and actually applying it to what was once a negative situation. I first heard of such an Idea from an Altapoint VAR. This VAR (Value Added Retailer) of Altapoint medical billing software (x-linkable to AC which is how I found it) was doing the ASP hosting and they said this was their arriagment with Altapoint, that the customer still had to purchase at least one full licensed copy of the program. I thought it was an awesome solution to this virtual verses own it ourself debate and again could make Jon and AC look even better while opening up a new group of users and revenue for him and the company.
So as you can see, Nancy and I really used to like Jon sincerely to the bottom of our provider hearts and really wanted (Still do as a matter of fact) to see AC not just survive but to thrive and grow. And we were even will to assist how and where we might be able to. At one time we were very involved supportive users, but this change in the enviornment has us concerned for quite some time now.
3) Al I am so glad to see another software designer, developer shares and embraces my concept of the chart and medical record as being the "jointly held intellectual property" of both the patient (it is their PHI after all) as well as that of the provider and/or institution that creates it. Doctors and other providers must be recognized as owning them, because at any time we may have to produce or access them whether for Medical, legal or financial reasons. This is your version of what is happening in your examrooms in your own words. Heck there are carriers that want to try and use the excessive use of templates verses freehand charting as a means of trying to extort give backs from providers (watch out all you Rocket Romanos out there...). But what are you recording but the health history of the patients you are treating so it is validly somewhat their property as well, right?
On this I would love to have this concept included in any legislation that passes on a state or federal level. Or perhaps it needs to be in a separate bill unto itself. Roy you seem pretty good at wording things the way lawmakers like to see. Think you could whip something up???
So in closing we have always wanted nothing but AC's continued success and to even be a part of helping and supporting how and where we could, that growth and success. This is why we used to step up more readily to Beta new features and releases. I think that we here at Village Medical have shown our good intentions and unfortunately this post facto change in the contract language equally says something about the corporate intent and changes at AC. If such is not really their intent, then simply be done with it all ready, make those of us who is concerns so feel better and get it off the table and off of the radar screen already. Lead in the best of ways, with that old AC we shall always treat you fairly type of corporate philosophy, lead by its policies. Pretty simple really.
Paul and Nancy
