Brian,
Althought the guys numbers may be a bit inflated he does have a bit of a valid point. If one was to purchase, new well built and well insured machines, with 3-4 years of support and accidental damage type stuff (urine in your laptop or the "Pepsi Syndrome" for example)2 or 3 laptops or other clients, and a strong, fast P2P server tower from some of the main reliable vendors (Dell, Gateway, HP, etc), AC and support ($1500 right there), some basic router and other network hardware, and then add some sort of PM module ($1-$2K) and the X-Link (was it $500 or $1500 for that?) to connect that PM module to AC, you really could be quickly starting to look at at least $10K if not even much more.
This has always been one of my gripes. Even with AC which is a wonderful company in terms of bang for the buck, my QuickBooks of EMR example, by the time one does even a small P2P network of 3 or 4 machines the cost is still getting pretty steep. And this is not AC's fault, it is mostly hardware and networking, along with purchasing some support from a contractor to help set it all up, if one doesn't feel ready to tackle learning everything all at once. And even all this will not be enough to satisfy those CCHITTY SOB's at CMS just to maintain our already starvation medicare fee schedule. They are just insane. Now imagine if someone wanted to purchase a new server based system with the addition of MS Small Business Server and a few extra CAL's for all the terminals or users in the office. It can get very expensive pretty fast.
I have been farting around with the idea of purchasing an extra laptop and a new main P2P server or NAS as many of you have read. But this could easily mean at least $2-$4 K by the time all is said and done with good coverage for the machines. Especially from a reputable vendor with, a RAID 1 or 10 set-up on the tower with the extra good support and protection. Now add a nice little MidMark based ECG and/or spirometer that interfaces nicely with the EMR (as these bastards say the want us to) and that is another $2-$4K again. BULLCCHIT! People want these things, but they need to put up or shut up. Has anyone noticed that the price of ECG's keeps going down all the while folks keep trying to get us to use these expensive high tech ECG's that interface with EMR's??? Bullcchit.
