The clinical advisory board (which is a group of 9 clinician users of AC) spent the day at company headquarters in Boston recently. The charge of the CAB is to facilitate communication between the company and EMR users. What follows is a brief personal report on particularly relevant aspects of the meeting.
Overall, I would say that AC leadership is trying to maintain the personal, "by physicians, for physicians" philosophy initiated by Jon Bertman. This can be a challenge as AC is now a division of a much larger company, and that division is no longer responsible for just one product. Direct interaction has convinced me that John Squire and his team are serious about this goal and have been successful in maintaining this relationship with us through the transition.
With this new corporate structure comes the benefit of many more resources to tackle product and support issues. A major area of concentration has been quality assurance. The QA team has been dramatically expanded, and significant resources have been directed towards formalizing the beta testing process and automating product testing. The end result should be fewer bugs in new releases and less need for quick, patch releases. More resources have not always translated into smooth sailing for users. The issue of slowing of recent updates has been recognized and is a major area of attention. Improving product performance (e.g. speed) is now a major focus of quality improvement.
Another focus is on meeting release date targets, with regular (quarterly) releases. Easier installation of AC was another priority; one that most of us would agree has been met. The challenge of meeting government mandates while trying to simultaneously address user-requested improvements continues. The process for receiving and quantifying suggestions for product enhancements has been formalized. Your suggestions (e.g. those submitted via the "Recommend Improvements" tab under "Help" in AC) are being read, considered, and analyzed. If you would like to provide additional input in more specific areas, you can join "Product Ear" which is a group of users who agree to respond to surveys on particular aspects of the user experience.
An update on "Inlight", which is a cloud based EMR being developed by AC in parallel to our current one was presented. This EHR is based upon a problem oriented medical record and may prove to be a good alternative to AC for certain practices (especially those transitioning from another EMR).
Messages conveyed to AC by clinician members of the CAB included:
1. In the process of creating improvements, it is critical that upgrades not "break" old features or degrade performance.
2. Close attention to exactly how we use the EMR will lead to improved product development. Adapting the EMR to our work-flows (rather than the other way around) is what we want to see.
3. A variety of product improvements were suggested. Some were already in the works, a number seemed to be "moved up" in priority in response to our comments, and others were essentially new ideas.
4. Additional communication, including more participation here on the user board was encouraged.
My opinion remains that AC stands near the top of software companies in their willingness to engage and pay attention to its users. While we still have issues to pursue with the company and the EMR, some facts are indisputable. Over the past year the company has devoted significant resources to quality assurance. The process for "intake" of recommendations for product improvements has been significantly improved. The number of rapid, patch updates has dropped. Finally, the number of implemented improvements and fixes that we have requested is accelerating. Here are a few examples of items from the "wish list" here on the user board that will appear in upcoming releases:
- automatic medication inactivation
- category creation for imported items
- fix the conflict of the current date showing on the "most recent encounter" tab
- an "archiving option" for imported items, so older items will be hidden
- PQRS and prior auths from within the program
- better order reconciliation, including a reconcile button on the sign-off page
If you go back and look at Bert's development poll from 2011(!) you will see that many features we requested have been added in the past year and many more additional ones are in line for inclusion.
As always, government mandates on the horizon may complicate things. The initial look at how AC handles ICD-10 is pretty promising. If MU3 is put on hold for awhile, and if AC can tame performance issues in the coming year, the planned enhancements to the program should make all of our lives easier.
