Home Forums Discussions General Discussion My tongue is bleeding due to Logician

OK, for those of you who know me, biting my tongue is not my strong suit. OK, no comments.

So, I am having a meeting with the chief of pediatrics who is going over my re-credentialing. Part of this was his coming out to look at my office and our EMR. So, he goes through ten visits and records the pluses and minuses.

Well, ultimately, I passed, but when he went through my EMR, he compared it with Logician. My guess is he couldn't name two other EMR companies like NextGen or eMDs. He is a neonatologist, and they don't use the traditional EMRs.

So, he is telling me Logician can do this and Logician can do that and AC can't do this and that. And, wouldn't it be great if it could do what Logician could do. (Bangor is a Logician town -- The FQHC uses it, all of the hospital FP centers and their owned practices use it. Probably over 300 or more Logician EMRs.

One quote about AC in his review: "It's a lower-budget EMR than Logician, and there is not a lot of capabilities for enhancements."

I guess he has no idea that it takes 20 minutes to do an office note in Logician. And, that those patients who transfer to me after 6 months at the other office bring 300 pages of notes for a healthy child. And, he may not wonder why the hospital-owed practices run in the red as their multiple providers see 10 to 15 patients per day. Sure the FQHC may run in the black, but that is because they are subsidized quite handsomely by the federal government AND our FQHC just received $10,000,000 from the federal government stimulus package to purchase EMR infrastructure that they already have. In the interest of full disclosure, I should submit the amount of money I received from the stimulus package: Ummm, oh yes, nothing. Nada.

But, for some reason, with AC, I somehow document what I need to, see 30 to 40 patients per day and run in the black. Bigger is not always better, and you couldn't pay me to use Logician.

Way to stand your ground! Nothing worse than a physician-come-hospital lackey.

Yeah, I bit my tongue pretty hard.

Good stuff Bert.

I discussed my choice of EMR with a colleague who went with e-MDs. He shook his head a little when I told him I was going with AC. He thought I was going down the wrong path. He had me come over to his office so he could show me how great his system was and how robust it was and how I was making the wrong choice. He talked about the million things it would do.

He was right. It was robust. It's a good program. It's point and click for the most part. It has an integrated PM system. It was $60,000 worth of software, hardware, and training for one doc.

Woops!! $60K. $15k for TRAINING. My AC was $0 training and $995. I picked a PM system that fit my office staff and wasn't forced to use the one with the program.

Sure, AC isn't perfect but neither is eMDs.

My old nurse went to work for that surgeon and she HATES the EMR. She says it consumes them. Reminds me of the hospital where our nurses sit in front of the computer for 11 hours and squeeze an hour in to see patients. No thanks.

Anyway, AC works for me. Actually, the more I use it and template things, the better it is.

Thanks Travis. Ironically, the FP doctor I lease from uses eMDs. I agree, the bells and whistles are nice, but so are the ones on a Ferrari.

If only the chief of peds had filled me in on what he was looking for perhaps I could have tweaked my system a bit. I remember when I was with the pediatric practice owned by our local hospital. They rolled out Logician, and the grumbling could be heard form here to Portland. Imagine rolling out something with its learning curve to doctors who weren't computer literate nor wanted to be.

And, I luckily paid $250 and no training. And, I can email or call the head of the company.

When I was in residency, we had a CPOE and EMR type computer system called PCIS. I think it stood for Physician Controlled Information Systems. Actually, I don't think that was it. BUT...we called it Patient Care Is Secondary, because you sat there for hours looking at it. It was pretty good though. A lot better than PowerChart.

LOL $60K for s/w for 1 physician! Plus training. Man, that system needs to be more that "robust."

Yeah, when i was emr shopping, I saw some big quotes--mainly from third parties because the actual companies, when you ask about price, they change the subject to your potential ROI. "Let's talk about price in a minute..."

When I was shopping around, the sales person would typically open the discussion with something like "what are your needs," or "what kind of software are you looking for?"

I would come back with: "I'm looking for an EMR in the price range of Amazing Charts."

Sales person: "Then you would not be interested in our EMR."

I saved so much time this way!

Then there's the occasional attempt to convince you how affordable their EMR when financed like a 30-year mortgage.

Yes, I always loved the return on investment argument. The thing they didn't understand was it was either based on something I didn't already do such as dictate, therefore I couldn't save thousands of dollars on dictating or the infamous $1.00 per chart pull.

If I could get paid $1.00 per chart pull, I would give up doctoring and become a file clerk.

I think the saying time is money is overused or too simplified. I tend to think that time is time and money is money. Before EMRs, my staff was expected to pull the paper charts, and they always did, and we always finished by the end of the day.

As an aside. The one thing I miss about paper charts? It insured there was always something for your staff to do when they weren't busy -- file charts (it was an endless job). Now, with EMRs, when they can't find something to do, they browse the Internet or find some other unproductive thing to do. But, then again, maybe since EMRs mean there are no charts to file, employees should be able to go on eBay once in awhile.

Bert, that last paragraph is so true. My staff have gotten bored in the last 3 months since I've been using AC. They're pretty much there to answer the phone and file the faxes into AC (which takes about 30 minutes/day). They've commented about having nothing to do and started doing MafiaWars and Farmtown? or something like that on Facebook.

Oh well, no doubt the lack of paper in my office has significantly cut down on the amount of paperwork for my office staff. I still have my fax print out incoming faxes which is the majority of paper and toner used in the office (About 8 reams of paper in 3 months). Why do I still do that? Well, I use the Brother fax and if the computer it's attached to closes the fax-receive (on reboot even though it's in the start menu or for whatever reason), I missed a ton of faxes. It only happened twice but nobody caught it and I missed a ton of faxes for almost an entire day. Not good. So I haven't quite gotten away from that just yet. The cost to keep that going is less than $500/year so I'll hang on to it for a little while.

I can't say the EMR has sped me up at all and may have slowed me down some now that I don't dictate as much, type a moderate amount, and do all the letter writing and faxing to my referring providers myself. So I'm working just as hard if not harder while my office staff is playing games on the internet. Gotta love modern medicine.

I have two Master Farmers on my staff. One just bought a truck seeder.

Leslie

Bert the "time is money" isn't false. We reduced staff once we got AC. Not only did we not have to pull charts, we didnt have to buy them, or have someone "put them together". We didnt ahve to have people put stuff in them either (well you still to have to scan but that doesnt take as long. really). And we didnt have to buy anything to store charts in. Or should I say anything else. But they take it too far and it becomes invalid at that point. They tend to inflate it to justify their product for smaller practices.

Well...when you put it that way...