Home Forums Discussions Problems Does anyone in tech support return calls?

First off let me say that I'm a big advocate of Amazing Charts and feel that Jon has made tremendous strides towards providing physicians with an inexpensive, easy to use EMR.

Unfortunately, the switch to SQL seems to have overwhelmed the company's ability to provide timely technical support. Since the new version adds a layer of complexity to the installation and troubleshooting, no doubt the demands place on Jon's tech support group have risen exponentially. I decided to upgrade to version 4 recently, figuring that by now the bugs would have more or less been beaten into submission. While I could easily have done the upgrade myself, having paid for tech support I chose to have them do it remotely. It took multiple calls + messages left to finally get someone to schedule an appointment. In fact no one even replied to the initial message as of five days after it was left. On the day of the upgrade, the appointment time came and went without a call from tech support. I waited patiently, but eventually gave up and called. And called. And called. When I finally reached a live human she promised to look into the issue and I was eventually connected with a (very helpful) tech who did the install. (They said they were "just about to call [me]".)

The next day was a disaster, as the other EMR we have in our office was unavailable (server upgrade), so we were to use Amazing Charts exclusively that day. My receptionist logged in to her Windows screen and promptly found Amazing Charts spontaneously attempting to reinstall itself repeatedly, resulting in multiple error messages. Between 8:30 and noon, 4 messages were left with Amazing Charts requesting help for our unusable installation. We were stuck without a chart system, unresponsive tech support, and were not amused.

Eventually at around 1 p.m. I finally reached a tech who reinstalled some DLL files, which seemed to get the program functioning again. Unfortunately, every second or third time I try to print a patient instruction handout, the program crashes. Sometimes it closes Amazing Charts completely, sometimes I am just taken back to the print screen again. The time wasted restarting the program is making Amazing Charts pretty much unusable in our office. The custom signature in the patient instructions also is not printing, even though it shows up onscreen in the letter. Multiple messages were left all day on October 15, 2009 and no one has thus far bothered to call us back.

A suggestion to Jon: if your tech support department is overwhelmed, please hire more people. Also, you really need to at least provide users with a prompt response indicating when you can schedule time to help them. Ignoring a physician's request for help resolving a buggy installation is not acceptable, given the setting in which this software is being used.

For several years I have recommended Amazing Charts to any colleague that was looking for a simple, reliable EMR, but given the apparent problems that are ongoing with technical support being overwhelmed, I can no longer vouch for the software at this point in time. It's really a shame - Jon has done a good job with the program, but unsupported medical software simply cannot be trusted in a busy medical clinic. The time wasted and frustration caused by loss of a charting system nullifies the advantages of low cost and simplicity offered by Amazing Charts.

If anyone reading speaks to Jon directly please let him know that lack of adequate tech support will drag the company down.

I too have noticed problems since the migration to V4. I believe that you are absolutely correct in that the migration SQL led to an exponential increase in problems. I sometimes get ACs attempt to re-install itself too, but if I let it try and fail, then I can start it ok. I didn't update to 4.073 because I didn't want to fight with the update. Previous updates were easy to install--I could do it in no time flat. Now I get error messages and have to call tech support--and I haven't had the time to do so and possibly wait for a call back. Though Claire and Jodie tend to call me back.

I was thinking the other day that I have stopped contacting AC for problems because I have not been getting helpful / effective responses. ( am using version 4.073 or whatever that number is) There is definitely room for more tech support. A thread related to this subject was going earlier, I would be willing to pay more for an increased level of support, but this not currently even an option. Some one who is enterprising and computer capable could offer independent tech support and probably make a go of it, I think there is a market particularly if AC expands as more Docs switch to EMR.

There was a problem with unregistered DLL files - did they try that fix? I went from version 3.7.15 to 4.0.73 on Monday and have had a lot of problems so far. I know my way around computers, so this is the first time I've had to call tech support to resolve issues with Amazing Charts in over a year. (The only other time I called was to get a workaround for a bug in the program causing it to not read the Windows system date properly, resulting in a jumbled calendar.)

The newfound speed with the switch to the SQL backend is nice, though. And the automatic backups are a timesaver.

I'm going to reinstall the program from scratch this weekend and see if that fixes the problems. Hate to say it, but this is why most physicians are wisely reluctant to switch to EMRs. You shouldn't need to be a computer expert just to run a charting program in your office.

I would suggest you email Jon and let him know how you feel about the level of tech support that you're receiving. You shouldn't have to fend for yourself if you're paying for support. Jon seems like a good guy, but I suspect that between the switch to SQL in version 4 and the push to achieve CCHIT certification in version 5 he and his staff are getting stretched thin. I feel hiring more tech needs to be a priority for Amazing Charts now that the program is getting more complex.

I never had trouble getting support, but it's been sixty days since my installation. Maybe lately things have changed. Or maybe I had better attention being "on-trial".

In any case, it would sure raise confidence to get an official response on this.

There are 2 ways to get support. Phone is the weakest. If you use the internet it is usually faster and often they use a combination of internet and phone.

I do agree that a scheduled install should be fairly high priority and should be on time.

Sorry to hear about the problems with the installation, but I've done several between my 2 offices and dummy installs and tests, and most work like a charm. One was impossible but it was a test dummy and I gave up.

While we're on the topic of tech support, I had to call today because I have been getting computer crashes; and eventlog indicates one of the errors involves the SQL Server.

What really sticks in my craw is the tendency for tech support to tell me to turn off my firewall. Please pardon the ire, but where does he get off telling me I have to turn off my firewall? I am not referring to the brief shut-off recommended during installation here. He actually advises me to turn off windows firewall--permanently. Can a tech support guy be THAT clueless? I ask how I'm supposed to protect my computer from attack without a firewall, and all he can answer is, "well that could be the source of the problem." and BTW there is nothing to indicate this. It's a quick cop out when they don't know what to say. I managed to politely excuse myself from the support session.

I brought up this issue when the guy advised the same during my initial install, talked to Dr. J.B. and thought we understood that it's an inappropriate recommendation.

My IT help came by and worked on my system for half an hour getting rid of various MS Vista background processes which Bill Gates apparently decided were a good idea, and hopefully that will solve my problem: which would indicate my problems aren't AC related at all. Still, please stop asking physicians to compromise network security. end rant....(for now)

We left another message for tech support (they apparently NEVER pick up the phone when you call) on October 16, 2009 and did not receive a reply. To be honest, I'm rather shocked that an EMR company can have a policy of not replying to requests for help by its customers. This is absolutely insane - we're not talking about trivial videogame software here. Amazing Charts is being used by busy physicians who are seeing real patients in the Real World. Downtime is not an option.

I gave up and tried the "Chat" help link on their site. I was shocked to see "Nick" reply in probably less than a minute, but from the delays in his responses to my messages during the session I suspect he was attempting to deal with at least 4 or 5 other individuals simultaneously. He was helpful (as all of the techs seem to be), and remotely ran some diagnostics on my office and server installations of Amazing Charts. The problem is this was all going on while I was trying to see consults in clinic. This whole episode trashed my schedule this afternoon and at one point I had to log our receptionist off her computer, leaving us unable to register patients, book appointments, etc. In other words the office came to a complete standstill while we waited to see if the program could be fixed. Nick found that there was a problem with the permissions set up for sharing the C drive. Unfortunately once I started using the program again the crashes continued. I have requested that they do a fresh install, but I'm not holding my breath waiting to hear back when this will be arranged. He said he would also have a "Tier 2 tech" look into the problem. At this point I think I may have to revert back to Version 3 - it may not have been fast, but at least I could trust that it wouldn't crash every 10 minutes. (I spent over 30 minutes today just logging back in to Amazing Charts after the endless crashes.)

Please fix these tech support problems, Jon. If the status quo remains when you release your CCHIT-certified version you're going to have a nightmare on your hands one day when the program's crashing leads to a patient care disaster.

I agree that Jon needs to fix the Support issues. I almost never have to call the support guys since I can mostly figure out the issue and especially since I am so comfortable with SQL.

This is a area that I feel so uncomfortable when I am recommending AC to other physicians. I can devote all the time and energy to make sure my wife's practice is running, but then everyone does not have this luxury of this super techie guy

It is critical that he fixes the Support issues or very soon they will lose customers.

Maybe I should start a AC Support Call center

When doing an upgrade of any software, there should be some basic steps taken to protect yourself and your office. I don't know if there are documented on Jon's website but some basics of change control include:

1. Do the upgrade on test hardware or in a virtual machine environment. This makes sure you are comfortable with all aspects of the upgrade and have documented what you need to be successful.
2. Give yourself only a certain amount of time to do the upgrade, the change window (say Friday 6:00pm thru Sunday 7:00pm). Plan and write down how long the major steps will take. You must have a contingency plan if the upgrade is not completed in the alloted time. The contingency plan will be activated if you don't complete all steps by a certain decision point (say 5:00pm Sunday). The contingency plan is where you backout your changes. All work should be completed by the end of change window (7:00pm).
3. You should have a backup installation that can be reinstalled in time between your decision point (500pm SUN) and the end of change window (7:00 SUN). This backup makes up your contingency plan and backout. If you have hardware available, an ideal way to do this is to have separate hardware old vs. new. Then, it is just plug the old installation back in and reinstall is very quick. If no extra hardware, you will need a larger amount of time for your contingency plan.
4. There should be a test plan to verify a good install. Add dummy patients, schedule dummy patient appointment, read your imported items, and create a dummy encounter. This testing all needs to be done before the decision point or the contingency plan should be put in place.
5. I recommend doing the installation a Friday night or Saturday. This gives you a long window of time to complete your work and do the followup testing.

although too late for those having tech support issues now, if basic change control procedures like these are followed there should be reason where the program's crashing leads to a patient care disaster.

Most of the physicians that I know would have gone ballistic if they went throught what I did this week after the "upgrade" to Version 4 on Monday. I generally use Amazing Charts as a backup system in my clinic + on my laptops, but I would not feel comfortable running my practice with Version 4 as my primary chart system given the current issues with obtaining support. Despite this, the $1000 I spent buying Version 3 was a tremendous bargain given how functional, simple and reliable the program has been over the past couple of years.

Good advice in general, but not always realistic to achieve in the Real World. For those of us getting tech support to do the install we are at the mercy of their schedule, in which there are very limited slots for getting installs done in the near future.

In my case, I arranged for the install to be done the morning of a day off (Monday) and made backups of Amazing Charts Version 3 databases and saved the databases to a few different flash drives, desktops and laptops. Version 3 and the databases were installed on a backup Tablet PC, to be used in case of disaster.

I chose to have tech support do the installation in case there were any known issues to avoid with following the default install routine.

After the install I tested the scheduling and reviewed previous notes/imported items, all of which functioned well. I also tried making a note, writing prescriptions and saving imported items for a fake patient. I did not try printing a consult letter or writing + printing a patient instruction letter. I also failed to check whether or not the program was installed under my receptionist's profile in the reception computer (the tech installed it under my profile as "administrator" and I assumed the tech had made the install available to all users who access the computer). I should have known better than to skip testing ALL parts of the program after the install, but I assumed everything was okay.

When disaster struck on Tuesday morning we had already started clinic, so it was too late to roll back the reception computer to Version 3. Using my tablet with Version 3 was not a realistic option, since there was no server (reception desktop) to obtain new patient charts from. Paper was the obvious solution while we waited (in vain) all morning for tech support to return our calls. Lunchtime was spent troubleshooting and eventually a few DLLs were reloaded, stopping the program's continual attempts to reinstall itself. On Tuedsay afternoon, crashes started occurring with writing the patient instruction letters, but we held off rolling back to Version 3 expecting (naively) that tech support was going to call back to address the issues. For the next 3 days we kept calling tech support and waiting by the phone like a lonely teenage girl: "Why won't [he] tech support call me?"

As much as I like Amazing Charts, this episode has taught me that I need to assume that things will go wrong and to be better prepared if they do. I could have avoided all of these headaches by simply keeping an extra laptop with Amazing Charts 3 loaded on it, ready to take over as the server. Live and learn...

Nepron:
When you said " maybe I should start an AC call center" that is exactly what I had in mind. You could sign me up in a heart beat. Tech support is always polite, but response is slow ( therefore I do not use this during the workday because I have to take care of the patients...not the computer) even with chat session. And, call back may not happen at all. Basically I have just dropped ( for the time being anyway )my current problems, the largest of which is erratic messages that get lost. I don't know how many weeks ago they were going to look into that and get back to me.
The docs who have not yet migrated to EMR are the ones who aren't fancy, aren't in big groups, aren't in a position to throw a lot of money around and aren't computer hounds. They would be very good AC users but are going to require better support than AC currently is providing.
I agree, I think the new users get more prompt attention, I got much better help when I first signed on than I do now. I guess that's why I don't contact them anymore, it doesn't solve my problem and takes up my time, makes me frustrated.
I hope the things that are currently bugging me are fixed in the next version.

Prior to this week, the only other time I called tech support was over a year ago when I was still using a demo version. Tech support was more efficient at that time. I assume it was because their resources were not yet being drained by Version 4, but maybe you're right in that new or potential users receive more attentive support than the rest of us. That would be a shame. I still feel that increasing the staffing in tech support needs to be taken care of before any more versions are released.

Well my installation just went from bad to worse. I has noticed that after tech support's work last week I was left with two routes to the sharing of the Amazing Charts folder (either through "Program Files" or through the root of the C drive). Digging around in Windows (right click "My Computer" -> Manage) I see that both the C drive and the Amazing Charts folder are listed in the "Shared Folders" section, so I assume this is why the two routes are present.

I uninstalled the program on Saturday, hoping that a fresh install would fix things. I then got the dreaded error message telling me that my office computer could not access the SQL database because Port 61067 was being blocked. I've checked the setup of the exceptions to the Windows Firewall port blocking on the server and it appears to be configured correctly to allow data through port 61067. The database loads properly when run locally on the server, and when I turn off Windows Firewall completely on the server the remote computer is also able to access the database on the server.

I had hoped to get some assistance resolving this today before clinic starts tomorrow, but even though they claim to monitor messages left on the weekend I never heard back from tech support today (Sunday). Does anyone have any suggestions on how to fix this?

I added an exception for Amazing Charts in the remote computer as well and now can access the server database. Is it usually necessary to make exceptions in Windows Firewall blocking in both server and the computers that will be accessing the server before Amazing Charts can send data through the port 61067?

I tried setting up my laptop and got the same error messages about the blocked port. Since I am connecting to the network via Wi-Fi, I accessed the router's set-up screen and configured the router to allow traffic through port 61067. I am able to browse to the database load it on my laptop and after entering my password at the Amazing Charts log-in screen the program keeps freezing at the final step where it says that it is loading the data for speed. Close, but no cigar. Any ideas why the database will not fully load on the laptop?

I had hoped this thread would solve itself, as the thousands of other users who have had consistently great support would chime in and Osler’s issues would get resolved, but alas it is not to be, and I guess it is well overdue for me to address these concerns.

You are correct that we are in the throes of a “perfect storm” of (1) migrating to the markedly more robust - but markedly more complex - SQL Server database, (2) a “rush” on EHR systems due to all the recent hype surrounding the HITECH stimulus funds, and – most importantly – (3) our dedication to providing a truly affordable and usable system with no hidden fees or surprising charges.

The first issue is improving as we continue to learn from the unique issues of using SQL Server on various operating system platforms. We have over 3000 practices and there is many times this number of computers running Amazing Charts, each with its own programs, tasks, networking, viruses, anti-virus software, firewalls, etc. Yes, supporting all this is difficult and complex to say the least and we are constantly facing new problems related to Windows updates and software and hardware conflicts – but we work to solve each one, and are continually building on our experiences to facilitate solving similar issues more rapidly.

Add to that the recent rush of new clients, often much less technically savvy than the first wave of “early adopters,” who not only need help with learning basic Amazing Charts functionality, but also require help networking computers and configuring routers. Rather than do what most vendors do, and tell the clients they need to contact their hardware or software vendors from which the underlying problem emanates, our support people roll up their sleeves and dive in. We help everybody fairly, and only stop helping to assist “emergencies” where a practice can’t access Amazing Charts at all. Otherwise, we help our clients equally, even when a client yells louder than another or has issues that aren’t caused by Amazing Charts but rather effect Amazing Charts. As has been noted here – most of the issues aren’t Amazing Charts problems per se, but rather due to the complexity of Windows, SQL Server, and the myriad of hardware and software products being used. Yet we still take responsibility and strive to solve the problem, even though this sometimes can take time and multiple contacts.

Which leads to the third issue, cost. Despite striving to support our clients with whatever they need help with, we have also struggled not to charge any extra for this support. Keep in mind that our $500/year charge for “support & maintenance” pays for all our software improvements and enhancements. The CCHIT Certification we have completed as part of V5 is included. The Health Maintenance module that is now in alpha testing is included. Even our e-Prescribing has been reworked for usability and will be included in V5 at no additional charge to our clients even though we have to pay our vendors for access to the data, updates, etc. We do this because we feel it is not fair to charge physicians to write scripts. We do this because most of our clients don’t require us to spend hours sorting through unusual networks or configuration issues and so we can afford to do it.

And despite our low cost, and the impression from this thread that our support is lacking, our support is consistently rated higher than the vendors who not only charge ten thousand dollars per physician for a license, but also charge thousands a year for their support. In fact, a 2008 study of EHR users published in Family Practice Management showed that EHR users asked their “Overall Satisfaction with Support and Training” rated us higher than eClinicalWorks (eCW), eMDs, SOAPware, Healthmatics (now AllScripts), Centricity, Misys, and others. The ongoing AAFP Center for Health IT survey also finds that we are rated above EVERY OTHER EHR for quality, price, support, ease of use, and impact on productivity. And the October 2009 Medscape survey of EHR users also rated Amazing Charts higher than EVERY OTHER SYSTEM on 12 areas of performance, including vendor customer support. So for those considering Amazing Charts and reading these posts, please don’t mistake the fact that we allow our users to share their frustrations on an uncensored user board as meaning our support is lousy. It isn’t, and when the vast majority of users are asked about their experiences, it becomes clear that not only do we do a great job in general – we do it without gouging our clients.

All this may be terrific, but unfortunately it doesn’t solve the real problems that Osler and a few others have reported here. And while these experiences are not those of the average user, and while I also suspect there is a lot more going on with Osler’s set up than the average practice (since the vast majority of our users have never experienced anything like this), I do agree that the experiences he relates would certainly frustrate me too. So we need to find a solution for those clients who require a level of access and support beyond what the vast majority of our existing practices require. As dklehmannmd noted, she would be willing to pay more for an increased level of support, which is not currently an option.

So why haven’t we increased our annual charges? First off, as noted above, the vast majority of our clients never have support issues, or when they do they are immediately solved rapidly and well (it would be great if some of our users would actually chime in here). It has not felt fair to raise our prices across the board to support the relatively small (but outspoken) number of clients who have experienced something unusual.

I have also resisted instituting a “two tiered” system as I am concerned that most of the people who should have this additional service won’t purchase it outright, and then will get upset (and more outspoken) when they are advised that their expectations or problems aren’t “normal” and are required to pay more. But it sounds like that time has come and we need to offer a more intensive technical support option for people experiencing situations like Osler and dklehmannmd.


And while you may get the sense that I’m shooting the messenger with this post (and I guess I am a bit – sorry Osler and dklehmannmd), the bottom line is you guys are not thrilled with Amazing Charts. And that is not acceptable. Period. So the question is, how do we get there? Do we raise prices for everybody to hire and train more support people so our average “time to resolution” goes from under a day to under an hour? (Of course, as this thread proves, there will always be situations that are not easily solved, no matter what we charge.) Do we offer two tiers of support and require clients needing more help to pay more? I’m not sure of the correct approach and would really like to hear from other Amazing Charts users before making a decision.

Jon

I never chimed in on this conversation because I didn't have much to add. I've never been anywhere in my life where computer programs are utilized that every single person is happy. It just doesn't happen. So listening to someone vent just seemed like a norm for an EMR user board.

It's just like marketing your practice though. One negative experience will get around to 15-20 people while one positive experience only gets around to less than 4 people. On the internet, that is multiplied exponentially I'm sure.

I have officially been using AC for 3 1/2 months now although I utilized the program for at least 2 months prior to that. I have only contacted AC support once about a problem I had importing templates. I used the internet chat and was IMMEDIATELY assisted. It was Nick and we couldn't quite figure it out. He moved it to Level 2 tech which was fine. I continued to work on it that evening and eventually figured it out. It was a problem with my XML document and had nothing to do with AC. I sent Nick a message the next morning and he called my office later to assure everything was fine. Can't get much better service than that in my opinion.

Anyway, I haven't had any problems with support. But as Jon said, I really haven't needed it. It's the easiest, simplest EMR out there and you rarely need any help.

My router has more problems than my EMR. That thing loses passwords and has to be restarted way too much.

Maybe some of the issue is that with all the other EMRs, you have to have a dang network specialist come and set the entire thing up, all of your hardware and software, and you can just call them to come work on it. With AC, we all are cost conscious and try to do it all ourselves. With small simple practices, a half-way computer savvy doc can do this without much effort. With a more complex practice and set-up, maybe those people need to get a network person to help them out.

Jon, I doubt docs will sign up for the 2nd tier of support. Docs who use AC are cost conscious as a rule in a smaller office. Dropping another $500 or $1000/year would probably be a rarity. Maybe I'm wrong. I personally would not. I really like the $500/year because I'm assured of getting upgrades.

Maybe $500 per year for general support and updates.

Then a per incident fee for problems complex enough to require level 3 support personnel and/or "emergency" level needs. Say $100 for a request for "urgent, intense" level 3 support guru.

Look at it like the difference between an office visit for bronchitis vs. a trip to the ED for high-risk chest pain.

A self test could be offered for offices to choose their level of support. Levels of support could be 1) upgrades/functionality assistance @ $500/yr and 2) upgrades/functionality/setup assistance for $1000/year with a per incident charge 3 weeks after the initial successful setup.

Self test questions about rating your comfort level using a computer, comfort level setting up your network, rating your ability to search google for answers. I'm sure a couple others like this could be added with the results steering you to a particular support arrangement.

Truth be known, I wasn't even aware that the AC team would do the 4.0 install on your behalf...if an office opts for this, that office certainly seems a candidate for an uplevel support contract. Maybe I should have read the upgrade notes a little more carefully....kinda like not reading the manual with my new VCR or TV.

In situations like this, I would ask: "What would Microsoft do?" They have been charging for support a lot longer than AC. They charge a reasonable "per incident" fee after a certain break-in post-purchase period. Those that aren't computer saavy know that if they get a snafoo with a MS product, for less than $60 they are assured to get their issues resolved. The money allows MS to offer instantaneous support, that over the years I've found it to be really good. Here are their prices in 2007 which seem to still be active in 2009 .

Increasing the per-year charge of $500 would penalize those that need minimal support. Such a system as outlined above would mean that Osler, for example, could get his issue resolved for a mere $60 immediately.

Now, a great support section as advocated by Peter here is needed. It would NOT complicate the board much if done like Microsoft does it here, including their excellent search engine.































Just my thoughts...

Al

I agree with the incident fee, but some support should be offered for the $500 annual fee, otherwise the $500 for people who need minimal support ends up being just a fee for updates.

That's why I say, if it's a feature help issue, include it in the $500 annual. If it's a problem with errors or getting AC to work in the office setting after the initial installation and setup, an issue which is not resolved by the support "grunts" (no offence ) then do a per incident.

When this is spelled out clearly up front, there should be little "upset". That "per incident" is still tiny. Also I imagine that major issues like that will not occur very often to a typical practice once a network is setup. Later, with upgrades in operating system or network, another "incident" may be needed.

In addition, you can promise licensees that, should the problem prove to somehow be a fault in AC, the incident might be waived.

I also agree that having a more complete wiki may help.

You know, you will never please everyone all the time. You can only do your best to make everyone happy. And for every 100 quick and efficient, thrilling support experiences, there will be one unhappy (or just frustrated) licensee, who will vent on the board. Notice how those who are thrilled with their support session rarely post about it.

If you were to charge a dime for a support session, you'd have SOMEONE out there complaining. HA. Reminds me of the Simpsons episode in which Homer is in a nursing home getting fed by IV; he looks over and sees a guy on a ventilator and whines: "Hey! How come he doesn't have to breathe!"

(Make a 'bitch' thread, accessible only by members?)

I'll chime in....I have never had trouble with support. Compared to the total lack of it I got from SoapWare, AC is the bomb!

Leslie

I would like to chime in. I have had a few headaches as we have went thru the multiple upgrades since 3.6. I have always been helped as tech support has solved the problem even if we had to do several different things. They checked back to see what was going on when we had an increase in "bug" reports. Ac has been a great system as we are glad we have it. My old practice has a system that runs roughly 60k per doc and no one likes it and the docs think it stinks. They have been working on implementation for over a year and finally went live at 18 months into the project. We up up with AC within 30 minutes.

I have only sparing used support services. I am torn between the need to have it working consistently every day and additional costs over and above the basic fee, which I feel is reasonable.

Extensive support calls/internet that require more than a 99213 (15 minute) may deserve a service fee IFF they are not AC related. This can be somewhat touchy at times, but may allow a somewhat more beefed up support service. I again, have not needed much help, so per service without a base charge might have been acceptable (I prefer the Guardian Angel over me though)

I have rarely if ever had any problem with AC support. Except that they are not available on weekends.

Thanks for sharing your concerns about technical support and apologize for not responding to your inquires in a timely manner. I became technical support manager in May 2009 and have since implemented the following changes:

o We added 2 additional technical support team members in early September.

o We added 24-7 coverage for technical support - also in early September.

o We added a 2 hour turn around goal for voice mail messages. (This is aside from a "crash" - if a practice is down and cannot access Amazing Charts on any computer - we triage these for immediate action.)

o We added additional in house training for the team - just getting started in an organized fashion including assessment of team member capabilities.

o My team and I will be monitoring the User Board and responding to issues and questions. I am also available for direct contact if you do not get the issues resolved in a timely and/or accurate manner via email- trish@amazingcharts.com



Trish

Thanks tech support! It doesn't get any better than that.

WOW. Trish is on it!

Hi everyone (and Jon),

This can be a very delicate balance between price and support levels. I too have had difficulties with non emergency customer support and my IT guy has allegedly called AC and left messages and NOT gotten return calls. Having said that, the support for true emergencies and urgencies with AC and my practice has been over the top excellent. Jon even helped me out from his home one weekend when we had install issues with the new AC4 upgrade last year!!

Regarding price of support per license and per event I feel like I am potentially on the short end of the stick. I or my IT person are the ONLY ones who ever use AC support yet we pay for 8 licenses (soon to be 10). The system either works or doesn't for the most part. My docs individually never call into AC and never have individual workstation problems. So in effect, I am paying 8x the price of support as a solo doc with a small network and with similar support needs (maybe less because we have a half time IT person). I am okay with this to a certain extent but would not be okay with paying more per license. My two cent rant.

Best,

James Clayton, M.D.
US Virgin Islands

James, why do you need 8 licenses? If you're a solo doc, it isn't clear to me why you would need more than one license, maybe two if you semi-regularly have another provider come work part time along side you.

Welcome Trish. Glad to have you here to help Jon and address the users problems.

We are a patient bunch, knowing that we are getting the best deal out there among all the EMRs and function in this ever increasing complex technological requirements for the office.

Best regards.

Ben,

We have 8 providers (last time I counted), soon to have 9 or 10 by February. We are one of the 'larger' groups using AC.

James

Hi, Jon. Thanks for taking the time reply to this thread. It's almost unheard-of for a CEO to engage in completely honest conversation with their customers the way you have always done. You're clearly a class act and your ethics put all other EMR vendors that I'm famiar with to shame. First of all, I'd like to say that I have been a huge supporter of Amazing Charts over the years. You've almost single-handedly been responsible for keeping the other EMR vendors honest by providing physicians with a great product at a fantastic price. By offering physicians 90% of the functionality for 10% - 20% of the cost of many other EMRs you've allowed hundreds of your colleagues the opportunity to move their offices into the 21st century. The fact that almost no other companies besides Amazing Charts offer downloads of their software to permit extended evaluation is quite telling.

The simplicity and intuitive nature of Amazing Charts version 3 appealed to me because I knew that it would be easy to set up and run in my office and my staff would be able to pick up on how to use it without requiring any formal training beyond the time I spent explaining the EMRs features to them. It actually took less than an hour for me to review all of Amazing Chart's features with them and get them to the point that they were comfortable doing everything from registering patients to scanning in and filing lab reports. I've been using EMRs for a number of years and my office currently has a different EMR as our primary system. I use Amazing Charts mainly as a backup charting system and for charting on out-of-office consults. I was always secure in the knowledge that if ever our main EMR went down, Amazing Charts would be there to back us up. Unfortunately, as a specialist even if I wanted to it would be impossible for me to use Amazing Charts as my sole EMR because of the lack of a usable method of generating consult letters to referring physicians. (I had spoken to you about this last year and would request again that you include the ability to easily generate editable consult letters in version 5 of Amazing Charts. By not fixing the letter writer you are actually making it essentially impossible for most specialists to use your EMR. While I have your ear, my second request would be that you include the ability to save a list of editable favorite prescriptions that can easily be chosen by the physician.) Even with just using Amazing Charts as a backup EMR the money spent licensing it was probably the best software investment that I've ever made. In fact, we purchased some extra licenses for our clinic - even though they were not needed - just as a way to say "thank you" for providing physicians with an alternative to the ridiculously expensive EMRs that dominate the marketplace.

We held off on upgrading to Version 4 until a few weeks ago because we wanted to make sure that all of the bugs had been worked out of the current release and because version 3 still is quite functional "as is". Our main EMR is currently being updated, and we took the opportunity to do a server upgrade at the same time, so we decided to use Amazing Charts as our primary EMR while we were waiting for things to be sorted out with our main EMR. Because in the past when I used Amazing Charts version 3 I had experienced periodic crashing of the software (which I had attributed to it running on the Access database) I felt that this would be the ideal time to make the upgrade to the SQL-based version 4. And thus began the unfortunate saga chronicled in my original post to this thread.

Jon, as much as I like your software and your company, I was appalled by the complete lack of any timely response to what must have been well over a dozen messages left for Technical Support over the period of one week in mid-October. I'm sure you can imagine what it must feel like to be in the middle of a busy clinic depending on an EMR, only to have it not working and at the same time having Technical Support neither answering the phone nor responding to multiple urgent messages that have been left. To make matters worse, the failed installation of version 4 somehow prevented our Practice Management software from running, resulting in our receptionist being unable to even book, confirm or reschedule appointments during the time that Amazing Charts was not working.

Despite the extreme difficulty in reaching Technical Support, I must say that every time we have been able to actually get someone to help they have been phenomenal. Your techs are easily the most dedicated and helpful techs that I have EVER dealt with. "Joe", in particular went so far beyond the call of duty trying to help us that I was amazed. You need to find a way to clone him! After dealing with the third day of post-installation crashing, I sent an online request for "chat help" via your website a few minutes after your office would have been closed. Joe not only answered the call but he also stayed two or three hours overtime, trying to help resolve our problem so that we would have a usable chart system for the following day's clinic. In our discussions I mentioned the problems I had experienced getting a scanned signature sized properly to fit the signature box for prescriptions. No one in technical support had replied to any of our messages that had been left about this, so I had decided to remove the (poorly-sized) signature. Unfortunately, Amazing Charts actually does not provide an option to delete a saved signature. With no response from Tech Support expected, I had checked this forum and discovered a post explaining that the signatures were saved in the Data001 folder and can be made visible by changing the file extension to e.g. .bmp. I did this and deleted the signature. Only problem is that by deleting just that one signature file it's possible that I may have corrupted my database, resulting in the constant crashes that I was experiencing. Joe manually went through my databases, looking for where the structure may have been broken. All told, he spent several hours trying to help me, including the next morning when the database was fixed.

The crashing improved immediately, and Amazing Charts now crashes 2 or 3 times a day instead of every 5 minutes as it was doing immediately after the upgrade. I had experienced daily crashes with version 3 and had assumed this was normal, but now have been advised that it isn't. I suspect there was a problem with the database dating back to version 3, so perhaps these problems were carried forward with the upgrade to SQL.

Most days I don't even have time for lunch, much less calling Technical Support, so I haven't tried to get the current crashes resolved. I'd love to see someone fix the crashing that we're still experiencing, so that I could know that the next time we need Amazing Charts it won't let us down. I'll try emailing tech support and see what happens.

I hope no one reading these posts who was considering getting Amazing Charts changes their mind because of anything that I've written. I believe that the vast majority of Amazing Charts users seem to be having no major issues with the upgrade to version 4. Furthermore, if you're looking for a well-written, complete, well-supported, inexpensive EMR, then Amazing Charts is really the only EMR that you should even bother considering. I've been using EMRs for a long time and have no qualms about saying that Amazing Charts is easily the best low-cost EMR that I've ever seen. The only way to get a significantly "better" EMR would be to spend at least another $5,000 getting a program like e-MDs. And once you commit to buying a more expensive mid-level EMR then you're stuck with having to pay annual "support" fees that cost more than the purchase price for Amazing Charts.

As far as to your question on how best to handle the support of your customers, I have a few suggestions:

1) Ensure that you have hired enough technicians to handle the typical volume of daily calls that you receive in a timely manner. All calls should at least be answered by a live operator who knows enough to triage the calls appropriately. Customers experiencing disasters like the one I went through should be prioritized, with every effort being made to at least get them to a state where they have a functional EMR on one computer. For example, in my case when I had called on the morning after the installation when my receptionist found that Amazing Charts was continually trying to install itself under her profile and had somehow inactivated our scheduling and billing software, this brought the office to an essential standstill. I gather from reading posts here that others have experienced similar issues with Amazing Charts trying to reinstall itself and also somehow inactivating Practice Management software that also use databases. Had someone triaged our call and realized that the situation was a disaster for our office, a senior tech could have been assigned to deal with things immediately. They would probably have been able to solve the problem in less than five minutes by reinstalling the missing DLL files that apparently caused the problem in the first place (I gather this is a known issue with Amazing Charts). By at least having one computer up and running our office could have limped through the rest of the day and dealt with getting the rest of the office up and running at a more convenient time.

2) Along the same lines of suggestion #1, even if you don't have enough technicians to deal with all problems within 24 hours, at least let customers know that you have received their request for help and that you will be getting back to them within a specified period of time. To have no one answer the phone, be forced to leave a voicemail, receive no acknowledgement of receipt of the request for support, and then to not even receive a call back several days after an urgent message has been left is in my opinion unacceptable. I still can't believe that our calls indicating that the chart system was completely unavailable were ignored in this manner.

3) It would be helpful if you could assign a technician to spend one hour a day reading through the posts made on this message board and respond to questions or give advice. It seems frequently that the posters here are left to fend for themselves, with one or two people like Bert altruistically doing an incredible amount of work attempting to troubleshoot problems and come up with solutions for those of us posting here. To see an official representative of Amazing Charts in the forum helping out daily would be rather reassuring and would alleviate the nagging feeling that some of us get that we're "on our own". Having said that, I really commend you for having the confidence to keep an uncensored message board on your site. I don't think I've ever seen another EMR vendor that is so confident in the quality of their product that they would be willing to support an uncensored message board like you do.

4) As far as to what might be the best option to keep prices down, yet ensure proper support of disasters, I think a compromise solution would be that for the current $500 annual support fee you would offer 30 days of telephone support/disaster support after the initial installation (or perhaps after the initial call), followed by (up to) 11 months of e-mail or "chat" support, as well as all software updates. After the initial 30 days of telephone support/disaster support any calls requiring/requesting immediate telephone support would be charged a flat fee of $50 or $100 (or whatever you feel is a realistic amount to adequately cover your costs). These per-incident support calls would be triaged to experienced technicians who hopefully would be familiar enough with common problems to rapidly diagnose and fix these issues. Since most of your previous users probably haven't needed to call technical support I suspect there wouldn't be significant resistance to such a pricing model. The flip side is that as you start selling to less computer-savvy physicians you are inevitably going to be finding more and more demands being placed on technical support. If you are not adequately compensated for these calls then you will quickly be put in a no-win situation. (In my case, I'm fairly knowledgeable about computers and I would estimate that your techs probably had to spend at least four or five hours working hard trying to sort out the various issues that had cropped up after the upgrade to version 4. While our situation was obviously atypical for what happens after upgrades, if even 1% of your users experienced similar issues, this could easily overwhelm your Technical Support department. I would expect that the more features you continue to add to Amazing Charts, the greater the demands will be placed on your Technical Support department. If you introduce version 5 without first significantly ramping up the number of techs on staff, I would not be surprised if you quickly start to hear from a lot of unhappy physicians who feel as if they've been abandoned. By charging a per-incident fee, at least you would be recouping some of the expenses incurred by these support calls. The benefit to your customers would be that hopefully such a tiered system of technical support would guarantee that immediate access to advanced support was available whenever indicated. I don't know about other people, but I would gladly have paid $100 to quickly end the nightmare that we had experienced in clinic the morning after the upgrade to version 4.)

5) One of the best ways to improve support is to do everything possible to obviate the need for such support in the first place. You've actually done a fantastic job simplifying the SQL installation, as well as providing users with the tools needed to perform some basic troubleshooting. If there is any way that you could figure out how to prevent some of the more common problems that people have been experiencing then this would probably alleviats some of the load on your techs. There are known issues with DLLs having to get reinstalled; is there any way to avoid this problem? Also, Amazing Charts seems to conflict with certain Practice Management software, presumably because of some bizarre interaction between Amazing Charts and the PMS databases. I've never seen this kind of problem before, but surely there must be some way to avoid it.




Jon, you did a great job providing physicians with an intuitive, sub-$1000 EMR with version 3. The update to version 4 gave us the industrial-strength stability of a SQL database, yet somehow you did not raise your price. Incredibly, you're now planning to introduce a CCHIT-certified version of Amazing Charts - which I thought would be impossible to do at your current price level (since most CCHIT-certified EMRs sell for over $10,000). Health maintenance, electronic prescribing and practice management are all features that you are planning to implement in the near future. While I completely understand (and for the most part agree with) the business rationale for moving Amazing Charts in this direction, my main fear is that by widening scope of your software you will lose focus on improving what should be the core element: the EMR. If EMR usability remains your primary focus I would have hoped that your first concern would have been to maximize the functionality of simple features that are used on a daily basis before you directed all of your resources towards "features" like achieving CCHIT certification (especially since - I'm sure you'll agree - CCHIT certification is something that you're being forced to add solely for marketing reasons, as it adds very little functionality and historically, CCHIT-mandated "featureitis" has actually both detracted from EMR usability and increased costs). The two features that I had spoken to you about last year (fixing the letter writer so that at the bare minimum it would default to opening up WordPad as the text editor; and adding the ability to save "favorite" prescriptions) are features that have huge impact on EMR functionality and (in my opinion) should have been very easy to add to Amazing Charts. I hope you'll add these features to any upcoming versions of Amazing Charts and ensure that improving the actual EMR never takes a backseat to the race to add less critical things like e-prescribing and PMS.

Keep up the good work.

Hi, Trish. That's nice to hear. Unfortunately, my install problems started in the middle of October and no one would return messages that had been left until sometimes a week later. In fact, we typically did not receive any responses to messages left on your answering machine and found it nearly impossible to get anyone on the phone during the week that we were calling trying to get help. Not good when you're in the middle of clinic attempting to see patients and the Amazing Charts installation has not only failed, but taken out your Practice Management software as well. You clearly don't have enough techs to meet the demand. And those demands will likely rise exponentially once version 5 is released.

Wow! Power Post!



But really, you posted good stuff. And I say "ditto."

When the system is down, even for thirty seconds, the effect on me (and I am sure for all of you) is just like fingernails on a chalk board. We have been fairly lucky with the problems we have encountered, and being in a big city, we have the luxury of an IT company with 3 employees who are only 10 minutes from our office. We have had a couple problems over the years that we needed AC help with and the help has been very very good. Even the IT folks have been impressed with both the speed, and the depth of knowledge on Amazing Charts side of the fence. I have been lurking on some other sites and I must say that we are truly blessed with what Jonathan has here.

Hi Osler

I apologize for the inconvenience and frustration that this has caused you. I would be happy to discuss this further with you. I can be reached at 866-382-5932 or via email at trish@amazingcharts.com

I want to remind everyone that Tech Support can also be reached via chat by going to www.amazingcharts.com/help and clicking on start session.

I look forward to hearing from you.

Trish

Of course, I have to chime in here. I guess I can't think of many censored message boards. I see nothing wrong with people's venting here.

I would argue over the years that the message board's positive comments have far outweighed the negative. I have never seen a message board as helpful as this one and with the cameraderie it engenders.

It is always good to have free feedback even if it may cost a customer or two. Because in the long run, support will get better because of it. Just read Trish's post. Some of these changes MAY have come from some negative comments.

The board has made it through more than a few threads of discontent. Remember the EULA wars that actually resulted in a few users' leaving. Many were upset, but if I recall many more defended it. I know I was one of the leading proponents of the EULA.

I have only needed support once, and it was very good. As I recall I did post a compliment right away, which was followed by compliments from four or five other users.

We all understand how much more work it is to support a change to SQL and all of the platforms it must run on. But, the increased support needs to be considered at that time. Most everyone here knows that my programmer and I make a few small applications for helping with the daily work of medicine. We have given a few versions out for free -- well all for free. Why? Because we can't support it, so we say that right up front. Although we do what we can.

I must say I agree with everything Osler has said. I don't know what the best way to do support is. Per incident or whatever. And, no, I don't think it is unfair if one pays for a year of support and doesn't use it. That's just part of software and support. But, I do know that things like servers with Dell or HP have choices of warranty service up front. I was thinking I wouldn't need the 5-hour 24-7 onsite service, but it was great when the server went down. Having an HP tech at the office at 2PM the same day with a new CPU installed by 3:45PM was a sight to behold.

My only disagreement would be that deleting a signature file out of a folder should not corrupt one's database.