Home Forums Discussions General Discussion Pre-Purchase Questions

We are in the process of shopping for an EMR and Practice Management software. However, as I have played with the demo version, there are some things I certainly don't like, and was wondering how others handle the same issues.

First, a bit about my situation. I share an office with two other neurologists. Our practices are each sole proprietorships, but we share all overhead, including staffing, payroll, and our current (DOS-based) billing/scheduling software.

Here are the issues.

1 - Document and Prescription Headers. We must name a practice to register AC, and that practice name gets put on all headers. Obviously that really doesn't work for us as we want all our documents to reflect our registered business names, but we want to use the same EMR. I've requested/suggested to Jon that document header be editable, but in the meantime has anyone else dealt with this?

2 - Patient IDs. Is there a way to specify the starting number for Patient IDs? When I import all my old patients from my PM software there's no option to include patient/account #s. We want to keep our account numbers synced between the EMR and PM software, and it seems to me that we'll have to just use whatever AC assigns for new patients, but this seems less than ideal given we have a large number of existing patients who already have patient/account IDs. How have others dealt with this issue? (Hopefully it will be moot when the AC PM software is released next year.)

3 - Scheduling. Each of the three of us have different appointment schedules with appointments ranging from 10 to 45 minutes. In order to be able to schedule for all three providers, this means that the scheduler has to be set for 5 minute intervals, which is a PITA - too much scrolling just to see the whole day's appointments. When a patient is scheduled, a start time has to be selected by mouse click. Why can't there be a box where the appointment time can be directly edited/changed? After playing with many schedulers, I don't think there are any that can beat the EZClaim scheduler, and I'd love to see more of its features included in the scheduler for AC. As it is, we actually would likely continue to schedule with our old DOS based scheduler rather than change to AC's. Any tips or tricks to make the AC scheduler easier to deal with?

I completely agree with the scheduling. I, personally, find that to be one of the weakness of AC. It's simple, sure, but maybe too simple. I like color coding, different time increments, don't like to see the patient's name twice for a 20 minute appointment if I have 10 minute blocks, etc.

I don't have any suggestions on how to fix your particular problems with AC though.

Completely off the subject of AC: Why doesn't your "group" of neurologists for a separate company that you each own a piece of? That would be the header name such as "Smartest Neurologists in the Western Hemisphere". It would also provide a company that you each own a 3rd of to pay shard employees, shared equipment, lease payments, etc. You then each have your own "S" corporation as your self (i.e. NeuroDawg, M.D., PA) to buy your own personal equipment or pay your personal nurse, etc.

Anyway, this is way off the subject but if you guys aren't doing that, it really helps come tax season.

Habit. It's how the other two were doing things long before I joined them. And one is close to retirement and I think is a little afraid of being a "co-owner" in a limited partnership or corporation. Our bookkeeper and CPA has been dealing with it for years, and our CPA and financial advisors tell us there's no advantage to doing so, that when all is said and done, it's a wash; same costs either way.

So I think I figured out how to work around the header issue. Our "practice name" will be the first line of our address. Then in the first line of the address fields will be our Suite #, and then the city, state, and zip. That way there is no name on any header that could be construed as a partnership or corporation.

So our header will look like:

123 Main Street
Suite #789
Anywhere, WA 98000
Phone 360-123-4567 Fax 360-789-1234

When I first started with AC I too had the issue of not being able to use the already existing account/patient numbers. I know of no work-around for that although it would seem so simple to me to just allow one to put a number in the account number field without it being automatically assigned. Over the years however, it really has not made all that much difference. Patients in AC have a different number than the one in my PM program. I rarely even look at or search for the account number in AC while we do use it in the PM. The scheduler is also weak, I agree. But, these just a few of numerous things that many, many of us have begged for over the years....the simple things...that seem to keep getting pushed to the side in favor of "new and improved" features.

Leslie

Actually, the existing practice management (PM) account numbers can be put into the Chart ID (Miscellaneous Field) in demographics. This can then be searched under the Search window as need be, and will tie into our PM system as it gets built as part of V6.

Leslie - the "new and improved" features are not things we are adding just to have as new and improved. They are the features that are required for your practice, my practice, and everybody else, to be eligible for the stimulus funds and improved reimbursements that are long overdue.

Everything added and changed in Amazing Charts is a balance between client-requests, government and insurer mandates, usability, etc. So let me rant a bit - now that I'm frustrated and defensive when hearing comments like: "But, these [are] just a few of [the] numerous things that many, many of us have begged for over the years....the simple things...that seem to keep getting pushed to the side in favor of "new and improved" features."

I know eMDs, for example, has a good scheduler that is color coded and will likely handle all the scheduling needs of any group. Their price is something like 25X the cost of Amazing Charts. eClinicalWorks (eCW) too has color coding and schedule preferences/settings up the wazoo. My wife (a pediatrician), whose large practice forced eCW on her, asked me this morning to help her schedule a patient in her system because she can't figure out how to do it! (Their nurse manager, btw, recently counted the number of mouse clicks to enter a single flu shot on a patient - it was literally 30+. But I digress.)

Now of course this doesn't answer the core complaint, which is why can't Amazing Charts do some bell & whistle things that seem pretty simple, even when clients have requested these features for awhile. I don't have a perfect answer - so I'll give you the truth. Amazing Charts is a work in progress. It is moving forward, and most users who have been with us for years recognize it to be a slow, but steady, process. While we certainly have plans to enhance the schedule piece with color coding and indication when a chart has been signed, etc., those enhancements got delayed as the priority list was adjusted to take into account more pressing features that became evident.

In fact, scheduling and practice management additions were to be the core changes in V5, but the rapid change of the EHR landscape earlier this year - with the introduction of the HITECH (ARRA) stimulus money and insurer promises of improved reimbursements for CCHIT certification, e-prescribing, health maintenance, and other features - forced us to make the hard decision to hold on the planned practice management improvements on which we had been aggressively working (we even had a group of users help design this).

These features make up our V5 (now in alpha testing), and as V5 moves to beta and then release, we will focus back on PM development - most of which has already been designed and now just needs to be built. It is clear, however, that even as this happens, the rapidly moving Patient Centered Medical Home (PCMH) model will also become much more widespread and required, and adding easy wizards and tools to allow practices to gather and submit required reports and data will also be required as part of the V5 to V6 transition. And yes, these "new and improved" features might again delay adding some of the "simple things" that we would all certainly like to get into the program.

Anyway, my point is simple. Amazing Charts is a work in progress and will continue to grow and improve over time - in a manner that actually works. What is most telling, I believe, is that even though the eMDs, eCWs, and the other "big boys" already have color-coded scheduling and a combined PM, their systems literally costs tens of thousands of dollars per provider to implement, and their users can't figure out how to schedule an appointment!

And it isn't just my wife. In the October 2009 Medscape EMR survey, Amazing Charts received the highest total overall score from respondents, beating everybody else, including such well-known systems as MediNotes, Allscripts, Practice Partner, eClinicalWorks, Cerner, Centricity, NextGen, and eMDs. Most amazing to me, when these users were asked if they would recommend their EMR to other practices, while 100% of Amazing Charts respondents said yes, the vendors who give great color-coded scheduling didn't fare so well. Nearly 25% of users of eCW, eMDs, and GE’s Centricity would NOT recommend their EMR to another practice, 32% of Allscripts users would not recommend Allscripts, and more than half of Cerner users would recommend against buying their system!

In summary, Amazing Charts will continue to strive to be the best, most affordable, EHR, and a reality-check for the businesses charging ridiculous money for mediocre products. But we need your support, your faith, and your trust. And bitching on the board, while I'm sure is cathartic, causes me to spend time defending our approach, rather than working on adding the enhancements that we all would like to have. (Not a great argument, I know; but simply the truth.)

Jon

P.S. I actually really like Leslie and have known her for a long time, so I know she can take being the lightening rod and focus of my diatribe.

Jon,

I actually really like you too!! And, as you know, I have often been one of your biggest supporters and have come close to blows with others when they talked nasty about AC. I know as well as most that you have worked extremely hard on making AC the best valued EMR out there and for that I am very grateful. However, being one not known for keeping my mouth closed I also have to remind you that this board has collectively and on numerous occasions spoken in unison about the need for some fixes to the basic core of the program. Go back to the WISH LIST threads and see users have wished over and over for improvements to the letter writer, the scheduler (color coding is the least of my concerns), spell check, medication writer, search function, etc. I get so excited when a new version comes out because I am hopeful that many of these issues will have been addressed only to find that some other "enhancement" such as links to other programs which I never use are there instead.
I am well aware that you and your competent staff have been consumed most recently with the CCHIT certification and I know how the whole thing infuriates you. So I have remained patient, confident that these other issues will be addressed at a later time. Even for all my disappointments, I continue to love AC and recommend it to everyone and anyone that will listen. I know a good thing when I see one.
So, no hard feelings, Jon! You can stop with the lightening bolts now

Leslie

Jon,

Despite the complaints, all of us posting here are either using or considering AC. After all, why have user board section for requested features, and not expect the posting users to point out deficiencies, and expect a response from the staff?

For my own part, I can honestly say that AC has transformed my practice (positively) over the past 3 years, so that I produce a much more comprehensive and effective medical record, and essentially paperless. Wherever EMR is headed in the next few years, I feel I am ready, and with AC, I essentially did it myself, and not at the mercy of the vendors that you mention. Believe me I know the other side of the fence, since I was just soaked for a $7,000+ mandatory upgrade by my physician office lab vendor, Antek -- the second in 3 years.

However...some of the repeated requests (letter writer, imported items glitches, ERx, backup to NAS, etc.) are daily annoyances for some of us. Without diverting from the main effort, perhaps addressing a small number of these would be possible using a strategy of hiring or contracting with a "troubleshooting" programmer, with users who needed this function willing to pay extra for an "add-on", ie, formatting letters in Word, etc. This may be a naive suggestion on my part (I am one of those fools who donated money in advance to develop Opera, after all). I really have no idea what a project like this would cost, but by comparison X-Link has quoted me $4,000 for an interface between AC and my lab software. For 20 users, this would be a manageable cost, and if it helped the feature eventually be rolled into the next version, all users would benefit.

Anyway, I am one of your fans. But I reserve the right to whine...sometimes.

John,
I am a relatively new user who sometimes whines. I have to tell you, I have had nothing but great success using your system and I am an obgyn (not your most typical user). My staff picked up the program quickly and we have adapted it to our practice! I analyzed the other systems but was not about to spend 100K on them especially since they are far from great and not better than AC (except the PM portion). Believe me I thought about spending the money,, just couldn't justify it with your PM software supposedly in production!
I am holding off on PM and eprescribing since it is supposed to be improved in the near future. However, I am anxiously awaiting every improvement and would like to reiterate the importance of keeping your loyal informed of testing and timeframes for version releases. The reason for this is simple, starting a new practice, I don't want to spend 10K's of dollars on PM software that is not perfect only to have it be obsolete in 1 year. That would not make fiscal sense. But I can tell you this version 5 release is being anxiously awaiting, if not for some great improvements but for the fact that hopefully your motives will switch to the version everyone will be anxious to ee: Version 6 with PM management! I know the delay is really hurting my review of my practice.
My little growing practice is rapidly outgrowing its excel based (archaic) PM system and needs a more robust answer
Thanks for listening,
Jack

Fair enough, and frankly I'm posting here (and check out my other post from today) out of frustration - breaking my first rule of not responding when frustrated (of course I break that rule all the time).

I certainly understand that when an issue comes up day after day in practice, and you can clearly see a solution that would solve it, you can barely wait to see it instituted. That is literally why I started Amazing Charts in the first place. I knew what needed to be done, and how the solution would so easily and wonderfully work for my practice. It did. But as soon as I solved one issue, I realized three more that could also make my life easier.

I guess what has happened since is that we’ve grown to the point that there are literally thousands of requests from users and they take time to implement. Worse still, we need to implement other requirements that are out of our control. CCHIT is a good example of these requirements. Painful, fraught with detrimental and complex programming requirements, and not something the majority of our users (me included) believed mattered. But despite this, it became evident to us from hearing from small numbers of practices across the country that their local insurers were using CCHIT certification as an excuse to lower reimbursements. (Since a small minority of practices were using an EHR - let alone a CCHIT certified EHR - payors said they would reimburse higher amounts to those practices using a CCHIT certified system.)

So even though this meant stopping development on other requested features, we decided that we had to get this done. The same thing is going to happen as PCMH and meaningful use gets defined. We’ll have to stop what we are developing – the tons of features our users clearly can see will help them get through the day – to put in place the tools so they will be able to get reimbursed more.

And unfortunately, throwing programmers at the problem doesn’t work (I’ve tried this). Having a feature doesn’t make it usable – look at eCW’s 30+ clicks to document a flu shot, or, in fairness, our own V4 e-Prescribing that I find to be essentially unusable. It is the integration of the feature with the rest of the system without requiring extra clicks and navigation of menus and windows that is the difference between something that is usable and something that slows you down and is frustrating. And making something really usable is the most difficult and time consuming part of my job. (Well, actually, dealing with clients that complain is worse.)

So I apologize if my frustration overshadows the fact that I truly do agree with what you are saying. Amazing Charts will get to where it needs to be. It is taking time, and although I am exploring options that, in theory, could get us there faster, for example by selling a stake in the company to raise enough cash to bring in a larger development team, I fear that this path will actually lead to a less usable and more expensive product (having shareholders means you have to answer to them). I base this on the fact that there are many more expensive EHRs that are already much less usable (according to user satisfaction surveys discussed above and in my other post from today). Many of these vendors have essentially unlimited money behind them (e.g., GE’s Centricity, Allscripts, NextGen, etc.) So I am not confident that just having a larger development team means that the added features will actually be usable.


I guess the question is, can you wait and trust that we’ll get there on our own? Does Amazing Charts do 90% or more of what you need to get done? And are you able to wait for us to add the rest? But Jack, I think you may have hit the nail on the head. Perhaps the real issue is that we’ve not clearly communicated our development plans – or provided information when these plans change. That is something we can and will immediately solve.

Jon

Thanks Jon! I can't wait for beta testing of Version 5! It should be exciting! Keeping us informed will make a lot of us happy for our practice planning!

P.S. Please don't sell out to investors! I would not want AC to turn into GE or Allscripts, they need a group of instructors and thousands of dollars to use their overly complex systems! It is ONLY part of their grand profit-making scheme! The real benefit to computers, EHR's and any other software ie. Word is that they are simple to use and learn. That is what truly makes computing excel and efficient and last! This coming from an ex-Allscripts user! We are all able to wait based on the fact we understand your position. However, the larger you get the harder to adapt to your clients. It is truly impressive you have so many followers on AC that are willing to wait! Keep up the good work!

I love AC. Without it, I would not have an emr. The flexibility is awesome and the support is fantastic-both from staff and other users. What other software program actually asks for and responds to suggestions from users-esp in a public forum.

Would love to see a News section on the Boards or the website that is similar to the list of changes after they are already done.
eg Changes/Improvements coming In Version 5
A new and improved eprescribing program
A sortable message list that will stay sorted
Ability to enter icd codes without having to use a dropdown box

Well, these are just things I hope to see, but it would be great to have a brief list of "things to come" from your perspective. Your vision and drive have given us this wonderful program and community. I am also grateful that you have not sold out to bigger companies.

PS, lightning bolts are ok. You open yourself to us, we need to be able to understand where you are and be support to you. We are all in this together.

Don't cave Jon. Keep it up just as you've been doing. :-)

There are many EHR products on the market. Some with all the bells and whistles, some which just provide the basic key features needed for good patient care. Most EHRs are outrageously priced and are so filled with features that even the tech savvy providers and staff that use them get lost within the record (or need to spend too much time clicking around in the record decreasing efficiency which forces providers to spend more time on clerical data entry duties than actual caring for patients). I have worked with a few of these EHRs and was very unsatisfied.

regarding Jon's statement..."In summary, Amazing Charts will continue to strive to be the best, most affordable, EHR, and a reality-check for the businesses charging ridiculous money for mediocre products."

I wholeheartedly support Jon's statement above, and that is why I chose AC. AC isnt perfect (no EHR is) but it is very good, affordable and it and it gets the job done. Ease of use and affordability, I believe, will be key components for ACs longevity and success. For those that want all the bells and whistles (features which no doubt cost more to develop and maintain), there are plenty of other EHRs to choose from so have at it. Let AC focus on developing/maintaining key EHR features, maintaining ease of use, and remaining affordable which will allow AC powered practices to keep their overhead low while providing high quality care to patients at fair prices.

BJE

Jon,

Remember, I am the one that said to users several years ago who were wishing for a lot of bells and whistles "Be careful what you wish for". I am the one that has bent your ear about my desire that you keep to your original plan and not try to "run with the big dogs". I am one of the ones that has discussed with you my concerns and worries about how you could possibly keep upgrading AC and still make it be financially profitable for you. I have expressed to you my disdain for any plans which might include selling off shares of AC to non-users. And I still have those concerns. But my biggest fear is that, in adding things that may not be a CCHIT requirement in lieu of shoring up the basic core of AC you will end up with a program that none of us can afford or will know how to use. I was using SoapWare when it was still in its infancy and it was a great program....easy to use, easy to get support, fairly priced. And then it went out of control and morphed into something that was no longer adaptable to most small practices. So, I searched and searched and was so fortunate to find you and AC.

And I hope you know that I really am one of your biggest advocates. You have ventured into the EMR business at a cost to your own medical practice and your home life...more than most of us would even consider. But as a fellow business owner (although not in any way as robust as you) I realize how important it is to keep one's feet on the ground. Take what works and make it better. Shoot free-throws until you can do it with your eyes closed. A "better" mouse-trap does not always catch the mouse. Do not throw the baby out with the bath water.
Ok I am an old lady which entitles me to say these stupid things.

I appreciate your frustration and I apologize if I added to it. But, I am not sorry it stimulated you to respond on the boards.

Leslie, who is wondering if any of this will matter in the end given the recent House vote.

OK, I had decided I was not going to comment here, but many of you know it is impossible for me. I was just going to say, "Yeah, Leslie. What she said." Also, I will say that I like everybody on here. The very premise of what we are talking about is that Jon owns AC and has made the best EMR ever. And, we own the boards (OK, actually Jon does), but we have made it the best EMR user board ever. Sure, you can't make everyone happy. I deplore the production of the PM, but there are those on here or those looking to purchase who won't without it. It is the yin and the yang, and it ultimately boils down to the direction of the product.

You have rarely broken that rule, but I must say it is a VERY good rule. As Vicki states, a news letter or separate blog (I don't think a separate forum would be wise as we would all end up replying) would be a great idea so we know not only where it is going but also little things about why radio buttons are very hard to tab through. Bill Gates doesn't jump into the fray, but then again, you aren't Bill Gates, and that is what makes AC so user friendly. I have often wondered how you have stayed off the boards as much as you do. Personally, I would simply have to not look.

We saw 104 people yesterday at our H1N1 flu clinic. Wow. But it was fun. Based on the 30 clicks, it would have taken my MAs 3120 clicks, and we would still be here. Fortunately, we have VIPER, one of the most incredible immunization and inventory programs every built. It took 104 to 208 clicks, given it only takes one click after the vaccine is chosen to place it in the program AND in AC.


This, to me, is an unfair statement. My analogy is that the user board is like a patient chart. The chart belongs to the practice, but the patient has a right to review it or a copy. The message boards are owned by Jon, but we have a right to review it and comment in it. While asking for features, which after awhile may turn into complaints, may be frustrating for AC to hear, it is these comments that allow AC to see where its users want. As many have said, if AC does not want to hear ideas/complaints (depending on how they are said), then the Wish List shouldn't be there. One of the great things about the user board is that these ideas or requests are refined by the other users (usually with more experience) until the initial piece of coal becomes a diamond of an idea. I doubt any EMR has a better source of fresh ideas or feedback than AC. My guess is NextGen's Wishlist would simply be "Lower the price." Over and over.

I am sure you receive quite many. Part of the problem is there are so many different ways to get those requests to you, email, the program itself, the user board. But, hopefully, you can distill these down to the ones that come in the most frequently: #1 the letter writer, #2 the lettter writer, etc.

I have often commented to users on here to compare AC to Office Word. I have asked for a few things from Microsoft and even get a polite response, but no matter how many things people ask for, none of them are applied until the next version. AC may be the same. But, again, it is a smaller company with smaller code and lends itself more easily to changes. This may not work, but I love the way Firefox does it with these small updates all the time.

This would be very helpful. A statement such as we have kept the letter writer so that it opens in AC's own window, because we are concerned that others don't have Word, etc. To that, it would be easy for users to reply that most people nowadays have Word, or Open Office or definitely Word Pad, all of which are editable and can be saved in a format that is reuseable. Take the fact that AC is only compatible in Windows and not Mac (unless they use bootstrap or whatever it is) means those who wish to use it have to go out and get 10 new computers that run Window. Definitely more expensive they downloading Open Office for free.

"Bitching" on the board is not cathartic. Sure, it may be misery loves company, but it helps to know that everyone wishes they could put an allergy in the script writer or note in real time. To know that many of us want a better letter writer which leads to your knowing that this is a big feature to many and led me to spend 10 useless hours on a workaround, which actually works. No, it's not a great argument. And, you don't have to defend yourself on the board. Just getting back to us as Vicki said or even changing the letter writer would be helpful.


We are all happy it moves forward. I, for one, love SQL and love the improvements. But, I wonder if it would be helpful to return every once in awhile to the core program and at least fix a few things. I have the advantage of using a progrmmer to make our programs who does let me know that it isn't so easy as changing a line of code. But, adding a new letter writer or even changing the GUI (very cool), would be helpful.

I think of a conversation I may have with a possible new user:

Shopper: Does AC have an incredible scheduler?

Bert: It's OK. Actually, shopper, most schedulers suck. They are always an afterthough of the PM programs. But, you can use AC's or a separate one as we do in Medware.

Shopper: Can it autocode and do all sorts of cool things like eMDs?

Bert: No, it is just the least expensive, fastest and best EMR ever designed.

Shopper: Is it CCHIT certified, and AHY certified and DDTHHJJ& certified?

Bert: No it is just the least expensive, fastest and best EMR ever designed.

Shopper: Does i thave ePrescribing and can you pay $10,000 to help them train you each year?

Bert: No, they won't take $10,000 for training. You barely need it. Did I tell you it is just the least expensive, fastest and best EMR ever designed?

Shopped: How did that happen?

Bert: Because it was built and designed by one person, Jon, who is a doctor and knew what doctors wanted. He also listens to his customers and makes sure to try to get what they want.

** And, I know we have CCHIT.

Thanks, Jon, for a great EMR. We aren't bitching. We are all just on here until 2AM sharing thoughts and commenting on how things could be better. Sure, eventually, it may lead to frustration. The boards also help everyone to help others with no only AC but with many other things, some of which do not even pertain to healthcare, such as home security systems, etc.

Wow, I stay off the boards for 1 day and lots happen.

To Jon: Keep the good fight, do not sell pieces of AC. If anything consider opening it up to programs that will fill the gaps and that can be added ala cart.

We do not "bitch" that much on the boards. Actually, there are often solutions to many of the issues others bring up. There are some issues (about 50 by my last count) that we throw our hands up and say "Well that would be nice," or "We have asked for that for a long time."

We might do well to take your first rule to heart and not answer out of frustration, but be aware that we are very grateful to you for creating the best EMR out there

We realize this is a work in progress, and what a wonderful work. I have been using it for 8 years now. The basic premise of V 1.26 or something like that is still there but faster, better, better backed up and beefed up to more 21st century standards.

We realize that you are pulled in many different ways. All of them are critical. CCHIT is as it sounds, but it is the defacto standard (or is it???) and you needed to have certification. We heard you loud and clear at the Users Meeting that it was a waste, but things changed a lot in the last 18 months.

But there is frustration when you hear V5 will be out this summer and it is November. When we call customer support and hear "Oh, that is fixed in V5." When we know that V5 is truly CCHIT cert but don't quite know how it will change the work flow. We have had an occasional presence on the boards by You, Carlos and tech support. It might be nice to have them chime in on a more regular basis. I absolutely agree with Bert that keeping us at least appraised of upcoming plans would be helpful.

I am eagerly awaiting V5 and even though Bert has no interest in a PM even more eagerly awaiting V6. Hopefully some of the little things can be addressed along the way.

I agree completely. DON'T SELL IT.

Hit the wrong key and there it went!
take two:
I agree completely, DON'T SELL IT. Amazing charts needs the direction of one person to keep it on track, to make it USABLE and to remain faithful to the vision of it being fairly priced and open structured.
I would be fine with Wendels thought on allowing other PM' or Billing software to plug in.
Keep up the good work. There is nothing even Close to AC in function or ease of use.

I agree with Wendell and Martin. Now that AC has achieved notoriety and fame, perhaps you could take the upper hand and put out feelers to other vendors of currently respected, robust, intuitive, fairly-priced PM programs and simply make it easy for AC to link to them. Then you and your team continue to concentrate on what you do best...EMR.

Leslie

I agree. Rather than just link. I think Martin is saying even more.

Can anyone think of examples where a successful company has agree to work strictly with another company for something like that?

Describing the linked requirement as "no double entry" might be clearer. The demographics table within AC would be used as the data source for the PM module. The primary key for a patient would be the same in both systems. Whenever a new patient or existing patient information is changed in AC or the PM side, it is reflected in both sides as the underlying table is the same.

Probably the best example of a shared resource edited and read by multiple software packages might be LDAP and the x.500 directory services. Multiple applications across an enterprise can use LDAP for authentication or for user lookup, all from the same data source. As long as the directory keeps to a standard, the various apps can plug in and play together. Have to be the same if any AC demographic tables were opened up in an SDK arrangement. The standard tables & fields exposed would need to be versioned & managed by AC team to make it work (which is being done already anyway with the 3.x, 4.x and 5.x releases).

Excellent points. And, my staff would be ecstatic. This all depends on the PM being good enough.

If not, I would prefer doing double entry.

The beauty of AC offering an SDK arrangement to all Practice Mgmt vendors would be competition. The chance of a great program being out there would be greater than if Jon tried it on his own. As an aside, when you have an SDK arrangement, AC could also insist that any vendor participating enable free trials to be offered as AC does for their main product.

One of the best things about Amazing Charts is this kind of honesty. It makes one thing that there's a person who ACTUALLY understands doctors' needs, rather than someone who SAYS they do.

Better communication (maybe a blog?) about company news would be nice.

In my humble opinion, I agree, but a quarterly email with all of the new may work better. Jon has everyone's email. It would be simple to do, although it does take some time to do it. But, quarterly would not be that much effort.

I don't want to keep spending Jon's money, but a person in charge of advertising and PR would be perfect for doing something like that.

One of the things I love about Amazing Charts as a company is how its users feel empowered and have a sense of ownership in the product. This is one of its successes and Jon should be congratulated for fostering this environment. Unfortunately I suspect it is also a source of frustration for him, as the expectations are much higher and the disappointments possibly greater. It is very analagous to patient care: be nice to patients, and try not to charge too much and they demand more rather than appreciate what they receive. If AC were put out by GE, Microsoft or some other traditional company, there would be no discussions like the ones above. Constructive criticism and feedback is important for improvement, yet I as an AC user realize this program is a work in progress and am willing to be patient with its development. I sincerely hope Jon sticks with his current business model, as it is what attracted me in part. As much as I hate to confess this, I would be willing to pay more (i.e. $600-$650 a year) for the Guardian Angel program if this would allow Jon to develop the program as an independent vendor. It would be a small price to pay for what I get in return.

(FOR THE RECORD I do not use the PM portion of the program as I use Lytec through my billing service server)

@Scott,

Good post; you make a lot of very good points!

There is another option not mentioned. AC could identify a small but very capable and user-friendly PM. Then, AC could BUY THEM. Then work to get the "no double-entry" accomplished and then work to furhter integrate the two over time. But immediately get the basics done.

How many SMALL CAPABLE USER FRIENDLY PMs exist (much less that are for sale at an affordable price.)

The problem would be that purchase of another company would come with the headache of supporting another company.

Well, there is EZClaims, that currently Quasi-connects to AC, but it is not great as a PM.

It would be easier to create links (other than x-link) and allow Docs to choose which PM they would like to use.