Home Forums Discussions General Discussion can you help me decidev

Sorry to bother all you professional AC users.

I stumbled across this system in my diligence to get an EMR. Obviously the price and camaraderie is a big plus...but why should I go with this EMR over the "big" guys with the expensive sales force who would like to convince me otherwise?

Can someone lay out the pros and cons of AC?

As a side, I can't seem to find a place to place labs or x-rays in my notes on the demo...is this possible? Shouldn’t this be part of every note (review of data)?

Thanks.

AC is easy to learn and has all the things a good EMR needs.

It was designed to be fast to use. It does not use click boxes and does not try to suggest diagnoses. It will document your note quickly and leave the medicine to you.


You can design templates very easily and many of the things you need to do can be templated.

They are connected to a large number of labs, which allows the results to be tracked. You can always import them into the import section but they will not be numerical and cannot be tracked.


They are upfront with costs and there should be no surprises.

Cons: best for small offices, if you have a large group it may not be the best fit.
They do not have a large outfit to install and train. They do have people who will do that, but it is pretty easy and if you are at all computer savvy you do not need a lot of help (That being said, the latest versions can be a little difficult to upgrade and they will help you)

It does not calculate your billing codes. But this is usually fairly straighforward or you have a billing person to manage it.

It does not have an integrated practice management at this time, but will soon.

Download it and play with it. How many other companies let you use it like shareware.

You can put labs and xrays in the import item. You can reference them. Actually this would be similar to a paper chart where the labs are not in the same section as the notes.

Look at Jon's comments on the website about stimulus reimbursement by the feds. If you are getting an EMR for stimulus money why? And is there any guarantee that money will not vaporize and leave you holding the bag. Even if it does come through, do you want to give it all to a software company?

Amen from me. As a new user, it has fairly straight forward to get up and running, although there is more to go to use it fully. Kind of like the game of Go: "5 minutes to learn, a lifetime to master". However, I am using IT to assist me in doing things the way MY office needs; my exposure to others is that I was forced to be a slave to the program. Most of my learning as been from the forum and playing with the program itself; other programs require a week or more of dedicated time for training. I feel its strongest point can be summed up that it does the job without the BS and fluff of others. It is kind of "the people's EMR".

Doesn't that answer your question?

I could make a list of pros and cons like Wendell did.

But, for me, it's easy. It's simply the best EMR ever designed. If you want to take five to ten minutes "building" a note, go with NextGen or eMDs or Centricity or eClinicalWorks. If you want to write a note in less than 30 seconds, go with AC.

Or wait until you get records faxed to you from Centricity (formerly Logician) from a patient with 10 visits. Make sure you put a new rheam of paper in first or you will run out. I have never seen such redundant, overblown progress notes in all my life. I won't even read them anymore.

Well put David.

@tceg I am not really sure what you mean about x-rays and labs. Do you mean physically attach them to the note? I have not really found any reason to do that. First, I doubt you will have an x-ray or lab on the same patient every time. But, if you had an x-ray result, you would import it, and then reference it in the HPI or PE if you want to call it objective. Just write "noted CXR of 4/25/10 showing a RLL pneumonia."

tceg, just do what I did to answer that initial question. Download it and try it for 3 months. If you like it, pay for it. If you dont, it will cut off. Then go sit through a few sales meetings and do a rushed 30 day trial and get asked for $10K. Then make up your mind. It won't be that hard.

Why do people think it is not for a "large group"...how big is large? We are 3, but may grow to 6 in the next few years...

Hi Tceg:
I have to weigh in with my two cents, (but that may be overstating the value of my opinion in this matter!) We are three in our group and we have family practice residents, with usually 2 or more at any time of the year. As it stands right now we would NEVER give up AC. In the earlier version when the data base was handled in a format called "Access" we had a fear that we would out grow the system and need to move on. As we got into AC we realized we would not give it up, but planned instead to separate into 3 separate corps with three programs in one office. That became a moot point a year ago when AC became a "Sequel" database. (This makes it sound like I have technical knowledge, don't be mislead!)

I have become impressed with how different we all practice and chart our patient encounters. Some Doctors use a check list for the patient to record history and then they selves record physical exam and history on check list forms. AC doesn't use that style well, and those Doctors would be better suited to used a program written for check lists. They are already limiting themselves to the check list and with a system designed for it, they would have the data captured as granular data. (I believe "Granular data" means phrases or facts the computer can recognize. If you type "the patient says his throat has been sore for three weeks" the computer knows you typed 10 words. If you check a box, "sorethroat" the computer can attache this to the ICD-9 for Acute Pharyngitis and recognize this as a fact that can be linked to other actions.) Granular data is good, if you have a use for it. If you don't use it, then it can be a negative if you have to do extra work to create the granular data.

My partners and I use the history in the patients own words, and we frequently transcribe a lot of data when the history justifies it. Our Residents have no choice in the matter, (one of the three of us was one of our Residents some years ago, so there is even less chance for variation).

In your case if you get 6 doctors what will be the chance that they all chart the same, and use a style that is suited to Amazing Charts? That is the only reason I can see for saying it might not be suited for a larger practice. However I completely agree with Bert and Wendell, there is NO OTHER EMR that allows you to create a note of this quality in so brief a time.;

Finally in our situation three doctors and we use AC three ways. Mark prints the summary sheet, any new labs and goes in the room without a computer. Donna, uses only the computer. I bring the computer but have a face sheet to scribble on. We all complete the note at the time of the visit, although Mark has to go back to his desk to write it up.

Get AC and try it. The investment is small, if you decide to move on, you will still have the data in the demographics in a form that can be moved to the next EMR. I suspect you will be very happy with AC.

I downloaded and used AC within 30 minutes. I had tried to use three other electronic records for years. AC is just intuitive and fits how I practice medicine. I am solo. I have a laptop in each exam room and a couple of desktops that I use for smooth efficient office hours. End of the day....the days work is done. No piles of charts. I have been using AC for a year and have upgraded twice and now I'm using V5.024. My husband who has no formal IT training is my tech guy. I have had no down time. I vote for AC.

Martin, you gave me an idea for an AC wish list item. When you make a template, it would be nice if you could somehow tie that template to an ICD if you wish. So when your CC or HPI template selected is, say, "sore throat" it automatically puts the ICD code over in the assessment section. So you dont have to go look up codes.

Tcge, you can read our comments forever, but the only way to understand AC vs anybody else is to download the free trial,install iton one PC and try it out. They don't even make you sit through a sales presentation to do it. Just go download, install, and if you have questions go to online support.

If I recall correctly, one could do that in SoapWare. One could select an entire template (such as pharyngitis) rather than having to template each area (HPI, PE, Assessment, Plan). And, the diagnosis code was already assigned. Pretty convenient.

The complexity of networking increases with the number of computers. Jon initially (I believe from what I have seen)intended AC to be on a peer to peer network, but you can have a maximum of 10 or so computers linked.

With a server you somewhat increase the complexity, although Bert will successfully argue that this this is the best way to do it. A server increases the cost factor as well, and then you should probably invest in an IT consultant (which might not be a bad idea even with peer to peer.) But is also increases your reliability, redundency and recoverability. (There are other ways to acheive this though.)

That is why I stated AC is better for smaller practices. I do know there are larger practices using it. We sometimes have myself, my NP, and a resident using the system at the same time with the MA, receptionist and billing person also on the system. We are peer to peer. There are no issues.

I usually can get a resident up and running on the program in a couple of hours. Try that with one of the big boys.

I do not see an issue with six docs, especially if you use a server setup.

I use a server - cost 1200 dollars for the computer, 600 for Windows 2003 server (ebay). Mine works well, although I am far from Bert - I really only use mine as a file server and the whole network works as a peer to peer. 12 computers on the network - multiple exam rooms up and going at the same time and it works well.

I think where you run into problems is when you start getting really complex like running two different offices, people syncing laptops back and forth, etc.

Coming from a large group practice and having Allscripts, now using AC I am dumbfounded at how easy and I would never give it up.
To answer the question of why this is not good for a large group. If you are 10 providers and have inhouse billing which needs the ability to have a robust practice management system this is NOT thee system for you. That is what my old practice essentially consisted of. I too had demos done of most of the large systems including Allscripts, ECW, EMD, Praxis, Centricity and they ALL could not do what I wanted and they were ALL outrageously priced. I tried AC and had my reservations at first but the more I used it the more impressed I was! I could now chart way faster than Allscripts!
Also, AC is inexpensive and does not try to rip you off with training costs. Most systems out there are at least affordable, up to 15K for software, but the kicker is you need double that to learn the software!!! I always likened that to Microsoft Office, Word, Excel, etc... these are all easy to use and learn and if you wanted more complex features you could self-train, well that is why they are so successful. That is why AC is so successful!
If you want to be the next "DUMMY" that these large companies prey on due to thinking DOCTORS are rich and easy pickens go for it! To me AC allows me to praactice more efficiently, saves money and is quick to use and train.
Oh by the way, I am an OBGYN so even more impressive that I made AC work for me, none of those 150K systems even impressed me with their fancy OB templates! I just made my own
Jack

I never understood why it isn't for a large group. Can't see why it won't work for 20. The only limitation would be your "main computer" and SQL Express'limit of 4GBs.

I have never really understood the P2P vs Client/Server. The way most people set it up, they are both the same.

Peer-to-Peer: two or more computers connected to each other via a switch. One happens to be designated the "server."

Client/Server: two or more computers connected to each other via a switch. One happens to be designated the "server." OK, the server may be a real server designed to run a network. And, more importantly, it may have server software, therefore, getting around the one obstacle that keeps you limited to ten clients.

For me, a true Client/Server network is a domain with Active Directory with users and permissions, etc.

I think, while Jon still states P2P, that was when it was with Access, which has far less room as a database. But, certainly, there is no advantage to run AC on a P2P (by that, I mean it can't be run on a server).

Metcalf's rule. The value of a network is a function of "n" where n = the number of things hooked to the network. Peer to peer vs Server: We have three Docs, 11 employees and on a good day, all are here. The Fax comes and goes Via the server. Access to the lab, ordering the lab, Viewing X-rays and retrieving Medical records from two hospitals. (and signing charts), Authorizations from the HMO, and checking on the status of other peoples authorizations. The security camera access, (which I look at to see the waiting room, and the operator looks at to see the Dr's at their desks. Epocrates on line, The AC users forum, Netflix and probably somebody is ordering lunch. The server never breaks a sweat. I don't know how that would run on a peer to peer.