Home Forums Discussions General Discussion EMR for F.P.?

I had a local F.P. who is going independent and called me about Amazing Charts. He is between McKesson's Practice Partner (which he is told by his new office manager that this is the best EMR out there) and possibly Amazing Charts. Of course the price difference is astronomical but he asked me what I thought of AC.

Of course I like AC. It does everything I need it to. Sure, it has it's issues and I wish the orders sections was usable but I have some paper orders in my office that suffice. It would be nice if it was on the same level as the other EMRs that have a good integrated PM system but that's not why I got it in the first place. I know it's coming soon so we'll see.

He asked me what I think AC is missing? What I wish it had? I'm looking at it from a surgeon's perspective so the needs are different. Can you guys help me help him make a wise decision and know the weaknesses of AC going into it? Lab interfaces? Terrible superbill abilities? Whatever?

I don't think the PM system is an issue as he's going to keep using his billing service I believe.

I have been using AC since 2002 in a FP office and feel that is great.
Good features -
- lab interface for major national labs allows import and manipulation/analysis of data
- e prescribing at no cost
-easy functional templates and ease of making your own templates
- intra office messaging
- the orders section is actually evolving and works well for generating, printing, faxing orders. the reconciliation is still a pain but in conversations with one of the programmers they are working on it.

Issues.

- lab interface for your local hospital can be difficult and costly but my small hospital hosts their labs with PAML and it worked out, if more than one practice in your locale uses AC then you might be able to get your hospital to work with AC and get an interface to keep your business if there is competition.
-reconciling orders is still an issue but I have no doubt it will improve
-pm program is on horizon and should be great integration.

I have used medisoft since 2002 also and it is now I believe owned by mcKesson and it's service is very expensive (bought 2,000 upgrade and would not install -they wanted 3-4 hundred for assistance). they cone out with frequent expensive upgrades.

With all the "givens" that I have to assume in my answer ("given" that going electronic was a wise decision, "given" that it has to be MU certified, etc.) then I'd say that AC does the basic job quite nicely and with decent cost effectiveness. However, I do sort of shudder when I read of a practice basing its decision solely on the apparent up front cost. It is the same feeling I get when a student pilot comes in for a flight physical and happily states he/she wants to learn to fly so he/she can get a plane and go hunting, and I know the skills required to use an aircraft for hunting are a couple of orders of magnitude above where this person will realistically be in a couple of years, and that I am looking at a statistic in the making. As you can see by the threads of backup power supplies, networks, backup systems, servers, etc. the cost of the software can become really only a modest percentage of the cost. IMHO, AC does a fairly good job of adhering to the KISS principle.

I have first hand experience with one other EHR before AC and that system just happened to be Practice Partner. Although their ads are extremely impressive, the system is exceptionally difficult to customize. So, if your friend is the type that likes to customize his own temnplates, like I do, he will probably not be very happy. While it is possible to do, the syntax for template writing is very complex, and time/labor intensive. Most physicians in practice would find it impractical do on their own so good local support is a must. It is also written very inefficently and requires a massive server if you are not using the cloud version. Because of the complexity of the customization process, one is likely to requiring ongoing support services which over time are much more expensive than the software itself (also very expensive). There are also a lot of per user licensing and support fes that also add to the expense. For example, if the practice uses more than one scanner, each one has to be separately licensed, etc. I would suggest he talk to other collegues in his area to get their opinion. There are a fair number of disgruntled docs in this area! To be fair though, some people like it, especially if they are doing mostly dragon dicatation.

First, I can think of five EMRs better than MPP.

Second, ask him if he can download MPP anonymously and use it for 90 days with support and then walk away all at no charge? That should do it.

Oh, and then ask him if they have 24/7 online support from at least 50 people. That would be the board.

Good ammunition. Thanks. I just don't want to oversell AC to him and he be disappointed. I don't think he would be, but EMRs for docs who hate EMRs are a hard sale no matter what. I just think he would be unhappy with MPP. It's a lot easier to deal with idiosyncrancies of the software when it didn't cost you an arm and leg.

I could see him using eMDs which I have used in the past. It was too much for me and too many checkboxes but had some advantages. Cost was not one of them though.

David: He's fully aware of all the hardware costs. He's just worried about the ongoing costs of an EMR that he may hate including licenses, support, upgrades, offsite backup, etc. Then switch to another EMR and deal with the headaches and costs of that. It's tought to change EMRs once you've dove into one.

All,
I realize I tend to sound negative about AC when it is really a pretty decent solution. It's just that I feel I have had a good outcome from an operation that I did not want to have performed. It's tough to be chipper about it all.

I wouldn't go back to paper for anything, most offices have basic computers for scheduling and billing so they are already used to the cost of hardware and support/repairs. Even though i knocked one of my laptops off the counter and it is really "toast" that sort of cost doen't compare to the cost of mainaining paper charts. We literally had an entire room with 18 metal 5 drawer filing cabinets that is now used by my MA to take vitals, give shots, draw blood etc. ( Translate: more pleasant spacious office for patients and us alike.) AND we don't have to go searching through drawers OR close the office for a week while we cull out charts that are more than 7 years old....all of the information that was in those cabinets can fit on a thumbnail drive that doesn't cost $35. I don't pay a transcriptionist, we never play the "where is the chart" game.
I love my EMR.
I hear people complaining about the lab tracking, personally I think it works very well and is much less labor intensive than the old tickler files, ditto with ordering labs, xrays,followup. I can't think of a single thing that isn't better with my EMR. Some of my colleagues who have othr EMRs are not happy....
As for AC, I am a fan. It is very functional and user friendly, actually does a whole lot more than just create a record; it improves workflow in the office. I would think for a Family Practice doc it would be top choice. Wasn't AC rated the #1 EMR by AAFP?

David, I don't think you sound overly negative at all. Many of us share your ambivalence about the whole process. On the other hand, if you must do it, then AC is the best way to go, IMHO. And sometimes though you may not want that that hip replacement, you do walk better afterwards!

I just read that the CEO of McKesson made $54.6 million last year. That alone would make me look for another EMR. Don't know for sure, but I think Jon Bertman makes a bit less than that.

Update: His business manager/office manager came over to the office today to look at our set-up. This guy loves MPP because that's what he knows. I was in the O.R. so my M.A. showed him how we do things. Apparently he was floored by the simplicity as well as the ability to do all the things an F.P. needs. Good. Looks like they are going to go with it. They want to pay my M.A. to come over and help them with office flow....as long as they don't steal her

He was asking about the Health Maintenance part and I don't use it at all in surgery so that's something he'll have to figure out on his own. Is the Health Maintenance part useful for you F.P.s or is it a bit of a mess? I was just trying to get it to pop up schedules for patient's screening colonoscopies and couldn't figure it out but I don't use it regularly.

I use the tracked data section more than health maintanence. I think it is a little more useful for a quick look to see who is utd with what. It is easily customizable.