Home Forums Discussions General Discussion "potential" AC user

New to this board and wanting feedback. Leaving group practice soon and going back to solo in Internal Medicine. Have been using NextGen for last 3 years and considering using AC's this time time around. I've looked most closely at AC's and Practice Fusion and have been reading the user boards here for a month or so. Even considering paper charts again and saying the heck with MU money and all the headaches that go along with it and accepting Medicare's ignorant penalties they will impose(seems like the extra time spent in recovering any MU money is more time away from patient care and who knows if it's truly worth it emotionally OR monetarily). Thanks in advance for any feedback.
D.Ray

Well...I am here Sunday 1201 pm EST doing charts. I see 26-30 a day and cannot get them done during a pt visit. I am doing the MU and decsion support functions on AC. I would never go back to paper, but the time away from patient care and family is making me give up all hospital work next month.

Never go back to paper.

Couldn't agree more on the Meaningless Use.

Probably won't go back to paper but I remember the learning curve involved with starting EMR's the first time (curve seems to never end 3 years later) and remember the learning curve when we upgraded to new version for MU (was horrible again and company nor our IT people still have not got the bugs out 4 months later). But seems like the time, money and resources put into Meaningless Use could be better spent. Anyone truly think you came out ahead even after getting the government check for attesting?
D. Ray

....Also, Does Amazing Charts seem to be as reasonable as any other choice of EMR's? My limited research and experience suggests it to be a reasonable choice.
D. Ray

I'm glad to be rid of paper. It has taken 2 years for the last of the paper charts to go away. AC works fairly well. I hate the trend to template use, but if they are used very judiciously and sparingly, AC is capable of producing an accurate, useful, clean, coherent and legible record unlike paper. It is not especially more efficient for me than paper due to all the clerical requirements, but along with those comes some opportunities for better care and more patient involvement, which I do believe is an advancement. We did not do Meaningful use.. I see it as generally income negative all in all, never mind the frustrations. AC is much less costly than, say, eClinical works, but has some modules that are still pretty crude, like the letter writer. There is a promised third party fix for that in the wind, however. I'd give it one and a half thumbs up.

D. Ray
I use AC and if you are near you are welcome to see it in action. But between you and me the MU money isnt worth it and with the increasing hassle with clerical work that I need to do in the AC environment along with hospital hassles - I am giving up hospital care to concentrate on being a better office doc. Will be prepping for Accountable care organization's, etc.

In my opinion, it is by far the best choice.

never go back to paper. I had paper when I started 6.5 years ago. Never go back.

Even without the MU features, AC provides me EXTREME time efficiency compared to the old paper days.

during paper chart days, my work day was 8 hours of patients, 3-4 hours of paperwork, 1 hour hospital = 12-13 hours per business day. Sat & Sun was another 1-2 hours paper each day, thus another 2-4 hours, totaling 62-65 hours weekly.

Now with AC I have less after hours paper work, thus greater patient contact hours so I work 10 hours of patients, 30-60 min after hours computer work, 0 hospital b/c I got sick of it (literally got pneumonia and said screw this), and 0-1 hours per total weekend, totaling 52.5-56 hours.

Granted this comparison includes the fact that I'm no longer spending hours in the hospital. However a key difference is that AC has freed up at least 2 hours per day where I can spend my time productively seeing more patients per day. on average 2 more hours spent seeing patients per day, this translates into multiple tens of thousands of dollars per year revenue.

Forget about the MU component for a minute, the EMR has freed up so much more time that I'm not only WAY more productive in the office, way more financially secure, but gives me time to get to the gym every night, and visit my fiance who lives in Pennsylvania as a peds resident. I never would have had time to pursue this love relationship with a paper charting system.

So thank God for AC, it changed my life.

Maybe JB or Charlie should do a series of AC commercials - AC improves your love life!

Truly happy to hear how it has impacted your life Adam - thanks for sharing that perspective.

You may want to reach out to David of Alaska, or some of the others here are not taking Government pay-er money at all, in their cases it sounds like the business/sanity case was against Government $$.

Taking Adam's numbers as a baseline there is an argument that AC increases topline and net revenue.

Todd,
Findlay might be 3 hours or so away from SE Ohio but might take you up on your offer. Really "like to see what I'm buying" type of person. Also wanted to see how Dragon integrates in real time rather then the demos...have any insight to that?
Dray

You are going through what I did no long ago. I left a group (hated the job) and returned to solo IM practice. I had been using an early version of SOAPWARE that I really like - simple and clean but was pre- meaningless use. They were no longer supporting it and the new MU version was reportedly quite difficult to use and required extensive training. So I started looking. I tried to make myself use Practice Fusion but there is no way a real live normal practicing physician created that program. The wish list on it was a mile long. I played around with AC for months (trial) and finally got on it two weeks ago. It really is very easy to use as far as the basics. I'm sure it can do a ton of things that I don't know about yet. I look at this user site often and it helps. I really questioned if cloud based would be better in the long run and still don't know, but it would have been a lot more expensive over time. I'm not sorry that I made this choice and I, like you, looked at a lot of reviews and actually had three free programs on my computer. Good luck!

thanks Indy.
I only wish I had followed Bert's advice when I started up.
He said don't use paper, start off fresh with AC.
I used paper for 2 years, then saw the wisdom in his words.

My $0.02..

Left an academic practice 3 1/2 yrs ago and joined my wife in her solo practice (she's IM and I'm family med). She was still using paper charts but I started with AC from day 1 after researching options. My wife gradually transitioned to AC over the next year, scanning her old charts, etc. A pain, but she was 100% electronic too within 9 months and she loves it. And she is one of the least computer-literate people born after 1965, I'm pretty sure.

I use Dragon to touch up my notes at the end of the day, especially those lovely psychosocial visits that don't fit templates all that well. "I know I told the nurse that I have a headache but what I really want to tell you is...." I don't use Dragon to its full potential but I really like it.

I'm now much faster than I was on paper but it took a year or more before I could really say that. Changing over to an EMR is a big transition that is frustrating. But I agree that this is the perfect time to leave the paper behind forever - you'll be slower in terms of patient numbers for a while, most likely, and you'll have the extra time to learn your new workflow. And as I watch others in my hospital medical group take on various other EMR programs, I'm mystified at how little research of their own they do prior to diving in. They usually leave it up to a non-medical administrator or practice manager or consultant to do the legwork of finding a program for them, and wind up with an expensive product they hate.

IMO, you found a terrific product in AC.

Jim

D. Ray.
Hate to see you drive that far..but you are welcome anytime. I dont use dragon yet and dont have the time to do it yet.....I am trying to get certified as a medical home provider....

I have been using AC for long enough that I cannot compare it to paper. What I can say is that my notes are much more accurate. I rarely leave a note unfinished and I leave on time (unless the patients are late/slow/problematic)
I had done extensive research over the years and still find that AC is comparable to the 20K systems. Everyone has a point that they do well, AC's is simplicity.
I prefer having my database on site.
Although practice fusion (PF) is "FREE" you get ads. I am told they are not that distracting but, looks bad to patients when you are ad bombarded while charting. If you pay %100 per month to get rid of the ads, AC is cheaper. Not sure if PF is fully MU certified. I think so, but verify this. They were claiming it long before they actually were.

You should play with AC and see if you like it. You can see demo's of the other ones but it is not like doing it for yourself. Check out the field. Then we will see you back. Of course, we are a jaded group, we have shelled out the money and feel we have the best deal (which we do.)

I am a user of AC for 3 years with a solo specialty AND small primary care practice. I have used 3 other systems and find AC the best overall.

The notes are detailed, accurate, easy to use and professional looking. There is a nice balance between full text and "click codes". Dragon works well with it for the most part; I have not needed to hire a transcriptionist at all.

There is room for improvement in the orders and e-prescribing sections.

However, what I like best about this company is their willingness to respond to user feedback and their accessibility to users.

If you can attend the yearly User Conference in early June I would recommend it. It's a great way to see the system in action and learn from people who have solved problems using it.

I was able to submit data for MU very easily. I had more trouble with the CMS website than getting data out of AC!!!

This is a great thread and has garnished a lot of comments in a short period. I agree with Adam that this is a marvelous chart system. Its beauty is in the simplicity. I used Centricity (formerly Logician)in residency and then went to eClinicalWorks. These programs have entirely too many screens and too much clicking with the mouse. When I opened my own practice, I started with AC and I am so glad I went this route. eCW is much more expensive and the customer service is terrible beyond belief. AC has great service. There are a few nagging things, like the letter writer that they have not/ will not fix, and I am embarrassed about when I recommend to other doctors. Indeed, at least 2 other practices have picked up AC on my recommendation. (I'm still waiting for a kickback. ha!) This user board is almost enough reason to use AC - what a great group of helpful people, many of whom are small business owners and physicians.
You as well can swear off Meaningless Use and avoid a lot of complexity. You too should be able to get finished with a visit on the chart before the patient leaves the room. I can usually leave, if I want too, before my staff finished emptying the trash and vacuuming the floor. I never do charts on the weekends and really, I think I am living the dream up here in Alaska.

Dr. Ray,
First of all, if you would share your first name, it will make it more comfortable for us to communicate with you. Of course, you could just say "you can call me Ray, or you can call me...". But I digress.

One of the nice things about AC is that you can begin to use it in stages. Others have described this in posts before; just ask if you want specifics. The reason I bring this up now is that I would suggest that you postpone the decision about MU for now. Learn about the basics of the program and pay NO attention to the MU aspects. If you decide that you want to go after the incentive, you can get your 90 days in at the end of the year.

There is a lot of anti-MU sentiment here, and I fully understand it... but I wouldn't rule it out at this stage. Just my suggestion.

Dr. Ray,
Jon (JBS) makes a great point. Implement the use of AC in stages before getting bogged down by MU requirements. I've been using AC since January 2008, feeling very proficient in AC and had some initial stress over MU implementation. I can't imagine being a new AC user and also trying to implement MU at the same time. Break it down into bite sized chunks.

For example just get used to writing office notes in it for a while, then create some templates from typical office visits (create them on the fly by holding down ALT key and RIGHT mouse clicking in the text window of an office note). Then after awhile practice using the letter writer, even though it's not a very good letter writer (a sentiment most users share). Then practice sending office messages and training your staff to take their phone messages in AC.
Then you can learn to scan incoming mail to AC, or develop a system for importing faxes directly from a networked fax machine so you don't have to print faxes anymore, just have them directly convert into PDF or TIFF images. Get used to sending ERx's, get your staff trained in refilling incoming ERx's through NewCrop for you. Implement each phase of additional AC usage over days or weeks.

Then spend a few months just simply using it and becoming expert in AC. Once you are feeling 100% proficient in the use of AC, you can then focus some attention to MU.

Spend a couple nights reading through the Meaningful Use section of the posts on the AC User Board. There is a lot of great information there. Remember the first year of MU attestation, you only need 90 days of reporting in that calendar year to qualify for the full year. This is applicable for your 1st year of MU only. So you have PLENTY of time to get used to AC. You would need to start collecting MU information by the 1st of October 2012 at the latest.

Again congrats on joining the AC community. You will find everyone here very helpful.

Thanks to all! Wow, great responses. By the way my first name is Dave. Hope you all don't work for AC's...because I feel like I'm buying into this EMR. Much great response I've received. Having worked with NextGen for the last 3 years I feel like jumping into AC's with both feet,not sure I would have the patience to go in increments. Getting caught between paper and EMR together can very inefficient I've learned, but we'll see. With the 3 month free trial, would that be enough time to "play around with it" at home to have the info I need to decide?
Dave Ray

David, the 3 month trial is adequate. I only played with it for a month at home, then implemented it in the office. Just jumped right in. Good luck, friend. I sincerely hope that your EMR quest works out.

Another question....about interfaces. Seems AC's offer interfaces for about everything, price seems pretty good considering I've seen major labs offer to do this for thousands of dollars. Have these ratcheted up the costs significantly to be able to interface labs, ekg's,etc?

Dave Ray

Dave,

I've been using AC for about a year. I tried to get my hospital to set up an interface for labs but it didn't happen. I switched to Quest and established an interface about two months ago. The interface saves my MA some time, but otherwise is not much of a help. I wouldn't worry about interfaces until you get settled into using the program. It's easy enough to scan material into the Imported section without an interface and it's not an essential MU requirement--at least for now.

With best wishes,

John

The cost to use the lab interface is minimal. John, do you recall the fee?
I want to say $100? maybe $200? it's a one time fee then you own access for life. Or is it actually free to use some of the built in interfaces?

David,

Three months? Should take about three days.

Do we work for AC? Hardly.

Dave,

I would say one of the best things about Amazing Charts is this user board. I've found many times I can search here on the board and find answers to my questions without having to contact tech support.

I found the user conference extremely helpful in that I was able to talk with other users and see how they do things with AC (workflow etc).

Actually Bert, you are somewhat wrong. We do work for AC in that we are avid spokespersons for them. We don't get paid, other than the fact that we are furthering a product that we believe in. We do have a financial interest in that if AC were to fall apart or become nonfunctional, we might be forced to use something silly like nexgen or eClinicalworks. Other than that we are independent agents and if you read the posts enough will see that we often differ from the official opinion of AC but eventually they come around to our way of thinking. We have the the power of positive suggestion.

I too think 1 month is probably adequate, by the second month you are getting into the groove and probably hooked. By the third month you are just avoiding paying. But that's human nature.

I too have found the board to be very useful. I think I learn more than I reply.

Having decided to go electronic in the first place, we probably knew all we needed to know to decide to buy AC In less than a week. It took a couple of years to decide to go electronic, however.

Actually, even though the first versions were simpler, it took me four days to find AC and go live. Found it on a Friday and the staff came in on Monday and started using it. This is completely true.

Same for me, quite impressive and a credit to AC. I downloaded on a Friday, as well as Praxis and some others. I just started using it Live on Monday and never looked back.