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Leslie,

I feel much better, I attended the #1 party school of 2012 and now this!!!!
It may say on this page but where is this survey from?

It is from Medscape. Here is a link to the article

http://www.medscape.com/features/slideshow/EHR2012?src=ptalk

I'd love to know how Cerner, Centricity, and eClinicalWorks even made that list.

Cerner - Expensive and their sales reps are condescending morons. Their tech-support reps were not beaten enough by their parents when they were children.

eClinicalWorks - Hard to use and non-intuitive. There is a separate screen for every little thing you do. Mouse-clicking in that software is guaranteed carpal tunnel.

Centricity - Expensive. Uses Oracle for its database which means EVEN MORE EXPENSIVE. Hard to use and difficult to maintain.

Wow. Just wow.

JamesNT

Leslie,

Thanks for the heads up and link on the survey--
There were 3 things that stuck out in my mind in the survey.
1. The majority of the 21,000+ respondents did not know the cost of their EHR.
2. 34% did not know if their EHR was web based or not.
3. Physicians who work in a hospital or large facility were not aware of installation cost.
WOW!

James,

Great comments!!! I loved your note about Cerner. Spot on!!

Centricity is the only EMR that can take a chief complaint of a hang nail and make it a six page progress note. The average two month old has a medical record of over 100 pages.

They are impossible to read. If I absolutely need to, I look for the impression and plan. That only takes about five minutes to find.

I have not had any experience with any of the EHR's mentioned except e-clinical. I agree 100% with James' assessment. However, I have been duly impressed with the Next Gen product our local Hospital is implementing. I can't even imagine trying to justify an appropriate charge with the documentation that I have seen with the notes generated. It must be some type of archaic templating system utilized to capture the encounter.

This survey provides some interesting information. It is good news for AC, and by extension, for us.
The size of the survey (over 21,000 respondents) is 10 times as big as the Family Practice survey, with comparable favorable results for AC.

An interesting new finding is that AC is not just the most popular in 1-2 provider practices; it is also first with 2-5, 6-10, and 11-25 provider groups! Who knew...

The survey confirms my view that EMR selection is paradoxical. In most businesses, the better products are the most often purchased. With EMR's, there is an inverse relationship between number of users and product satisfaction. The biggest, most used are the least liked. On the other hand, the most popular are relatively little used.
Two probable explanations for this. One is perversion of the market by MU incentives (hospitals hear that a product will cost $3 million to implement, but figure they will get much of that back in incentives; who cares how well it works).
The other reason probably relates to some of Jimmie's points. Epic, Cerner, Allscripts, etc. are often purchased by hospitals for large, multi-specialty groups. The users, the docs, often don't know how they run, how much they cost, or anything except that they are a pain in the [censored] to use.

So as we struggle to keep our heads above the waters of the "sell to a hospital" tide, keep in mind that we independents have one additional benefit: we get to select and use a functional EMR rather than be forced to use a dysfunctional, unpopular one that only makes hospital administrators happy (if them).

Jon,

One other thought I had, and it may have been JamesNT or Indy that previously discussed design of EMR software. I think AC has been designed for a more focused audience (primary care) and smaller practices, and is truly a functional EMR when utilized in this setting.
One of the difficulties has been to design a software EMR to meet the needs of a large multi-specialty or hospital physician group with a lot of special needs. Something that all can use turns out to be unuseable by all.
So this I think plays a role too.
I still maintain that the functionality of AC gives one many more options on practice style. As I have said before, regardless of one's subjective views on the Affordable Care Act, if one chooses not to participtate in collecting the MU money and instead accepts the penalties, I think he is still money ahead by the enhanced efficiencies in the office AC makes possible by the incredible time savings and reduced redundancies one may experience with paper charting or one of the more utilized, less efficient, difficult to design EMR's.

I was actually concerned that my current nemesis at the hospital where I practice, CPSI did not make the list. I would give them lists of reasons that this has made practice miserable. Unfortunately I think the reason most of what I have seen in other EMRs is that it is designed by programmers who then tell us how to practice and use the software - that is why I think AC has done well in that Jon initially designed it.

I agree with JBS as one of the primary reasons I have tried to remain independent is that I think using for instance CPSI in my office might be the death of me.