Home Forums Discussions General Discussion AC use in hospital owned practices

I have used AC unilaterally in 2 different family practice groups for 12 years, but never as the "group's EMR." I am part of a hospital collection of 10 providers (7 FP's, 1 ortho, 1 GYN, 1 GI). We have tried to install our hospital's chosen EMR (CPSI), which was a total failure. I would like us to all go with AC. Medscape's EHR survey ranks AC #1 in categories of physician users: 1-2, 3-5, 6-10, and 11-25. AAFP's survey shows about 7% AC users in groups of 6-10. My question is how well does AC do in groups of up to 10 users, in multiple locations? We do have a fast fiberoptic line connecting the offices. Any AC users have any experience working with a hospital employer in this setup? Any interfaces made between AC and hospital billing, lab ordering/results?

No, but a related question -- if all the AC solo users in our area were to get together in a common practice (that is, when Hell freezes) could all of the data in all the implementations of AC be merged?

I second your comments about CPSI -- a total disaster at our hospital, which is now replacing it (with something almost as bad, I fear) at a cost of $millions. What a racket, and how can a company be so bad for so long? Answer to that, of course, is there is no "free market" in medicine.

Part of them not currently showing up in that section of the survey is AC hasn't competed in that space because it takes a services partner to successfully deliver that kind of solution. [disclosure - we are one, so that is changing]

Besides expertise, a successful large scale implementation requires infrastructure, full SQL Server, appropriate hardware and third-party technology. All very 'doable' with the correct integration skills.


Network performance is a necessity, and you have that covered.

If the hospital is the employer, that may make some of the integration work more manageable. case in point, one of the practices that we are implementing is multi-location, and the facilities that they use are hospital-owned. The toughest part is working through the food-chain to find someone in the hospital IT that has the appropriate knowledge and authority.

Updox has done some great work in bringing their value to hospital implementations in a way that really reduces the work [and annoyance] of Doctors, and we have success in dealing with larger organizations because we look to solve some of their problems as a way to get the Doctors what they want and need.

Can be done, has been done. But as has been alluded to before, the results are directly dependent on the quality of the data on the data that you start with; garbage in, garbage out (GIGO).

A related issue is what is called "slowly changing dimensions" in DB analytics. An example in patient data is payer information; the primary payer information changes over time, as well as the addition and subtraction of additional payers. Different practices may have different data which conflicts, even if it was accurate at the time that it was collected.

Bottom-line, it can be done, but requires some finesse.


<chooses to skip the soapbox> Too True. I remember when I was told by a certain person that the way to get our proposal accepted {with large medical corporation} was a set of <certain expensive brand> golf clubs should appear. I considered about telling him *where* they would appear if it were up to me.

2013 might be the watershed year for small private practices.
There may be some possibility for survival if they can band together-- and AC and Updox might be a ticket.
Trouble is, seems like most of the private docs would rather just give up and join the hospital as a white-collar wage slave -- without even the protection of a union.

I really don't understand what is going on; I can't figure out what modern doctors are thinking. I'm almost 70, and the world of medical practice is a foreign land-- I feel like a dinosaur just before the K-T event (they didn't know it was coming, either, but in the dinosaurs' case case it wasn't willful ignorance!)
Why would anyone give up independence?
Why did our forebears bother to fight a revolution?

I am 20 years your junior and I have turned the hospital down once and will continue to do so even if it means I work for nothing or choose a new profession.

Congratulations! No sarcasm here -- serious question: Can I sign you up for our IPA, the County Medical Society and the Oregon Medical Association? We need people like you.

Oregon docs seem to be going all white collar employee.

I suppose that a few dinosaurs made it through the K-T event -- that's supposedly why we have birds today.

I wonder what things will look like in 5 years -- forget 65million!

I am independent and solo as well. I was having a spontaneous meeting with the hospital admin and just shooting the breeze over the water cooler, he asked if I had any ideas as to why his providers were not ssing enough patients to cover their cost of being employees. The hospital uses CPSI. I told him that when you employ physicians you take away their incentive and you get employees who don't want to work any harder than other employees and when you have a cumbersome EMR, like CPSI, it takes the Docs too long to enter he data. I have mentioned AC to him in the past. Last friday he called the office and asked my receptionist for the name of our EMR. I should had him sign a contract for my consultation.

And one of the things that has kept me from wanting to be absorbed by our hospital is their EMR - amazingly CPSI which is clunky and slow - takes forever to document an encounter when I can use AC and generate the encounter in a couple of minutes.

Send him to us, and we would be glad to have you consult with us.