Home Forums Discussions Problems Would you choose AC again?

Solo family doc with a NP, converting from the Allscripts MyWay fiasco and am looking for user insights into the AC product? Ty!

ABSOLUTELY!!!!!!!!!!

Hi,

I am also a solo FP with a PA. I started this practice in 2005, after leaving a Community Health Center. I have used AC since day 1.

Has AC been perfect? No. Has it been usable, intuitive, and a great value? Yes. Would I choose it again? Absolutely.

At this point this forum, AC User Board, is one of the major benefits. For AC problems, or general technical help,or ideas about medicine or business (or life in general), you will find a group of very right, very helpful, and very supportive guys and gals.

Good luck in your quest!

Gene

pdana,
I forgot to mention.
I have not used any other EHR's but our office has two office nurses from other parts of the country and both have commented that AC is much simpler and intuitive than the systems they have used--altapoint,centricity, and medinformentix. And also a citrix program.

I would recommend that you try to find an AC user in your area and get a hands on view of the way AC works. Jimmie has done that with a number of doctors here.

Also, do the 3 month Trial. After checking it out, ask yourself would you be satified with it AS IS for the current price. It may not do everything you want, but it costs 50% less than others. I say AS IS since you cannot gaurantee what will be added. Be careful to look at other systems faults also, because you can't be sure what will be fixed or added to them, and they will cost alot more, but they may have more "right now". Its a trade off, basic cost/benefit analysis.

For myself, honestly, given the resources I had/have available, there is a 90% chance I would get AC if I was buying one right now, and I definitely would if I was doing it over in 2005/6 when I got AC.

There are a heck of a lot of hidden costs in these systems though, not just the obvious ones when you initially purchase. For example, lab interfaces. AC is a one-time charge of $250 typically. Even a lab that doesn't do much business with you can do that. With other companies, I've heard the fee is a couple of thousand dollars. And possibly its a recurring annual cost.

Or the interface fee for some other 3rd party program who does not typically pay it for you. Check those things out when performing your cost/benefit analysis.

pDana,
I think that you will find that the great majority of AC users would choose it again. It is simple, economical, and practical. I would echo the advice to see it in action in someone's office, if that is possible for you. A free trial (what other EMR gives you that?) would be the next step; it will be a bit easier for you because you have a point of comparison with MyWay. You will probably find AC to be far more flexible and user friendly, with far better support, and better integration into your workflow (though all EMR's require you to make some changes). The board here can be a good source of information and support, as described above. Keep in mind that coming here allows a prospective user to read all about the product and our experiences with it; both the good and the bad. That can be a bit unnerving at times, but in the long run is very helpful. It is something else you cannot experience with any other EMR.

Ty!

Ty very much!

Tx so much!

Tx so much!

Where in western New York are you? I am in Rochester.

Brian

No brainer....definitely.

First, the usual. Can you put your name at the bottom with your location as an autosig?

I would only buy it again if there were a significant committment to improve the little things we have asked for for some time.

pdana,

By coincidence a geriatrician/internist was in the office today who uses altapoint. He took a look at the Updox/AC combo and was extremely impressed with the workability.

I am not sure. New solo pediatrician opens her practice in April. She has considered eclinical - said it is overpriced and complicated. Considered AC and Athenahealth. She went with athena health. She just said I liked it more. Go figure.

I've never seen AthenaHealth so I can make no comment.

I'm really surprised at your response, Bert. As negative as I am about the current state of the EHR, I would buy it again. At worst, I consider it the best of a bad lot, and probably better overall than dictating into word and storing notes as Word documents.

AthenaHealth has a great sales pitch, no software to buy, runs on any internet connected computer, Athena doesn't get paid until you do. Impressive to a first-timer looking at EMR & billing learning curves. I think we've discussed this before.

Bert, you need a beer.

@David,

I dictated using Dragon into Word for just under 10 years before transitioning to AC. AC/Dragon/Updox is exponentially better.

I always need a beer. But, do I need one now given my thoughts on buying again. I love AC. I can't say I love it more than anyone else, but I'm right up there. I am also limited at one I can say at times due to being the admin.

But, I will say it again and again. I understand CCHIT. I get that. I understand MU, so everyone can get rich. But, I don't understand chief compaints listed at past encounters, I don't understand the radio buttons not sticking on ePrescribe. I don't understand the words for the VSs staying in the note when they are not used. I don't understand PFTs being a default VS. It's a great EMR. I just wish it were a better EMR.

And by the way, Athena Health bought ePocrates.

Makes sense, big time cloud EHR/PM now acquires mobile EHR that runs on iDevices & Android. Could be a killer combination (on paper). But will they get it right?

I would love to get a look at their user forum. Indy, James -- don't y'all know any shady hackers?

Just sign up to be a member.

It was very funny as yesterday, ePocrates emailed me and said I have just one more day to upgrade to Essentials. I should have emailed them back and told them they had just one more day not to be taken over. Although, obviously they knew.

Our perspective is different that someone who uses AC clinically each day, but I do find what our clients (or prospects) are asking us indicative of trends.

We have had multiple clients ask us if we can support them if they become disenchanted with where AC is headed in the future, and in a few cases we have been asked if we could/would assist the practice in moving to another EMR.

It has been expressed in many ways by may voices here, but the essence of the message we hear is that Doctors in the user-base want AC to focus on their core product, starting with fixing long-standing issues, and new "bells and whistles" are NOT desired until all the known issues are addressed.

As I have said before, the natives are restless.

I was talking about AthenaHealth. No user forum I can find on their (gigantic) website. Anyone found it?

I had looked, too...no luck.
An Epocrates user board holds less interest...

That is perhaps like asking if the Pope is Catholic.

A conversation best had over 1 or more beverages, but, oh the stories I could tell .... (cue the Jimmy Buffet song)

Just to illustrate a few:
<>Guy who was programming for the government, then realized that he was writing the attack optimization code for nuclear attacks
<>Guy who cruised into my office and said that X was going to release a new program Y in a few days, but his friends in Eastern Europe had it already, so did I want a copy now?

Programmers and Hackers are some unique folks, trust me on this.

And Indy was referring to your post about me and agreeing that many are thinking the same way I am.

Back to original query: Would you choose AC again?

For our practice I am not certain. Our providers really like AC and we have no real need for CCHIT or MU nor are we interested in any federal reimbursement (opted out Medicare practice). We are a group of 9 with three sites and on two of the sites we remote into the main server w/o significant difficulty (I suspect similar to cloud platform in performance and stability).

We are NOT happy with having to use TWO programs -- EHS for our practice management and AC for our EHR. For this reason alone, IF I were starting out all over again I would look VERY hard at either eMD's or eClinicalworks. We have to do data entry into both systems (for some reason cannot get an HL7 bridge due to code incompatibility or so I have been told).

At this juncture, already using both systems, I would be loathe to incur the costs (both real, hidden and lost productivity for several months) of switching and am psychotically hopeful that AC will team up with someone to integrate both EMR and EHR functions in one platform.

Best,

James Clayton, M.D.
www.redhookfamilypractice.com
US Virgin Islands

For what I do I really like A/C. I don't take any of the gov insurance (medicare, caid, or tricare) so the MU stuff is useless to me. Even if I did take those I probably would not take the government $ because I opposed the stimulus and feel like I would be stealing if I did because in my mind all taxation is legalized theft.

I probably would have kept the billing inhouse if there was a PM/billing portion with it, but since it didn't have one, I just scan my superbill and ftp it to a billing company who takes 7% of what they collect, so overall I would choose AC again.

I would use AC again. I continuously looked at the alternatives for about 5 years (I have been using it for about 11) but never found anything that was as straightforward. There are a lot of programs I looked at originally and along the way that are no longer in business. As I look at the Meaningless Use requirements and the fact that most EHRs are trying to meet their standards, I suspect a few more will fall by the wayside. I do NOT think AC will be one of them. They are well positioned to keep abreast.

The thing that impresses me the most is that I can get a student or resident up and running on AC in a few hours. Take that e clinical works. Most people do not have a significant drop in productivity with AC, another thing to consider. I rarely leave charts undone, but that is a long debate on the board and you should search for it.

Wow, I wish that had been the case with us. Our 4-provider practice revenue dropped dramatically the first year. But, that is not to say AC per se is to blame; it was the entire shift to the EHR. Everyone in the office had to learn to use it, not just the providers, and our schedule was often limited by the slowest user, often nursing or front office. Remember the pleasure of having every encounter require the unreimbursed workload of a new patient? In a practice with a lot of older patients with multiple problems this would take a minimum of 45 minutes per patient, even if we could only bill a level 3 exam. Overall I figure going electronic cost us about 4 times the incentive money would have brought if we had gone after it (we didn't). I feel the question is not whether to choose AC over other electronic systems... my answer remains a resounding "yes"... but whether to go electronic at all.

Wow! I could never go back to paper. I know I have told this story, and everyone can think or say there goes Bert bragging again. I am completely with Wendell on this. We can hire an MA and have her using AC by the end of the day. Maybe not the bells and...wait...there aren't any whistles. Couldn't resist.

At the time, my boss (makes my stomach turn) would barely listen, but he would listen to my please for an EMR. I looked at tons of them. And, this was over 11 years ago, so there were way less. Every time there was a new one, I got excited, but there was another drill down program. Now those slow you down.

On a Friday night, I found AC. I couldn't believe how simple it was. I played all night and added a few workarounds and installed it on every machine. I came in early Monday morning and taught each person as they walked in the door. The other doctor saw my patients and, by Tuesday, we were all set.

From an "IT guy's" Perspective, I would also have to give a resounding yes.

Great Price - one of the most affordable EHR to license and deploy out there. For people who think AC's hardware requirements can be a little intense. Check out Praxis': http://www.praxisemr.com/system_requirements.htm . Often practices are operating on budgets, low cost of software lets me optimize that budget to setting a more tightly integrated system (e.g. automated backups, backup clearing, optimization, etc.) so the user doesn't incur maintenance costs.
Easy to set up - all-in-one installer that can even be installed by your average user. Fully configured SQL instance is set up. Most of the issues on the board are related to other technical issues (Windows permissions, firewall, etc.) rather than Amazing Charts itself.
Easy to maintain - optimize database every now and then and clear deleted messages and it runs pretty well.
Per physician cost is minimal - flat rate for additional physicians, no need to buy additional hardware, etc. Some EMRs just like to charge ten thousand because it's another physician.
Client licensing - unlimited licensing of client computers and users (e.g. MA's, NP's, etc.) Most software companies and cloud services like MS or Adobe charge per user or per device. They only charge per provider which is very nice. I hope they continue doing this.
Data ownership - The database is sitting right there on your server. You own it. If AC goes down or you terminate your contract, it's still there.

I especially like AC since it gives me (as well as the practices I setup) the ability to operate in whatever manner they find most efficient. The imported items feature is greatly underestimated. Lots of EMRs, esp. cloud-based either don't let you upload your own documents or put stringent size limitations. While I don't offer cloud services, I do offer managed services. I can single-handedly manage over hundred computers daily (as well as many other things) without running into significant issues. Most other EMRs tend to have higher revenue shares for people like me, but I'll take the simplicity and ease of use over a few extra bucks.

I think I would buy it again, but as Bert had posted earlier I would want to see a commitment to fixing some of the stuff that a lot of people have been asking for years...now I will counter that point (and my own) with the fact that when you buy a ton of other EMR's, unless you are a big player and most of us aren't hospital systems or running 10 office clinics, you wouldn't even have a board to put up your frustrations and send in your input on things...

I also think that we would never know from AC or any other company what their committment to fixing stuff is. . .

I would like a ton of small fixes like being able to have multiple addresses on the header depending on which office you are using it from...bigger screen to work on templates, some of the stuff listed above...but then again, I would still use it again for what i need..

i am a simple practice and doing simple things. . it takes one day to train someone...



I would definitely install the 90 free trial. . .play with it...use it see how you like it...

@Sandeep,

I think my "local IT guy" would echo what you are saying.

Sorry Mario below, but I do not like to edit, but just wanted to say how many EMR user boards have a genius like Sandeep? He has personally helped me intentionally or not, multiple times.

Undoubtedly "Yes."

Sandeep provides an excellent list of advantages that AC has over many EMRs. I'd also like to think that AC is easier-to-work with/learn, but I can't say so with any authority; most other EMRs exist behind a $$ iron curtain, so I have no benchmark for EMR user-friendliness with which I can compare AC. The AC free trial was wonderful to have. I got to mess around with the program and learned its strengths/weaknesses, limitations, and areas for improvement.

It never made sense to me that most other EMRs on the market don't provide trial periods. Well, no, I take that back. What never made sense to me is that doctors and managers didn't demand trial periods before purchasing. EMR use affects every aspect of and has the potential to change the workflow of an office. Why select an EMR based off of 5-minute demo videos and a few chats with sales associates?

I looked at an old poll that Bert conducted. After looking through the poll and comparing it AC as it exists today, I think it's fair to say AC values the community's input.

Positive:

The best EMR, period.

Negative:

AC, as it exists today, does not value the community's input.

They do. They did when I chose AC. But they tend to 1) require you to discuss your needs with their sales rep for probably 2 hours or whatever, and 2) Only give a 30 day trial.

I tried a few. One (Altapoint or Lytec, I can't remember which) was really cumbersome. It came with integrated PM, so I was really looking forward to trying it out and it was one of the lesser expensive EHRs. In fact, I found out about it the same way I did AC...Medical Economics Recommended inexpensive EMRs for small practices.

So, I installed this puppy and decided and decided to try to open a chart for the sample medical practice they provided for the demo. I couldn't figure out how to do it!! Some of you know, I have an EE background,so I'm no stranger to figuring out new programs. I tried and tried. Couldn't do it. I had to call their tech support to tell me, and found out it was a multi-step proceedure. Just ludicrous.

I did find one basic thing on AC that was counter-intuitive. Opening a new chart note on a previously seen patient. I didn't notice the menu item, and was looking for an icon. They should add an icon for that. But once they showed me, it was ok. On that other program, when I revisited it 2 months later, I could no longer remember how to open a patient chart! I just uninstalled the program right then and there and took them off of my short list.

Well, it makes me sad to hear that you think that. Given your time here and the breadth of your experience, it also makes me think.



Thank you for fact-checking me. I really hesitated to write "most other EMRs," but I wrote it against my better judgment; and then I just kind of ran away with that statement. I should have qualified it by saying "most other EMRs don't offer an easily accessible trail period."