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I went to the User Conference today in Boston. Lots of surprises--mostly good ones.

John Squire, CEO, spoke about new developments. AC/PriMed are getting ready to rollout a new cloud-based EMR called InLight. It's a joint venture with Mass. General Hospital and will use a problem-oriented format, integrate Pri-Med medical education, and is targeted especially for direct primary care practices. It would not replace AC or AC in the Cloud.

I was also pleased to hear that V8 will be rolled out Oct. 30 and will include (finally!) integrated PM. I met the AC staffer in charge of the PM module and was very impressed.

Dan Levy, chief technical officer, gave an interesting presentation focusing on internal improvements in how AC develops, tests, and rolls out upgrades. Sounds like AC has made huge progress in the last year. The plan is to start regular, quarterly upgrades in 2015. The upgrade process for us as users will be much simpler and more predictable.

There was also some very interesting info about MU. As announced by CMS recently, we don't have to certify for Stage 2 this year but the CMS requirements for Stage 1 will vary depending upon which version of AC we're using. If I stick with V6.6.7 the requirements will be somewhat less than if I upgrade to V7. Use of the portal will be required even though we're not yet on Stage 2. It's all a bit byzantine, but what else can we expect from CMS?

There were lots of opportunities to meet and talk with AC staffers--and ask questions in person. A great bunch of folks. There were also reps from Updox and Dragon available to answer questions. I was able to resolve a question about Updox that had been on my mind.

John,
Thank you very much for the update!!!
How did your talk on the AC cloud go? I hope you had a good turn out.

Bruce Jung, Aaron Way, and I gave talks on AC from the doc's perspective.
In the process of putting my thoughts together I had a good opportunity to reflect on my journey transitioning to an EMR over the last four years. Thinking about the role of technology in medicine, EMRs, the Cloud, MU, and such reminded me of the importance of Francis Peabody's assertion made in a lecture in 1927 to the staff of the Peter Bent Brigham Hospital in Boston (now Brigham and Womens): "The secret of the care of the patient is in caring for the patient."

http://courses.washington.edu/hmed665i/MSJAMA_Landmark_Article_The_Care_of_the_Patient.html

Interesting information, John but raises questions.

What is the rationale for marketing the new EMR to direct primary care? Why would an AC user want to change to an entirely different platform?

I have read everything that I can find on the CMS website about repeating Stage I for 2014, and can find no documentation of the need for the portal if using the 2011 CEHRT version (6.3.3). Did AC give any reference or documentation of this requirement?

The InLight EMR is not intended to replace AC but is an alternative product. The way John Squire explained it, AC under PriMed is now expanding its products from just AC to AC, PM, and InLight.

I was surprised about the portal issue as well. Evidently there's more to the story than is on the CMS website. It would be helpful if the folks at AC who are dealing with MU could post some further information for those of us who haven't yet walked away from MU in total frustration.

But, what is the rationale for targeting direct care practices specifically to InLight?
Is the goal to steer new users to InLight rather than AC, and over time phase out AC?
I don't understand why they are developing different products.
Any insight?

I've gone through the simulated attestation on the CMS website for 2014 Stage I and there is nothing that relates to the portal.

I think the answer regarding the portal is contained in the chart posted by John in another thread:
Hitech 2014 CEHRT Flexibility

If you are using the 2011 certified version (Version 6), you can do Stage 1 with 2013 criteria. Portal was added to 2014 criteria, so if you have upgraded to 2014 certified version (Version 7) you will have to have the portal.

Sounds like another fine argument for sitting tight with the Gold Standard (6.3.3) until such time as things are sorted out. Like the man says, "When you're right, you're right!"

Indy, you are exactly right (and have been all along!).
I had not upgraded to Version 7 because there were too many problems reported here on the board for me to be comfortable.
Especially concerning was the repair issue that you reported.

Ditto wish I hadn't went to 6.5.5, however sounds like Version 8 has addressed many old issues so will see

I checked with tech support about the portal question and MU. This was their reply:

If you are still on a 2013 certified version (v6) then you can use the 2013 requirements for Meaningful Use this year. Your first statement is partially correct, if you were on a 2014 certified version (v7) you would have to implement the Patient Portal for Meaningful Use whether you were doing Stage 1 or Stage 2. I hope this has helped clear up your concerns, if you need anything else please let us know.

If one is running version 6.3.3, does one simply run the meaningful use Wizard for a three-month period of time and report that, or is there something else that we should be doing?

If it is an EMR for PCPs, then it is a direct competitor to AC. Unless it is designed and targeted to a specific type of organization. For example, some EMRs are optimized (kindof) for use in long-term care facilities. Others for hospitals, or possibly specifically for practices with 10 or more providers. There may be capabilities that these clients want and will pay extra for that smaller practices either do not want, or do not want it enough to pay substantially more for the product. I guess we won't know until they actually release the product, but my hunch is that yes it is a replacement for AC. Unless it is a specialized product, I don't see the need for it otherwise.

Dr Mel,

For 2014, I think you have to report a calendar quarter, not random 3 months.
But, yes, I am planning to use the 6.3.3 wizard as before to attest for MU Stage 1 2013 criteria for either July-September or October-December.