Home Forums Discussions General Discussion leaving a/c

Been a frequent lurker and occasional contributor here. My thanks to all who give their time and experience to the a/c user community..

My practice has used a/c for about 6 years now and we've found it to be intuitive and easy with remarkably good support.

However, the increases in cost and a/c's misleading costing of the online version have lead me to decide to move on.

The straw has proved to be the costing of the online version. We were told on several occasions and I asked this explicitly how the online subscription was priced. I was told unequivocally hat it was based on the maximum number of simultaneous logins that would be available to us and was not related to the number of user names estabslihed. This made sense to me as that number of active sessions would determine the hardware and licensing costs for the host.

When we got our first billings, about 3 months into our subscription, we were being billed for user names, not available sessions. The billing was about twice what we had anticipated and beyond the budget we had established under our original understanding. In our correspondence with a/c about the issue, we are now told that user names are the basis for the billing contradicting what we had been told in the spring.

So partly for the costs and partly for the change in character from the old days, we are going to move away from a/c into another system that will be more affordable and allow the convenience of online availability. We are having a hard time getting our data back from a/c, but hope their better nature will re-emerge soon to facilitate the transition.

Again many thanks to the user community. Good luck to all. Suggest you have some concerns about a/c going forward under its new corporate ownership.

Bob Burr
Wasatch Endocrinology.

I remember inquiring with various representatives including their tech support and sales reps but I could not get a clear understanding about the cost model...fortunately I didn't pursue it.
However, thank you for sharing your experience and I wish you the best with your transition. I've only imagined how difficult a task it would be.

Bob,

Out of curiosity, what system will you be using?
I think we all want to all want to have a viable alternative should the time come when we might need it.
We all have some insecurity since Jon left the helm.

Given the vicissitudes of the ehr industry, we've always keep an eye out for options but never ran across one that we were as comfortable with as we were with a/c. We have also been working on a change to our billing provider so we looked at combined solutions, but were still content to keep a/c as our ehr. However, the changes this past year added a layer of concern that made us step up our surveillance and we've spent some time getting pretty deep into a couple of the combined billing/ehr solutions and have settled on carecloud. We were still going to stick with a/c until the online a/c billing problems surfaced, and our frustrations and disappointment with a/c's response has decided us to just move to carecloud for both billing and ehr. It's too bad and will be a lot of work to make the transition. But, companies change and I think a/c's move from an entrepreneur shop to a more corporate environment will have consequences. I think that those of us who have been with a/c for a long time will sense that something fundamental was lost in the change.

Hi Robert,

I, too, join with the others wishing you all the best. One of the advantages EHR companies have is the inertia of having to change to another company. It isn't like owning a BMW and then changing to Lexus. I have three questions for you, if you don't mind.

1. Was the pricing structure in writing. In your post you kept saying "They told us..."

2. Have you spoken with Indy as far as using his cloud alternative or are they linked? If you were already using Indy's, feel free not to comment. But, it would seem it would be fairly straightforward to switch.

Hey Bert,
I am dying to know, what's the third question?

But seriously, I just read the other thread about AC charging for webinars. The current managers seem intent on destroying every bit of goodwill that JB engendered with their new "corporate" ideas. The positive things that set AC apart from other EHRs continue to disappear. Rather sad.

Bob, thanks for sharing, and all the best to you.

This makes me so sad. As a forced-to-change-to-Epic user I still have held AC near and dear to my heart. I remember how many discussions we had and how much unpaid time we put in and all the hurt feelings many of us suffered while helping (at least IMO) Jon to deliver a terrific product. I cringed when I saw the Pri-Med advertisement for the Boston ACUC knowing full-well how the name of the original ACUC came to be and how the idea originated. I made so many great friends. Martin called me a Luddite....it was never the technology I hated, it was just this sort of thing. Guess now I will have to modify my signature.

@Donna,

Weird, I answered. Must not have hit save. I was going to talk about data and SQL, but then I realized he was in the cloud.

Leslie,

I suppose it is just as well that we called our get together Meetups years ago, there really is no confusing the two.

While the future is never certain, there are lots of requests to Meetup in Laramie next summer, hopefully both you and Martin can make it this time. Perhaps we can have a Doc Cook-off, as there is a Pediatrician in town who has a mobile rig for BBQ.

I wonder if other outdoorsy things like trail-rides, rock climbing, hiking Vedauwoo again, or a trip to the range would be of interest.

As usual, if I can I will.

Amazing Charts in the Cloud pricing model is published on our site and states that it is $39 per connection. The billing reflects the number of connections you establish. Our Client Services Team works with each practice to determine the right number of connections needed to support all your full time and /or part time staff. We work directly with the cloud hosting vendor to set up the connections. We are happy to work with clients to adjust or reduce the number going forward if there was misunderstanding of your needs.

As AC has stated in the past, your practice data is yours to take with you should you choose to stop using Amazing Charts. Contact us anytime or myself directly (ctremblay@amazingcharts.com) to make an appointment with our tech support staff if you need a download of your database.

Thanks,
Chris

Here is the site link: http://amazingcharts.com/services/web-based-ehr/

Chris - you raise an interesting question. We have had folks come to us after speaking with AC because they were told that each user account needed their own connection, or that part-time folks could share an account, which arguably could lead to a HIPAA issue either during an audit or routine use.

Part of why we offer a managed environment instead of hosting is we manage access by individual credentials, but our fees are based on simultaneous connections.

The more important issue that you are missing here is one of perception; Physicians are speaking out about their perception that AC has changed, and not for the better. THAT ISSUE is one that impacts this whole community.

I regret lending my name to the advertising of this "new" AC. I have not been able to get cloud support on a timely basis the last few times I needed it. I am not yet ready to move on from AC, but I am now keeping my eyes open for the possibility. Such is life.

I got a phone call Friday morning from my office manager. Apparently someone from AC took issue with my post above (which I placed Thursday close to MIDNIGHT!) and wants to talk to me. He left a message that he will call Monday (only one of my busiest days... of course I have time to chat Monday!Let me reschedule all my patients and I will be patiently waiting for your call. Then again, why wait? I am available this weekend. Don't you work weekends? I do!) I wonder if I am going to be reprimanded for misbehaving. If only their response time for angel support was as good. I really miss the old days when "Angel support" was really there when needed and the chat function actually worked instead of just redirecting you to a phone number where you have to leave a message. Then just wait a few hours while your clinic implodes. (I remember spending over 2 hours with Jon one evening when an Ac upgrade went kaput and erased my databases! Partly my fault as I did not do a back up. After many attempts we were unable to get back the databases but Jon helped me get to restore a week old backup. He was very apologetic. I then had to spend several hours reconstructing the encounters. Those days I still saved paper charts with copies of the office encounters so it was not too hard, just a lot of typing. Soon after that Jon setup the obligatory backup before upgrades. What kept me with AC back then, despite that FUBAR event, was the personal involvement from Jon. He may not have solved my problem, but he tried. And he was there when it counted)

To whoever left a message for me with my office manager: I do not intend to take your call now or never. Instead, spend more effort in hiring more angel support staff, train the ones you have so they actually provide help instead of just blaming my network, and actually support your product instead of harassing users that complain. I am already *this close* to leaving AC. This type of behavior is not helping. And don't bother calling me Monday about this post.

You are making me regret leaving Athena.

Hi Gerardo,

Wow. Read your post. I hope you don't mind if I inquire a bit. Please tell me to mind my own business if you do.

The key part of your post is the first sentence. What was said that made it appear to take issue with your post? I mean were they trying to talk to you to find out more about what was going on or did they actually say they were upset with it.

Just wondering. Thanks.

Sorry you are going through all this. You aren't the only one, believe me.

Hi Gerado,

Check out my PM. It may help.

I feel your pain. I'm having same problem. Support (when you actually get someone) has absolutely NO concept of what a full clinic or practice is like. We can't just stop patient care while they ponder solutions on their time frame and level of priority.
WOW, they have actually managed to screw up a perfectly good EMR.
Nate

Dear Clients,

Many of you are currently experiencing long wait times to get a call back from our customer support group. We want to explain what happened and what we are doing about it. We want to assure you that this is a temporary situation, and we are adding staff to deal with it. The wait times will decrease to normal shortly.Several recent events combined to push the capacity of our Client Services team to an unprecedented level. This negatively impacted some clients, and you may have seen several posts on the board about it. As the summer came to a close, our clients started thinking about the October 1 deadline for Meaningful Use attestation. In the past month, we have serviced literally thousands of customers for Meaningful Use education and attestation, and we spend as many as two hours with clients to ensure successful attestation.In addition, more than one thousand clients have been assisted with setting up their Amazing Charts Patient Portal. Finally, a NewCrop outage brought in literally hundreds of new service calls in just one day.While all of this was going on, we helped nearly one thousand practices upgrade to V7, a process that can take several hours.As of this writing, we plan to be caught back up with our call backlog in the next several days.No one should be experiencing significant delays in hearing back from us, or using chat to contact us in real time.To prevent future backlogs, we have invested to hire additional staff in Client Services and are adding new technicians as quickly as we can.In the meantime, thank you for your patience and understanding as we strive to deliver the excellent service and support to you, even during a ?perfect storm? of events like the one we recently experienced.

Sincerely,
Trish Viveiros
Director of Client Services

This is a good post. It would have been a great post three weeks ago.

If anyone from AC were really reading the board regularly, they would understand that their COMMUNICATION IS POOR.
Information is only forthcoming after complaints are posted here.
Why not be proactive AC? Why not get out ahead of a problem and TELL CLIENTS about these circumstances?

Also, perhaps it is time to think about a different support model. Right now, everyone pays the same whether we use support or not.
For those of us who are diligent about working through the MU criteria on our own, we need very little tech support, and are peeved about its unavailability when there is a true calamity.
Perhaps it is time for a pay to play model of actually paying for the amount you use.

Long time users are feeling the difference between a physician led company and one led by a software executive. AC users allowed a lot of leeway when Jon was at the helm because of his personal involvement and connection to users. The love is gone, AC. Produce a program without disastrous bugs, fix longstanding problems, and give clients the support for which they are paying. Physicians, especially small practices, are already facing enormous pressure to survive. Our software company should not make our lives worse.

My strategy has always been to stay "one version behind". I learned early on the havoc that is wreaked by upgrading to the latest version of AC.

Have yall ever heard of the word "Triage"? By now evereyone knows what the word "Cluster" means.
Nate

PS
For those who want to do MU and avoid penalties, you have had 3 years to learn about it.
Why would you wait until the summer of 2014?
As I say to patients, a delay on your part does not make it an emergency on my part.
AC needs to attend to clients with true software emergencies rather than MU laggards.
As Nate said, "Triage", deal with real problems first.

It's funny that you say that. You keep saying what I am thinking. Although maybe I wouldn't have said it quite like that, lol.

I understand why doctors would want to do MU, but I wonder if there should at least be support specifically for those who don't. Just a thought.

Bert,
I have never been accused of beating around the bush. Although, perhaps there is a slight exageration in my comments. I don't really say that to patients, but I do think it sometimes.

Also, the deadline for attestation in not 10/1, I believe that this is the last date to get started on Stage 1 to avoid penalties.

And, we all know that NewCrop has created a multitude of problems over the years.

And, why push people to Version 7 when it has significant problems as reported on this board?

In sum, AC has created these logjams by:
Being unable to prioritize what is important
Continuing to partner with NewCrop
Releasing buggy new versions
Offering unlimited support for a flat price which may create abuse

There, I think that is all I have to say. Many of us have been frustrated with AC for some time.

@Trish@AC

Forgive me for being skeptical but I heard this before.
To paraphrase one of my favorite movies (FMJ)
You can talk the talk, can you walk the walk...

Gerardo.

@Bert

I did not mean to ignore you. Nothing to add other than what is in my posts above. res ipsa loquitur (and not in the legal sense)

Maybe I am touchy, but I do not appreciate getting phone calls on my comments. If someone has an issue with one of my post, leave a message in the forum. Or delete my posts and ban me, I do not care.

As for the wonderful changes to angel support mentioned by Chris, I'll believe it when I see it.

I agree with Dcubed, except for the paying more part. We already pay enough. Provide the support for which we pay and don't give me any excuses. And you know what they say about excuses: Everyone has one...

(No need finish that sentence; it speaks for itself)

Gerardo

Hi Gerardo,

I think everyone agrees with you for the most part. I think Donna was saying pay for each incident as a lot of companies do. But, it does cover the updates, not that they are bug-free.

I think the question everyone wants to know that is following this thread is did you actually find out what their agenda was. I can't fathom that they didn't like your thread so they called to chastise you. Never heard any company do that, even AC. My guess is they were calling to try to provide support, because they saw from your post that you needed it. Just my guess.

I agree with the excuses. In fact, I nearly started an entire thread on it. I, myself, am really tired of hearing how MU has caused all this. I completely understand and think that the government has, once again, made things much worse. But, they have to continue to make a good product and provide support either way. Personally, and I am probably not the one to say this given I didn't sign up for MU, but I don't think AC should be providing any support for MU. All of it should be going toward the functionality of the program for taking care of patients. And, I completely understand that for the solo practitioner that leaving that much money on the table is hard or maybe not even doable, but the main reason I didn't do MU was because I knew it would add a ton of time to my workload. As far as MU, I agree completely with Donna.

And, while I know nothing about MU, so this statement is probably completely untrue, but what happens if there is MU3 and 4 and 5? I suppose that since MU can be rather profitable, maybe those needing MU support could pay an extra fee such as $1,000 or whatever so AC could hire specific support who would be well-trained on MU only. $1,000 is a lot of money, but if it gets you the $50,000 or whatever it is, it seems well worth it.

Yes, Bert, you are right. I was not suggesting that we pay more for support. I was suggesting that we pay for what we use. Those of us who use little would pay LESS. It seems that by offering support as an unlimited amount, many are using HOURS of support time from AC to get them through MU (at the last minute, no less!). This has created problems for those trying to get essential support for program problems. Right now the support fee includes program updates, ERx, support for program issues, support for MU issues. The model needs to be reconfigured.

Just like an all you can eat buffet, people will tend to take more than they really need.

I will address this at the next ACUB meeting.

I really don't agree with changing from a basic unlimited support structure. But I do understand why someone might think they want it. I don't request support very frequently (maybe a couple times a year unless there is an upgrade issue), but when I do need it, I need it quickly and it can easily go for hours. I don't want to have to worry about sudden charges for support.

The question of what AC is actually supporting is interesting. Are they providing support for how the AC product works to submit/attestate for MU (We don't do MU, so I don't know the details on it)or are they providing support for MU in a more general since. I agree, no they should not do the latter unless it is part of a "add-on" service that you pay for. But the former is just support of product functionality and they have to do that. If they focus on supporting the product's functionality then that should hopefully prevent their staff from being overwhelmed. And perhaps as the rapid introduction of features and capabilities ramps down things will return to something approaching what we had back before the chitt/mu double whammy (because things started going downhill when AC started trying to rush and meet CHITT certification which was then superseded by MU).

I really hope they do because while I haven't had the problems others have, I am really afraid of what will happen if I do. I'd hate to start looking to change EMRs just as AC is approaching being a complete EMR/PM system.

Once you have switched, I would like to know your opinion of the program.

Wayne,

How do you get support in hours?

We sometimes wait days.

I believe that paying for support based on usage is a really bad idea. You might compare it to paying for health insurance. You might rarely or never have to use it but if you need it then it's available and a lot better than shelling out a huge sum of money for a costly illness. Better to spread the cost of support across all users. In regards to MU, some physicians are opting to sit on the sidelines. My question is won't these MU requirements eventually become mandatory? So why not get used to the requirements and benefit from the monetary incentive now? We have started our 90 day period of MU 2 and I will admit that it is a real pain.

But, there are problems with paying for support for ten years and using it once. I don't think paying per incident would be that costly. It's kind of like a copay. We see private insured patients a lot less than Medicaid patients.

The nice thing also would be the incentive for AC to increase their knowledge. If they can't fix it, which is somewhat frequently, you don't pay just as with Microsoft. There are two different models and both have their advantages.

I am not sure what the penalty will be with MU, but if it is less than three percent, then I am never doing it. I will try my hardest not to.

Is there really going to be a full PM. I think they will be close but it will still require a 3rd party. CCHIT slowed AC down but so did the failed PM.

I hope not to offend anyone, but support should concentrate on the issues that come from new releases. MU is important, but there should probably be separate support staff for MU.

I agree that a penalty of less than 3% would make opting out of meaningful use much less painful. However, considering the way the federal government is becoming more and more heavy-handed I suspect that in the future the penalty might have a little more bite to it than that. Most AC users are not as IT-savvy as Bert so I think it would be a safe bet that most users need Guardian Angel support more than a few times per year.

Bert looks to me MU max's out at 3% and PQRS at 2% so if 1/2 your patients are mcare or mcaid then 2.5% reduction
unless the private payors jump on the wagon then ??? The way it looks to me I'd rather drum up seeing an extra patient a day then be a data collecting hoop jumper but I could be wrong and maybe it will be a tsunami that is coming.

As always Bert is the voice of reason. Since I did not talk to anyone I cannot say what they wanted to talk to me about. It just rubbed me the wrong way. In retrospect they were probably trying to fix the problem, rather than complaining about my post. I apologize to the board for misleading you all in that regard. Mea culpa.

That's OK. Anytime you can wake up a dead thread, you are doing something right.

By the way, as much as I don't want to contradict or second guess support, does anyone thing that the post where support was helping thousands and thousands of users was a bit of an exaggeration. If it takes 12 to 24 hours to get through on the phone, thousands is a lot.

When I do chats with Dell, HP and Microsoft, it will say 3rd in queue. But, can you imagine you are 998 in queue. Estimated wait time is two years after MU2.

Gerardo, vent all you want. You have earned it. Just remember when you have support questions, bring them here first. Sandeep can handle most of them.

Bert,

If Sandeep can handle most of the support questions here, why am I paying AC for support and not Sandeep?

Support needs to be quicker at responding and understand that a waiting room full of patients does mat want to hear that you are shutting the system down for support.

I use Epocrates and have been requesting support to get me to Epocrates, not the sale page. No response. It's getting frustrating.

Agreed. Again, as your representative on the Clinicians' Advisory Board that meets Tuesday night, I will bring up these concerns.