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Quick SHOUT-OUT to JamesNT

I was looking for a way to pull all my patient data out of AC in a format that I could use to easily update my new EMR (Praxis EMR - ABSOLUTELY AMAZING) AND James came through "bigly". 30 minutes on TeamViewer, 5 example folders to review to make sure everything was up to snuff and less than 12 hrs later..........

ALL MY PATIENT DATA IN PDF Format.


THANK YOU

THANK YOU

THANK YOU

JamesNT



Todd R. Waldorf, D.O.

Dr. Waldorf,

Glad to be of service. Let me know if I can ever do anything else for you.

JamesNT

Todd,
If you are willing and have a few moments, it would be interesting to hear the comparison and contrast of AC versus Praxis.

Agreed! I would greatly appreciate that as well.

Thanks

Gene

Agreed!
I would really appreciate if you can share comparison including cost.

Thank you!

WOW!!

Comparison just doesn't lend itself to being typed out. I would be more than happy to speak to whomever is interested to hear my experiences with Praxis EMR so PM or e-mail me a phone number and I will reach out. I have 2 hr drive to work and back home every Thursday so 7:00 - 8:30 ish or 16:30 - 18:00 ish including tonight so........

Todd

drw@adkomm.com

I watched Demo of Praxis EMR and it is impressive! Can you give us information about the cost? Thank you so much.

I'm also keenly interested! AC has chosen not to put in the time and money to fix critical bugs. GA service is going more and more unresponsive/not present. Problems that have existed in the chart for years are going unfixed. My recommendations and bug reports never get a response.

Please DM me for more information. There is more upfront cost per provider than AC, but the tech support is about half the price which is my main ongoing cost. You really have to look at the Demo.Cloud is 30 dollars per month per user.

Can you post the link to the demo? Can you please post per provider cost here?

I have been curious about Praxis for nearly a decade. Often heard it was great, but with a steep learning curve. (Also, someone annoyingly, "you have to spend significant time learning about it to see if it is for you").

Never put anything on here as I didn't think it was cool to post about a competitor, but I've surely given enough of my life to AC.

https://www.praxisemr.com/
Make sure you watch to the end of the demo. It's rather long and detailed, and the first time I didn't finish it. I used to think it was going to be really expensive, as you have to buy the chart plus the Oracle DB. However, that's not true anymore because of cloud! (It was my major reason for not going with them originally). But, it's actually not expensive at all.
Prices:
Chart: 36, 48, or 60 months $215, $170, $160. That's $10k purchase outright. You own it for life, including all upgrades. Discount for additional providers.
Tech Support $70/mo per provider. First year free.
Cloud $199 start up, then $30/mo/user

It's unlike any other EMR as it's not template based. I had an intro session with the founder himself (!) and he told me the problem with EMR's was back in the early days they just tried to duplicate paper charts, and EMR's were just glorified typewriters. Then all the other nonsense came along with MU, MIPS, etc. EMR's, other than Praxis, all use Templates. They are inefficient ,make your notes look like crap, and set you up for liability, as anyone can see they are templates. (Lawyer: "Doctor, did you really examine the patient or did you just place a template?" Let's look through your other notes..." Hmmm. here you say a murmur, then here's a note and the murmur is gone, then here it is again...")

Praxis uses an AI called the Concept Processor that remembers how you practice medicine and charts for you. It's hard to explain, but watch the demo. There is a little learning curve, but not bad at all. I think I'll have it mostly trained in a few days, and then it just gets better as you go.

Thanks for posting that information, Chris. As far as I am concerned, any prohibition on posting information on competitors is long gone. Certainly when Harris closed their board down and this independent entity began, that became the situation.

I never thought I would switch EMR's. in fact, I probably will not. Simply because the transition is such a huge PITA. Plus my horizon is fairly short.

The financial considerations are significant though and the information you provide is helpful. It would appear to me that the cost of Praxis is front loaded, so the first 5 years are more than AC, but after that it is much cheaper.

For our two person practice (office, not cloud based), for example, AC is $3200 a year (plus interface fees. Will leave that out for now). Assuming no price change (will assume that for both-may not be true for either) the first 5 year cost is $16k and second 5 years is another $16k.

Praxis would be 10k for the program over 5 years plus $140/month for support (after year 1), So $16.7 for 5 years but only $8400 for the next 5.

So if my math is correct, the cost is about the same for the first 5, and Praxis is almost half as much after that.


What we know though is that our time is the real cost. How much time (and stress) to exit AC? How much time to set up and learn a new program?
The impossible calculation is how long will it take to do notes? If Praxis is just 3 minutes a note quicker than AC, that is a lot of hours per month.
And that doesn't even touch potentially having a better, more useful record.

The speed and quality of notes is hard to determine, and it is about to become nearly impossible to assess. That is a topic I am posting here.

Hi Jon,

Your comments are an excellent summary of my thoughts as well. HUGE inconvenience to change from Amazing Charts, there may be a significant hit on revenues during the transition, may take a while to get a new billing clearing house operational, and so forth.

BUT if Praxis would really make life easier… With less time spent charting… That would be very very appealing.

I am guessing about 8 more years in practice for me, but who knows… I have given up trying to predict most things in life…

Thanks

Gene

I should note that Praxis gave me 10k but also 5k for an additional provider. They also give you another free year of tech support if you get another provider on board with your referral. I think that changes your math a lot. The question is, how much time do you spend charting each day? Praxis says they save on average 2.5 hours per day of charting. I spend about 2 hours every day after work charting, and that is killing my vibe. Even with dozens of templates I've made over the years. Most Praxis users just go home at the end of the day, from what I've heard. If they save me only an hour a day, that is an entire YEAR of 40 hour work weeks over the rest of my career. A YEAR of sitting here charting. Hell, if it saves me 15 minutes a day it is worth the switch. What's your time worth? Also, I could see 4 more patients a day if I spent an hour less charting.

Yes, Praxis along with Medpointe were the two I had pointed out earlier. I trained with them for two months before my partner didin't want to go with them. The training, if I recall, was a person (only the same person) talking to you over the phone as you charted.

I remember her drilling into my head over and over, "Don't take the diagnosis to find a new chart on the bell-shaped curve." I am trying to decide between Medpointe which is very similar. Both are similar in that they both get 5/5 for support. I would drop dead the first time I had someone on the phone or an email within minutes.

Medpointe is pricey, $399 per provider per month. The five years would be $19,152 for five years given the first year is free.

Both operate on the bell-shaped curve theory. It would take longer to chart in the beginning due to learning how to chart with it.

Praxis has this thing called Praxis agents. These are like AI themselves in that they remember what you did on a similar note. Lets say you saw someone for Influenza A, and they missed four days of school. It remembers that in a similar note you wrote a letter excusing the child. So, it automatically does a letter for you. Of course, you could change the timeline, etc.

If Praxis really is free after five years except for support, I would have to consider the other amount. I don't think you get a year of Praxis. One could use AC for the next year, trial Medpointe at home; make yourself do three notes every evening. In a way it is different than a template, because anything you didn't type that came over, you would know you needed to proofread. But, if some charts popped up with 12 points in a physical, that would be tough to go through.

There may be others like this, I just haven't seen them. I do feel I would he confident that an upgrade was safe and that beta testing is done the proper way.

I just look at it like if I am going to switch EMRs, may as well be one completely different.

I have been seriously looking at other EMRs especially with what happened two months ago soon to be heard after the first of the year. I convinced a good number of people to purchase AC in the beginning which Jon Bertman always appreciated. Now, I feel like taking 10 people with me. But, I would also save $16,000 over ten years which makes no sense. AC has pissed me off to no end and I doubt I will ever get over it. I talked to Jon Bertman about it for an hour.

The other place you win with Praxis and/or Medpointe is that you pay and GET support. At AC, you pay and get no support.

If they have a board, it would be weird to go on and ask questions.

@Todd,

I appreciate your offer to talk to you on the phone, and I suppose one could do either or both. But, I think with as many people talking about Praxis, it would just be more helpful if you posted. Obviously, you left there, so you must have had a bad experience.

Please post here so we can all benefit.

Great thread -- some glimmers of light for younger docs.
I'm 77 so not likely to change, given the upfront costs in money, time, frustration, etc

Now I'm just trying to hang on I've given up MU and MIPS/MACRA -- too much administrative overhead, and essentially no payback.

What relationship does PRAXIS have with a fax program? Do they use Updox.
Did you notice that Updox has been acquired by EverCommerce, whoever they are. Expect some major degradation from that quarter.

I think most EMRs in that price range have messaging, secure email and fax. Not sure about fax, but Medpointe has it.

I got into AC because it was low cost. I was just starting a practice and saw that the future was in EMRs. I tried several of the inexpensive EMRs (soapware and ????) and found them lacking. I emailed Jon Bertman for information after having played with AC and he not only got back to me quickly he made some changes to make it easier. He was also raising prices around Thanksgiving in 2001. That did it, I bought AC. I had been renting space but was in the process of opening my own office which I would not do for the next 6 months. I couldn't leave a computer in the office i was renting space, things disappeared. So I continued to use an old laptop and just practice on a few patients. At that time, I was printing all my notes.

Over the years AC has steadily increased in price. Some of it was inevitable. There were government regulations to follow and essentials to add such as online prescriptions. They have changed hands now 2 times. The support has become much more difficult to access. I really had not looked at other EMRs until about a year ago. My main hospital is pushing Epic. It has some serious advantages as well as disadvantages. But the ultimate cost is only about $100 more than what I pay now. For that I get billing, much better support and integration to pull records from other sites on my patients. Yes, it's much more complex but....

I had not seriously considered retiring until COVID, but it has made everyone consider both their priorities and future. I may not see the point in going through the pain of changing EMRs if I'm going to retire in the next 3-5 or less years (the powerball is $410M on Wednesday, maybe it's time for me to play). Then again, perhaps I'll join another group for the end and not have to worry about EMRs, just go with the flow. I can probably learn any EMR if I'm paid to do it, but why do it if I'm the one paying.

I always thought EPIC was much more expensive. I am looking forward to changing EMRs. It would make life more exciting and, besides, there just things that are built into the higher-end setups.

Most of the other ones have much better support. The lack of support and the lack of communication tell me one thing. That AC will not be around much longer. They just have no support. None. Never have, now it's worse.

I would rather use this opportunity to get out before they make me.

EPIC can be more expensive, but the hospital is sharing in the cost. That's what brings it to a reasonable rate.

What really burned me with AC was having a critical error (script writer crashing) that disrupted my whole day and their tech support was really poor and snarky besides. Eventually when I got to "tier 1" support, they basically said that not enough practices were having that error for them to fix the code or investigate further. Okay! Lost me as a customer. That's where the departure from AC began, after 10 years of being a proponent. Hell, I was an evangelist for them and got others to join. It was made worse when I found out my PA had to pay the same tech support fees as I added him to AC, and then their tech support started just not showing up! I just saw Praxis at our last teamview meeting just slipped a shortcut for tech support on my desktop. THey are apparently available 24/7.

I def wouldn't switch if retiring in a few years. I have at least 10 to go. I have been so incredibly impressed with the service at Praxis. For my live demo, I actually go the found and CEO! He is so enthusiastic about the product! Right now they are doing a whole bunch with the implementation team to help me transfer my data into Praxis. I have regular training sessions, all included, with a trainer every Friday this month. Everyone is super professional, organized, available, English speaking, and helpful. There's an Implementation Manager, A personal Trainer, A Sales Manager, a bunch of different teams, very well organized. They are currently working behind the scenes to get everything set up and less work for me to do.

The biggest concern and hurdle is getting all the imported items into Praxis, and I don't know yet how much work that will be, as they CAN import a transition of care document AC spits out. All charts are required by law now to allow transfer of info in XML documents. I'll keep you updated on what I learn in that respect.


So Praxis is coming out with their own integrated version of Updox shortly so that files can come right into the chart. It's slightly more clunky now, how they handle the documents. That's one thing AC does better is the organization and quick access to the imported items. Most people now use some kind of eFax service and then upload everything into Praxis, so it's an extra step. The sorting happens in Scanaway, the program where you sort and upload to the server. However, in Updox you do that there before you send to AC. I've really enjoyed Updox over the years, intend to continue using that now for my fax server, but Praxis may obviate the need for it. Updox is to be praised for standing in the gap of AC's huge failing. Imaging AC without updox!

I am thinking of moving to Praxis also. The AC crashes and their inability to fix them and uncertainty about the company's future makes me nervous. Seeking advice and opinion from others who have moved on! Thank you!

I would at least talk to this user before taking the plunge.
I would at least talk to this user before taking the plunge.

I would at least talk to this user before taking the plunge.

We are in the midst of transition. I'll be able to give yous some good feedback soon. heritagemedicine@gmail.com

Yes keep us informed, I am getting tired of the 2-3 crashes a day and no resolution. I am in the probably practicing another 5 year mode so ? making the time/financing decision to change.

Todd,

We have tried to connect. Once I am sure others have. It looks like a few people are looking at Praxis. Rather than trying to talk to everyone one on one, it may be helpful to write your experience here. This is the AC users' forum not Amazing Charts or Harris Healthcare. After if anyone wanted to contact you for more of a one on one, that would be great.

I just think it would be helpful if you typed out your experience with Praxis.

Those docs who are ahead of me with decision making and have taken the plunge, any guidance is appreciated:
May I ask how has been your experience with Praxis?
How stable is the product? Do you think the company has a future as I am not sure where AC is heading?
Is it worth the move? I have another 10 years or to practice and have been with AC since 2005.

It's just that Todd went from Praxis to AC, so it seems his input would be valuable.

WOW!!

CLAIRIFICATION........ I just switched FROM AC(2009) to PRAXIS(2020)...... I'm 53 and will likely (financially and for the love of my craft and impacting peoples lives in the way I have been blessed to have learned) be treating people even on the day I die (if I'm that lucky)

COMPLETE TRANSPARENCY...... BOARD CERTIFIED FP specializing in Osteopathic Manipulation.... WITHOUT any financial or business links to Praxis.

AC was the bottleneck to me being able to get charts done and was costing me dearly in relation to my most precious commodity....... TIME.

Used Meditech (as a hospitalist x 10 years) , Athena (FP Multi-disciplinary practice for 10 years), AC (trying to build a private practice in Pittsfield MA and now in The Adirondacks) extensively and my ONLY REGRET SWITCHING TO Praxis is that I even had to switch. I honestly think that my life would have been infinitely easier and I can only imagine the time I might have saved had I been using praxis from the start.

Praxis has a STEEP LEARNING CURVE, ONLY BECAUSE you have to teach it how YOU practice medicine but the amazing thing is that as your practice of medicine evolves, Praxis evolves with you, ON THE FLY, making your life easier, faster and SAFER for you and your patients.

You made the time investment to become a Doctor, now make the time investment to get your time back!!!!! 100% worth it.

I am a subspecialist practicing Biodynamic Approach to CranioSacral Osteopathy and as such, my HPIs tend to dig a little deeper than some. Being able to embed selectable discreet variables into my chart has enabled me to complete an IN DEPTH, FOCUSED HPI faster than if using the templates in any other EMR even with VOICE RECOGNITION which I have not really seen a need to invest in yet as I am waiting for Praxis to transition to open cloud server access so I can use Apple's native voice recognition software which I have found to be at least as good as Dragon.

In my practice, the details can be very important....... this is a VERY simple example of the flexibility I have built into MY Praxis, that incorporates a series of tweaks that make using it even easier. This example is SIMPLE and I have many much more complicated examples that I use to collect accurate (searchable) data very quickly while TALKING to my patient, allowing me to actually have a conversation with my patient BECAUSE of the time it saves me from frantically typing while collecting important information.

Timing: [Chronic x |Acute x |Acute / Chronic x ][|1|2|3|4|5|6][|0|1|2|3|4|5|6|7|8|9] [Years|Days|Weeks|Months][| / 1| / 2| / 3| / 4| / 5| / 6| / 7| / 8| / 9][| / |0|1|2|3|4|5|6|7|8|9] [|Years|Days|Weeks|Months] [ ] [ ].


(NOT TO BE MISSED OR OVERLOOKED.......... Praxis has THE BEST AND MOST AVAILABLE SUPPORT structure I have ever experienced. PRICELESS!!!! Meditech/Athena/AC??? NOT SO MUCH!!!)



I can QUICKLY determine if their complaint is chronic, acute or acute on chronic, and for how long and be asking the NEXT question as I finish documenting this information, with just a few clicks (we're NEVER getting away form the clicks but with praxis, you accomplish much more per click than I have ever experienced in any other EMR) without missing a beat. When the new version of Praxis becomes available, I can only imagine how much easier this will all be when I can start using Apple's Voice Recognition in conjunction with Praxis's DATUM to fill in details that inevitably arise while collecting any HPI.


While working in the Hospital (Meditech) and the Multidisciplinary Group (Athena) one of my greatest fears was missing some of the most simple aspects of medicine with some of the greatest exposure, not ordering the colo, mamo, paps for patients and especially those patients with special considerations. Hell, maintenance care was literally a nightmare. I asked to have things automatically implemented into the chart, or even reminders to schedule followups for a specific group of patients and the response I got more often than not was ....... THAT WOULD BE A GREAT IDEA!!!! REALLY?????
The response I got from my trainer was, let me show you how to do that for this patient, for that patient AND for ALL PATIENTS, with FILL IN THE BLANK ..... NEVER TO BE MISSED AGAIN.

Being a sub specialist, I have but nary scratched the surface of what this program is capable of. I get to send all my patient's back to their PCPs for all tests and I don't write any scripts or orders so I would be lying to you if I started to opine on those aspects of Praxis but having practiced in FP and as a Hospitalist, I have a unique perspective to offer in that I can certainly relate how what I have seen and know about Praxis could have applied to my previous practice of medicine and how each new functionality I learn about Praxis could have impacted my practice of medicine and it makes me even more angry that I haven't been using Praxis from the beginning. This EMR has the HIGHEST Customer Satisfaction Rating for a multitude very good reasons. Is it perfect??? NO!!! In my opinion..... THE BEST that I have ever used.

If you don't EXPLORE making the switch NOW, I suspect you will regret it for a long.......TIME!!!!!


I would be more than happy to talk to any or all, separately or in conference call. I certainly wish that SOMEONE / ANYONE had recommended Praxis to me 10 years ago!!!!

That is great review. I watched Praxis Demo the other day. Looks like you have to write the code for about 50 encounters or the most commonly seen problems/ assessments and diagnoses and then the EMR takes care of the repetitive documentation. The program is very different and someone like me needs encouragement like the one above to jump the boat. Leaving a program that I have used for 16 years, and walking into an unknown territory requires a lot of courage. I will probably also have to lose the annual support cost that I just paid to AC in addition to paying for the next EMR. I have been told Midmark ECG does not work with Praxis and that also holds me back. I may not be able to use Midmark ECG or will have to purchase new software from Midmark to run ECGs, and save as PDF in Praxis. Perhaps more feedback from other docs who use Praxis or have made the switch to a different EMR may help someone like me.

Nadeem

Feel free to call me and I will be more than happy to answer any questions you may have to the best of my ability!!!

518-526-9996

Todd

Naeem,

I think you have it backwards. It's not up to you to make a decision to leave AC. I think AC has been making up our minds for us.

Will this be how it goes.....?

Thank you Todd!
Agree with Bert. The writing is on the wall. Still ambiguous. It is a big decision with consequences.

The writing is on the walls, the ceiling, the floor....hell the driveway up to the house.

Anyone try or play with MEDENT? Have a colleague who loves it. Seems similar to Praxis.

Any reviews for Athena? Expensive but good?

10 years on Athena.

I could have joined a consortium and gotten a good deal....... NOT A CHANCE IN __________

I was terrified pulling the trigger on Praxis but compared to my previous experiences on Meditech, Athena and AC........ I would NEVER go back and change my decision.

Praxis has the highest user ratings across the board. How do you pull that off against the Titans in this industry unless you truly are THAT GOOD.

PRAXIS IS THAT GOOD!!!.......... AND IT GETS BETTER EVERY TIME I USE IT!!!!

So I've hopefully got 15-20 years practice ahead of me.

~5-10 yrs hence likely to:

1) be hospital system employee (yuck) and use EPIC (mediocre but effective).
2) go concierge low volume with any emr i like
3) hire add'l provider and keep independent

In short term should I sign up for subsidized EPIC from hospital while remaining independent or go EMR shopping for the best performer?