Home Forums Discussions General Discussion Alternate EMRS

As I think about it, although I have looked at some others; I think using an EMR like Praxis, once you've mastered it would make medicine exciting.

I use Athena at a charity clinic and get a lot of notes from specialists who use it. Athena has built in order sets and it stamps those in to every note. They want to take over the billing and keep a percentage of revenue. If my calculations were correct, that ends up being 10-15k a month. Or you pay $600/provider per month.
Used Epic about 15 years ago. Very nice program (at that time called Hyperspace) and uses smart phrases to document. I don't knw how much it costs.
I am asking for reassurance, how many people think AC may be able to fix the problems and stay in business?

Able to??? 100%

Care to???? Haven't seen any evidence that they care to!!! AC did not change significantly from 2011 when I closed my office in Pittsfield to when I paid to have my files updated and started another account in 2019.
I should have know at that moment but........

Currently using Open Practice Management and paying a biller 7% for everything paid. Works very well.


Praxis gives me time and I no longer see my practice as an anchor that eats up all of my free time. PLUS, the quality of documentation and the actual quality of medicine that I am able to provide improves with each encounter. Athena never ever even came close to being able to do that, especially not without having so contact the practices super user or support.

1333


I know what Naeem meant when he said 'code.' But, you aren't really changing the code, correct? Of course, I could be wrong.

We talked about this prior. That is setting up your own "fake" charts to have something to go by." If that is still true (vs using theirs), Naeem really gets it.

Praxis has some unique terminology!! Instead of "Template", they use Assessment but.........

Even the assessments are a template of sorts but in reality, a super-template that can hold embedded discreet variables and offer INFINITELY more FLEXIBILITY than ANY template that I have used. Bert is referring to being able to edit your "Assessments" on the fly IN THE NOTE or step outside the note to edit it in a "VIRTUAL NOTE" which can be really convenient for different reasons.

As far as the order sets you use in Athena...... The way you can set order sets in Praxis is far superior in my opinion.


Todd

Thanks for helping out Todd.

NP

I wish someone had steered my to Praxis....... If for NOTHING other than to at least do an in-depth evaluation to determine if it was going to fit my need.

I can only imagine how things might have been different!!!

Offers STILL stands......

More than happy to answer any and all questions I can answer.

518-526-9996

Thank you very much Todd!
Before signing up for Praxis, I learned that they don't have Midmark ECG interface. That will require purchase of software from Midmark. In addition, I just paid AC for two physicians and am being told that whatever I paid (more than 3k) may not be refundable. I am a bit stuck. Reached out to managers at AC and they are looking in to at least providing with a more stable Beta 11 AC. Will wait until summer to decide.

Why world you want to continue with a company that won't reimburse you for two physicians.

Couldn't get much worse. Oh wait. I think paying for a nurse practitioner from last October until this October is pretty bad. Wait that isn't bad. Oh wait. She quit last March..

Just remember Naaem. Quote from a billing office to me: Do you know how much it costs to run a business?

I guess i don't. Can anyone tell me.

Damn my yearly fee comes up in March probably gonna get stuck paying the yearly 'maint' fee as I figure out what to do about EMRS for the backend of my career. I've got 1/2 a mind just to do eRx and paper charts/pdf documents until I figure it out.

I'm not quire sure what you mean. I think the eRX is tied to the maintenance fee. You can still use AC without paying the maintenance fee, you probably won't have a portal either, although I know that's another add on fee.

Aren't there some companies like Allscripts where you can do eRx directly?

I used independent ERx service many years ago. It was a pain entering patient demographics.
Currently I am working on getting new software from Midmark so that I can run ECGs independent of AC. I agree with above comments about true cost of running a practice. The hours one has to put in to keep it running and have to worry about all the equipment, supplies, PPE, billing, EMR in addition to taking care of patients is "a lot". I was telling a medical student hopeful that if you want to be a doctor, go in for the passion to heal and help and not for the $. There are a lot of easier ways to make more!

Y'all need to do a Praxis Demo!!!

The update is done and it will take them until August or September to migrate all data and make sure all the bugs are worked out but when this update comes out.....

I think providers be SCRAMBLIN' to get onto the Praxis train!!!

It literally stands to REVOLUTIONIZE the practice of medicine!!


JMHO

To play devil's advocate, I did a real trial/demo 17 years ago. I tried it (no EMR prior), because I was fascinated by it. It was the same concept then. Now obviously it is a very similar or same concept now, only much better. However, it wasn't changing medicine then. Why now.

And why are they so different and cool, get great scores, yet when people talk EMRs, they talk about Athena and eMDs and eClinicalWorks, EPIC, etc. You never hear (except now) about Praxis.

Now, I just say this. I am interested in Praxis. But, wondering on some of the above.

IDK

When I chose AC, I had done a significant amount of research and NEVER heard anything about Praxis. I was pretty proud of myself having even found AC. THIS TIME, I had already decided on two other EMRs before ever hearing ANYTHING about Praxis. The only reason I didn't choose the other two (Jane / CERBO) was because they hadn't been certified by CMS yet. Both were very similar template based EMRs but much more refined than AC with a LOT more enthusiasm about advancing their respective platforms.

I know Praxis is not perfect. I also KNOW that no EMR will be perfect but...... They have a mission and they literally have plans to change the practice of medicine and I am having trouble seeing how they can't accomplish their goal.

The people in the KNOW have been saying for years that TESLA was going to collapse on itself and implode like a dwarf star but....... others didn't so much have faith in TESLA as they had faith in Elon and they could see the map that he was creating and they had a good idea that he was going to follow that map to fruition. They stuck with him even when ALL of Wallstreet was telling people to dump TESLA stock and now who's laughing.

I broke my crystal ball last summer so I would never proclaim to have knowledge of the future, at least not without it but, I'm stickin' by Praxis and Richard Low, partly because I see the possibilities born out of the flexibility of what he has created but also simply because I have never met someone so compelled to not only impact the lives of patients but the whole of what has become a broken skeleton of a profession where providers have lost sight of what it REALLY means to be a PHYSICIAN because today, our profession REQUIRES all of your attention just to keep you head above water.

I see the possibilities with Praxis. I see what can be. I am confident that Richard Low, M.D. is committed to seeing his creation impact our profession maximally and I believe he will not stop until that happens.

I bought a Model Y in December. Is it because the fit and finish is second to none? Is it because the car is track ready? Is it because it's negative impact on the environment is a perfect NET ZERO, OR could it be that I have bought into what Elon Musk is doing and I can see that he has a vision and that I want to be part of THAT???

I can assure you that I would have thought a little harder if Elon had not been at the helm, even with all of his antics!!!!!

I may regret my decision to go ALL IN with Richard Low and Praxis but ....... I SERIOUSLY DOUBT IT!!!!! I choose not to get caught up in what others are saying about other EMRs and because I know that Docs are guilty of throwing the baby out with the bathwater if they think it will make it even the slightest bit easier on them RIGHT NOW because we are STARVED for our most precious commodity, TIME. I also know that Docs tend not to see the big picture or play the long game. That Model Y is my garage because I'm playing the long game. Praxis is my EMR because I'm playing the TIME SAVING, PATIENT ADVOCATING, PROGRESSIVELY IMPROVING QUALITY OF MEDICINE, MEDICO-LEGALLY SAFER long game. I'm all in. How many, talking about other EMRs, feel that way about their EMR???

There's a reason Praxis is rated as highly as it is AND IT'S ONLY GOING TO GET BETTER!!!!

Wow! Now Jon has competition as to the best writer on the board. Very powerful testimonial. Thank you.

Hi everyone,

Any updates? Any reports on experience with other EMRs?

Thanks.

Gene

AC is still working on fixing the bugs in V11. No release date.

Does anyone have experience with Athena?

I volunteer at a charity clinic and they use it. When i look at the notes from doctors who use it, all the notes look the same.
It costs $600/month per provider for the basic version. They prefer that they take over the billing and keep a percentage (I think 10%) of the revenue.

Athena tried to purchase Praxis from Dr. Low and he turned them down. They know he has a superior product and as soon as he starts getting the word out and practitioners start using Praxis in greater numbers that they will either be in BIG TROUBLE or they will have to do a complete re-write of their entire platform just in order to remain competitive!!

I currently pay less than $300/month with unlimited ACCESSIBLE support and that is for the initial provider. They currently charge subsequent providers $250-ish but their entire cost structure will be changing soon because these are purchase prices. In 5 years... Praxis is mine and I will only have to pay for any support I need.

Purchase Price: $10 000 - ish
Subsequent Providers: $5 000 - ish
Monthly support: $100


HURRY UP and take a look at this program because I'm not sure how much longer or even if they are still SELLING the program. Likely to become a monthly fee model.


AND...... I remain BLOWN AWAY at the flexibility and power of this EMR. The learning curve is steep but they are actively addressing that to make learning process significantly easier.

This program is already making me a better doctor, protecting me medico legally, and paying me back in my most precious commodity........ TIME.

I wouldn't use ATHENA if they paid me to use it!!!! (Having ALREADY used it for 8 years)

Hi Snow,

Thanks again for your helping with this thread. And, I am jealous you are in the Adirondacks, but Maine is not too bad.

Also thank you for your personal time with your emails.

I do want to call you out on one thing or at least ask a question. You mention that when Richard Lowe gets the word out....

I remember trialing Praxis 15 years ago. It was revolutionary. I liked it a lot -- just a few reasons including my partner not wanting to go in that direction which led me to not pursue it.

I believe it has much improved since then. But, it was a good product then. So, I guess my question given that was 15 years ago, when is Richard going to get the word out and how.

Just curious. I want him to be successful and get the word out.

At this point, I am not sure if it is a question as to whether they can fix the problems or if they even want to. AC development under Chris has always proved itself capable when it came to updates/upgrades and fixes. But, I haven't seen much coming down the road.

Bert

Programming languages have changed significantly since Praxis was first developed and because of the complexity of the program which gives it it's flexibility and range of function, Praxis was likely pushing the language and computers to their functional limits at the time that it was initially being developed. The whole program is being converted to C# and once that conversion is completed, Dr. Lowe will finally be able to show what an unbridled Praxis is truly capable of. You'll want to be on that bus!!!

I've been around for a few minutes. I have NEVER seen ANY EMR do what Praxis is capable of, so effortlessly. As often as I was told me by other tech support of other EMRs, "that's a good idea, maybe we can incorporate that", "I can see how that might be really helpful but it's not on the radar for right now", "Why would you want to do that", "Yes, you have to do all this to be able to do this".........

is as frequently as I have been told by Praxis Support, "Let me show you how to do that"!!!!!

Bert......

Once this thing catches, IT'S GOING TO EXPLODE, and I for one plan to help as much as I can because THIS EMR actually keeps all of the promises we were told about EMRs when we were all forced to adopt them.

This EMR will change that practice of Medicine. (PERIOD)

MY HUMBLE OPINION



Todd

Thanks Todd,

I was being critical, just wondering.

In the process of looking at alternatives to AC since no AC updates and their "cloud" version is nothing more than remote desktop. The buyout looks like it is going swimmingly well; all they seem to be doing is milking the existing users. Anyway on the hunt to replace AC. Demo'd Praxis. Having run a custom software house at the C level, intrigued. Looked great but then when I asked if it could generate a Form 1500 or HICF, they had no idea what I was talking about. Threw up red flags since they are very focused, but to narrowly focused. Once explained, "oh just get this third party biller involved". Sorry but I am a fee for service practice. All I need from a piece of software is to generate a claim so I can hand out to patients to file. I will not be submitting claims or hunting for insurance to pay. So not looking for robust billing, but for the price of admission for Praxis I do expect them to at least generate a claim or even know what a claim is. Everyone has their specific issues and hot buttons. Ours seem to be meet with ChARM, but will see. Still trying to get my head above water to pull the trigger so still open to suggestions.

I recently had to update to AC 10.2.0 and what a nightmare. The program crashes whenever I forward a chart and log out "too quickly". Deleted charts remain in the inbox folder. Most of the annoying quirks of the program still remain to annoy me. Additionally, my office computer cannot print orders because of an issue with Crystal Reports. I finally got through to support and asked if they could fix it, but they could not get Crystal Reports to re-install properly. They gave up and said to have my IT person look into it... My practice is going to be consolidating with 4 other ophthalmology practices in the area and most of them are using Medent. The consensus was that we all will use the same EMR. I demo'd the program and am comfortable with it's capabilities and user interface. It is light years ahead of AC. It will be nice to have an established PM/EMR system in the office that will be able to easily communicate with the fellow group practices in the area. For me, Amazing Charts days are numbered. I ,for one, am not sad to see it go.

Do most of you think AC days are numbered? I am very ambivalent. Have been looking at alternatives but have not been able to make up mind. Looked at Praxis. Small company, very similar to what AC was before being sold to Pri-Med. I am afraid they may be swallowed up or unable to keep up also.
Any other EMR suggestions?

I know that Praxis has been around for at least 17 years. I think the reason Praxis will survive and users will like it (once past the learning curve) is that Robert Lowe, the President and CEO is like Jonathan Bertman. I doubt he would sell. He likes his product way too much. He likes it because he built it.

Harris Healthcare brags about its acquisitions and its ability to acquire businesses. But, the funny thing is, practices are paying for the annual support daily. Would Harris Healthcare have to stop taking that once they realized they were going to let AC go or just be prepared to reimburse everyone. Or is there a clause that says you forfeit your support contract if we quit. The bottom line is they seem to have given up on Chris doing more developing. But, the bottom line is does AC make money or not. Maybe they seem to need an EMR company in their portfolio. It is quite large for a midsize company.

I started using Beta V11 in April of last year. The reason was AC crashes while writing scripts. Since then I am not sure if I should have installed it. We have dozens of crashes every day (among 7 office users). They cannot tell me when the bugs will be fixed. Moving on with 13000 charts and 16 years of practice data is a big deal. It has been a long and painful experience and don't see a way out.

There is always a way out, especially given AC seems to have no intention of fixing the bugs or upgrading to the release of v11.

You do have a lot of charts. But, moving one chart is just as difficult as 13,000 I would think. Does AC want to help you move those charts? Nooooo.

Do any of the new EMRs you are considering want to? Yessssssssssssss. In fact, my guess is they have a whole department just for that. It is hard to sell you an EMR if they say, "well we can't do anything with that data."

Which is worse? Going through the decision to move all your data or putting up with dozens of crashes per day. Every crash is frustrating. Every chart being moved is positive. You can choose when to do that. You can't choose when not to.

Question: If you are considering changing and you need to buy some time is going to the cloud worth it?

There are also a lot of good SQL people out there.

This is all very depressing.
There is a glimmer of hope on the horizon. I think we can expect that V11 will be released soon - in fact it must be released before 9/1/21 since that is the new date for implementation of the eRx changes. Obviously, we must have it a few months in advance to enable everyone who chooses to upgrade to do so.

Maybe this last year of silence indicates that AC is working on some improvements that go beyond the regulatory requirements...

They are working on the new ERx requirements but the version 11 that I have has a lot of bugs. Random crashes for all the office staff being the most bothersome. I have not seen any major improvements.

It's the lack of communication that is deafening. Maybe they don't like our forum anymore.

The other thing is like the post above. You don't like Dish Network, you can switch to Direct TV with one phone call. EMR companies make it much more difficult (not necessarily on purpose) to switch to another company.

Isn't there a way of exporting AC charts to a standard database which then can be imported (mapped) into other EMRs? I thought AC provided a utility for that purpose. Perhaps 13,000 charts, though......

Sometimes, one wonders about just having the AC for a database of charts and starting over.

I look at it this way:

If AC was on its way out, AC may just keep it on the download so as to make plans how best to sell it, etc.

But, if they were wanting to stay the owners and improve AC, one would think they would be all over the board talking about that or sending emails. I find it interesting that it is more like the first sentence.

This board has always had a somewhat complicated relationship with AC management. Not necessarily a good or bad relationship, but I think the owners going all the way back to Jon Bertman were a little unsure how to handle us.

Harris has clearly made the decision that they want little to do with this board, for whatever reason.

Obviously I do not agree with that decision (nor do I like their decision to be so stingy with communication in general) but I do not think it necessarily reflects on their short or long-term plans for the EMR.

That's a very good post and when put like that makes a lot of sense. Agreed to the fact that their not being on the board much likely contributes little to their overall plans.

But, forgetting the board, I do think their short-term plans are to lose customers, as I am sure this thread represents about 0.1% of their total clientele. They don't need to communicate to us, but they should be communicating to us some way.

Hell, I remember when John Squire and Charlie and the Chris's, et. al. met every month with the Clinical Advisory Board. No matter what the meeting was about, everyone came back to the board and spread the word that AC was going nowhere. Well, they did go to Harris, but you get the drift.

But, not arguing with your post. Very well put.