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I thought it was based on % like a clearing house.

I've fully switched to Praxis now, and it has been an interesting ride. There are some things AC does much better and more efficiently, but the key concept of how Praxis works as an AI EMR is amazing. We've had a bumpy road switching, but the training has been great and we are starting to see the fruit of our labor! My partner just commented on his busy day yesterday of 20 patients, and went home at 4:30 with all his charting done! That's never happened under AC! I was really getting burned out before, and it was the staying until 7 or 8 with the charting that was doing it.

Do you know the day AC lost me? We were having that problem with the script writer crashing the system, and it seemed no one could solve it. AC Level 3 tech came on and wanted to "watch" it happen, as if to prove I was telling the truth. They didn't seem to have any ability to diagnose it from the logs. At some point, they decided it was a really bad problem for me, but it was affecting so few practices, that MY serious problem was not worth investing the resources on a fix. Telling that to a 10 year user was the last straw. I decided I'm not paying tech support prices for a "Guardian Angel" service that is never online and can't fix my serious problems.

Dr. Low really cares and is enthusiastic about the problem. I've had at least 2 personal meetings with the CEO for more than an hour, and he's incorporating at least 5 of my suggestions into the New Praxis. As you mentioned, it's being completely reworked and will be about 16 times faster. The cloud Praxis is already extremely fast and we are really enjoying it.

How did the data conversion from AC work? Is it (AC data) all in PDF? Large fPDF files are sometimes difficult to sift through.
I wish AC could fix the problems that have come up in the past couple of years. It appears they don't even know where the problem is.

I believe they are trying to get digital data from one person's SQL Server or MySQL or who knows, even Oracle directly into their databases. If it were just pdfs, it seems that James could quit his day job.

AC made a "shortcut" with just storing everything in "Imported Items" rather than actually in the record. This does leave you with a large number of PDF's and it's just not practical to bring all those into another EMR. Praxis uses much smaller HL7 files that get imported directly through interfaces, like from you lab company, imaging company, hospital, and so on. They work actively with vendors to provide interfaces that bring data items directly into the chart. These much small files don't hog gigabytes of space, like PDF's do. AC PDF's have no name convention that links them with a patient, they have nonsense file names, so it's no possible to have a program that brings them all into a certain patient's chart. That would have to be done manually.

So, the government has mandated years ago that EHR's output files that can be directly imported into another EHR, so that patient's can easily transfer records. AC has always had the verbage that they are compliant with these government mandates, but AC has not set themselves up to be compatible with others, and no one really wants to, despite being mandated by the government to have exported EMR files that can be imported into other EMR's. When you export the files from AC, they actually are not compatible when tested with the government test website. The files are unreadable by other EHR's.

Boondoc, thanks for reporting back to us. The information is valuable and much appreciated.

Can you describe more specifically what it is that allows your partner to get notes done so much more quickly and efficiently?

When you say "There are some things AC does much better and more efficiently"... can you tell us more specifically what we will be giving up?

Praxis must still allow you to import items that are not brought in via an interface, right? How does that work?

Oh boy, it been ages since I have been on this site. I have been a very early user for my wife's practice (2006 ?) with AC. Again I am that software guy married to a nephrologist. The early days of AC, that time I used to work with Bert and Dr Jon and few folks in modifications, and I wrote some of my own scripts to import labs and do some other queries to mssql(considering I used to work in the MS SQL server team)

Life has moved on, I have become busy and dont have much focus on the IT needs for practice. They are now 5 physicians and support staff. I do manage the on prem system with remote access, but always count on my days when something goes down.

The Guardian angel support is just fleecing of money. I have never got a single decent answer from them.

I am coming to a point where I feel its time to move to a new EMR, and wanted to see what people have been considering. We anyway spend almost $15K a year on AC(for 4 physicians) , so maybe another 10K will get us something like eclinical works or something that is much easy to work with, cloud based and I dont have to worry about manage and maintain.

Has anyone worked with EPIC Community connect. My wife's practice is associated with couple of hospital systems and they use EPIC.

anyone with ideas offers ..

Can I use dragon on Praxis? I do not like typing.

Thanks,

Praxis EMR works seamlessly with all voice recognition software solutions. Although there are several options to choose from, we recommend the best solution available to our customers.

The best voice recognition software in the market today is Dragon® NaturallySpeaking® Medical Edition.

Dragon Medical is currently the most successful and widely used voice recognition solution in the industry. It is used by over 70,000 clinicians in the US today to document care, directly in an EMR, in Microsoft Word, or in other clinical software.

With the aim to provide our customers the best service and product experience, Praxis EMR has teamed up with 1450 Inc., the world’s largest Dragon Medical distributors.

Through this partnership, Praxis EMR customers are able to purchase and use Dragon NaturallySpeaking Medical in the most efficient and cost-effective way possible.

Praxis customers will be provided:

Discounted Pricing
Outstanding Maintenance and Support
Excellent Dragon Reseller Expertise
Subscription to Medical Content Macros

If you have any questions about choosing or using voice recognition software, please feel free to contact our customer support team via Live Support.

Just a little more input supporting Praxis.....

STILL my contention that if you don't take a VERY CLOSE look at Praxis....... at some point in the not too distant future...... you will wish you had!!!!

http://www.americanehr.com/ratings/ehr_ratings/ehr-top-10-ratings.aspx

Dr. Low is a HUGE reason that I made the transition.

He has more integrity in his toe-nail clippings than any other EHR Exec I have EVER talked to, Physician or not. I too have had multiple conversations with him and he is also incorporating a multitude of suggestions I have made to better support manual medicine practices into the C# version of Praxis which will be infinitely faster with a breadth of new possibilities that will eliminate a host of limitations that the old platform had imposed on their programmers.

Furthermore, Dr. Low has already turned down a plethora of offers to purchase Praxis from Big Business including Big Pharma and Silicon Valley BECAUSE..... he wants Praxis to be his LEGACY to medicine, KNOWING that Praxis has the capacity to COMPLETELY CHANGE medicine for the practitioners, returning their most precious commodity.....TIME, all while providing a much better experience receiving a superior quality of medicine for the patients.

If you don't give Praxis a SERIOUS LOOK right now...... YOU WILL WISH YOU HAD!!!!

I have been waiting to upload all of the PDF files that James was able to convert from AC into PDF format because… One of my last conversations with Dr. Lowe was that they were working on a document management system that would not only facilitate uploading documents of all formats into Praxis but, a management system that would also be able to automatically suggest both patient and folder placement for each document based on the contents of the document being uploaded.

This is just one example of the flexibility that converting Praxis to the new C# ( C - Sharp ) platform will allow their programmers to incorporate into the program. Can you even imagine a document being scanned into a PDF or other format where you had an option to simply approve the patient and folder that that document was going to be stored in and affiliated with instead of having to place that document into a specific folder for a specific patient by searching the patient and then finding the folder?

Praxis is also investigating the possibility of creating a system where praxis will be constantly monitoring your input to a note and making suggestions on the fly for which physical exam you want to use, which diagnoses you want to use, PRESENTED IN..... hierarchical presentation to ensure that you get the highest billing code possible, medication's that you, your colleagues and or everyone using Praxis uses to treat a specific diagnosis and a plan of management all based on the entry that you are working on at the level of the HPI. Can you imagine entering an HPI for a patient and having an EHR making recommendations for all of these things on the fly and having them incorporated into your note with the click of a mouse?

As far as my work with Dr. Low, trying to better incorporate changes to the program that would facilitate manual medicine practices, we have been discussing the possibility that while Praxis is monitoring the creation of a new note that praxis could also offer options for the incorporation of anatomical structures into your note based on the patient's chief complaint and HPI and previous notes. I'm not sure about you but I don't have a list of all anatomical structures at the tip of my tongue and to have my EHR offering recommendations that would jog my memory while in the middle of developing a progress note, OMG!!

ALL OF THIS CONTROLLED BY THE PROVIDER...... if you don't like it... you can turn it off.

THIS EHR IS ( already insane but ....... ) IS GOING TO BE I N S A N E !!!!!!!

JUST ONE MORE THOUGHT.........

How many of you have made suggestions to the FOUNDING AND DEVELOPING CEO of your EHR that he promises will be incorporated into the platform updated iteration of your EHR upon release because he is willing to listen and learn from the users of his program????

Is THAT not one of the most AMAZING things EVER????

A physician Developer / CEO who encourages suggestions, challenges you to explain to him why your suggestion should be incorporated and when you successfully plead your case, PROMISES to incorporate your suggestion ALL WITH THE GOAL of making his EHR BETTER so that your practice of medicine is BETTER from a Quality and Efficiency of care perspective AND.....AND ....... A N D...... gives you back your most precious commodity ....... TIME????

THE WRITING IS ON THE WALL !!!!!!

All the future plans and promises about Praxis sounds great.
When they become reality, I would love to hear about them.

Right now I would like to hear very specifically what is good about the program, as it exists now.

There are many software programs which are able to bring up past workups and suggestions at every stage of the note based on previous entry. I trained on Praxis for over a month, and the AI throughout the program is impressive. There are many software programs which listen to their users and incorporate their suggestions. I will admit that this isn't the strength of AC (it was much greater during the Jon B days).

I think AC could do a much better job incorporating ideas from users into their software especially not based on numbers but acuity of the suggestions. But one of the tradeoffs is the cost. The cost has increased enough that more of this should be done, but we are behind the curve.

I will not argue that after a steep learning curve Praxis can be amazing. But from my research on it; it is still a niche program. It benefits mostly from word of mouth such as Snow's and very little advertising. When looking at other EMRs recently, I was talking to a physician using Athena, and he belongs to a city-wide group of physicians working together to help with healthcare in that specific area. There are about 15 physician practices from 2 physician groups to 25, and none of them use Praxis. It is more of a rather great EMR that has a niche following.

Just three more cents.

Jon

You really need to do your own research on this one.......
Praxis, IN IT'S CURRENT ITERATION, is the BEST EHR I have ever used or seen. Once on the C# Platform, it will be I N S A N E !!!

I used Athena for 10 years and the only "SUGGESTION" I got from Athena was that I should be looking for a different EMR because EVERY request I made to Program Support was lauded as a great idea they had no plans on implementing in the foreseeable future. AC never suggested ANYTHING. CERBO never suggested ANYTHING. AND none of them suggested which folder in which patients chart I might want to consider filing a supporting document for a patient BASED ON THE CONTENT of the supporting document and not from information transmitted from the sending entity.

PRAXIS .....ALREADY helps providers to provide better quality healthcare, more efficiently and easier and as Boondoc noted, has returned to himself and his partners their most precious commodity ...... TIME.

ALL I'M SAYING IS...... COMPLETELY VET THIS EHR NOW or you will wish you had.

Niche EHR or not..... PRAXIS is light years better than one of THE MOST POPULAR programs currently available and you couldn't pay me to use ATHENA ever again.

I wonder why Athena has been sending so many offers to Dr Low to buy Praxis????

THEY KNOW IT'S NOT JUST A NICHE EHR!!!!

ANY TIME if you really want to talk about this EHR
518-526-9996
BUT ...... I would suggest you schedule a tour of the EHR yourself.

So, I remember from experience 18 years ago, having a trainer and working with her a few days each week for about two weeks. The recommendation of where to start the note was a little different.

I can't remember how we got a trainer prior to making the purchase. I don't mean watching a demo. I mean someone already commited to helping us learn the program and to that point we had not paid anything.

Is it still the same. And, let's say you are interested in the program, do they give you a sandbox to play in to see how the workflow goes?

Bert

I'm not sure.

When I saw that I could insert discreet selectable variables throughout the note that could be searched.....

When I saw that the construction of each note is built layer by layer that can be placed on the note or removed from the note layer by layer.....

When I saw what the current iteration of "Agents" was capable of as far as creating reminders or alarms for not only future notes but also applicable to closed notes.....

When I saw the power of his search protocols and after watching Dr. Low literally search EVERYTHING we challenged him to search.....

I dove in head first.

Not only because of what I saw but a huge part of my decision was based on my discussions with Dr. Low and the INTEGRITY he presented with throughout those discussions and continues to display.

I also saw Praxis as an EXTREMELY POWERFUL tool to accomplish ambulatory evidentiary outcome based research which my specialty sorely needs..... to be able to show Pediatricians across the country why the FIRST REFERRAL for latching issues, sleeping issues, colic, recurrent ear infections, respiratory issues, reflux, recurrent UTIs, developmental delays, learning disorders, seizures AND MORE need to be to a qualified Traditional Osteopath who practices 100% Osteopathic Manipulation, BEFORE being referred anywhere else, ESPECIALLY for myringotomies. ALL of which are difficult to construct research studies to validate or even collect and parse enough ambulatory data to meet standards of, even outcome based research.

When I say that this EHR is going to change medicine.... I honestly believe that!!!!!

ALL while making our lives medico-legally safer, ensuring that we are practicing the best, EVOLVING, medicine we can all practice and giving us back our most precious commodity........


I would contact them and ask.

I have to admit that taking into account the complexity and flexibility of this program this is not really something you can take to a sandbox and play with without direct supervision. It's kind of like learning how to drive in a Bugatti Chiron. This program is so incredibly flexible and in that vein very very complex and even if you have to go back for multiple tours and ask Dr. Low to slow down to help you understand, THIS EHR IS WORTH EVERY SECOND OF TIME YOU WILL SPEND INVESTIGATING IT.

Still available if anyone wants to speak to me


518-526-9996