CALLING ALL DOCTORS! EMR Software Opinions Wanted

This is a SHOUT OUT to all doctors who use EMRs. Which EMRs do you use and how do you like them. Do you love them or hate them? Are you luke warm in your like or dislike? Tell us which EMR you have and how you feel about it. Also tell us what you would do (the mistakes and the good moves) if you were looking into getting an EMR at this time.

I have personally looked at Greenway PrimeSuite, SOAPware, SRSsoft, e-MDs, AmazingCharts, NextGen, Centricity and others.

Can you comment on the cost and the usability?. Let’s share information so we can help other doctors choose systems that are usable, simple to learn, effective and efficient.

If you don’t have an EMR and are looking into one, what questions would you have for those “who have gone before you”? What advice would you be interested in receiving?

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Dr. Jeff

33 Comments

  • We are one of around 30 clinics owned by Heartland Health, a regional medical center located in St. Joseph, MO (50 miles north of Kansas City).
    The hospital and all the clinics share a single EMR, Cerner’s Millennium application with the primary physician and nursing front end called PowerChart.
    Our clinic has aggressively used this application and is currently paper chartless and about as paperless as can be in this day and age.
    All of the providers and nurses use the same suite of tools at the point of care in the exam room and in general are satisfied with the capabilities and especially the seamless data sharing. Of course, each one of us has their own complaints and most of these are centered on policies and procedures that were encoded into the “build” of the application to accomodate both inpatient, ambulatory and departmental use of the system. While the system is quite flexible (allowing for multiple ways of clinical documentation) there’s no one workflow that can meet all of the needs of 180 physicians and 500 nurses interacting with patients in various venues of care.
    Patients can access a significant portion of their charts through a web portal but we haven’t initiated the virtual or e-visits yet (to come soon).
    It should be said that the most satisfied “users” are the patients.

  • I use and love OpenEMR. I would not use an EMR that can not be modified on the spot for my needs. I don’t want to be a hostage of an EMR company and it’s developers. If you buy a commercial EMR, make sure you can get all your data out in a usable format if you decide to switch.

  • I have Greenway PrimeSuite and it is very good. Has all the bells and whistles. Great functionality and flexibility. It is a template driven system with drop down menus. What I like is that you can create and change the templates on your own. It is fun to program! They are also well connected with CCHIT and other important organizations.

  • I am one of 8 pediatricians in a busy practice in Idaho. We have been using ChartConnect for about a month. It is a poorly thought out program with significant limitations. The interface is archaic and feels like software out of the 80’s. Getting useful data in the system is cumbersome and extremely time consuming. Multiple clicks are required to do even simple tasks, and it significantly slows the workflow by not allowing more than one person to be in a patient chart at a time. Creating a problem list for a pediatric patient with any health issues is almost impossible because ICD-9 codes have to be used for each problem. The challenge is that ICD-9 is not pediatric friendly, and it communicates billing information, not clinically significant information. Try describing, with ICD-9 alone, a patient who has a specific deletion syndrome with an unbalanced AV canal and residual MR after repair, who also has chronic lung disease secondary to recurrent aspiration and prominent oral aversion requiring a gastrostomy. Oh, and don’t forget the mild renal failure from recurrent UTI and high pressure nephropathy. Even simple patients require more information than just the terms used in ICD-9. Additionally, several of our nurses have accidentally refilled the wrong medicine because one must click from a list of alphabetically ordered medications rather than use their brain to say or write down what they want. If this is the state of all EMR, we are taking a serious step backwards.

  • Dave,
    Thanks for sharing your story. Sadly, I’ve heard a number of pediatricians tell similar stories. However, I don’t think this type of situation is true for all EMR software (thankfully). I wonder how your current EMR vendor would have responded to the question you posed here during a demo. That would have been insightful. Plus, they probably wouldn’t have known about the EMR needs of pediatrics well enough to answer properly.

    I can say that it’s not the state of all EMR, but sadly it is the state of many.

  • Misys EMR is what we have been using for over 2 years and have kept up with all the current updates. We began with 8 providers and now have only one. The cost is over the top for only one provider and the plan is to stay with only one. I am currently working with support to find an affordable option within Misys/Allscripts. This project has been my baby since its inception and don’t want to give it up.
    On the user end the physicians have found it difficult to work with, as it is a bit step heavy. I come from the user end as a nurse and trainer for the physicians as well as the developer of all the customization of templates and applications. Just as George said of Greenway, this application is fun to learn and develop. I have yet to use or realize all of the functions available. I have learned hardware maintenence, networking and software during this process. The customer support that I have gotten during this process has been a positive experience.

  • I use to work at a community health center and they chose Centricity by GE. It was okay, had some features I liked and some that I didn’t. I then worked somewhere else for 2 years that was on paper and I missed electronic charting. Now I have my own practice and picked AI Med by Acrendo. It’s okay but you have to do a lot of building yourself, it’s not ” out of the box” friedly. supposedly the new version available in December will be better. I didn’t realize this when I bought it but only the names of the medications were in the database. Not the dosage forms, I have to put that in. the conncetion to Surescripts is not available yeet so I cannot check interactions. The software has the ability to track health maintenence things, after I put it in. It had ICD-9 codes but you have to know the code. You cannot tyoe in the name of the diagnosis and the code pops up. You can look for a code but you have to go to another screen to do this and leave the note you are charting in. This was not apparent during the demmo. I am now looking for another system, something I can’t really afford to do because I have a new practice, but I can’t afford not to do this.

  • Check out AmazingCharts, XLEMR and SOAPware.
    These are very affordable, I think.
    I like SOAPware the best.
    AmazingCharts is very inexpensive

  • As I read the posts, I notice one or two items that jut do not add up.
    I understand the Dr who thinks writing code is fun but, if I were his patient I would like to think he was thinking about me and not about how to alter a template that should have been intuitive enough in the first place.
    Also as a provider I think it should be pointed out that by scanning your paper records with an outsourced provider is not only the most fiscally responsible method to achieve compliance, but it reduces your liability overall.
    I also do not believe a Dr should have to worry about ram requirements. By outsourcing, you leave the worries of equipment to the provider, while you are focused on being a doctor. (notice a pattern here?)
    I my humble opinion anything that takes away from you being a doctor and focusing on the patient is in some form will have a negative impact.
    Just like self diagnosis isn’t a recommended in a medical practice,
    I would recommend you keep using what worked for years paper BUT have it scanned to be compliance by a qualified imaging company. Preferably one like Media Spiders that owns its own software that has not large start up costs no upgrade fees and “tribute” to the large software overlords. Best of all its completely customizable as your needs and the legislation changes.

    Am I the only one who see the benefit?

  • If your records are only on paper, suppose a drug is recalled and you want to contact all patients in your practice on that drug right away? How do you find them? Just one example of a benefit of an EMR. Management of patient data with the best technology available is very good practice. Patients appreciate it when their health care providers can spend more time with them and less time “charting”. That being said, current EMRs are primitive and still have a long way to go.

  • We encountered that exact issue with the the practices we work with. It is important to choose software that is flexible enough to change as your needs do. We added an address book module for the doctors that wanted it. It even has direct plug ins for word so they can query up patients with a particular diagnosis and send reminder postcards for flu shots etc…
    This flexibility is also extremely important as legislative requirements change.

  • When everyone talks about an emr being good or bad could you please put costs into perspective?

    I have an EMR that I absolutely love, called Intellegent Medical Systems (IMS) from Suitemed. It is great for my two provider Internal Medicine practice. We have always provided great service to our patients (time to be actually seen, advice that is given and understandable, call backs on results…) but the system has made it even more organized with the reminder system and the scheduling and in-office features.

    The cost was pretty good (I was looking at getting Eclinical works but thought the monthly and yearly charges were excessive, I stumbled upon this EMR by accident and am I glad). Eclinical is the leader in the NY area but IMS meets it feature for feature and has much better charting features. The kicker is that it is also less expensive, the software based upon your configuration will run you between 14,000 and 20,000 for the software and training. The monthly costs are much less than eclinicals.

    Everyone should also realize that when implementing any EMR system you are not going to be able to see as many patients as you normally would in the same amount of time. It takes a while for you to get used to working and CHARTING (This is where the most time is spent) and customizing the EMR to your practice. It took us 3 months to start seeing the normal amount of patients (we were seing 35-40 a day and then we dipped down to 24 and now are back to 40).

    Hope that helps.

    PP

  • I cant speak for anyone other than Media Spiders, but If PP had just stuck with the paper and had it converted. He/she would have experieced no drop off (A great observation by the way) no extra time being spent to re learn and re organize.
    Media Spiders Costs are as follows :

    .06 per age to scan.
    for up to 8 person access $89.00 per month.
    This includes 24/7 multi-level access from anywhere with web access
    Redundant back up on enterprise level servers
    A back up of all records on a provided flash drive you can carry on your keychain-Plug it in and it works just like your online system.
    And the ability to have your system completely customized to your needs.
    We have systems in place that Doctors use the valuable internet presence to inform patients, New Patients can go online and fill out the new patient registration form etc…
    It only makes sense to run your practice in a manner that you are comfortable with. With Media Spiders you choose how much you want to change and when it’s right for your practice.

    If you do the math, you can scan 10,000 pages of patient records and your first moth of access for $689.00 . After the backlog of old records is complete the scanning going forward will be minimal.

  • We have E-MDs and I hate it! We have had multiple issues with bugs in the system. E-MDs doesn’t get back to me in a timely fashion and doesn’t seem to have any concerns for fixing the problems I’ve complained about. For example, we did an update in March and now cannot use our reporting system to pull patients by ICD-9 or CPT codes. Makes it very difficult if you are trying to see which diabetic patients want to come to a group session or see how many patients have sleep apnea and could be helped by our office purchasing a new piece of equipment. Like I said, that update was in March. No fix yet. We did an update over a month ago that has screwed up our accounts receivable report. Instead of just showing balances due, it shows every claim we’ve ever had. The report is almost 500 pages and will not group the balances together so I can’t just print a few pages. The report itself it so large for our printer so I can’t even print it. We have been having problems with our DSHS claims for MONTHS. We haven’t been able to send to them electronically in over a year. Washington State DSHS came out with new requirements about needing certain information in certain loops. E-MDs told me they got everything correctly entered in February. Not so. And everytime I show them what DSHS needs (directly from a page I printed off of DSHS’s website) they say its very odd that DSHS wants this information in those loops and that they don’t think they can do that. Don’t they have any other clients in the state of Washington? This is nuts. I have other reports that return false information and E-MDs has done nothing. Please don’t make the mistake of signing up with them.

  • I have to say the best EMR has to be software eplatinumMD. I have compared and shopped around and they really amazing. I love that the program can be modified and personalized for any office and they have free upgrades. My contact Elaine was amazing! Since she was a previous biller and OM she knew exactly what my office needed. I have to suggest her. I honestly have to say it was the easiest software to implement.

  • Lani Js,
    Thanks for sharing, but are there any things about the software that you don’t like or wish they’d improve? Otherwise, it kind of discounts any review that you do since EVERY EMR software out there could be improved and is stronger in certain areas and weaker in others.

  • ALLSCRIPTS PROFESSIONAL
    Expensive
    Clicky
    Hard to customize
    Minimal support and what there is, is poor
    Functional, but there are better products out there

  • The current leader in orthopedic EMR software, Chartlogic has a longstanding record of excellent and certified EMR service.

    We have a long list of Chartlogic referrals to anyone that would like to take a look at our product. Give me a call at (800) 686-9651, extension 1808 for a free consultation and evaluation to see if Chartlogic is right for your practice.

    Thomas Dobson
    Chartlogic, Inc.

  • Love Centricity. Ability to share templates, customize- easy to use. I will it had more pretty colors. It’s old looking but the workflows that you can build are amazing. Support is fantastic and all local and I don’t pay for any updates. We almost didn’t evaluate them thinking GE would be expensive. Quite the opposite- We’re a 2 man practice and saved $80,000 in the first year.

  • We’re looking at Health Fusion EMR. We’re a FP solo practice. I would appreciate any information that will aid in considering this EMR system.
    Thank you

  • I’m a pa that worked in a large group practice for about 5 years. The hospital was also integrated. We all used centricity. As someone already noted you can easily customize your physical exam, med lists, ect. I found it very easy to use. We had some issues with updates slowing everything way down or being offline entirely but I’m not sure if that was a software problem or our IT folks.

    Just started using greenway at a new job. Working in the ER now. Greenway looks prettier but seems cumbersome. Too many clicks to do simple tasks. Their templates are awful and much more time consuming and difficult to customize. I build 3 yesterday and it took me 2 hours. They cover uri symptoms, rash, and diarrhea. How long will it take to build a template for chest pain or neuro changes….its still too soon but it seems to be very time consuming.

  • My horrendous experience with Aprima EMR appears to mimic the experience of many others. It is for this reason that I would like to create a class action lawsuit against Aprima. If you also feel that you have been deceived by Aprima, and that their product was misrepresented to you and deficient, please send me an email so that I can start gathering names to submit to a lawyer. An Aprima executive told us today that since so few people ever follow-through on their threats to sue, they don’t have to take practices like ours seriously when we complain. I look forward to hearing from you.
    Jonathan Liss, M.D.
    Jliss@lissmd.com

  • My group of 3 internists has been using Greenway PrimeSuite for 1 and 1/2 years. It has NOT been a good experience. The implentation and training left much to be desired. Support can be useful-when someone calls you back. The only time we get a quick response is when what we need ( an interface etc ) will generate a fee for them-and almost anything you want to add will cost you extra-per doctor, per month. It is costly and I don’t see that it is any better than the Practice Fusion EMR (free) that my wife uses.
    The system itself is time consuming to use and has so many annoying, time consuming flaws that it is hard to name them all. One example though is in responding to a message from a staff member the response dialogue box opens on top of the original message so you can’t see it.
    It takes so long to do a note that even after 1 and 1/2 years I am spending an extra 2-3 hours per day finishing notes and reviewing labs and documents.
    It is possible that we are using the system inefficiently but, again, there were major issues with training.I would defintely not recommend this product unless you have alot of time and patience and do not need to see many patients to have a viable practice

  • Dr. Feldan,
    As bad as your system is, I promise you Aprima is worse! I will likely soon buy a new system and call this miserable experience an expensive life lesson. If misery loves company, I thought I would add my fellowship.
    Regards,
    Jonathan Liss, M.D.

  • “The system itself is time consuming to use and has so many annoying, time consuming flaws that it is hard to name them all. One example though is in responding to a message from a staff member the response dialogue box opens on top of the original message so you can’t see it.”

    That such fundamental violations of usability principles are present in systems in the field is really scary and speaks to the lack of human factors expertise in the systems’ development, testing before release and implementation.

    Greenway is a publicly traded company and not a fly-by-night outfit. You can only imagine what other craziness is going on with systems being used for patient care.

  • Dr. Liss,
    Aprima was on the short list-I guess I’m glad I didn’t choose it.

    mark-Good luck with templates etc. As you you more diagnoses to the system it becomes more and more cumbersome to find anything. I have devevolved into using about 3 templates in which I free type the majority of the note.

    Ron- I don’t know if you use any of these but they all look great on demos. It quickly becomes apparent on using the system that they were not designed by anyone who actually has to see patients and run an office in an efficient manner.

  • Well, I’ve seen a lot out there – both good and bad. Lots of promises made and a fair number broken with some of those ‘big players’. I have converted a great number of our clients to MediTalk by OneHealthCare Solution. They’re continually adding to the product, and I have the owner’s cell phone number, so if there’s a problem, I can go right to the top! They might be worth a serious look. Pricing is very fair, especially with their hosted version.

  • Thanks for the advice. I’ll take a look. Companies like Aprima took advantage of the fact that most of us lacked any meaningful experience with EMR and therefore could not know what elements are essential or how to test their claims of superiority before buying the system. For example, Aprima’s system is so flawed that during a deposition I gave on behalf of one of my patients, it was noted that when I removed a medication from her list, it deleted it from all prior notes, making it appear that I had fraudulently manipulated the chart. If this had been an adversarial encounter or if I had been accused of malpractice, I would have been doomed. Who knows how many other charts I have unknowingly changed. My mantra is now “friends don’t let friends buy Aprima”.

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